[Amended by Ord. No. 2002-35; Ord. No. 2003-2]
A. Establishment of a Health Benefits Selection and Buyback Program.
The Health Benefits Selection and Buyback Program allows an eligible
individual to voluntarily select health benefits that best suit his/her
individual need by voluntarily declining certain or all of the health
benefits accorded that individual as provided by the Township. For
those benefits that the individual declines, he/she shall be compensated
according to this policy.
B. Coverage. This policy covers all employees and officials who are
eligible to receive health benefits.
C. Procedure.
(1) Selection.
(a)
An employee or official who is entitled to family coverage may
amend their coverage as follows:
[2]
Reduce from family coverage to single coverage;
[3]
Decline medical benefits (must provide documentation demonstrating
coverage elsewhere);
[4]
Decline dental coverage only;
[5]
Decline prescription coverage only;
[6]
Decline any combination of coverage types listed above.
(b)
An employee or official who is entitled to single coverage may
amend their coverage as follows:
[2]
Decline medical benefits (must provide documentation demonstrating
coverage elsewhere);
[3]
Decline dental coverage only;
[4]
Decline prescription coverage only;
[5]
Decline any combination of coverage types listed above.
(2) Proof of other medical coverage. Participants who decline medical
(hospitalization) coverage must provide written documentation as described
by the Township to prove that he/she is covered elsewhere. No employee
or official will be allowed to decline this coverage without proof
of other coverage.
(3) Payment in lieu of benefits.
(a)
For those individuals who wish to participate in the buyback
program, said individuals shall receive payment for each option declined,
for each quarter of the calendar year. Such quarterly payments will
be made no later than the 10th day of the month following the end
of the quarter; i.e., April 10, July 10, October 10 and January 10
of the following year. All payments to the individual shall be for
the preceding three months. All such payments in lieu of benefits
are taxable under federal and state regulations, (including Federal
Wage Tax, FICA, State Income Tax, State Unemployment Tax and State
Disability Insurance). Taxes will be deducted in accordance with the
employee's form on file at the time of enrollment. Payment in lieu
of benefits shall have no effect on pension deductions or calculations.
(b)
Amount of payment. Any individual who declines any coverage
set forth above, or any combination of coverages, resulting in savings
to the municipality for the cost of such benefits, shall be entitled
to be paid 50% of the savings, up to maximum of $5,000 incurred by
the municipality. Such payments shall be made quarterly to said employee
as set forth above (Example: if an employee is eligible for, but declines,
family coverage and retains only single coverage, at a resulting savings
of $5,000 in healthcare costs to the municipality in any particular
calendar year, said individual shall be entitled to 50% of such savings,
payments totaling $2,500 for the year in question, i.e., $625 per
quarter. All employees hired by the Township subsequent to October
1, 2002 and choose to utilize the buyback program will be kept at
their buyback rate with a maximum buyback of $5,000. All employees
who are in the employ of the Township on or before September 30, 2002
shall be entitled to be paid 50% of the saving which the municipality
may receive.
(4) Enrollment in the program. Any individual who wishes to participate
in the Health Benefit Selection and Buyback Program shall do so to
be effective May 1 and November 1 of each year. The individual must
notify the Township in writing no later than the preceding April 1
or October 1 of his or her intention to participate.
(5) Emergency enrollment. If an individual chooses to decline certain
benefits based upon spouse coverage and the spouse coverage is later
eliminated, or in the case of a plan change from single to family
due to marriage or divorce, the individual may do so at any time during
the year with a thirty-day notice to the municipality. A fifteen-day
emergency enrollment, or enrollment to the first day of the following
month, may be allowed under extreme hardship. The Township Committee
shall determine, in a case-by-case basis, whether there exists an
extreme hardship. If an individual changes their benefits plan, their
quarterly payment shall be amended accordingly on pro rata basis.
(6) Preexisting conditions. Preexisting conditions shall be covered in
accordance with the benefit plan at the time of enrollment.
(7) Carriage of deductible. When any individual reduces his/her coverage
and subsequently thereafter during an enrollment period adds back
to the coverage, he or she will not be able to receive credit for,
and carry, the deductibles, if any, that were met earlier in the year.
(8) Special enrollment period for 1999. A special enrollment period for
1999 will allow employees to enroll effective October 1, 1999, for
the months of October, November and December 1999. Such enrollment
shall be on prorated basis for calendar year 1999. Any payment to
be made by the municipality with respect hereto, shall be made by
January 10, 2000.
[Added by Ord. No. 2007-36; amended 12-8-2011; 6-4-2012 by Ord. No. 2012-11; 10-11-2012 by Ord. No. 2012-21; 9-27-2018 by Ord. No.
2018-14]
The Township of Ocean shall assume the cost of insurance coverage
for those employees, in the same manner for which benefits are provided
to regular full-time employees, who meet the following criteria:
A. With respect to employees hired prior to July 1, 2018, the Township
of Ocean shall assume the cost of insurance coverage for those employees
and their spouse in the same manner for which such benefits are provided
to regular full-time Township employees who retire after 25 years
or more of service credit in the State Pension System and a period
of at least 25 years of employment with the Township of Ocean or for
those employees who have retired and reached the age of 65 years of
age with 25 years or more of service credit in a state or local administered
retired system and a period of 25 years with the employer at the time
of retirement.
B. With respect to employees hired subsequent to July 1, 2018, the Township
of Ocean shall only assume the cost of insurance coverage for the
individual employee, and not their spouse or dependents, who retires
after 25 years or more of service credit in the State Pension System
and a period of at least 25 years of employment with the Township
of Ocean or for those employees who have retired and reached the age
of 65 years of age with 25 years or more of service credit in a state
or local administered retired system and a period of 25 years with
the employer at the time of retirement.
C. Those employees
who retire with 25 years or more service credit in the state pension
system and a period of at least 25 years of employment with the Township
of Ocean and/or the former Ocean Township Municipal Utilities Authority
are included within the terms of this section.
D. Employees
of the Township with 25 years or more of credit in the state pension
system may be eligible to include any years of service in the Armed
Forces of the United States to be counted toward his/her 25 years
of service with the Township in the same manner as he/she may receive
credit for such military service under the state pension system in
order to meet the 25 years of employment with the municipality.