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Fallbrook Union ESD |  BP  4354  Personnel

Health And Welfare Benefits   

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The district shall provide health and welfare benefits for certificated and classified employees in bargaining units in accordance with state and federal law and subject to negotiated employee agreements.

(cf. 4140/4240 - Bargaining Units)

(cf. 4141/4241 - Collective Bargaining Agreement)

Management, administrative, confidential and supervisory employees shall receive the same benefits as those specified in the collective bargaining agreements for certificated and classified employees.

Retired management, administrative, confidential and supervisory employees hired after December 17, 2007 shall receive the same benefits at retirement as specified in the collective bargaining agreements for certificated and classified employees.

Retired managers, confidential, administrative, and supervisory employees hired prior to December 17, 2007 are offered retirement benefits as follows:

1. The Fallbrook Union Elementary School District will provide retired management employees the same health and insurance benefits being provided other district employees to the extent stipulated under the following rules and regulations:

a. The employee must retire from the Fallbrook Union Elementary School District

b. Must be receiving a retirement from either STRS, PERS or both

c. Not eligible if employee leaves for reasons other than retirement

2. The employee must have served a minimum of at least five years with the Fallbrook Union Elementary School District just prior to retirement.

Premiums

Years of Service w/FUESD Percentage of Premium for Employee

Just Prior to Retirement Only to be Paid

Less than 5 years 0 percent

5 years 25 percent

6 years 30 percent

7 years 35 percent

8 years 40 percent

9 years 45 percent

10 years 50 percent

11 years 55 percent

12 years 60 percent

13 years 65 percent

14 years 70 percent

15 years 75 percent

16 years 80 percent

17 years 85 percent

18 years 90 percent

19 years 95 percent

20 years 100 percent

Amount to be paid by the retired employee:

1. 100 percent of dependent coverage. Applicable percentage of employee premium as determined by the above chart.

2. Retiree shall pay the full amount of this share of the annual premium in advance each year. (Education Code 44965, 44978; Labor Code 1420.2)

For purposes of granting benefits pursuant to state law, a registered domestic partner and his/her child shall have the same rights, protections, and benefits as a spouse and spouse's child. (Family Code 297.5)

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. 4112.6/4212.6/4312.6 - Personnel Files)

Continuation of Coverage

Retired certificated employees, other 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 benefit plan and dental care benefits in accordance with state and federal law.

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 FALLBROOK UNION ELEMENTARY SCHOOL DISTRICT

adopted: September 6, 2011 Fallbrook, California