(A) Generally. The village will pay the premium for each eligible regular full-time employee’s health insurance coverage with a health and major medical group insurance program chosen by the Village Board. The village will pay 50%, with an additional 20% taken off the 50% total for each eligible regular full-time employee’s health insurance coverage for a spouse’s, child’s or family coverage with a health and major medical group insurance program chosen by the Village Board. The employee and covered spouse, children or family must pay the first $750 toward the applicable health insurance deductible. The village will contribute the next $1,000 toward the applicable health insurance deductible, and the employee and covered family members will then be responsible for the remainder of the deductible as well as any co-pays or uncovered expenses.
(B) Terms and conditions. The insurance program referred to in this manual will be subject to all the terms and conditions of the contract of insurance provided by the insurance carrier and entered into with the village. The programs and criteria for eligibility will be explained at the time of employment and will go into effect after employees become eligible to join. The Village Board reserves the right to make changes in the carriers and provisions of these programs when deemed necessary or advisable. All benefit plans are subject to change from time to time.
(C) Eligibility. All full-time employees only will be eligible to apply for said Health and Major Medical Group Insurance Program. Temporary and regular part-time employees do not qualify and will not be provided with health insurance.
(D) Continued coverage provision.
(1) Ninety calendar days after an employee has been approved for coverage after the village’s Health and Major Medical Group Insurance Program, the provisions in division (D)(2) below will apply.
(2) An employee who has been approved by the Village Board for a leave of absence, with or without pay as aforesaid, may, from said date of approval, continue the employee’s Health and Major Medical Group Insurance Program for a period of 90 calendar days. The employee must make application in writing, and approval will be in the discretion of the Village Board and the insurance carrier. The approval of the insurance carrier shall be solely obtained by the employee, and at the employee’s sole expense.
(E) COBRA. If any employee terminates regular active work from the village for any reason, coverage of benefits under the Health and Major Medical Group Insurance Program must be offered as a CORBA plan, with identical benefits to the employee and dependents at the time of termination.
(1) If any employee elects to take COBRA, an application is required within 60 days of the qualifying event. The effective date for COBRA coverage may be assigned retroactively by the employee or beneficiary.
(2) Each qualified beneficiary has the right to elect coverage, so the spouse and/or dependents may elect coverage on their own even if the employee does not.
(3) Said coverage shall remain in force for 18 months, or a beneficiary becomes disabled during the first 60 days of COBRA coverage, the period must be extended to 29 months, or if the beneficiary cancels coverage.
(4) Coverage shall also cease for any of the following reasons.
(a) The qualified beneficiary fails to make timely payments of premiums to the employer.
(b) The village ceases to provide any group health plan for all employees.
(c) The qualified beneficiary becomes covered under another group health plan as an employee or dependent (unless that plan has a preexisting condition clause) or the beneficiary becomes entitled to benefits under Medicare.
(d) Continuation rights are not available if an employee is terminated for “gross misconduct.”
(e) An administrative handling fee over and above the cost of the insurance premium may be charged to employees or their dependents who elect to exercise their COBRA continuation rights.
(Ord. 648, passed 11-9-2020; Ord. 688, passed 9-11-2023)