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FIFTH AMENDMENT TO
CITY OF CARMEL
EMPLOYEE HEALTH BENEFIT PLAN
WHEREAS, the City of Carreel ("Employer"), by action of its governing body,
adopted the City of Carreel Employee Health Benefit Plan ("Plan") effective February 1,
1992, and has subsequently modified the Plan by a full restatement effective February 1,
1998 and a First, Second, Third and Fourth Amendment to the restated Plan; and
WHEREAS, Employer wishes to further amend the restated Plan; and
WHEREAS, Employer is authorized to amend the restated Plan by Section 18.01
of said Plan.
NOW, THEREFORE, pursuant to the authority granted in said Section,
effective January 1, 2001 the Plan is amended as follows:
Section 2.01 (D)(2)(d) is amended to read:
(d) Emergency Room
Preferred Provider
Non-Preferred Provider
Section 2.01 (D)(2)(f) is amended to read:
(f) Ambulatory Surgical Facility
Preferred Prorider
Non-Preferred Provider
Section 2.01 (G)(5) is amended to read:
(5) Chiropractic
Maximum benefit per calendar year
Section 2.01 (G)(10) is added:
(10) Routine Exams and Immunizations
Maximum benefit per calendar year
100% after $50
Employee Copayment
80% after Deductible
100% after $25
Employee Copayment
80% after Deductible
$50O
$500
Section 2.02(A) is amended to read:
(A) Employee Copayment (deductible does not apply)
(1) Drug card (30 day supply maximum)
Generic drugs
Name brand drugs
(2) Mail order (90 day supply maximum)
Generic drugs
Name brand drugs
Section 7.02(J) is added:
(J) Routine exams and immunizations.
Section 13.01 is amended to read:
13.01 Leave of Absence
$10
$25**
$20
$50**
An Employee on leave of absence may continue coverage for himself and his
Dependents in accordance with Ordinance D-1490-00 if:
(A)
Such Employee is on a duly approved medical leave or personal leave, or
has been suspended for disciplinary reasons or pending resolution of
criminal charges; and
(B)
Such Employee pays the required hi-weekly contribution to the Employer
on or before each payday.
Such non-COBRA coverage will continue until the date the Employee returns to
work or the date coverage would otherwise cease under the termination provisions
of Article V, if sooner.
This Plan shall comply at all times with the provisions of the Family and Medical
Leave Act of 1993 (FMLA).
For a Participant who is receiving disability benefits under the applicable state
disability or pension fund, coverage shall be continued for as long as such
disability benefits continue, but in no event shall coverage continue after the
Participant's Medicare eligibility date; however, coverage under this provision
will end on the date such Participant returns to work or the date coverage would
otherwise cease under the termination provisions of Article V, if sooner.
In all other respects, the terms of the Plan are unchanged.
Approved and adopted this ff~ day of C ,2000.
CITY OF CAR_MEL, INDIANA
By and through its Board of Public Works and Safety
BY:
rainard Presiding Officer
ill~y~alker, Mem~ber
ary A~urke, Member
ATTEST:
Diana Cor~d~-Treasurer
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