§ 9500 GROUP HEALTH AND RELATED BENEFITS POLICIES

§ 9501 Our Employee Benefit Programs.

§ 9501.01 Social Security.

UHCSSD employees automatically participate in the federal Social Security plan. The UHCSSD matches the employee contribution.  Social Security benefits and rules change from time to time.  By calling the Social Security office, information on current policies and benefits can be obtained.

§ 9501.02 Utah Retirement System.

Each Full-Time Regular benefitted employee of UHCSSD shall be eligible to receive a retirement benefit provided by the Utah Retirement System.  This benefit shall be equivalent to a percentage of their base salary.  Additional contributions to the URS 401k and 457b plans are on a voluntary basis and are done by payroll deduction.

§ 9501.03 Waiting Period for Benefits Equalized.

When a new employee is hired into a full-time position or an existing employee has a Personnel Action that changed them to full-time status, they have a 30-day waiting period before they can become eligible for benefits.  The employee’s average hours worked per week during the last 60 days of the waiting period must be 30 hours or more for mandatory health insurance and 36 hours or more for all other benefits.  If the employee fails to reach the 36-hour average by the end of the 30-day period, the employee will not be eligible for benefits at that time.  The employee can then work to get their hours up for the next open enrollment which will begin another 30-day waiting period starting in October with a 60 day look back in November and December to be eligible on January 1st.

Part time employees will be measured monthly to determine if they have averaged 30 hours a week over a 30-day period that would qualify them for full time status and benefit for mandatory health insurance and 36 hours or more for all other benefits.

PRN employees will be measured annually to determine if they have averaged 30 hours a week over a 12-month period that would qualify them for full time status for mandatory health insurance and 36 hours for all other benefits.

The annual open enrollment period begins in October and ends October 31st. Employees may make changes to their benefit plans at this time.  Qualifying events such as adding a dependent after the birth of a new baby, adoption etc. may be done within 30 days of the event.  Please talk to the Payroll Manager for more information regarding open enrollment or a qualifying event.

 § 9501.04 Health, Dental, Vision Insurance.

(a) Medical Insurance Benefit: Each full-time regular employee of UHCSSD shall be provided a group medical benefit insurance coverage.  This benefit shall cover the employee and/or family (domestic partners and their children are not eligible) and ninety percent of the medical insurance premium will be paid by UHCSSD.

(b) Dental and Vision Insurance Benefit: Each full-time regular employee of UHCSSD shall be provided a group dental and vision insurance policy.  This benefit shall cover the employee and/or family (domestic partners and their children are not eligible) and the eighty five percent of the dental insurance premium will be paid by UHCSSD.

§ 9501.05 Continuing or Converting Group Health Insurance Coverage.

If an employee resigns or is terminated from UHCSSD's employ or if employee’s hours are reduced, and if this event makes employee or employee’s dependents no longer eligible to participate in the UHCSSD group health insurance plans, employee and employee’s eligible dependents may have the right to continue to participate in a COBRA program through the UHCSSD for up to eighteen months at employee’s (or employee’s dependents') expense, subject to current state and federal law.

Employee’s eligible dependents may also extend coverage, at their expense, for up to thirty-six months in the UHCSSD health insurance plans in the event of employee’s death, divorce, legal separation, or entitlement to Medicare benefits, or when a child ceases to be eligible for coverage as a dependent under the terms of the plan, subject to current state and federal law.

Should employee or employee’s eligible dependents elect to continue as members of the UHCSSD's plans, employee will be charged the applicable premium charged by the UHCSSD plan.  If this election of continuation coverage is made, employee has the right to convert this coverage to an individual policy with UHCSSD insurance carriers at the end of the continuation period, subject to current state and federal law.

Continuation coverage for employee and/or employee’s eligible dependents may end, however, if any of the following events occur:  1) failure to make timely payments of all premiums; 2) assumption of coverage under another group plan or entitlement to Medicare; or 3) termination of the UHCSSD's group health plans.

The UHCSSD group plan or a representative will provide employee with an initial notice informing employee of their rights regarding such coverage as well as contact employee concerning these options at the time termination occurs or employee’s work hours are reduced.  However, in the event employee becomes divorced or legally separated, or one of their dependents ceases to be eligible for coverage under the UHCSSD health insurance plans, employee and/or employee’s dependents are responsible for contacting the Executive Director to discuss employee’s continuation/conversion rights.

For further details regarding continuing or converting employee’s UHCSSD health insurance benefits, please contact the payroll manager.

§ 9501.06 Life Insurance, Accidental Death & Dismemberment.

Regular full-time employees are also eligible to participate in the Group Life Insurance Plan that includes accidental death and dismemberment coverage. Rates and full details of this and other life insurance programs are explained in a separate booklet.  The UHCSSD will pay for the employee's basic life and accidental death and dismemberment insurance.

§ 9501.07 Worker's Compensation.

Accidental injuries or occupational diseases arising out of or in the course of an employee's employment with UHCSSD are covered by Worker's Compensation Insurance.  The insurance coverage, subject to state and federal law, pays the following benefits.

·         Medical and drug bills

·         Allowance for lost time from work

·         Permanent loss of body function at predetermined rates for each part of the body by percentage of disability

·         At death, pays $1,500 funeral benefit and weekly allowance to the widow up to a period of six years and/or to dependents until age 18.

·         May pay for a portion of the decrease in earning capacity created by a job-related injury or disease.

Injuries or disease covered under worker's compensation are not covered by the UHCSSD's medical and health insurance.

For additional information regarding employee’s rights under Worker's Compensation, refer to the appropriate poster displayed on designated UHCSSD bulletin boards or employee may contact the Executive Director.

§ 9501.08 Unemployment Insurance.

The UHCSSD, through the Department of Workforce Services and based on the employment of the employee and state and federal law, offers unemployment compensation benefits.

To familiarize employee with unemployment rights employee may refer to the appropriate poster displayed on designated UHCSSD bulletin boards or employee may contact the Executive Director.

§ 9501.09 Employee Meals

Employees responsible for meal quality control shall eat UHCSSD prepared meals free while all other employees must pay the posted rate for meals.

§ 9501.10 Insurance Loss Prevention Benefit Policy

Benefitted employees who fall below the ACA mandated 30 hour per week average or the UHCSSD 36 hour per week average for all benefits have the opportunity to retain health and life insurance benefits temporarily by paying the full cost of the insurance premiums until hours are restored to a full-time status. This can only be done for two consecutive pay periods.

·         After each pay period, the payroll clerk will run an “hours worked report” for benefitted employees for the previous 60 days.  The clerk will review the report and note on the report any benefitted employee that has fallen below the 30 hour per week average.

·         The employee will receive a letter explaining that the employee does not have enough hours on average to retain benefits.  In the letter it will explain that the employee will need to either decline benefits or pay the full premiums of their insurance for up to two pay periods.  Full premiums mean both the employee and employer portion for both

·         health and life insurance.  If the employee’s hours are brought up to full-time status in one pay period, then only full premiums would be paid for one pay period.

·         If insurance coverage is discontinued, they may be reactivated during open enrollment.

·         If the employee does not get his /her hours up to full-time status in the two pay periods, then the employee will lose all benefits.