Skip to code content (skip section selection)
Compare to:
260.08  HEALTH INSURANCE.
   (a)   (1)   All full time employees of the bargaining unit shall be eligible to participate in a group health care plan established by the City, which shall include medical, dental, vision, and prescription drug coverage. The City shall offer a base plan and may offer alternate plans, (less expensive and/or a buy-up plan(s)). Cost containment measures may be adopted by the City pursuant to the provisions of division (c) of this section.
      (2)   Eligible employees may elect the base or alternate plan, and single or family coverage (or other appropriate and available tier) at their option and in accordance with the provisions/requirements of the plan(s).
      (3)   Effective January 1, 2018, a high deductible health plan through a health reimbursement account ("HRA") plan shall be the base plan.  Annual deductibles for the HRA plan shall be:
         A.   $3,000 for single coverage in network; and
         B.   $6,000 for family coverage in network.
      (4)   The City will fund the health reimbursement account of each enrolled and participating employee based upon the applicable coverage up to the following maximum amounts:
         A.   Up to $3,000 for single coverage; and
         B.   Up to $6,000 for family coverage.
      (5)   For plan year 2018, the City will make available a high deductible health savings account (HSA) plan as an alternate plan with the following deductibles and City contributions to the account of each enrolled and participating employee based upon the applicable coverage as follows:
 
Annual Deductible Plan Year 2018
Annual City Funding Plan Year 2018
Single Coverage
$3,000
$2,000
Family Coverage
$6,000
$4,000
 
      (6)   For plan year 2018 (January 1, 2018 through December 31, 2018) the above contributions shall be made in January 2018.
      (7)   Commencing with plan year 2019, if it is determined to continue with an HSA as an alternate plan, contributions will be made semi-annually in January and July respectively.
 
Semi-Annual Funding Plan Year 2019 and Forward
Single Coverage
$1,000
Family Coverage
$2,000
 
   (b)   Cost Sharing.
      (1)   Participating employees shall be required to share in the cost of health care coverage up to the maximums permitted by the Patient Protection and Affordable Care Act (ACA) as may be applicable.  For the year 2017, employees shall maintain their current group health plan and continue to share in the cost at their current contribution amounts for single and family coverage (i.e., eleven percent of the total cost for medical, dental, vision, and prescription drug coverage based upon the cost for the base or alternate plan, as applicable).
      (2)   Effective January 1, 2018, the City shall contribute the following maximum amounts toward the total cost for group health plan coverage excluding any HRA or HSA employer funding amount:
 
City Base Maximum per Month
Single Coverage:
$691.00
Family Coverage:
$1,787.00
 
         An employee shall be responsible for any cost in excess of the City maximum contributions as set forth above.
      (3)   Effective January 1, 2019, any costs for the base (HRA) plan in excess of the combined total base maximum amounts set forth below shall be shared with the employer contributing fifty-five percent and the employee contributing forty-five percent of such additional (excess) cost.
 
Combined Max Base per Month
Employee Max Base per Month
Employer Max Base per Month
Single Coverage:
$746.02
$55.02
$691.00
Family Coverage:
$1,973.94
$186.94
$1,787.00
 
         A.   The employer base maximum plus the employer's fifty-five percent of any excess cost of the HRA shall be the maximum employer contribution toward the base HRA plan and toward any alternate plan.
         B.   Additionally, any surcharge for continuing coverage for an overage child shall be the responsibility of the employee.
   (c)    Health Care Committee.
      (1)   A Health Care Committee will be created for the purposes of reviewing usage, studying cost containment programs and options for health plan coverage (medical, dental, vision, and prescription), and recommending changes to the base plan and benefit levels. Once created, the union agrees to participate in the Committee. The first order of the Committee shall be to establish bylaws/ground rules and the parties recognize that no by-law/ground rule can supersede or conflict with the provisions herein.
      (2)   The Committee shall consist of the following representatives from the recognized bargaining units, non-bargaining employees, and administration. Each representative must be an active participant in a City provided group health care plan except as otherwise provided herein.
         A.   FOP/OLC - Dispatchers: One employee representative selected by the applicable bargaining unit employees;
         B.   FOP/OLC - Patrol officers: One employee representative selected by the applicable bargaining unit employees;
         C.   FOP/OLC - Sergeants and Lieutenants: One employee representative selected by the applicable bargaining unit employees;
         D.   IAFF: One firefighter/paramedic representative selected by the applicable bargaining unit employees;
         E.   IAFF: One rank officer representative selected by the applicable bargaining unit employees;
         F.   USW LOCAL 836: One employee representative selected by the applicable bargaining unit employees;
         G.   USW LOCAL 836-1: One employee representative selected by the applicable bargaining unit employees;
         H.   USW LOCAL 1-865: One employee representative selected by the applicable bargaining unit employees;
         I.   Non-bargaining unit: One employee representative selected by the non-management, non-bargaining unit employees;
         J.   Administration: Up to five administrators/department heads selected by the Mayor/designee; and one of the administrators shall be the Director of Human Resources, whether a plan participant or not.
      (3)   The Mayor, plus one staff representative from each certified union, may attend all or some of the Committee meetings for informational purposes, but shall not be a voting member. Additionally, the City's health care consultant and labor relations consultant of the City may also be requested to attend for informational purposes only.
      (4)   The Health Care Committee shall have the authority to recommend alterations to the base plan and benefit levels and/or to recommend adjustments to coverage levels for the next plan year through a majority vote. Recommendations will be in compliance with the ACA regarding coverage levels and will be submitted to the Mayor in writing at least thirty calendar days prior to the end of the applicable plan year, except where the deadline is extended in conjunction with the City's health care consultant and the applicable plan provider. Specifically, the Committee may recommend any of the following options:
         A.   To keep the same plan and/or benefit levels and pass on any cost increase consistent with the cost sharing provisions set forth in division (b) of this section;
         B.   To change the plan and/or alter the benefit levels to reduce or minimize the cost increase to be passed on; or
         C.   To change the plan and/or alter the benefit levels so that there is no increase in the cost of the plan(s).
      (5)   A timely and valid recommended option of the Health Care Committee (A., B. or C. above) will be considered an agreement between all the bargaining units and the City, and will be implemented by the City.
      (6)   If, however, the Health Care Committee fails to submit a timely and valid recommendation for the following plan year, Option A shall apply and will be implemented.
      (7)   The Health Care Committee may also recommend alterations to any of the alternate plans; however the City retains the right to determine the provision and benefit levels of any alternate plan(s).
   (d)   "Opt-Out".  The City will provide members of the bargaining unit a cash incentive plan for those eligible employees electing to "opt-out" of the medical, dental, vision and prescription drug coverage that is made available. Any bargaining unit member that elects to "opt-out" of family or single insurance coverage shall receive a cash incentive equal to forty percent of the monthly premium cost. Effective January 1, 2018, the cash incentive for "opting out" shall be twenty percent of the monthly premium cost for the base plan. To be eligible, the employee must show proof annually of insurance from an alternative source, excluding the City of Avon Lake. The City shall permit the bargaining unit member the ability to enroll back into the medical, dental, vision and prescription drug plan provided by the City during open enrollment periods throughout the duration of this collective bargaining agreement, or upon a qualifying event. The City shall provide bargaining unit members the time period for open enrollment and definitions of allowable qualifying events.
(Ord. 12-95.  Passed 1-23-95; Ord. 82-00.  Passed 3-27-00; Ord. 27-03.  Passed 2-10-03; Ord. 79-2003.  Passed 4-14-03; Ord. 46-04.  Passed 3-8-04; Ord. 11-07.  Passed 2-12-07; Ord. 3-09.  Passed 1-12-09; Ord. 147-2014. Passed 11-24-14; Ord. 6-2018. Passed 1-22-18.)