Title 10. City Employee Specialty Funds
Article 179
CITY EMPLOYEE PRESCRIPTION DRUG REIMBURSEMENT FUND
Sections:
179.01 Creation of employees benefit fund.
179.02 Declaration of purpose.
179.03 Creation of accounts within the fund.
179.05 Definition of benefits.
179.06 Annual account adjustment.
179.08 Termination of accounts and fund.
179.01 Creation of employees benefit fund.
(A) Creation of Account. There is hereby created among the accounts of the City of Meadville a special account for the purpose of providing city employee prescription drug reimbursement in accord with the terms of this article.
(B) Name of Fund. The fund hereby created shall be known and denominated as the Meadville city employees prescription drug reimbursement fund. (Ord. 2972, 1979)
179.02 Declaration of purpose.
(A) Purpose. It shall be the purpose of the Meadville city employees prescription drug reimbursement fund to provide prescription drug reimbursement benefits to persons on the active full-time city payroll in accord with the hereinafter- stated terms and conditions.
(B) Limitations. The employee benefits arising from the establishment of this fund shall be paid and administered only in accord with the terms of this article. (Ord. 2972, 1979)
179.03 Creation of accounts within the fund.
(A) Unit Funds. The Meadville city employees prescription drug reimbursement fund shall consist of a separate master unit account for each employee group participating in said fund whether by the terms of a labor relations agreement or by action of city council.
(B) Employee Accounts. Each unit account shall consist of individual employee accounts. One such employee account shall be assigned to each full-time employee on the active payroll within participating employee unit. (Ord. 2972, 1979)
179.04 Contributions.
(A) Employer Contributions. The Meadville city employees prescription drug reimbursement fund shall be funded by contributions of the City of Meadville. Contributions shall be allocated to appropriate unit and employee accounts upon receipt of the fund.
(B) Basis of Contribution. City contributions to the fund shall be based upon rates from time to time approved by motion of the city council of the City of Meadville whether through approval of labor relations agreements or otherwise.
(C) Time for Making Contribution. Contributions shall be paid from the general fund to the Meadville city employees prescription drug reimbursement fund in equal quarterly installments and shall be paid on or before the last day of each quarter.
(D) Allocations of Contributions to Unit and Employees Accounts. Upon receipt of contributions by the fund, such contributions shall be immediately assigned to the appropriate unit and employee accounts in accord with the terms of this article, then existing labor relations agreements or separate council action.
(E) Charging of Claims. Individual employee claims for reimbursement of prescription drug expense made pursuant to the terms of this article shall be charged to the applicable employee and unit accounts within the fund when paid.
(F) Accounting. An annual accounting of all transactions of the Meadville city employees prescription drug reimbursement fund shall be made and filed among the record of the City of Meadville. Such accounting shall be in writing and as a public record shall be available for review by any employee of any participating employee group.
(G) Abatement of Contributions. Whenever the fund balance allocable to any unit account is sufficient in amount that the net interest thereupon, after administration expenses, equals the contribution to such unit account then required under the terms of labor relations agreements or city council directives, direct city contributions shall cease and abate. Direct city contributions will resume when necessary to meet agreed funding levels. (Ord. 3009 §§ 1, 2, 1981; Ord. 2972, 1979)
179.05 Definition of benefits.
(A) Reimbursable Expense. Full-time employees on the active payroll within any participating employee unit shall be entitled to cash reimbursement for any prescription drug expense actually incurred while such employee is a full-time employee within a participating unit and on the active payroll of the City of Meadville.
(B) Family Coverage. Reimbursement shall only be allowed for prescription drug expense incurred by employees as aforesaid or on behalf of the spouse or dependent children of any employee qualified under the terms of this article who are single and under the age of 19 years.
(C) Limitation of Benefits. The total amount payable to any employee individually or to any employee as the result of any prescription drug expense of a spouse of child shall not exceed the balance assigned to the claiming individual employee’s account at the time a claim or claims are made. Eligible claims properly filed which exceed the balance in any employee’s account at the time of filing will be reimbursed in installments in accord with the balances from time to time existing in said employee’s individual account within the fund.
(D) Time for Making Claims. Claims must be filed within 30 days after an eligible employee incurs a reimbursable prescription drug expense.
(E) Manner of Making Claim. Claims shall be made upon claim forms available in the office of the city clerk. A pharmacy receipt for the claimed expense must be attached to the claim form and must indicate that the prescription drug charge for which reimbursement is sought has been paid by the employee and that such charge is reimbursable under the terms of this article.
(F) Liability of Fund. The Meadville city employees prescription drug reimbursement fund shall only be liable to participating employees for valid claims. No employee or city officer may obligate the fund to any pharmacy or third person or entity for the payment of any prescription drug charges. Payment shall only be made to qualified employees as reimbursement for reimbursable charges actually paid by such employees.
(G) Fraudulent Claims. Any employee who submits a claim for prescription drug charges not actually incurred or not actually incurred by or on behalf of the employee, the employee’s spouse or child shall be considered to have submitted a fraudulent claim. Any person determined to have submitted a fraudulent claim shall be disqualified from all future participation in the plan and shall forfeit to the fund any and all sums credited to such employee’s individual employee account prior to the filing of the fraudulent claim.
(H) Time for Paying Claims. All reimbursable claims shall be paid to the claiming employee quarterly, beginning July 10, 1979. (Ord. 2972, 1979)
179.06 Annual account adjustment.
(A) Plan Year. The Meadville city employees prescription drug reimbursement fund shall operate on a calendar year.
(B) Unexpended Balances. Any and all unexpended balances in unit and individual employee accounts at the close of business on the thirty-first day of December of each year during the fund’s existence shall be adjusted as follows:
(1) Employee Account Adjustment. All unexpended sums credited to any individual employee account shall be canceled and transferred to the proper employee unit account for allocation in accord with subsection (B)(2) of this section.
(2) Unit Account Adjustment. All sums transferred to participating employee unit accounts in accord with the term of subsection (B)(1) of this section shall be equally allocated and credited to the individual employee accounts of each full-time employee within the unit on the active city payroll on January 1st of each year during the existence of the fund. (Ord. 2972, 1979)
179.07 Fund administration.
(A) Fund Administrator. The finance director of the City of Meadville shall administer the Meadville city employees prescription drug reimbursement fund. It shall be the duty of the fund administrator to comply to terms of this article and to properly manage the affairs of the fund.
(B) Investments. The fund administrator is hereby authorized to make such investments of sums to the fund as the fund administrator in his discretion deems proper and consistent with the proper operation of the fund. Interest earned in any calendar year shall be credited pro rata to the unit accounts and any interest balance in any unit account after payment of administration costs on the thirty-first day of each December shall be allocated to the employee accounts within such unit accounts in the same manner as herein above provided for reallocation of unexpended contributions.
(C) Administration Cost. The fund administrator shall keep records of all personnel and service costs incurred in the administration of the fund. Such expenses may be quarterly charged against the fund to the extent that there is interest or other income available for paying such expenses arising from the investment and management of the contributions of the city to the fund. In no event shall the base contributions of the city to the fund be chargeable for administration expenses. (Ord. 2972, 1979)
179.08 Termination of accounts and fund.
(A) Termination of Employee Participation. Any employee who ceases to be a full-time employee on the active city payroll shall become ineligible for continued participation in the fund. Any and all sums credited to such individual employee account shall be canceled and assigned to the appropriate unit fund for reallocation to the individual accounts of employees within such unit in the next calendar year.
(B) Unit Termination. Any employee unit which terminates its participation in the fund shall have no claim upon any individual employee accounts within such unit at the time of termination. Such sums shall be transferred to the general fund of the city upon termination of unit participation.
(C) Fund Termination. The Meadville city employees prescription drug reimbursement fund may be terminated by agreement with participating labor unions or by action of the city council for employees not subject to collective bargaining agreements. Should termination of the fund not provide for other distribution of moneys held at time of termination, such money shall revert to the general fund of the city.
(D) Dispute Resolution. Any disputes arising under the terms of this article or as a result of the administration of the fund created hereby shall be resolved by the majority vote of an arbitration panel which shall consist of (1) a representative of the employee unit from which the dispute arises; (2) the city manager; and (3) the chairman of the personnel board of the City of Meadville. (Ord. 2972, 1979)