ARTICLE 7-HEALTH AND WELFARE BENEFITS
Joint Powers Agreement Representative7.1 Coverage
The Employer shall provide each member of the unit and the member’s dependents the health and welfare benefits as provided hereinafter. While on an unpaid leave of absence, except as noted in 8.15 of Article 8 - Leaves, a unit member may participate at his/her own expense in any of the health and welfare benefits available to unit members. Unit members on a part-time assignment may participate in the health and welfare benefit plans (Sections 7.3 - 7.7) in accordance with the provisions of Section 7.2 of this Agreement. Such participation shall be contingent upon the requirements and limitations of the carriers.
7.2 Part-Time Unit Members
A part-time unit member shall receive the same health and welfare benefits as a full-time member only if the part-time member pays the District in advance on a monthly basis the difference between the member’s pro-rata share and the District’s costs of the health and welfare benefits. Part-time members who do not pay the District as described above shall receive neither the benefits nor compensation in lieu of the benefits.
7.3 Health Insurance
The Board shall provide all unit members and their dependents with a health insurance plan. Benefits and coverage will be determined by the Insurance Committee and will include:
7.3.1 Major medical benefits at no less than $2,000,000.00 or as determined by the Insurance Committee.
7.3.2 Prescription coverage as determined by the Insurance Committee.
7.3.3 Maternity coverage as determined by the Insurance Committee.
7.3.4 Psychiatric care as determined by the Insurance Committee.
7.3.5 Chiropractic services as determined by the Insurance Committee.
7.4 Dental Insurance
A dental plan and orthodontia plan shall be provided by the Board for all members of the unit and their dependents. The dental plan will include a $2,000.00 per calendar year maximum as determined by the Insurance Committee.
(The orthodontia plan to be provided will be coverage of 50% of costs up to a $2,000 lifetime maximum.)
7.5 Life Insurance
The Board shall provide all unit members with a life insurance policy. (The policy changes to a decreasing term policy when the unit member reaches the age of 65.) The yearly premium paid by the District for said policy shall be on par with the yearly life insurance premium paid for other employees of the District. Such policy shall also provide for double accidental death coverage and provide optional employee-paid dependent coverage of no less than $3,000.00 or as determined by the Insurance Committee. 15
7.6 Vision Plan
The Board shall provide all members of the unit and their dependents with a vision care plan as determined by the Insurance Committee.
7.7 Change in Carriers
Carriers may only be changed during the term of this Agreement by the Insurance Committee.
7.8 Insurance Committee
No fewer than 60 days prior to the policy renewal date, the Insurance Committee (comprised of management, certificated, and classified representative(s) will begin meeting to review current benefit plan options with the opportunity to change benefit levels, co-pay levels, providers, and/or purchasing models with mutual agreement of all parties in the committee. All determinations of the Insurance Committee are subject to ratification by the Association.
7.9 Medical Examinations and Tests
7.8.1 The cost of the initial tuberculosis examination, required as a condition of employment, shall be borne by the unit member. Thereafter, examinations for tuberculosis, as legally required, shall be paid for by the District, provided the unit member uses a District-approved agency.
7.8.2 A physical or mental examination may be required of any unit member, at District expense, anytime the employer has good reason to require such an examination.
7.10 Duration of Benefits
7.9.1 Should a unit member’s employment terminate during the school year, the member shall be entitled to continued coverage under the health, dental, and vision care plans in accordance with appropriate federal and state regulations in effect at the time. Such member shall pay the premium for the continued coverage on a month-to-month basis.
7.9.2 Should a unit member’s employment terminate following the last day of the school year and before the commencement of the ensuing school year, such employee shall be entitled to continued coverage under the life, dental, health, and vision care plans until October 1 of the ensuing year.
7.11 Disability Retirement
Any full-time member of the unit, plus his/her dependent(s), who receives the District-provided health insurance plan (Section 7.3 and Section 7.16) will also receive said benefit as provided to current active employees after disability retirement under the following conditions:
7.11.1 The unit member has been employed with the Redlands Unified School District with fifteen (15) or more years of service including up to five (5) years of out-of-district allowable service credit, or has attained the age of sixty (60) years with ten (10) or more years of District allowable service credit as a full-time employee. [Full time, for the purpose of this Article, is six and one-fourth (6 1/4) hours per day, ten (10) or twelve (12) months per year.]
7.11.2 The unit member applies for and is granted monthly disability retirement benefits from PERS. The disability retiree must provide proof of continuing receipt of PERS benefits on an annual basis upon written request by the District. 16
7.11.3 The unit member must have served as a full-time employee of the Redlands Unified School District for the five (5) years immediately preceding the disability retirement or must have served as a full-time employee for not less than ten (10) years of the fifteen (15) years immediately preceding retirement.
7.11.4 Coverage under the District-paid health insurance plan (Section 7.3) will terminate when the retired unit member reaches his/her 65th birthday or when s/he becomes eligible for full Medicare benefits.
7.11.5 Part-time unit members on disability retirement shall be entitled to such benefits on a pro-rata basis provided the part-time unit member remits to the District, monthly in advance, the difference between his/her pro-rata share and the full cost of the premium.
7.12 Early Retirement
Any full-time member of the unit, plus his/her dependent(s), who receives the District-provided health insurance plan (Section 7.3 and Section 7.16), will also receive said benefit as provided to current active employees after retirement under the following conditions:
Retirees may continue to receive dental and vision benefits (Section 7.4) at their own cost in accordance with federal and state regulations in affect at the time. In order to qualify for these retirement benefits described in this section, unit members must have first met the following conditions:
7.12.1 The unit member has attained the age of fifty-five (55) years with fifteen (15) or more years of service as a classified employee of the Redlands Unified School District.
7.12.2 The unit member will be receiving monthly retirement benefits from the Public Employees Retirement System.
7.12.3 The unit member was a full-time employee of the Redlands Unified School District for not less than ten (10) years immediately preceding retirement.
7.12.4 Coverage under the District-paid health insurance plan (Section 7.3) will terminate the first day of the month in which the retired unit member reaches his/her 65th birthday or when s/he becomes eligible for full Medicare benefits, whichever comes first.
7.12.5 Any part-time hourly classified unit member, plus his/her dependent(s), who receives a District-paid health plan on a share/cost formula, will also receive such benefits after retirement upon attainment of the age of fifty-five (55) with fifteen (15) or more years of service immediately preceding retirement as a part-time unit member in the District.
7.12.6 Spousal Coverage
Contingent upon agreement of the carrier, when a retired unit member reaches his/her 65th birthday, or when s/he becomes eligible for full Medicare benefits, whichever comes first, the retired unit member’s spouse and dependents will be eligible to continue health benefits in accordance with state and federal regulations in affect at the time. The premium will be paid by the retired unit member to the District. 17
7.12.7 Surviving Dependents
Contingent upon agreement of the carrier, when a unit member dies while under contract, his/her spouse and dependents will be eligible to continue to be covered by the District health plan (Section 7.3) if the spouse is under the age of sixty-five (65) or not eligible for Medicare, in accordance with state and federal regulations in affect at the time. The premium will be paid by the spouse of the deceased unit member to the District.
7.13
With prior notification to the immediate supervisor and provided that there is no interruption of the normal flow of business, the authorized representative of the Association shall have the right to attend meetings of the joint powers agreement for fringe benefits as an observer. The Association recognizes that this individual is not a member of the Board of Directors of the joint powers agreement and has no authority to act on behalf of the District. The release time shall be charged to the Association release time pursuant to Article 5.8 and shall be requested pursuant to provisions in Article 22.
7.14
Fringe Benefit ProrationThe District/Employee share of the Fringe Benefit costs shall be prorated based upon the hours of employment of each unit member. The proration shall be based upon contract hours only and will be as follows:
District Pays Employee Pays
6-1/4 hours or more 100%
4 - less than 6-1/4 hours 80% 20%
2-1/4 - less than 4 hours 60% 40%
Less than 2-1/4 hours 40% 60%
Payroll Deduction7.15
The District will work with the Association to determine allowable payroll deduction plans. Participation shall be voluntary and all costs shall be paid by the unit member through payroll warrant deductions. This deduction is subject to agreement by the carrier to pay any reasonable expenses relating to the cost of processing.
7.16
Annual Health and Welfare Benefit ContributionEach year the District will provide an annual contribution no less than the District’s prior year’s contribution toward each unit member’s or retirees Health and Welfare plan.
7.16.1
If the total Health and Welfare Plan premium decreases from the prior year’s contribution, the Association will select the difference to be placed in an employee benefit reserve and/or applied to the salary schedule.
7.16.2
If the total Health and Welfare Plan premium increases above the prior year’s District contribution, the following shall be implemented after agreement between the District and the Association on Total Compensation:
When Total Compensation has been increased the Association reserves the right to apply any or all of the agreed upon Total Compensation increase to raise the District’s annual contribution level to the Health and Welfare Benefits package. Should any increase to the District’s contribution not result in a contribution equal to the total cost of the Health and Welfare Benefit premiums or should no funds from Total Compensation be used to raise the District’s annual contribution level, the remaining excess costs of the Health and Welfare Benefit premium shall be borne by unit members through payroll deduction. Unit members retiring after June 30, 2009 shall also be required to cover any excess costs of their Health Benefit premium. 18
7.16.3
Should negotiation of Total Compensation not be completed by the beginning of the benefit year the District shall cover increased premiums until October 1 of the benefit year at which time it may begin charging unit members through payroll deduction any premium costs in excess of the District’s previous year’s contribution until such time as negotiations are concluded. Unit members retiring after June 30, 2009 shall also be required to cover any increased costs of their Health Benefit premium until such time as negotiations are concluded. At the conclusion of negotiations payroll deductions and retiree contributions shall be adjusted, if necessary, to be in compliance with the settlement.
7.16.4 Unit members married to other District employees that enroll in one District provided Health and Welfare Plan shall have a choice of the following options:
7.16.4.1 If plan selected has an employee contribution, the contribution will be borne by the District.
7.16.4.2 If the plan selected has no employee contribution, they shall receive medical office co-pays and/or prescriptions reimbursement for expenses incurred during the school year, up to the amount of the highest available employee contribution. The employee shall provide receipts for reimbursement within 30 days of incurring the expense. This benefit shall not accumulate from year to year.
7.16.4.3 Any difference between the highest available employee contribution and the actual contribution for the plan selected shall be provided as reimbursement for medical co-pays and/or prescriptions. The employee shall provide receipts for reimbursement within 30 days of incurring the expense. This benefit shall not accumulate from year to year.
7.16.5 Unit members married to other District employees that enroll in separate District provided Health and Welfare Plans shall receive District contribution toward the second premium not to exceed the amount of the highest available employee contribution. The unit member will be responsible for bearing all costs in excess of the District’s contribution for the second premium.