AFSCME Local 328
4006 Barbur Blvd, Portland, OR 97239
ARTICLE 15 - INSURANCE BENEFITS
ARTICLE 15. INSURANCE BENEFITS
Regular and limited duration employees. Employees who hold an FTE status of 0.5 FTE or greater are eligible for insurance coverage on the first of the month following the date of hire or date of obtaining a benefit eligible position. Coverage shall be effective the first of the month following the employee’s date of hire or date of obtaining a benefit eligible position. If an employee does not enroll within thirty (30) days from the date of hire or date of obtaining a benefit eligible position, the Employer will place the employee in the default medical, dental and core life insurance coverage effective the first of the month following the employee’s date of hire or date of obtaining a benefit eligible position.
Relief employees. Relief employees shall be eligible for health insurance benefits as provided below:
New relief employees are eligible for insurance coverage if they have had a minimum of 520 compensated hours during a six (6) month initial measurement period. An initial measurement period is defined as a six-month period commencing on the first of the month following the employee’s date of hire. Insurance coverage for such employees shall begin on the first of the month following one month after the end of the initial measurement period, and will continue for a period of at least six (6) months. New relief employees will qualify as ongoing relief employees after they have worked an entire ongoing measurement period as defined in (b) below.
Ongoing relief employees are eligible for insurance coverage if they have had a minimum of 520 compensated hours during the most recently completed six (6) month ongoing measurement period. A six-month ongoing measurement period is defined as either December through May or June through November.
Insurance coverage for ongoing relief employees shall begin on either the January 1 or the July 1 following the ongoing measurement period and will continue for a period of six (6) months.
The amount of the Employer’s insurance contribution to a relief employee’s benefit coverage is determined by the hours compensated during the qualifying measurement period, consistent with the provisions of Section 15.2.
Temporary employees and flex staff. Temporary employees and flex staff are not eligible for insurance benefits under this article.
Loss of eligibility. Employees on an unpaid leave of absence that is not protected under FMLA or OFLA shall lose eligibility for coverage at the end of the calendar month in which the unpaid leave begins. If the employee returns to a benefit eligible position within 12 months from such loss of coverage, the Employer will reinstate the employee’s coverage as of the first of the month following the employee’s return. The foregoing 12-month restriction does not apply to employees returning from an unpaid military leave of absence as set forth in Section 14.2.3.
Insurance Contributions. The amount of the Employer’s insurance contribution to an employee’s benefit coverage is determined by the employee’s FTE status except as set forth in Section 15.1.2.
Full time employees. For employees who hold an FTE status of 0.75 to 1.0, the Employer will pay for Employee Only coverage 100% of the cost of the OHSU PPO Plan and ODS Dental Insurance (or its equivalent), and for all other tiers 88% of the cost of these plans. The benefit dollars contributed by the Employer for all other tiers of coverage shall be the equivalent of 88% of the cost of these plans. Employees choosing opt-out coverage will receive a monthly cash benefit of $50 plus the cost of Employee Only dental (or its equivalent), if any is required, or core life insurance.
Part-time employees. For employees who hold an FTE status of 0.5 to 0.74, the Employer will contribute 75% of the above amounts. Employees choosing opt-out coverage will receive a monthly cash benefit equivalent to the cost of Employee Only dental (or its equivalent), if any is required, or core life insurance.
Maximum annual contribution increase. The annual increase in benefit dollars contributed by the Employer for any tier of coverage under this Section 15.2 shall not exceed ten percent (10%) of the previous year’s benefit dollars.
Employee premium deductions. The employee’s share of insurance premium costs will be deducted from the employee’s pay in the applicable payroll period during which benefits apply.
Employer premium reduction. The Employer may use plan funds to offset premium expenses provided it does not negatively impact the employee’s net pay.
Insurance Coverage and Employee Benefits Council. The Employer shall provide at least two (2) medical plans, including one plan that includes non-OHSU health care provider service and one OHSU plan. Insurance coverage is otherwise governed by the rules of the Employee Benefits Council as set forth in Appendix C hereto.
Default insurance coverage. Employees covered by the Employer’s program for default insurance coverage shall be placed in Employee Only coverage under the OHSU PPO plan and shall receive an Employer insurance contribution in accordance with Section 15.2 above.
Termination of Employment. Benefits coverage will cease on the last day of the month of an employee’s termination from employment, except that qualifying employees who are separated under Article 19 may continue benefits coverage and Employer contributions thereto in accordance with the provisions of that article and of Appendix F – Severance Program.
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