Common use of Payment in Lieu of Health Insurance Clause in Contracts

Payment in Lieu of Health Insurance. Employees who are eligible for health insurance coverage through the County and elect to NOT enroll in the group medical benefit plan because they are eligible for coverage under another qualified group medical benefit plan available to their spouse and/or eligible dependents will be eligible to receive additional monthly compensation based upon their health insurance coverage eligibility status. The amount of such compensation may be fixed by the Board of Commissioners, but shall not be less than $166.67 per month. Payments will be made once per month on the first paycheck in each month that the employee would otherwise be eligible for health insurance coverage. This amount will be pro-rated based on the number of hours the employee is regularly scheduled to work and the eligible months of service. An employee must provide proof of insurance coverage under a qualified group plan for the employee and eligible dependents as defined or required by the Affordable Care Act or implementing regulations and complete all forms or certifications required by the County and under the Affordable Care Act of such payments. It is agreed by the Parties that an employee will not be eligible for payment in lieu of health insurance if such payment would violate the Affordable Care Act or implementing regulations, or cause the Employer to be subject to penalty or fine. Should insurance coverage through the secondary source terminate for any reason, the employee should notify the County Administrator, or his or her designee, within (30) days and re-enroll in the County health insurance program. Failure to timely notify the County may result in the ability to re-enroll being limited to the open-enrollment period. Employees who are insured under a Grand Traverse County health insurance plan provided to their spouse are not eligible for this payment. The benefits provided under this section shall be secondary to any personal protection or personal injury benefits available from an insurer under a motor vehicle policy described in Section 500.3101(1) of the Michigan Compiled Laws. Eligibility and benefit provisions are provided subject to plan documents. The employee is obligated to pay any applicable cost share whether actively at work or on an approved leave. Failure to make the required cost share payment in a timely manner will result in loss of coverage.

Payment in Lieu of Health Insurance. Employees who are eligible for health insurance coverage through the County and elect to NOT enroll in the group medical benefit insurance plan because they are eligible for coverage under another qualified group medical benefit health insurance plan available to their spouse and/or eligible dependents will be eligible to receive additional monthly compensation based upon their health insurance medical care coverage eligibility status. The amount of such compensation may be fixed by the Board of Commissioners, but shall not be less than $166.67 per month. Payments will be made once per month on the first paycheck in each month that the employee would otherwise be eligible for health insurance coverage. This amount will be pro-rated based on the number of hours the employee is regularly scheduled to work and the eligible months of service. An employee must provide proof of insurance coverage under a qualified group plan for the employee and eligible dependents as defined or required by the Affordable Care Act or implementing regulations and complete all forms or certifications required by the County and under the Affordable Care Act of for eligibility for such payments. It is agreed by the Parties that an employee will not be eligible for payment in lieu of health insurance if such payment would violate the Affordable Care Act or implementing regulations, or cause the Employer to be subject to penalty or fine. Should insurance coverage through the secondary source terminate for any reason, the employee should notify the County Administrator, or his or her designee, Administrator within thirty (30) days and re-enroll in the County health insurance program. Failure to timely notify the County may result in the ability to re-enroll being limited to the open-enrollment period. Employees who are insured under a Grand Traverse County health insurance plan provided to their spouse are not eligible for this payment. The benefits provided under this section shall be secondary to any personal protection or personal injury benefits available from an insurer under a motor vehicle policy described in Section 500.3101(1) of the Michigan Compiled Laws. Eligibility and benefit provisions are provided subject to plan documents. The employee is obligated to pay any applicable cost share whether actively at work or on an approved leave. Failure to make the required cost share payment in a timely manner will result in loss of coverage.