HEALTH INSURANCE MEMORANDUM OF AGREEMENT
BY AND BETWEEN
THE CITY OF LYNN AND
LYNN PUBLIC EMPLOYEE UNIONS
JULY 1, 2022 – JUNE 30, 2025
WHEREAS, the City of Lynn (“City”) currently provides health insurance benefits to its public employees pursuant to a Health Insurance Agreement signed by the City and all of the Lynn Public Employee Unions (“Unions”) dated May 23, 2019 (“the 2019 – 2022 HIA”);
WHEREAS, the 2019 – 2022 HIA expires on June 30, 2022 and the City and the Unions desire the City to continue to provide health insurance benefits to its public employees for a term of three (3) plan years starting on July 1, 2022 and ending on June 30, 2025;
NOW, THERFORE, the City and the Unions hereby stipulate and agree to the following terms comprising the Health Insurance Agreement for the three (3) year time period from July 1, 2022 and ending on June 30, 2025 (“the HIA”):
1. Administrator. The City shall continue to use Harvard Pilgrim Health Care as its Plan Administrator.
2. Length of Agreement. This HIA shall cover the three (3) year time period from July 1, 2022 and ending on June 30, 2025.
3. Premium Contributions. Under this HIA, Medicare Eligible Participants/ Retirees will continue to pay twenty five (25%) percent of the cost of their Medicare Supplemental Plan and the City shall continue to pay seventy-five percent (75%) of the cost.
A. The premium contribution splits for the City and for all Active Employees and non-Medicare Retirees shall be as follows:
Plan/Coverage Type City Contribution Employee Contribution
PPO Individual Coverage 70% 30%
PPO Family Coverage 70% 30%
EPO Individual Coverage 75% 25%
EPO Family Coverage 75% 25%
4. Plan Design. For the term of this HIA, the plan design shall be as follows:
Plan Feature | Plan Design |
Office Visit – Primary Care | $25 |
Office Visit – Specialist | $25 |
Emergency Room | $100 |
In Patient Hospitalization | $50 |
Out Patient | $50 |
Mail Order Prescription Drugs | $20/$40/$80/25% co-insurance* |
Pharmacy Prescription Drugs | $10/$20/$40/25% co-insurance* |
Medical Out of Pocket Maximum | $2,000 member/$4,000 family (Separate out-of-pocket limit applies to Pharmacy |
Prescription Drug Out of Pocket Maximum | $1,000 member/$2,000 family |
*The 4th Tier for prescription drugs is a twenty-five percent (25%) co-insurance up to a maximum cost for the subscriber of the 3rd Tier co-payment.
5. Prescription Drug Carve Out. The City shall maintain Maxor Plus as Pharmacy Benefit Manager for all Active Plan Members. The Formulary shall be the Maxor Plus Closed Formulary for all Active Plan Members.
6. All Active Employees and Medicare Eligible-Retirees shall participate in and utilize the mandatory generic prescription drug program.
7. Medicare Eligible Retiree Benefits shall move to a fully insured Prescription Drug Program (“PDP”) formulary (Humana).
8. Medicare Migration. The City will conduct an analysis starting July 1, 2021 to estimate cost/savings impact to migrate active Plan Retirees over the age of 65 to the Medicaid Enhanced Plan. Should the results of the analysis show a savings, the City will migrate the active plan Retirees on January 1, 2022. If migrated, Active Plan Retirees shall remain responsible to pay the full cost of Medicare Part B premiums and the City shall pay seventy-five percent (75%) of the Medicare Enhanced Plan. The City shall pay all penalties and interest related to the migration.
9. Other Features: Under this HIA, the City shall provide the following programs:
A. Flexible Spending Account (FSA): The City will continue to provide a FSA Program to lessen the impact of copay charges.
B. Telemedicine Benefits: All Active Employees and Medicare Eligible Retirees shall have 24/7 access to call or video conference with a doctor for diagnosis and prescribed medication at no copay, provided, however, a copay will still apply for any and all prescriptions.
C. CanaRx: All Active Employees and Non-Medicare-Eligible Retirees shall have the option of using CanaRx, an international prescription purchasing program (90 day supply of certain maintenance medications at $0 copay. Current Medicare-Eligible Retirees utilizing the CanaRx program can continue to use the program.
D. Diabetes Management Program: All Active Employees shall have the option using a compliance based program offering diabetes related prescriptions and supplies at no copay. All other wellness and disease management programs provided by Harvard Pilgrim under the HIA shall remain intact for the term of this Agreement.
E. As part of the National Health Care reform, preventative care visits will have no copays and dependent coverage will be extended to age 26.
10. Incorporation of HIA. This HIA shall be incorporated into each Union’s Collective Bargaining Agreement with the City or School Committee, whichever is applicable.
11. Bargaining For A Successor Agreement. The City, on one side, and the Public Employee Unions who are signatories to this HIA on the other side, agree to commence discussions for a Successor Agreement to the HIA no later than October 1, 2024. If the City and the public employee unions are unable to agree to a Successor Agreement on or before January 4, 2025, the City may negotiate directly on a successor health insurance agreement with each Union separately pursuant to M.G.L.c. 150E.
12. Authorization to Sign HIA. Each signatory to this HIA represents and warrants that he/she is authorized to bind the entity and members he/she represents and that this Agreement is binding on all subscribers and their Unions, representatives and members.
13. This Agreement shall take effect upon each of the following: (1) the ratification by each Union (2) execution of the Agreement by all signatories, (3) full funding by the Lynn City Council and (4) ratification by the School Committee.