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HomeMy WebLinkAbout16781 ORD - 12/23/1981-0;12/21J81;1st AN ORDINANCE AUTHORIZING THE CITY MANAGER TO EXECUTE A SIX MONTH CONTRACT WITH THE TEXAS MUNICIPAL LEAGUE UNIFORM GROUP FOR THE CITY GROUP LIFE AND HEALTH INSURANCE PROGRAM BEGINNING FEBRUARY 1, 1982; AND DECLARING AN EMERGENCY. BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CORPUS CHRISTI, TEXAS: SECTION 1. That the City Manager be and he is hereby authorized to execute a six month contract with the Texas Municipal League Uniform Group for the City group life and health insurance program beginning February 1, 1982. SECTION 2. That upon written request of the Mayor or five Council members, copy attached, to find and declare an emergency due to the need of efficent administration of City affairs, such finding of an emergency is made and declared requiring suspension of the Charter rule as to considera- tion and voting upon ordinances or resolutions at three regular meetings so that this ordinance is passed and shall take effect upon first reading as an emergency measure this the e77.,„3 day of December, 1981. ATTEST: Cl Secretary MA OR THE CITOF CORPUS CHRISTI, TEXAS APPROV D: o DAY OF DECEMBER, 1981 Y! Bruce Cit Attorney 16781 SEP 281984 MICROFILMED 1. Eligibility a. All permanent full-time employees and their dependents shall be eligible for insur- ance. The Mayor and Members of the City Council and their dependents shall also be eligible. Dependents are defined as the spouse of a permanent full-time employee and unmarried children between birth and 23 years of age or full-time students dependent upon employee for financial support. (No age limit applies to full-time students) b. All City employees and dependents must be accepted for coverage without regard to pre-existing conditions during the 30 day open enrollment established the effective date of the contract. Pregnancy benefits will be provided with the same coverage as any other illness. 2. Benefits for Employees Only a. All permanent full-time City employees will be covered for life insurance benefits and 24 hour AD&D. b. The amount of insurance for an insured employee shall be in accordance with the following Schedule of Life Insurance: (1) Basic Insurance - $3,000 Life and $3,000 (24 hour) AD&D. (All Employees) (2) Supplementary group life and 24 hour AD&D All Employees less than age 70 when becoming insured An amount equal to the employee's annual earnings adjusted to the next higher multiple of $1,000. Maximum insurance $25,000 reduced by the basic amount of insurance. All Employees age 70 or more when becoming insured or attain age 70 while insured An amount equal to 1/2 the employee's annual earnings adjusted to the next higher multiple of $1,000. c. An employee's life insurance and AD&D under both basic and supplementary group plans will cease upon termination of employment or retirement. •ts'for Employees only Cont'd. d. Group,life,insurance shall contain waiver of premium provision for total and perma- nent disability occurring prior to age sixty (60). e. Group life insurance will provide for conversion to individuai policy, without evi- dence of insurability, in the event of termination of employment, or retirement. f. Accidental death, dismemberment, and loss of sight benefits shall be payable on the basis of the full amount of insurance applicable to each employee as specified in the schedule of Life Insurance Benefits and according to the following table of losses:. IN THE EVENT OF LOSS OF: THE BENEFIT WILL BE: Life The Full Amount of Insurance Both Hands or Both Feet The Full Amount of Insurance Sight of Both Eyes The Full Amount of Insurance One Hand and One Foot The Full Amount of Insurance One Hand and Sight of Ore Eye The Full Amount of Insurance One Foot and Sight of One Eye The Full Amount of Insurance One Hand One Half - The Full Amount of Insurance One Foot One Half - The Full Amount of Insurance Sight of One Eye One Half - The Full Amount of Insurance 3. BenoFits for Employees and EIigible Dependents Maximum Benefit, Lifetimo , $1,000,000.00 Co -Insurance, Reimburseable Percentage All Other Eligible Expenses Deductible Supplemental Accident Surgical Fees Pays 80N of the first $2,500 of expenses and 1007, of the expenses above $2,500 during a calendar year_ Pays the same and is combined with Hospital Bills_ $100 annually per individual_ Family Aggregate Deductible ---$300_ The deductible ap- plies to all charges_ Pays 1001; up to $500. No deductible applies_ Pays 100:; with a confirming. second or third surgical opin- ion on elective surgery; if second or third opinion does not confirm need for surgery, bene- fits are paid at 80%. -Deductible applies in either case. (2nd and 3rd opinions at full ex- pense of insurance carrier). U'ENSES HOSPITAL BILLS "riospital Room and Board - Charges for room and board. (For private accomodations, in a hos- pital, the eligible expenses for room and board are subject to a daily limit equal to the , hospital's standard semi -private room rate). Other Hospital Services - Services and supplies furnished by the hospital for medical care such as operating room, x-rays, laboratory tests, medicines, etc., but not professional services. OTHER ELIGIBLE EXPENSES Doctor's Services - Surgery, home, office and hospital visits, and other medical care and treatment. Nursing Care - Private duty nursing by a registered graduate nurse. Speech Therapy - By a qualified speech therapist to restore speech loss, or correct an impair men;., due to (a) a congenital defect for which corrective surgery has been performed, or (b) an injury or sickness except a rental, psychoneurotic or personality disorder_ Physiotherapy - Treatment by a pysiotherapist. r-bulance service for local travel. Anesthetics and their administration. X-ray and laboratory examination. X-ray and radium treatments and treatments with other radioactive substances_ Medical Supplies - Drugs and medicines dispensed by a licensed pharmacist; blood and blood plasma; artificial limbs, eyes and larynx; electronic heart pacemaker; surgical dressings; casts; splints; trusses; braces; crutches; rental of wheel chair, hospital bed, or iron lung; oxygen and rental of equipment for administration. Oral contraceptive pills ordered by a doctor for use by the employee or dependent while a covered individual. This item will be eligible even though not necessary for medical care. SUPPLEMENTAL ACCIDENT EXPENSES .ihis of the insurance provides benefits without a deductible for certain expensk to an ,,,.cident occurring while covered. An expense paid under this part will be excluded from the benefits previously described. This insurance will make a payment, up to the amount shown in the Schedule toward the ex- p,,nses incurred within 90 days after the accident for the following services and supplies. Hospital services and supplies for medical care. Doctors' services for surgery and other medical care. Dental Treatment: Treatment by a dentist, physician or dental surgeon of a fractured jaw or injuries to natural teeth, including their replacement. X-ray and laboratory examinations. Services of a registered graduate nurse. Drugs and medicines dispensed by a licensed pharmacist. Surgical dressings, casts, splints, trusses, braces and crutches. Ambulance Service for local travel. EXCLUSIONS Mental, Psychoneurotic and Personality Disorders In th? case of mental, psychoneurotic and personality disorders, the benefits for a doctor's services will be payable at the rate of 50;i, the maximum payment being $20 a visit, or 50% of 540, and not more than $1,000 of benefits will be paid in a calendar year. Conditions The insurance does not cover treatment of periodontal or periapical disease or any condition (c h.cr than a malignant tumor or a congenital birth defect of the oral cavity) involving taeth, surrounding tissue or structure. However, this exclusion doesn't apply to: a. The benefits for dental treatment described under the "Supplemental Accident Expenses" section, or b. Charges for the following dental services received within 12 months after an accident: Treatment by a physician, dentist, or dental surgeon of injuries to natural teeth includ- ing replacement of such teeth, and related x-ray. The charges for these services will be included with the "Other Eligible Expenses" previously described. COORDI;;ATION WITH OTHER PLANS Non-profit provision coordinating it with other plans under which an individual is covered so that the total benefits available will not exceed 100;; of the allowable expenses_ r• MOP- ' HEALTH CARE INSURANCE FO{ ONS ELIGIBLE FOR U.S. MEDICARE An individual who'is covered under this Group Insurance Plan and also is eligible for part A under Medicare, will be assumed to have full Medicare coverage whether or not the individual has enrolled for the full coverage. EXTENTION OF BENEFITS Benefits for an illness or injury which causes an individual to be continuously totally dis- abled from the date his insurance cancels will be continued until the earlier of (1) one year from the date the insurance cancels or (2) the date the individual becomes insured under another group insurance plan providing medical care benefits. Retiring employees while covered with medical insurance may select to continue coverage at group rates. This benefit will also be extended to the spouses of retirees if the retired employee becomes deceased. Corpus Christi, Texas Ae day of � , 1981 TO THE MEMBERS OF THE CITY COUNCIL Corpus Christi, Texas For the reasons set forth in the emergency clause of the foregoing ordinance or resolution, an emergency exists requiring suspension of the Charter rule as to consideration and voting upon ordinances or resolutions at three regular meetings; I/we, therefore, request that you suspend said Charter rule and pass this ordinance or resolution finally on the date it is introduced, or at the present meeting of the City Council. Respectfully, Respectfully, Council Members The above ordinance was Luther -Jones Betty N. Turner Jack K. Dumphy Bob Gulley Herbert L. Hawkins, Jr. Dr. Charles W. Kennedy Cliff Zarsky MAYOR THE CI ' OF CORPUS CHRISTI, TEXAS passed by the following vote: