§ 203-44. Health Care Benefits For Membership Dates On and After January 9, 1997.  


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  • (a)

    In addition to other benefits provided in this chapter, the health care benefits described in this Section shall be provided to the following persons:

    (i)

    A Member whose most recent membership enrollment date is on or after January 9, 1997 and on or before December 31, 2015, and who:

    (A)

    Retired on or after August 1, 2011 and on or before January 1, 2016 with 15 years of Membership Service and who is not entitled to benefits under Section 203-42 or 203-43, or

    (B)

    Retires on or after February 1, 2016 and who is at least 60 years of age with a minimum of 20 years of Membership Service and who is not otherwise eligible for health care benefits under Section 203-42 or Section 203-43, or

    (C)

    Retires on or after February 1, 2016 with 30 or more years of Creditable Service consisting of a minimum of 20 years of Membership Service and who is not otherwise entitled to benefits under Section 203-42 or Section 203-43.

    (ii)

    Persons receiving the benefits of a retirement optional allowance under Section 203-63 of this Chapter, and who are eligible for benefits under Section 203-48 of this Chapter, provided that the Member satisfied the requirements of paragraph (i) above at the time the Member retired and who is not otherwise entitled to benefits under Section 203-42 or Section 203-43.

    (iii)

    Members whose most recent membership enrollment date is on or after January 9, 1997 and who are not covered by the provisions of the Collaborative Settlement Agreement and who retire on or after February 1, 2016 and on or before January 1, 2017 and who have at least 15 years of Membership Service.

    (iv)

    Each surviving spouse, eligible dependent child and orphan of a deceased Active Member who would have been eligible for benefits under this section, who is receiving survivor benefits as provided in Section 203-49 of this Chapter, provided that:

    (A)

    the deceased Active Member's most recent membership enrollment date is on or after January 9, 1997 and on or before December 31, 2015; and

    (B)

    a surviving spouse may only obtain benefits if the surviving spouse possessed a valid marriage certificate or other proof of marriage recognized by the State of Ohio, dated prior to the date of the Active Member's death. However, if the deceased Active Member dies on or after January 1, 2019, the surviving spouse is eligible for coverage only if the spouse was not legally separated from the deceased Active Member at the time of the deceased Active Member's death.

    Accordingly, the provisions of Section 203-33 of this Chapter, which provide for Service Retirement Allowances after vesting, shall not entitle persons who are so vested to health care benefits under the provisions of this Section unless such persons are Members who also qualify for health care benefits under the provisions of this Section.

    (b)

    The benefits to be provided under this Section are:

    (i)

    Medical and prescription drug coverage similar to the most favorable plan available to active Employees, excluding Police & Fire and Building & Trade unions; and subject to Member premium contributions described in (c) below; and

    (ii)

    Dental and vision insurance coverage shall be purchased and fully paid for by the Member, their surviving spouse, and their eligible dependents or orphans.

    (iii)

    To the extent allowable under applicable federal law, coverage under this section for any person who is eligible to be covered under Medicare shall be secondary to coverage of such person under Medicare. The benefit payable under this Section shall be reduced by the greater of: (a) the amount actually paid by Medicare Part A and Part B; or (b) the amount Medicare would pay if the person were enrolled in Medicare Part A and/or Part B. A person is considered eligible for Medicare for these purposes during any period such person has coverage under Medicare Part A or Part B or, while otherwise qualifying for coverage under Medicare Part A or Part B, does not have such coverage under Medicare Part A (premium free) or Part B solely because such person has refused, discontinued, or failed to make any necessary application or applicable payment for Medicare Part A or Part B coverage.

    (c)

    Except for dental and vision insurance coverage, the percentage of the full funding rates, or premiums, for medical and prescription drug coverage to be paid by the Retirement System on behalf of persons entitled to benefits under this Section shall be based on a formula consisting of the sum of (i) the number of the Member's full years of Creditable Service, and (ii) the Member's age at the earlier of the Member's Retirement date or the date that the Member ceased to be an Active Member, with each such full year of Membership Service and each such year of age at Retirement date counting as one point each. Years of age at Retirement shall mean years of age at the birthday immediately preceding the earlier of the Member's Retirement date or the date that the Member ceased to be an Active Member. The number of full years of Creditable Service and the years of age at Retirement date shall be added together and shall result in the payment of medical and prescription drug coverage in the following percentage amounts:

    95% of full cost or full premiums for 90 points

    75% of full cost or full premiums for 80 to 89 points

    50% of full cost or full premiums for 70 to 79 points

    25% of full cost or full premiums for 60 to 69 points

    If a Member's total points are less than 60, the Member is only eligible for individual medical and prescription drug coverage. The Retirement System will pay 25% of the premium for individual medical and prescription drug coverage. No spouse or family coverage is available.

    A Member's years of Creditable Service shall be used for the purpose of determining the points of a Member under this subsection (c), but will not include years of Creditable Service credited under a previous Service Retirement Allowance provided under this Chapter.

    (d)

    If a Member leaves the City service prior to Retirement and is entitled to a deferred Service Retirement Allowance and such Member is entitled to benefits under this Section, no benefits shall be provided to the Member until the Member reaches the later of their normal retirement date, or their Medicare eligibility age.

    (e)

    Any Inactive Member who is rehired on or after January 1, 2016 shall not be eligible for benefits under this Section.

    (f)

    The director of retirement or his or her designee shall adopt rules and policies necessary to implement this Section.

(Ord. No. 1-1997, eff. Jan. 8, 1997; a. Ord. No. 284-2000; eff. 8-2-00; a. Ord. No. 352-2001, eff. Oct. 31, 2001; Emer. Ord. No. 0020-2007, § 2, eff. Jan. 1, 2007; Emer. Ord. No. 379-2008, eff. Nov. 19, 2008; Emer. Ord. 290-2009, § 8, eff. Oct. 28, 2009; a. Ord. No. 360-2009, § 2, eff. Dec. 25, 2009; a. Ord. No. 085-2011, § 2, eff. April 16, 2011; Emer. Ord. No. 083-2013, § 2, eff. April 10, 2013; a. Ord. No. 336-2016, § 1, eff. Nov. 26, 2016; a. Emer. Ord. No. 343-2018, § 1, eff. Oct. 31, 2018)