(a) Health Insurance. The City, in addition to the salaries and wages set forth in compensation ordinances, shall provide group health insurance coverage for the benefit of its employees with a carrier as selected by the City. Such insurance shall be subject to conditions imposed by the carrier over which the City has no control. The plan selected shall be known as the standard plan.
(1) The Director of Public Service and Safety is authorized to contract with a third party to administer health savings accounts or health reimbursement accounts.
(2) The current Insurance plans and employee contribution rates will continue unchanged through August 31, 2022, except the City will make an additional one-time contribution of $500 single and $1000 family to the Health Savings Account of employees on the Standard Plan during the plan year beginning September 1, 2021.
(3) Effective September 1, 2022, the City will make available to employees the same health insurance options as the City makes available to the Director of Public Service and Safety and to other non-represented employees, provided that, for employees participating in a High Deductible Health Plan, the City will contribute a minimum of 25% of the deductible to the. Health Savings Account of employees for the plan years beginning September 1, 2022, September 1, 2023 and September 1, 2024.
(4) The City will, for each insurance year, maintain the Standard Plan in place the previous insurance year so long as the per-employee premium cost does not increase more than the percentage increase in the statewide cost of a family insurance plan as reported by SERB in its most recent (as of April 1) report on health care costs in Ohio's public sector. If the increase would be more than the percentage increase derived from the SERB report, the City may select a different plan as the City's Standard Plan which will keep the increase from exceeding the percentage increase derived from the SERB report while keeping coverage as comparable as possible.
(5) Employees shall pay 13% of the health insurance premium for the standard plan for the plan year beginning September 1, 2022. 14% of the health insurance premium for the standard plan for the plan year beginning September 1, 2023 and 15% of the health insurance premium for the standard plan year beginning September 1, 2024. The City shall pay the balance of the premium. Employee contributions shall be made through payroll deduction as a condition of coverage.
(6) The City will offer a more expensive plan, if available, as an alternative to the standard plan; if the City does so, employees who select that plan will pay an amount equal to their premium contribution for the standard plan plus the difference in cost between the standard plan premium and the more expensive plan premium.
(7) The City also may offer a less expensive plan as an alternative to the standard plan; if the City does so, employees who select that plan will pay an amount equal to their premium contribution for the standard plan minus the difference in cost between the standard plan and the less expensive plan (but not less than zero). (Ord. 69-2021. Passed 12-6-21.)
(b) Opt Out Program. Through August 31, 2016, non-bargaining unit employees who are eligible for the health insurance benefit who opt not to take that benefit shall pay paid annually an amount equal to 25% of the current premium net of the 12% co-pay, with such benefit paid in equal installments per pay period.
Effective September 1, 2016, non-bargaining unit employees who are eligible for the health insurance benefit who opt not to take that benefit shall be paid annually $2,400.00 for waiving family coverage or $800.00 for waiving single coverage. This amount will be paid in equal installments per pay period. In the event there are 27 pay periods in a calendar year, one pay period will be skipped.
An employee who opts out of the health insurance benefit cannot be a dependent on another City of Troy health insurance plan.
This provision shall not commence each year until five (5) or more eligible non-bargaining unit employees opt out of the health insurance benefit. This annual benefit will run with the plan year.
If there are factors that eliminate other coverage, the employee may opt back in subject to the insurance plan eligibility and the opt-out amount will be pro-rated.
If in any plan year the number of non-bargaining unit employees that opt-out drops below the number of five (5), there will be no Opt Out Program incentive paid. If there are factors that eliminate other coverage, the employee may opt back in subject to the insurance plan eligibility, and the opt-out amount will be pro-rated.
Participation will be subject to the employee providing the City with required evidence of other coverage.
(c) Dental Plan Benefit. The City will maintain a dental plan benefit. The City reserves all rights as to the determination of the insurance carrier. The City will pay for 50% of the cost of each employee’s dental plan coverage, including dependent coverage if applicable. The employee shall pay the remaining 50% through payroll deduction as a condition of coverage. The City will have no obligation to provide this benefit if the number of employees who elect to participate falls below the carrier’s minimum participation requirement, if any.
(d) Affordable Care Act Impact. The City reserves the right to modify the health insurance provisions of this section to the minimum extent necessary to avoid the imposition of any penalty, tax, or fine under the Affordable Care Act, its implementing regulations, or any subsequent health insurance laws or regulations enacted.
(Ord. 47-15. Passed 12-21-15.)