ARTICLE XVIII INSURANCE

Middletown School District

A. Designated District Healthcare Plans

The Committee shall provide paid designated District healthcare Plan A or Plan B, subject to subsection (A)(13) herein, on an individual or family coverage basis, in accordance with the following:

1. Teachers employed as of August 31, 2006 may elect to be provided either a Preferred Provider Organization (PPO) Plan (Plan A) or an Indemnity Plan (Plan B). A summary of coverage levels (including co-payments, deductibles, coinsurance, and some benefit limits) for Plan A and Plan B are attached hereto within Exhibit A. Teachers must elect in writing prior to July 1st the type of insurance coverage they wish, should they seek any changes.

2. Effective September 1, 2012, Plan B will be eliminated for active employees.

3. Effective September 1, 2013, all Teachers will receive a Preferred Provider Organization (“PPO) plan ($250/$500 deductible as attached), which shall be the standard health insurance plan offered to members of the bargaining unit.

4. Effective July 1, 2017, all Teachers will receive a Preferred Provider Organization (“PPO) plan ($500/$1000 deductible as attached), which shall be the standard health insurance plan offered to members of the bargaining unit.

a. The District will indemnify individual teachers for any additional deductible payments made over the present 250/500 plan (this relates to the additional potential payment of 250/500) for the period July 1, 2017 through June 30, 2018.

b. The Committee and the Association shall work out agreeable language which establishes a fair and timely process for reimbursement and which protects the privacy interests of Teachers.

c.  During the first payroll period following January 1, 2018, the Committee shall pay Teachers with family health insurance a one-time payment of five hundred dollars ($500), and Teachers with individual health insurance a one-time payment of two hundred and fifty dollars ($250).

5. Effective January 1, 2013, offer a medical Flexible Spending Account at no cost to employees.

6. Medicare Supplement Insurance will be provided on a fully paid individual or family basis for any active certified members of the Middletown School Department over the age of 65. A summary of coverage levels (including co-payments, deductibles, coinsurance, and some benefit limits) for the Medicare Supplement Insurance plan shall be prepared and made available to employees no later than September 1, 2010.

7. All teachers shall be provided individual or family Delta Dental Level IV, subject to subsection (A)(14) herein, with student rider to age 25.

8. Such medical coverage will include:

a. Plan B - major medical - $1,000,000 maximum

b. Plan B and Plan A - student rider to age 25

c. Plan B - $100.00 deductible

9. Effective September 1, 2012, active teachers shall co-pay 17% of the cost of the medical coverage plus 5% of the cost of the employee’s dental coverage.

10. Effective September 1, 2013, active teachers shall co-pay 18% of the cost of the medical coverage plus 5% of the cost of the employee’s dental coverage.

11. Effective September 1, 2014, active teachers shall co-pay 20% of the cost of the medical coverage plus 12% of the cost of the employee’s dental coverage.

12. Effective August 31, 2015, dental co-share for active employees shall increase to 15%.

13. Effective September 1, 2010, Plan Design changes intended to reduce cost of medical coverage by 2% -- increase emergency room co-pay to $100.00 (1%) and drug co-payments to 5/20/40 (1%).

14. Effective September 1, 2011, Plan Design changes intended to reduce cost of medical coverage by 1% -- increase office visits for primary care to $15.00 and specialists to $15.00 (1%)

15. The Middletown School Department shall provide family or individual health insurance coverage, as applicable, for all certified personnel, subject to the following:

a. The School Committee shall provide each employee covered by this Agreement with the health insurance package(s) described in the attached summary of benefits within Exhibits A and B.

b. In the event the School Committee changes the healthcare provider, it must provide a health insurance package(s) substantially equivalent or superior to the package being replaced.

B. Buyback

1. For those employees who are eligible for either the family or individual Blue Cross or Delta Dental Plan and choose not to receive any coverage, the Committee will pay the following:

a. For all teachers, employed as of August 31, 2006, payment shall be at the rate of $3,200.00 commencing 2010-2011 school year.

b. For all teachers, employed as of August 31, 2006, payment shall be at the rate of $2,850 commencing 2013-2014 school year.

c. For all teachers, effective September 1, 2014, payment shall be at the rate of $2,500 commencing 2014-2015 school year.

d. For all teachers appointed on or after September 1, 2006, payment shall be at the rate of $2500.00.

2. Payment to be made at the end of the school year. Notification for the following school year must be made before July 1.

Employees resigning from the system or re-entering the Plan will receive a pro-rata payment.

C.  Wellness Incentive Plan. The parties agree to meet and consider the implementation of a Wellness Incentive Plan. The Wellness Incentive Plan, if implemented would provide that Teachers participating in the School Department’s medical plan and who meet the wellness criteria established by the School Department, in consultation with the Association, shall receive a reduction in medical insurance co-share payments in an amount mutually agreed upon by the parties.  The earned reductions in medical insurance co-share payments shall be awarded to active employees in the fiscal year following the employee’s participation in wellness actives. The Wellness Incentive Plan will integrate preventative and wellness behaviors into the medical plan.

Examples of possible activities include completion of the Health Assessment, obtaining a primary care physician, wellness coaching programs, preventative screenings, non-smoker or completion of smoking cessation program, and/or participation in a program that measures key points in assessing an individual’s overall health.

D. HSA Plan -- High Deductible Health Plan / Health Savings Account.

1. The Committee may offer employees, as an alternative, an HSA plan, which is a consumer driven health plan with a $2000.00 annual deductible for an individual plan and a $4000.00 deductible for a family plan. A summary of coverage levels (including co-payments, deductibles, coinsurance, and some benefit limits) for the HSA plan shall be prepared and made available to employees no later than September 1, 2010. In conjunction with these plans, a health savings account will be created for each employee enrolled, in which the District will contribute fifty percent (50%) of the annual deductible each year. For employees enrolling in the Healthmate for HSA Plan there will be a onetime payment equal to fifty percent (50%) of the District’s savings, paid out at the end of the fiscal year via payroll subject to changes in the Internal Revenue Code made possible by the Medicare Modernization Act of 2003. The parties recognize that the Health Insurance Provider may require a minimum utilization rate to provide an affordable system. The District reserves the right not to offer an HSA Plan unless such minimum utilization rate is achieved.

2. The final language for the voluntary HSA plan is to be agreed upon by the parties. The parties understand that the teacher’s participation in HSA Plan will be voluntary and the District will not be required to offer any HSA Plan if it determines, in its sole opinion, that the plan would not be cost effective.

E. Disability Income Insurance

The Committee shall provide to each certified member of the Middletown School Department a Disability Income Insurance policy with the following coverage:

1. 180-day Waiting Period (elimination)
2. Coverage for Accident or Sickness
3. Payment to Age 65
4. 66 2/3% of monthly salary or two thousand dollars ($2,000), whichever is the lesser amount
5. Teachers pay fifty percent (50%) co-pay of premium

The Committee shall provide on a fully paid basis to any certified member of the Middletown School Department who so desires term life insurance equal to one times salary rounded down to the nearest thousand, but not less than thirty thousand dollars ($30,000). Face value will decrease by fifty percent (50%) when insured reaches 65th year. For new hires after September 1st of 1987, coverage will decrease by fifty percent (50%) at age 60.