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Kingsburg Elementary Charter |  BP  4354  Personnel

Health And Welfare Benefits   

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The district shall provide health and welfare benefits for certificated and classified employees. Benefits will be provided in accordance with negotiated employee agreements, if applicable.

The Superintendent or designee shall maintain the confidentiality of employee health records in accordance with law.

(cf. 4112.6/4212.6/4312.6 - Personnel Files)

The district participates in a health insurance program for qualified employees. The program includes the payment of health insurance premiums for qualified employees, and payment of premiums for dependents up to the District cap. The amount the district contributes towards insurance coverage will vary from year-to-year according to premium changes, and the amount set annually by the Governing Board. Qualifications and benefits are as follows:

Certificated full-time duty hours = 7 hours per day

Classified full-time daily hours = 8 hours per day

1. Health/Dental/Vision Coverage - Full District Cap

In order to qualify for full district cap, an employee must work at least 86 percent of a full-time equivalent duty day and at least 10 months per year.

2. Health/Dental/Vision Coverage - One-Half of District Cap

In order to qualify for one-half of the district cap, an employee must work from 75 percent to 85 percent of a full-time equivalent duty day and at least 10 months per year.

3. No offer of coverage - No District Cap

Any employee working less than 75 percent of a full-time equivalent duty day or less than 10 months per year does not qualify to participate in the district health insurance program.

4. Affordable Care Act (ACA) Eligibility - No District Cap

Employees who average 30 hours per week or more during the district's measurement period will be offered participation in the district's health insurance program during the district's established stability period. The district will not provide any contribution toward the district cap and the employee will be responsible for the full monthly premium.

Additional Qualifications

Employees not enrolled in the health insurance program as of June 1, 1998, must meet the above qualifications to participate. Employees eligible or participating in the health insurance program as of June 1, 1998, may remain in the program on a continuing basis or join during a later enrollment period. Overtime will not qualify an employee on eligibility for health benefits participation.

Qualified employees may enroll in the district sponsored health insurance program during open enrollment (August/September) with coverage beginning October 1.

Qualified employees hired during the school year may enroll in the district sponsored health insurance program during the month following their employment hire date with coverage beginning the first day of the month following enrollment.

The Superintendent or designee shall advise all employees of their rights and responsibilities related to continuing their health insurance benefits when their eligibility changes.

Termination of Coverage

If an employee terminates during the school year, district-sponsored health insurance coverage will end the last day of the month in which the employee resigns. If an employee completes a school year, insurance will end as follows:

12 month employee - June 30

11 month employee - July 31

10 month employee - August 31

Retired Certificated Employees

Retirees who qualify shall receive paid benefits as per Board Policy 4254.1. For those who do not qualify, benefits shall be available to retirees and their spouses, and the spouses of employees who died while employed by the district. (Education Code 7000)

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 Records)

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 Deductions in salary payment as requested by employee

44042 Payroll deductions for collection of insurance premium

44986 Leave of absence for disability allowance applicant

45136 Benefits for classified

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

297.5 Rights, protections and benefits under law

GOVERNMENT CODE

22750-22944 Public Employees' Medical and Hospital Care Act, especially:

53200-53210 Group insurance

HEALTH AND SAFETY CODE

1366.20-1366.28 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 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

10128.50-10128.58 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 26

105 Self-insured medical reimbursement plan; definition of highly compensated individual

4980B COBRA continuation coverage

4980H Penalty for noncompliance with employer-provided health care requirements

5000A Minimum essential coverage

6056 Report of health coverage provided to employees

UNITED STATES CODE, TITLE 29

1161-1168 COBRA continuation coverage

UNITED STATES CODE, TITLE 42

300gg-300gg95 Patient Protection and Affordable Care Act, especially:

300gg-16 Group health plan; nondiscrimination in favor of highly compensated individuals

1395-1395g Medicare benefits

CODE OF FEDERAL REGULATIONS, TITLE 26

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

54.4980H-1-54.4980H-6 Patient Protection and Affordable Care Act

1.105-11 Self-insured medical reimbursement plan

CODE OF FEDERAL REGULATIONS, TITLE 45

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

Management Resources:

CALIFORNIA SCHOOL BOARDS ASSOCIATION PUBLICATIONS

Health Policy: Implications of Covered California for School Boards, Districts and Personnel, Governance Brief, January 2013

INTERNAL REVENUE SERVICE NOTICES

2011-1 Affordable Care Act Nondiscrimination Provisions Applicable to Insured Group Health Plans

U.S. DEPARTMENT OF TREASURY PUBLICATIONS

Fact Sheet: Final Regulations Implementing Employer Shared Responsibility Under the Affordable Care Act (ACA) for 2015

WEB SITES

CSBA: http://www.csba.org

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 KINGSBURG ELEMENTARY CHARTER SCHOOL DISTRICT

adopted: June 11, 1998 Kingsburg, California

revised: July 11, 2005

revised: January 19, 2010

first reading: June 16, 2016

revised: August 11, 2016