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BILL NO. 92-119 AMENDED
SPONSORED BY COUNCILMEN GREEN, NILGES, WOODMAN, WRIGLEY
x, ORDINANCE NO. 11828
i`; AN ORDINANCE OF THE CITY OF JEFFERSON, MISSOURI,
AMENDING THE
. PROVISIONS OF THE CITY'S HEALTH PLAN PERTAINING TO COVERED
-
BENEFITS, AUDIT INCENTIVES, AND SCHEDULE OF BENEFITS.
WHEREAS, The City has previously adopted the City of Jefferson Employee
Health Care Plan (hereinafter the Health Plan"); and .
3
x, WHEREAS, Certain amendments to the Health Plan are necessary and
appropriate from time.to time; and
NOW, THEREFORE, BE IT ENACTED BY THE COUNCIL OF THE CITY OF
JEFFERSON, MISSOURI, AS FOLLOWS:
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Section 1. The current Health Plan is hereby amended by the addition of the
following provisions:
sn
(a) Under MAJOR MEDICAL EXPENSE BENEFIT FOR COVERED
PERSONS AND COVERED DEPENDENTS
1.
„ (g) charges related to the drawing and storage of patient's own blood
prior to surgery, provided dra 'vying and storage are not more than 60
IN days prior to surgical procedure. Eligible charges are further limited to
3 $100 per unit of whole blood.
(b) Under SCHEDULE OF BENEFITS, HOSPITAL AUDIT INCENTIVE
As an incentive for covered persons to audit their own bills, should a
Y. covered person, or covered dependent discover an error in billing for
services received, the City of Jefferson Employee Health Care Plan will
reimburse the employee 25% of the savings resulting from the error
recovery.
If an error in billing is discovered, the covered person should notify the
' { claims examiner immediately, in writing, of the error. The examiner
will then begin procedures to recover the overbilling and will notify the
covered individual of the results of these procedures as soon as they are
Y •
z,. complete.
The Health Plan is hereby amended to substitute the following
Section 2.
t deductibles and coinsurance factors for those in the current Health Plan.
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' (c) Under SCHEDULE OF
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Deductible Amount per 1 1 person $200.00
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Deductible 111 per :.'11 .41111
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Coinsurance : 1'. of next $5,000
then 100% of covered expenses for the remainder
of the calendar year per family.
Section 3. The Mayor and Clerk are hereby authorized to
documents 1 carry out provisions of this ordinance.
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Section ordinance be force •' effect from and after the •ofits passage and approval.
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Passed Approved:
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