The District shall provide, upon the request of an Administrator, the benefits of an individual,
two-person or family coverage under one of the following plans offered by the Board of
Education, or a comparable plan as determined by the Board:
a.__Point-of-Service (POS) Plan;
b. HMO Plan: or
c.__High Deductible Health Plan (HDHP) with Health Savings Account (HSA):
d. High Deductible Health Plan without Health Savings Account (HSA).
Health care plan options are at the sole discretion of the Board, and the Board reserves the right
to change a health insurance carrier providing comparable benefits. The District shall have the
right_to_ provide prescription benefits through a separate provider managed by a pharmacy
benefits manager.
Any Administrator requesting initial membership in a olan _may enter during a specified
enrollment period. Any eligible Administrator desiring to select a different plan may make such
a change only during the annual enrollment period or a qualifying event:
The group health insurance of any Administrator.terminating employment with the District for
whatever reason - resignation, retirement. lay-off, discharge or unpaid leave of absence other
than sick leave - shall expire on the last day of the month following the month the Administrator
terminates employment with the District.
The District_shall contribute 70% of the premium for a point-of-service_ plan, and 80% of the
oremium for an HMO.and High Deductible plans. All.olans offered by the district shall have the
following co-pavs.and deductibles:
1. POS and HMO:
Twenty Dollars
One Hundred Dollars {$100.00}-ner emergency room visit;
b.
c._ Two Hundred Fifty ‘Dollars ($250.00) per person, Five Hundred Dollars {4500.00} per
two-person/Family Inpatlent/Outgatient Facility Deductible: and
d... Three (3) Tier Pharmacy Benefit of $5/15/35 ($5/530/570 mail order].
The following.co-navs and deductibles below will become effective on July 1, 2023.
a. Twenty-five Dollars {525.00} per medical visit;
b.__One Hundred Dollars ($100.00) per emergency room visit:
c. One Thousand Five Hundred Dollars {$1500.00} per person, Three Thousand Dollars
($3000.00) per two-person/familv Inpatient/Outpatient Facility Deductible: and
d. Three (3) Tier Pharmacy Benefit of $10/30/50 ($20/$60/$100 mail order).
2. Anthem HDHP with Health Savings Account (HSA):
a. Deductibles for the HDHP are $2,000 (single) and $4,000 (two-person/family)};
b. Annual $1,500 single and $3,000 (two-person/family) contriubtion to the HSA:
c._Prorating of HSA contribution based upon enrollment date —- Employees who ioin
the HDHP with HSA at any time other than July 1 will receive a pro-rated city
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