Health & Welfare Menu

LIFE INSURANCE

FULL-TIME EMPLOYEES

Employee Life Insurance	$20,000
Spouse	$2,000
Child up to 14 days	not applicable
Child 14 days and older	$1,000
Accidental Death & Dismemberment	$12,000

 

PART-TIME EMPLOYEES

Life Insurance	$5,000
Accidental Death & Dismemberment	$1,000

 

        

HOSPITAL AND PHYSICIAN’S SERVICES

FULL-TIME EMPLOYEES

Deductible per calendar year
$300 per person
$900 per family
Plan’s co-payment	80%

Out-of Pocket maximum (including deductible)
$2,500 per person per calendar year
$5,000 per family per calendar year
Lifetime maximum	$1,000,000 per person

PART-TIME EMPLOYEES

Deductible per calendar year
$300 per person
Plan’s co-payment	80%
Out-of-pocket maximum (including the deductible)	$2,500 per person per calendar year
Lifetime maximum	$250,000 per person

            

**Subject to plan limits this benefit covers such things as:

• hospitalization
• doctor’s office calls
• physical and speech therapy
• chiropractic care
• injections
• surgery (in and out-patient)
• private duty nursing
• diagnostic x-ray and laboratory procedures
• durable medical equipment
• hearing aids
• chemotherapy
• colonoscopy
• diabetic, cardiac and obesity education
• hospice care

 

PRESCRIPTION DRUGS (Prime Therapeutics)

Plan #1 (Full-time)
20% with a $10 minimum co-payment and a $50 maximum co-payment
34 day supply or 100 units

Plan #2 (Part-time)
20% of the discounted cost

Plan #3 (Early Retirees not Medicare eligible)
25% of the discounted cost

NERVOUS AND MENTAL DISORDERS/SUBSTANCE &/OR ALCOHAL ABUSE

BOTH FULL-TIME AND PART-TIME EMPLOYEES

Inpatient	31 days in-patient care per calendar year
*if not pre certified or recommended by TEAM, 15 days maximum per calendar year, paid at 60% after deductible
Inpatient chemical dependency lifetime maximum	90 days
Outpatient:	50 visits per calendar year
*if not pre certified or recommended by TEAM, 10 visits maximum calendar year, paid at 60% after deductible (Combined with Mental Health)

VISION CARE

FULL-TIME EMPLOYEES

Eye exam, lenses, frames, and laser eye surgery
Plan’s co-payment	80% to maximum of $300 per person per calendar year

 

                                        

DENTAL CARE (Delta Dental)

FULL-TIME EMPLOYEES

Diagnostic and preventative	80%
Restorative and prosthetic	80%
Maximum benefit	$1,250 per person per calendar year
Orthodontic for dependent children 8 to 18 years old	50% to a lifetime maximum of $1,000

PART-TIME EMPLOYEES

Diagnostic and preventative	80%
Restorative	80%
Prosthetic	50%
Maximum benefit	$1,000 per person per calendar year
Orthodontic	50% to a lifetime maximum of $1,000

                       

WEEKLY DISABILITY INCOME

FULL-TIME EMPLOYEES ONLY
60% of the average weekly earnings to a maximum of $300 a week and 26 weeks

Note: The deductible and co-payment amounts are waived for covered expenses related to the following services.   The Plan pays 100% of the usual and customary charges incurred for these services, up to the specified maximum.  These benefits are NOT subject to the lifetime maximum.

ROUTINE PHYICAL EXAMINATION

FULL-TIME EMPLOYEES
80% after deductible per employee per calendar year
80% after deductible per dependent spouse per calendar year

PART-TIME EMPLOYEES
80% after deductible per employee per calendar year

WELL BABY/WELL CHILD

FULL-TIME EMPLOYEES
80% after deductible per dependent child, birth to age 2

 

FOR RETIREES AND THEIR DEPENDENTS
PLAN 3 – AVAILABLE BEGINNING AT AGE 55)

COMPREHENSIVE MAJOR MEDICAL BENEFITS

Deductible amount per calendar year

Per person	$100
Per family	$300
Plan’s co-payment	75%
Lifetime maximum per person	$2,500

Co-payment rates that differ from preceding rates:

Partial hospitalization for nervous and mental conditions, alcoholism, and substance abuse	80%, up to 20 days per person per calendar year
Outpatient treatment of nervous and mental  disorders	80%, up to 8 visits per person per calendar year
Emergency first-aid	100%

Deductible and co-payment requirements waived:

Outpatient surgery	100%
Pre-admission testing	100%
Routine physical examinations (one per calendar year for each employee and each spouse)	100%
Second surgical options	100%
Hospice care	100%
Home health care	100%, up to 40 visits per person per calendar year