In order to qualify for the full and complete cost of hospitalization, dental and prescription insurance, the staff member must work what is considered a full and regular assignment.

Those who work less than the full and regular assignment will be eligible for the benefit on a percentage basis equal to the amount of time served on the job.

Full benefits will be extended to:

Exceptions to this because of the nature of the position will be:

All other employees who are contracted for regular positions will receive coverage equal to the percentage of time contracted for the job.

Payment for the additional cost of coverage will be paid by the staff member on a payroll deduction basis.

Substitutes and temporary employees are not eligible for insurance benefits.

Teachers on leave of absence may remain on the benefit listing provided they pay the monthly premiums. Replacement employees are eligible for insurance benefits providing they qualify according to this policy but the coverage is not to exceed their last day of service.

The Board shall purchase from Blue Cross/Blue Shield or other carrier licensed by the State of Ohio, basic, hospital-surgical major medical insurance coverage for each certificated employee now or hereafter employed and his/her family. Such coverage will meet or exceed the current level of benefits in effect as of January 1, 1983.

One hundred percent (100%) of the full cost of such insurance and one hundred percent (100%) of any increases thereof in these insurance premiums for the term of this agreement shall be paid by the Board.

Employees are required to complete enrollment forms indicating the desired coverage and to meet the enrollment requirements of the policy in effect.

Days Per Confinement 365 days

Ward or Semi-Private Room Full Cost

Other Covered Services Full Cost

Maternity (Single and Dep. Daughter) Full Cost

Emergency Accident Care (72 hrs.) Full Cost

Non-Bed Patient Surgical Care Full Cost

Diagnostic Medical Services Full Cost

Outpatient Medical Emergency Full Cost

Surgical Schedule Usual and Customary

Asst. Surgeon

(when medically necessary) Usual and Customary

Anesthesia Schedule Usual and Customary

Consulting Physician Schedule Usual and Customary

In-Hospital Medical Usual and Customary

Days Per Year Usual and Customary

Radiotherapy Schedule Usual and Customary

Obstetrical-Normal Usual and Customary

Obstetrical-Caesarean Usual and Customary

Diagnostic X-Ray (72 hrs.) Usual and Customary

Diagnostic Medical Services Usual and Customary

Outpatient Medical Emergency Usual and Customary

Ambulance Service to Local Hospital Usual and Customary

Maximum $250,000.00

Deductible $100.00-200.00 Agg.

Co-Insurance 80% of 1st 2,000 (100% of

balance)

Room and Board Limit Semi-Private

Out-Patient Nervous 80/20

The Board shall purchase from Oasis Trust or any carrier insurance by the State of Ohio, employee and family dental insurance protection equal to or exceeding the specifications below for each certificated employee now or hereinafter employed who is a member of the bargaining unit.

Each teacher shall pay three ($3.00) per month for their share of the dental insurance.

Covered expenses will include all Reasonable and Customary charges by a dentist for dental care provided for in Schedule of Dental Services. A charge made for a dental service will be considered Reasonable and Customary if it is the amount normally charged by the provider and does not exceed the amount charged by most providers of comparable dental services in the locality where the services are received. In determining whether a charge is Reasonable and Customary, due consideration will be given to the nature and severity of the condition being treated and any medical complications or unusual circumstances which require additional time, skill or experience.

Class I, II or III $1500/person/calendar year

Individual $25 per calendar year

Deductible-Family $50 per calendar year

The family deductible will be considered to have been satisfied if two (2) family members satisfy the $25 deductible or three (3) or more family members incur an aggregate of $50 in dental expense.

(no deductible) charges*

charges*

charges*

(no deductible) charges*

Lifetime maximum on Orthodontia $850/person

*See following list of covered procedures.

Class I oral exams

x-rays

emergency treatment

teeth cleaning

fluoride treatments

space maintainers

Class II anesthesia

restorations

amalgam

silicate

acrylic

Class III restorations

gold fill

gold inlays

porcelain

crowns

installations of bridgework and dentures

Class IV orthodontic

diagnosis

appliances

treatment

adjustments

Any amounts for expenses incurred in October, November or December of a year which are applied toward a deductible in that year, will be carried over and used toward satisfying the deductible for the following calendar year.

Dental insurance in force for dependents on the date of the employee's death will remain in force without payment of premium until the earliest of the following dates:

The coverage which is continued in force for dependent children because of the employee's death will not be affected if the surviving spouse dies during the two (2) year (maximum) continuation of coverage.

The Board shall purchase from Blue Cross-Blue Shield or other carrier licensed by the State of Ohio, a $2.00 Deductible Drug Program, that provides the following:

Any teacher, whether new or currently employed, but not covered by prescription drug insurance, may apply anytime but has a waiting period required by the carrier that is not to exceed thirty (30) days.

R.C. 9.90, 3313.202