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equal to fifty percent (50%) of the total monthly premium amount for the City's <br /> lowest cost single "employee-only" medical health plan. <br /> Pursuant to the Affordable Care Act (ACA) Employer Mandate "affordability" <br /> determination, an Eligible Opt-Out Arrangement requires the following for <br /> employees who opt-out of employer-provided health coverage and receive cash in <br /> lieu: <br /> 1. Employee must provide reasonable evidence that the employee and each <br /> member of the employee's expected tax family (individuals the employee <br /> expects to claim personal exemption deduction) have or will have minimum <br /> essential coverage(other than coverage in the individual market,whether or not <br /> obtained through Covered California) during the period of coverage to which <br /> the opt-out arrangement applies; <br /> 2. The opt-out payment may not be made if the employer knows or has reason to <br /> know that the employee or any other member of the employee's expected tax <br /> family does not have or will not have the alternative coverage; <br /> 3. The evidence of alternative coverage must be provided every plan year to which <br /> the eligible opt-out arrangement applies; and <br /> 4. The reasonable evidence must be provided no earlier than a reasonable period <br /> of time before the plan year begins. <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 (DHMO) plan and one (1) is a Preferred Provider <br /> Organization (PPO) plan. <br /> B. The City shall contribute a maximum amount of up to one hundred and ten dollars <br /> ($110.00)for each employee toward the payment of premiums for dental insurance <br /> plans provided by the City for employees and their eligible dependents. Effective <br /> the first full pay period following City Council approval of this 2022-2025 MOU, <br /> the City will increase the monthly contribution to one hundred thirty dollars ($130) <br /> for dental insurance plans. <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 Long-Term Disability Insurance <br /> A. The City shall provide LTD benefit plan coverage with a sixty(60)day elimination <br /> period,with a five thousand dollar($5,000.00)per month maximum benefit,for all <br /> employees at no cost to the employee. <br /> 2025 MOU City of Santa Ana&SEW Full-Time Employees Unit Page 61 <br />