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Alameda City USD  |  BP  4154  Personnel

Health And Welfare Benefits   

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Employees who are not in bargaining units shall receive health and welfare benefits as specified in this Board policy and accompanying administrative regulation.

Definitions

For purposes of this Health and Welfare Benefits policy, the following definitions shall apply:

1. Administrative and Supervisory Employees shall mean all certificated and classified administrative, supervisory, confidential, licensed and unrepresented classified personnel who are not subject to the district's collective bargaining agreements.

2. Full Time Employees shall mean those employees who are regularly assigned to work five (5) days per week, seven (7) to eight (8) hours a day, 35 (thirty-five) to 40 (forty) hours per week, and who are employed for either the fiscal or academic year.

Active Administrative and Supervisory Employee Health and Welfare Benefits

1. Basic Medical Plan

Effective July 1, 2011, the district shall contribute the minimum amount required by Govt. Code section 22892 per month for administrative and supervisory employees toward payment of the premium of a medical plan selected by the employee. In 2011, the minimum amount is $108.00. The medical plan chosen shall be one of those offered by PERS under the Public Employees Medical and Hospital Care Act.

2. Compensation in Lieu of Medical Benefits

Those full time administrative and supervisory employees eligible for medical benefits who can prove other health care coverage may elect to decline coverage by the district and receive $305.00 in cash compensation in lieu of medical benefits. This money may be used for any purpose and will be taxable to the employee.

Once health benefits are declined, no change may be made during the benefit year unless authorized under PERS approved exceptions to open enrollment period elections.

Any employee who declines coverage must renew that declination each year during the open enrollment period and provide proof of continuing health coverage.

3. Supplemental Benefits Plan

Effective July 1, 2011, the district shall provide as a supplemental benefit plan for full time administrative and supervisory employees an amount equal to the difference between the basic medical plan and the amounts designated as the district's maximum contribution for medical, dental, and vision insurance care plans selected by the employee for the employee and his/her dependents as shown on Attachment 1.

4. Flexible Benefit Plans.

A flexible benefits plan (as defined in Internal Revenue Code Section 125) consisting of options for premium conversion, unreimbursed medical expenses, and dependent care will be available for employees choosing to participate.

Health and Welfare Benefits for Employees Working Less Than Full Time

Administrative and supervisory employees who work fewer than 35 (thirty-five) hours per week, but 20 (twenty) or more hours per week, shall receive a pro-rata share of the supplemental benefits plan authorized for a full time employee if they elect to be enrolled in a health, vision, or dental care plan. The pro-ration shall be based on a 40 (forty) hour week.

Employees who work fewer than 20 hours per week shall not be eligible for benefits enumerated in this policy.

Retired Administrative and Supervisory Employee Health and Welfare Benefits

The district shall provide health and welfare benefits for retired administrative and supervisory employees of the district in accordance with the following:

1. Eligibility for Basic Medical Plan for Retirees

Administrative and supervisory employees who retire from the district will be eligible to be covered under the PERS medical plan for retirees provided the employee retired at or after age of fifty (50) years and had at least ten (10) continuous years of paid service with the district immediately prior to retirement. Each year the contribution by the district shall equal the amount allocated for the Basic Medical Plan for active full time employees as described in this policy.

2. Eligibility for Supplemental Benefit Plan

As part of an early retirement plan, administrative and supervisory employees who retire at or after the age of 55 years, and have at least 10 continuous years of paid service with the district immediately prior to retirement, may receive the supplemental benefit plan provided to active full time employees for employee only coverage until they are eligible to purchase or receive Medicare.

Eligible retirees under this provision may, at their cost, purchase coverage for their dependents or domestic partner. In the event a retiree elects to purchase coverage for his/her dependents or domestic partner, the employee shall pay the premiums, dues, and other charges, including any increases in premiums, dues, and costs incurred by the district in administering this program. The required payments from the retired employee must be remitted to the district office by the first day of each month.

3. Eligibility for Dental and Vision Plans

Administrative and supervisory employees who retire at or after the age of 55 years, and have at least 10 years of paid service with the district immediately prior to retirement, may receive the same dental and vision benefits as provided to active full time employees, as described in this policy.

Eligible retirees under this provision may, at their cost, purchase dental and/or vision coverage for their dependents or domestic partner. In the event a retiree elects to purchase dental and/or vision coverage for his/her dependents or domestic partner, the employee shall pay the premiums, dues, and other charges, including any increases in premiums, dues, and costs incurred by the district in administering this program. The required payments from the retired employee must be remitted to the district office by the first day of each month.

The benefit carriers for retired persons shall be the same as those provided to active employees.

Domestic Partner Coverage: Health, Dental and Vision

The district will fully implement state law provisions pertaining to domestic partner enrollment under PERS health plans offered by the district. In addition, the district will permit domestic partners to enroll as dependents under any non PERS benefit plan, including dental and vision plans. For purposes of enrollment in non PERS health, dental and vision plans, the definition of domestic partner will be as established pursuant to Chapter 588, Statutes of 1999. Domestic partners will be eligible for any benefits in the retirement period to which spouses or surviving spouses are eligible under the provisions of this policy.

Confidentiality of Medical Information

The Superintendent or designee shall not use or disclose any medical information the district possesses pertaining to an employee without the employee's authorization obtained in accordance with Civil Code 56.21, except for the purpose of administering and maintaining employee benefit plans and for other purposes specified in law. (Civil Code 56.20)

(cf. 4312.6 - Personnel Records)

Continuation of Coverage

Retired administrative and supervisory employees who would otherwise lose coverage due to a qualifying event specified in law and administrative regulation, and their qualified beneficiaries may continue to participate in the district's group health and welfare benefits in accordance with state and federal law.

For those programs for which deductions are not made by PERS, the required payments from the retired employee must be remitted to the district office by the first day of each month. Except as otherwise set forth herein, to receive continuation coverage, covered employees and their qualified beneficiaries shall pay the premiums, dues, and other charges, including any increases in premiums, dues, and costs incurred by the district in administering this program.

Legal Reference:

EDUCATION CODE

7000-7008 Health and welfare benefits, retired certificated employees

17566 Self-insurance fund

35208 Liability insurance

35214 Liability insurance (self-insurance)

44041-44042 Payroll deductions for collection of premiums

44986 Leave of absence, state disability benefits

45136 Benefits for classified employees

CIVIL CODE

56.10-56.16 Disclosure of information by medical providers

56.20-56.245 Use and disclosure of medical information by employers

FAMILY CODE

297-297.5 Rights, protections and benefits under law; registered domestic partners

GOVERNMENT CODE

22750-22944 Public Employees' Medical and Hospital Care Act

53200-53210 Group insurance

HEALTH AND SAFETY CODE

1366.20-1366.29 Cal-COBRA program, health insurance

1367.08 Disclosure of fees and commissions paid related to health care service plan

1373 Health services plan, coverage for dependent children over 18 who are full-time students

1373.621 Continuation coverage, age 60 or older after five years with district

1374.58 Coverage for registered domestic partners, health service plans and health insurers

INSURANCE CODE

10116.5 Continuation coverage, age 60 or older after five years with district

10128.50-10128.59 Cal-COBRA program, disability insurance

10277-10278 Group and individual health insurance, coverage for dependent children

10604.5 Annual disclosure of fees and commissions paid

12670-12692.5 Conversion coverage

LABOR CODE

2800.2 Notification of conversion and continuation coverage

4856 Health benefits for spouse of peace officer killed in performance of duties

UNEMPLOYMENT INSURANCE CODE

2613 Education program; notice of rights and benefits

UNITED STATES CODE, TITLE 1

7 Definition of marriage, spouse

UNITED STATES CODE, TITLE 26

139C COBRA premium assistance, elimination of subsidy for high-income individuals

4980B COBRA continuation coverage

6432 COBRA premium assistance

6720C COBRA premium assistance, failure to notify health plan of cessation of eligibility

UNITED STATES CODE, TITLE 29

1161-1168 COBRA continuation coverage

UNITED STATES CODE, TITLE 42

1395-1395g Medicare benefits

CODE OF FEDERAL REGULATIONS, TITLE 26

54.4980B-1-54.4980B-10 COBRA continuation coverage

CODE OF FEDERAL REGULATIONS, TITLE 45

164.500-164.534 Health Insurance Portability and Accountability Act (HIPAA)

Management Resources:

INTERNAL REVENUE SERVICE GUIDANCE

Premium Assistance for COBRA Benefits, Notice 2009-27

WEB SITES

CSBA: http://www.csba.org

California Department of Industrial Relations: http://www.dir.ca.gov

California Employment Development Department: http://www.edd.ca.gov

Internal Revenue Service: http://www.irs.gov

U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services: http://www.cms.hhs.gov

U.S. Department of Labor: http://www.dol.gov

Policy ALAMEDA UNIFIED SCHOOL DISTRICT

adopted: June 28, 2011 Alameda, California