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Docusign Envelope ID: 5BEB38E3-9A4C-4D1 9 -9586 -Al 7352C599AA <br />Section 12. Health and Welfare <br />12.1 Medical Insurance - Active Employees <br />A. Contributions <br />All employees participating in the City's health plans will contribute one of the <br />following two amounts, whichever is greater: <br />1. $25 per month for employee only coverage, $25 per month for employee plus <br />one coverage, or $50 per month for family coverage. <br />2. The difference between the family rate of the lowest cost HMO and the premium <br />of the employee's more expensive plan selection. <br />Contributions will be deducted from the employee's paycheck on a pre-tax and bi- <br />weekly basis. <br />B. Increases in Premiums <br />The City will pay for any increase in the medical plan premiums up to a maximum <br />of 15% annually of the lowest cost HMO family rate. Any premium increase above <br />15% will be deducted from the employee's paycheck on a pre-tax basis. <br />In the event that the medical premium increase is less than 15%, the City's sole <br />obligation is to pay the lower percentage increase. <br />C. Plan Co -Pays <br />The health maintenance organization (HMO) medical plans co -pays shall be ten <br />dollars ($10) for office visits. The prescription drug co -pays shall be ten dollars <br />($10) for generic, fifteen dollars ($15) for brand and thirty-five dollars ($35) for <br />non -formulary (the Kaiser HMO provides for a two-tier prescription drug <br />plan). The Preferred Provider Organization (PPO) medical plan co -pays shall be <br />fifteen dollars ($15) for office visits. The prescription drug co -pays shall be ten <br />dollars ($10) for generic, twenty-five ($25) for brand and thirty-five dollars ($35) <br />for non -formulary. <br />D. Changes to Plan Designs <br />The City reserves the right to make changes to the medical plan designs. <br />21 <br />