[Adopted 10-14-1997 by Ord. No. 57-1997; amended in its entirety 9-23-2003 by Ord. No. 18-2003]
[Amended 10-26-2004 by Ord. No. 12-2004; 4-22-2008 by Ord. No. 4-2008]
A. 
To be eligible for this coverage, an employee must retire with 20 years' service credit with the City, and have reached age 55 prior to retirement from the City, or have 20 years' service credit with the City and have been eligible for retirement pursuant to current and/or future laws of the State of New York. Retirees who opt out of the City's health insurance program shall receive $1,250, payable the first pay period in December. Those opting out must provide proof of other coverage. Those who opt out for less than one year shall receive a prorated payment. The decision to opt out shall be made by November 30 of the year preceding the opt-out year.
B. 
The City shall provide, on an annual basis, to all employees who retire, 75% of each retiree's health-care premium, and the employee shall contribute 25% of such premium. Spouses, dependents or survivors will be obligated to pay 100% of the premium for health-care coverage, whether single, single-Medicare (two-person), or family. The retirees and/or family shall have the same health-care options for insurance plans as current employees in each future calendar year, except retirees shall be required to enroll in a Medicare Advantage Plan upon meeting the qualifications therefor. The health-care premium shall be adjusted as the premium for the current nonindemnity plan is adjusted.
C. 
In the self-insured plan, the retirees and family (patient) shall pay a co-pay of 20% for brand-name and generic medications. If the patient requests a brand-name drug with a generic equivalent, the patient will pay 20% of the brand-name medication, plus the difference in cost between the brand and its generic. An individual who retires or has retired, and, therefore, any dependent or survivor of that individual, will be subjected to any or all formulary programs in place by the indemnity or nonindemnity plans.
[Amended 10-28-2003 by Ord. No. 10-2003; 10-26-2004 by Ord. No. 12-2004; 2-27-2007 by Ord. No. 2-2007[1]; 7-22-2008 by Ord. No. 7-2008[2]; 6-23-2009 by Ord. No. 6-2009; 6-28-2011 by Ord. No. 6-2011]
A. 
The City will provide health insurance coverage to officers and employees not covered by collective bargaining agreements. Officers and employees shall contribute 15% of health insurance premiums through payroll deduction. Those officers and employees electing to be covered by the self-insured plan, currently being administered by APA Partners, will contribute 15% of the premium of the Capital District Physicians' Health Plan (CDPHP) offered by the City. Common Council members shall contribute 100% of health insurance premiums through payroll deduction, whether in the HMO or self-insured plan.
(1) 
Deductibles for the self-insured plan shall be $450 for individual coverage, $700 for two-person coverage, and $950 for family coverage.
(2) 
Copays on prescription drugs for the self-insured plan shall be 20% of the cost for both brand name and generic drugs.
B. 
Officers and employees who opt out of the City's health insurance program shall receive $1,260 if eligible for individual coverage, $2,520 if eligible for two-person coverage, or $3,370 if eligible for family coverage, payable the first pay period in December. Those opting out must provide proof of other coverage. Those who opt out for less than one year shall receive a prorated payment. The decision to opt out shall be made by November 30 of the year preceding the opt-out year. Common Council members shall not be eligible to receive any payment under this section for opting out of the City's health insurance program.
C. 
The City shall offer dental and vision coverage for officers and employees not covered by collective bargaining agreements at a level determined by the Board of Managers. Officers and employees not covered by collective bargaining agreements shall contribute 15% of dental and vision insurance premiums through payroll deduction. Common Council members shall contribute 100% of dental and vision insurance premiums through payroll deduction.
D. 
The City shall also offer to its officers and employees not covered by collective bargaining agreements, subject to the contributions set forth above, the Capital District Physicians' Health Plan AvidCare 30 with an inpatient hospital copay of $1,000 and prescription copays of $10 for generic drugs, $25 for preferred brand name drugs, and $40 for non-preferred brand name drugs. The City will reimburse such officers and employees any cost incurred in excess of the cost the officer or employee would have incurred had the City offered Capital District Physicians' Health Plan AvidCare 25 without any inpatient hospital copay. There shall be no reimbursement for prescription copays.
[1]
Editor's Note: This ordinance provided an effective date of 1-1-2008.
[2]
Editor's Note: This ordinance provided an effective date of 1-1-2009.