SMCCE 19.2 Health Plan Changes

Health plan changes that are initiated by the health plan based on either legislative/regulatory changes or health plan organization policy changes are provided to employers each year. These changes are typically not significant in terms of the numbers of individuals who are impacted by the change. For instance, they do not often include co-pay changes for outpatient or inpatient physician or facility services, prescription drug co-pays or major plan design co-pays. Where health plans initiate these kinds of changes to the contract, Employee Benefits will share with labor the specific changes health plans are communicating at the time of renewal, before implementing the change. Where the changes may be eliminated by the employer purchasing, at additional cost, a rider to cover the benefit, it is the County’s desire to implement such changes without riders to keep its design in conformance with the health plans’ book of business design, provide however, it will first meet and confer with the Council on any such matter.