Common use of Alternate Coverage Clause in Contracts

Alternate Coverage. (a) If an employee’s spouse is employed by any department of the Town and is eligible to receive health and/or dental insurance coverage through a plan supported by taxpayer funds, the Town will provide the employees with only one health and/or dental insurance plan, and the Town shall have the sole discretion to choose which employee’s health and/or dental plan such employees will be enrolled in. If the Town chooses to enroll such employees in a health plan other than the health plan set forth in Section 1 of this Article XII, the employee covered by this agreement shall become eligible to receive a payment at the end of the fiscal year, equal to $3,500. (b) If an employee is eligible to receive comparable health and/or dental insurance through a spouse’s plan, other than a plan provided through another department of the Town, such employee shall be required to enroll in such plan(s) and shall not be eligible for health and/or dental insurance under this Agreement; however, the employee shall become eligible to receive a payment at the end of the fiscal year, equal to $3,500. (c) If an employee is eligible for Medicare, the employee shall be required to enroll in Medicare, and the Town will provide such employee with a Medicare Supplement Plan, subject to the applicable employee co-payment as set forth in Section 4 of this Article XII. (d) Employees shall be required annually to complete a form provided by the Town indicating what health and/or dental insurance benefits are available to the employee. (e) The Town shall provide two individual health and/or dental insurance plans to employee and spouse in lieu of one family plan, when there are no dependents eligible for coverage, or enrollee plus dependents if no spouse is eligible, once the Town health plan has been amended to accommodate these tiered choices. If dependents and/or spouse need to be added, the employee may transfer back to a Family plan at that time. (f) The Town may seek alternative health insurance coverage, which will provide the same level of coverage to that set forth herein. In such case, the Town will consult with the union, prior to implementing such plans.