ARTICLE XXIII INSURANCE BENEFITS

Jamestown School District

A. The Committee shall provide all members of the bargaining unit the coverage as explained in this Article and Article XXIII. The Committee shall provide these benefits to teachers teaching less than a full week on a pro-rated basis. Such teachers wishing to participate fully in these group benefits may do so by paying the remaining premium balance in addition to their percentage contribution to premium.

B. All teachers will contribute 20% of the existing premiums for individual or family benefits listed within this Article.

C. Whenever  there is a bargaining unit member serving on  the staff with his/her spouse, one may receive family coverage, or each may receive individual coverage, but it is not permitted for one to have family coverage and the other individual coverage. In other words, it is not intended that any family shall be entitled to more than family coverage.

D. Individuals waiving the medical benefit will receive an annual stipend of two thousand dollars ($2,000.00).

E. Medical:

The PPO plan will be a Co Insurance (var) plan with $250 deductible, $15 primary care co­ pay, $25 specialist co-pay, $25 urgent care co-pay, $100 emergency room co-pay, dependents to age 23 (unless otherwise required by law), and a $10/$35/$60/$100 tiered RX co-pay with 2.5x Mail Order RX. The Plan the Committee provides for individuals or  families  is described in the attached Summary of Benefits within Appendix C.

Teachers will be able to elect and purchase additional vision  coverage which includes  the cost of glasses. Teachers will be responsible for any additional cost above the cost of the current healthcare plan for such vision coverage.

F. Dental:

The Committee provides individual or family dental coverage. The specific benefit plan includes:

Students to age 19
Annual maximum of $1500 per member per calendar year
$0.00 deductible
Unlimited lifetime cap
50% Orthodontic coverage for dependents to 19, $1,200 Ortho Maximum

Typical procedures are covered at 100%, but several are covered at 75%, can be performed only once in certain year periods and may require pretreatment estimates. Please consult with the Business Office for particulars. Those in this special group include:

Crowns, build ups, posts and cores and replacements
Periodontal maintenance Root planning and scaling Bone surgery
Gingivectomies and curettages
Soft tissue grafts
Crown lengthening

G. Life Insurance:

The Committee agrees to provide $50,000 of term life insurance per bargaining unit member according to the following:

1. Level term to age 70
2. Conversion possibility upon leaving the system.
3. Twenty-four (24) hour coverage.
4. Benefits decrease by 50% after the age of 70.

H. It is agreed that all health care premium contributions will be made through a pre-tax basis pursuant to Section 125 of the Internal Revenue Service Code. Further, the committee agrees to establish a third party administered flexible spending account "Cafeteria Plan."

I. The failure of any insurance carrier(s) to provide any benefit for which it has contracted shall not result in full liability to the Committee or to the Association of any obligation undertaken under this or any other Agreement. However, nothing in the Agreement shall be construed to relieve any insurance carrier from any liability it may have to the Committee, Association, employee or beneficiary of any employee. The terms of any contract or policy issued by an insurance carrier shall be controlling in all matters pertaining to benefits thereunder.

J. The Committee agrees to offer teachers the following menu of short-term disability insurance options at the teachers' expense for so long as such coverage remain available to the Jamestown School District:

• Personal Disability Income Protector
• Accident Advantage
Critical Care & Recovery /Plus Rider
• Cancer Care

To the extent possible, the Committee will provide such chosen coverages through payroll deduction, pre-tax or post-tax, as appropriate; provided, however, the teachers shall at all times remain responsible for the entire cost of such short-term disability coverages.