Comparable Plan Definition: For the purposes of this Article, a comparable plan means
one that offers the same type of benefits, but benefits do not have to be exactly the same. In
addition, the plan must provide reasonable access to health services and physicians, including
specialists and hospitals.
The POS and HMO Plans shall have the following co-pays and deductibles:
(a) Twenty Dollars ($20.00) per medical visit;
(b) One Hundred Dollars ($100.00) per emergency room visit;
(c) Two Hundred Fifty Dollars ($250.00) Per Person, Five Hundred Dollars
($500.00) Per 2 Person/Family Inpatient/Outpatient Facility Deductible; and
(d) | Three Tier Pharmacy Benefit of $5/$15/$35 ($5/$30/$70 Mail Order).
Effective July 1, 2021 -
POS Co-pays and Deductibles:
The POS Plan sha!l have the following co-pays and deductibles:
(a) Twenty Dollars ($20.00) per medical visit;
(b) One Hundred Dollars ($100.00) per emergency room visit;
(c) Two Hundred Fifty Dollars ($250.00) Per Person, Five Hundred Dollars
($500.00) Per 2 Person/Family Inpatient/Outpatient Facility Deductible; and
(d) Three Tier Pharmacy Benefit of $5/$15/$35 ($5/$30/$70 Mail Order),
HMO Co-pays and Deductibles:
The HMO shall have the following co-pays and deductibles:
(a) Twenty-five Dollars ($25.00) per medical visit;
(b) One Hundred Dollars ($100.00) per emergency room visit;
(c) One Thousand Five Hundred Dollars ($1,500.00) Per Person, Three Thousand
Dollars ($3,000.00) Per 2 Person/Family Inpatient/Outpatient Facility Deductible;
and
(d) | Three Tier Pharmacy Benefit of $10/$30/$50 ($20/$60/$100 Mail Order).
High Deductible Health Plan with Health Savings Account (HDHP w/ HSA):
The deductibles in the High Deductible Health Plan with Health Savings Account (HDHP
w/ HSA) are $2,000 individual / $4,000 2-person or family. The City’s contribution to Health
Savings Accounts is $1,500 individual / $3,000 2-person or family. The City HSA contribution
will be distributed in 2 installments, one on or about July 1 and on one or about October 1,
provided however that if an employee is required to pay more towards his / her deductible than
the initial 50% contribution, upon presentation of suitable documentation, the City will
contribute the remaining 50% before October 1. Employees who join the HDHP w/ H.S.A. at
any time other than July 1 will receive a pro-rated City contribution of $125 monthly for a single
plan and $250 monthly for 2-person or family plan for each full month remaining in that fiscal
year.
21
