[HISTORY: Adopted by the City Council of the City of Lackawanna 5-15-1995 by L.L. No. 1-1995 (Ch. 111 of the 1987 Code). Amendments noted where applicable.[1]]
[1]
Editor's Note: Resolution No. 20-2005, adopted 10-5-2005, provided that effective 1-1-2006, all nonbargaining unit employees and lawfully entitled retirees entitled to City-paid health care insurance are to be insured by a single health insurance company (Independent Health Insurance Company), and all such qualified persons shall be provided with the same coverage, i.e., health, dental, vision, etc., if applicable and available on the date of their retirement. To be eligible, retirees must be retired with a minimum of 20 years of service with the City. All ineligible former and retired nonbargaining unit employees receiving City-provided health insurance be and the same is cancelled effective 12-1-2005.
A. 
A part-time employee is defined as one whose normal work week is less than 37 1/2 hours.
B. 
No part-time employee hired after December 31, 1991, shall receive City-provided health care insurance benefits except with City Council approval.
C. 
No part-time employee who retires after the effective date of this legislation shall receive City-provided health care benefits.
D. 
(Reserved)[1]
[1]
Editor's Note: Former Subsection D, regarding part-time employees with less than 20 years of service who receive retirement pension benefits from the New York State Retirement System, was repealed 3-20-2006.
E. 
No member of any City board or commission shall receive City-provided health care benefits.[2]
[2]
Editor's Note: Former Subsections F, G and H, regarding the cost of health care coverage and the purchase of additional coverage by part-time employees, which immediately followed this subsection, were repealed 3-20-2006.
[Amended 2-22-2005 by L.L. No. 2-2005; 8-31-2005 by L.L. No. 3-2005; 7-18-2006]
A. 
A ”full-time employee" is defined as one whose normal workweek is no less than 37 1/2 hours.
B. 
All permanent full-time non-union and appointed employees in the Civil Service Exempt classifications, including the Mayor, department and division heads, shall receive the same health benefits as the City Hall union employees. The City shall designate the health care provider which in its discretion best serves the needs of the City and its employees.
C. 
An employee who retires with at least 20 years or more full-time service with the City shall be entitled the same City-provided health insurance as retired City Hall union employees. "Retirement" for this purpose means formal retirement with the New York State and Municipal Employees Retirement System. The employee must retire from the City and begin receiving pension payments immediately following the employee's retirement from City service as well as continue receiving said pension payments.
D. 
Duly retired employees eligible for Medicare Part A and Part B must accept that coverage as their primary health insurance and pay the Medicare premium therefor. The City will supplement such retiree with coverage under the Independent Health Encompass 65 plan or a like or similar successor plan as the City may determine.
E. 
An eligible retired employee who lawfully resides outside the area that coverage is available from the City's designated employee health care provider is entitled to receive payment in lieu of insurance coverage, in an amount equal to the City's cost to provide for his or her insurance coverage subject to the provisions of Subsection D if applicable. If an employee and his spouse are both employed by the City, then one employee shall accept the medical coverage program provided. No such employee shall be entitled to City-provided health insurance if his or her spouse is entitled to employer-provided health insurance coverage or partial coverage and must divulge, in writing, such information to the City under penalty of discharge for failing to so comply. The opting retiree must apply the money in lieu of payments described herein to actually acquire and pay for his or her health insurance premiums which cannot be diverted for any other purpose, and to verify said coverage to the City Comptroller in a written form to be prescribed by the City.
F. 
Members of the City Council, part-time employees, temporary employees and any other employee not covered by a collective bargaining agreement, a local law, ordinance or a resolution are not eligible for City-provided health insurance coverage. A City Council member is eligible for the benefit if the City was his or her health care provider immediately prior to his or her election.
For all City-provided health care benefits, there shall be at least a $5 copay on prescription drug plans, and a $250 hospitalization deductible. These are minimum provision requirements which amounts may be increased by City Council resolution.
A. 
There shall be no duplication of employer-provided health care insurance coverage for any and all City employees or retirees.
B. 
In lieu of City-provided health care benefits, any retired employee, as described in Subsection A above, receiving any such benefits from the City may elect to be paid the sum of $1,000 for his/her single coverage or $2,000 for his/her family coverage annually, in lieu of receiving the City-provided health care benefits for his division of employment, except this section shall not apply to active or retired employees of the Fire Division. The City Council may from time to time by resolution increase and/or decrease the payments provided for hereunder.
[Amended 6-1-2006 by L.L. No. 3-2006]
C. 
Said payment by the City as aforesaid shall constitute full satisfaction by the City of any and all claims by any employee/retiree entitled to City-provided health care benefits.
D. 
No City employee/retiree shall receive any City-provided health care benefits if said person or his/her spouse is entitled to any other employer-provided health care insurance. This prohibition also applies to any employee whose spouse is also employed by the City, and is made to avoid duplicate coverage so that only one spouse employed by the City is entitled to health care benefits; or if the spouse of a City employee/retiree is entitled to any employer-provided health care benefits other than from the City. No incentive provided for hereunder is allowed to any City employee whose spouse is also employed by the City, or any part-time, provisional or temporary employee unless otherwise provided for by the City Council. It is further provided that a City employee/retiree or spouse thereof entitled to any other employer-provided health care insurance benefit at a cost to the employee, retiree or spouse thereof of $1,000 or less, annually, must take the incentive in place of the City-provided health care insurance plan.
E. 
Any collective bargaining agreement presently in effect must be modified no later than 45 days of the effective date of this chapter to allow for the provisions provided for by this chapter.
F. 
A retiree need not show proof of insurance to apply for the incentive payment.
G. 
The City shall pay the incentive in equal monthly installments after the suspension of coverage.
H. 
Participation in the incentive program does not bar an eligible employee or retiree from future coverage with the City should their circumstances change to warrant their return; provided, however, that the cost thereof, if any, shall be determined by prevailing City law at that time.
I. 
All employees and retirees eligible for City-provided health care benefits are mandated to respond by affidavit to any annual survey to determine alternate health care coverage available to said employee or spouse. Failure to comply with this request within four weeks from the mailing date will result in the suspension of the benefit until the City receives compliance. Said affidavit shall be an affirmation under the penalty of perjury, subjecting violators to either suspension of benefits, criminal prosecution or both.
Any employee who qualifies for City-provided health care benefits and is receiving said benefits on the effective date of this law may upgrade the type of coverage provided to him/her by the City by personally paying the cost of the difference of such upgraded coverage to the City, in accordance with a payment schedule established by the City Comptroller.
[Added 8-14-2006]
A. 
A duly retired City employee lawfully entitled to City-provided health insurance and cancelled by Blue Cross and Blue Shield of WNY effective August 1, 2006, and being less than 65 years of age is hereby transferred to Independent Encompass C Health Plan, and the City will continue to provide said retiree with City-provided health insurance benefits as described therein without prejudice to the City.
B. 
Said retiree as described above shall forthwith, on or before September 1, 2006, enroll with the City health care representative presently located in the Civil Service Office, City Hall, 714 Ridge Road, Lackawanna, New York. Said retiree shall complete any and all forms and undergo any procedure required by Independent Health rules and regulations to qualify for coverage.
C. 
Said retiree as described above 65 years of age or more eligible for Medicare Part A and Part B must accept that coverage as his/her primary health insurance and pay the Medicare premium therefor. The City will supplement such retiree with coverage under Independent Health Encompass 65 Plan C or a like or similar plan as designated by the City.
D. 
Retirees who do not reside in the Western New York area insured by Independent Health will receive a monetary reimbursement equal to the City costs to provide the retiree with coverage described above with Independent Health or any successor company subject to the provisions of Subsection C.
E. 
Every retiree must divulge, in the form provided by the City, if he or she is entitled to any other employer-provided health insurance for either himself or his/her spouse.
F. 
Each entitled nonresident retiree must apply the money paid to him/her by the City in lieu of coverage herein to actually acquire and pay for his/her health insurance premiums which cannot be diverted for any other purpose and verify coverage to the City Comptroller in a written form to be prescribed by the City. The City will pay the premiums directly to the insurance company, HMO or entity, etc., responsible to provide said coverage for said nonresident entitled retiree.
G. 
Application for this benefit by nonresidents must be made and completed by September 1, 2006.
H. 
In addition to the foregoing and until further notice, retirees receiving City-provided health insurance through Independent Health Encompass Plan C shall receive an additional stipend from the City by making a written application thereto to be used for reimbursement for "copayment" purposes as that term is defined as follows: $1,000 per annum for a single person; $2,000 per annum for married persons. This additional stipend shall also be allowed to qualified nonresidents and therefore not entitled to coverage with Independent Health or any successor plan provided by the City.
I. 
The City Comptroller shall notify all parties involved of this resolution forthwith upon certification.