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FAMILY (Employee + all dependents) $1,850.00 <br />The above amounts are inclusive of the CalPFRS statutory minimum amount <br />which CalPERS determines and publishes each year, <br />2. Any contribution necessary to maintain benefits under said medical health plans <br />in excess of the amounts set forth above shall be borne entirely by the employee. <br />C. Medical Waiver Option <br />An employee who has primary coverage under another non -City sponsored group <br />medical health plan and voluntarily waives, in writing, their City paid medical <br />health insurance coverage shall receive a cash payment each month in an amount <br />equal to fifty percent (501/4) of the total monthly premium amount for the City's <br />lowest cost single "employee -only" medical health plan. <br />If an employee opts out of medical insurance, he/she must be able to demonstrate <br />to the City's satisfaction that he/she has mhiimurn essential coverage, as defined by <br />the Affordable Care Act (ACA), through another source other than coverage in the <br />individual market (whether or not obtained through Covered California). <br />11.2 Dental Insurance <br />A. The City offers two (2) types of dental insurance plans. One (1) is a Dental Health <br />Maintenance Organization (DIIMO) plan and one (1) is a Preferred Provider <br />Organization (PPO) plan. <br />B. The City shall contribute a maximum amount of up to ninety dollars ($90.00) per <br />month [which will increase to one hundred dollars ($100,00) effective January 1, <br />2020, and then to one hundred and five dollars ($105.00) effective January 1, 2021, <br />and then to one hundred and ten dollars ($110,00) effective January 1, 2022] for <br />each employee toward the payment of premiums for denial insure -nee plans <br />provided by the City for employees and their eligible dependents. <br />C. Any contribution necessary to maintain benefits under said dental plans in excess <br />of the amounts set forth above shall be borne entirely by the employee. <br />11.3 Lone -Term Disability Insurance <br />A. The City shall contribute up to ten dollars and thirty-nine cents ($10.39) per month <br />for each employee enrolled in the one hundred and thirty (130) day elimination <br />period long-term disability (LTD) plan. The LTD plan provides a maximum benefit <br />of two-thirds (2/3) of the employee's salary up to twenty-five hundred dollars <br />($2500.00) per month. <br />2019-2022 MOU City of Santa Ana & SEIU Full -Time Employees Unit Page, 67 \ <br />v1�b�t`�pl�l <br />v11 1 <br />