ARTICLE IX – FRINGE BENEFITS
Hospital, Surgical and Major Medical Insurance, and Prescription, Vision, Dental and Term Life Insurance shall be provided to full time members only unless specified otherwise hereunder.
9.01 Hospital, Surgical and Major Medical Insurance
Hospital, Surgical and Major Medical Insurance shall be provided at Board expense with the appropriate member co-pays and deductibles specified below for all full time members and their dependents unless the member notifies the Board’s Insurance Department of his intent not to be provided such coverage. This is to include currently negotiated preferred provider organization (PPO) plans as offered under Aultcare, Medical Mutual Super Med Plus and SummaCare and one closed-panel HMO plan (currently Kaiser Permanente). Coverage under each plan is on file at the offices of the Board of Education and the Akron Education Association.
Member deductibles for major medical insurance shall be as follows:
|
|
In Network |
Out of Network |
||
|
Salary* |
Single |
Family |
Single |
Family |
|
|
|
|
|
|
|
$0 - $74,999 |
$100 |
$200 |
$200 |
$400 |
|
$75,000 - $109,000 |
$200 |
$400 |
$400 |
$800 |
|
$110,000 + |
$200 |
$400 |
$400 |
$800 |
* For members of the bargaining unit, salary is the base salary the member would be paid as a classroom teacher.
Mutual Health Services shall be eliminated as a provider effective November 1, 2005. Enrollees in Mutual Health will be offered an opportunity to enroll in one of the remaining plans.
Kaiser Permanente HMO Option II
Kaiser Permanente Option II coverage will be offered in accordance with the official plan on file at the offices of the Akron Board of Education and the Akron Education Association.
When both husband and wife are employed by the Board, the Board shall provide primary and secondary coverage.
There shall be no reduction of benefits, deductibles or changes in the exclusions to the above without mutual consent of the parties.
For members enrolled under the health coverage program, there shall be included a Second Surgical Opinion and Pre-Admission Certification program. The Pre-Admission Certification program shall exclude any notification requirements in the event of emergency admittance.
9.02 Term Life Insurance
Term Life Insurance shall be provided at Board expense for all full time members and tutors and part time hourly teachers who work 20 or more hours per week.
The face valuation of the term life policy will be 1.25 times the member’s annual salary, rounded to the nearest $1,000. The annual salary is defined as the basic contract rate not including supplemental contracts for teachers or other additional payments. For tutors and part time hourly teachers, the face valuation of the term life policy will be $25,000.
Members shall be permitted to purchase additional term life insurance for themselves, their spouses, and their dependents, subject to approval of the carrier.
Insurance shall be purchased in increments of $5,000 and shall cost the member the per thousand rate charged the Board by the carrier.
There shall be an annual September enrollment period for purchases of such term life insurance. Payment for the insurance shall be through payroll deduction in ten equal payments commencing with the fourth pay period.
9.03 Income Protection Insurance
Payroll deductions for Income Protection Insurance shall be provided by the Board through the Treasurer for all members.
9.04 Tax Sheltered Annuities
The Board through the Treasurer shall provide a payroll deduction for all members who wish to participate in a Tax Sheltered Annuity Program.
The various annuity carriers shall not be permitted to solicit individual members during the work day or on Board property.
The Board and the Treasurer shall assume no obligation, financial or otherwise, arising out of any payroll deduction plan.
9.05 Prescription Insurance
The Board shall provide a Family Coverage program of prescription insurance based upon the following table of deductibles and out-of-pocket maximums:
|
Salary* |
Generic |
Name Brand |
Out of Pocket Maximum |
|
$0 - $74,999 |
$5 |
$10 |
$600 |
|
$75,000 - $109,999 |
$10 |
$20 |
$1,000 |
|
$110,000 + |
$10 |
$20 |
$1,200 |
* For members of the bargaining unit, salary is the base salary the member would be paid as a classroom teacher.
The deductibles above shall apply to prescriptions filled at retail outlets as well as mail order prescriptions.
The Plan shall cover oral contraceptives regardless of medical necessity.
The Board may provide prescription insurance through a preferred provider arrangement with any provider who has at least fifty (50) outlets available throughout the greater Akron area. If the Board provides prescription insurance through a preferred provider arrangement, it shall provide for mail order filling of prescriptions for maintenance drugs to which the deductible shall apply.
When husband and wife are employed by the Board, the insurance carrier shall issue identical prescription cards to each, both cards shall provide for family prescription coverage.
9.06 Deductions for Towpath Credit Union
Payroll deduction for Towpath Credit Union shall be provided by the Board through the Treasurer for all members who are eligible and who request such deductions.
9.07 Severance Pay
The employer shall provide severance pay for those full time members and tutors who retire from the Akron Public Schools under service provisions of the State Teachers Retirement System within three (3) years of their last work day with the Board. Excluded from this benefit shall be any employee who is convicted of a misdemeanor or felony which results in the revocation of his/her certification/license. Members who have previously retired from the Akron Public Schools and have received severance pay are also excluded.
In the event of the death of a member, the employer agrees to pay severance benefits to the member’s estate regardless of years of service.
Such pay shall be determined as follows:
A. A member who qualifies for severance pay shall receive twenty-five (25) percent of said member’s accumulation of unused sick days.
For the purpose of this computation, such sick day accumulation shall not exceed 420 days as of July 1, 2007 and 425 days as of July 1, 2008.
B. A member shall receive two (2) additional days of severance pay credit for each year said member had perfect attendance commencing July 1, 1976 through June 30, 1981.
C. A member shall receive one (1) day of severance pay credit for each year said member has perfect attendance commencing July 1, 1981.
D. Perfect attendance shall be defined as the member’s non-use of sick days between July 1 and June 30 of each year.
E. The employee’s daily rate of pay shall be either (1) determined by dividing the total annual salary (regular plus extended time) for the school year by the total number of days (regular plus extended time) for the employee, or (2) determined by dividing the regular teaching salary by 190 days. The higher daily rate of pay shall be utilized in calculating severance pay. A member who retires from a job sharing position shall have his/her severance computed on the basis of the member’s daily rate of pay had said member been employed under a full time contract.
F. Upon applying for severance pay benefits, members shall furnish to the Board a copy of their initial retirement check from the State Teachers’ Retirement System. Members shall elect: (1) to receive severance pay within two weeks after submitting their application to the Treasurer, or (2) deferring severance payment until the first payroll period of the next calendar year. Members are advised to consult their tax advisor concerning any tax implications related to selecting either option.
G. Payment and Deferral of Severance Pay
1. Notwithstanding anything in this Agreement or Board policy to the contrary, effective July 1, 2005, in accordance with the terms of this Section and any related provisions of a plan document adopted by the Board to comply with the requirements of Section 403 (b) of the Internal Revenue Code (the “IRC”), certain retiring members shall have their severance pay mandatorily paid into an annuity contract or custodial account that is designed to meet the tax-qualification requirements of IRC Section 403 (b) (a “TSA”). For purposes of this Section, this arrangement that will be effective July 1, 2005, is referred to as the “403 (b) Plan”. The Bencor 401 (a) Plan and Bencor 403 (b) Plan shall no longer be used for the deferral of severance pay for any member whose last day of employment is after June 30, 2005. The Board may elect to terminate the Bencor Plans at any time on or after July 1, 2010.
2. The terms of the 403 (b) Plan shall include the following:
A. Participation in the 403 (b) Plan shall be mandatory for any member who meets both of the following requirements:
(i) The member’s last day of employment is after the calendar year in which the member attained age 54.
(ii) The member is entitled to $1,000 or more of severance pay.
B. If a retiring member is a participant in the 403 (b) Plan, an employer contribution shall be made on his or her behalf under the 403 (b) Plan in an amount equal to the lesser of:
(i) The total amount of the participant’s severance pay, or
(ii) The maximum contribution amount allowable under the terms of the 403 (b) Plan.
To the extent that a retiring member’s severance pay exceeds the maximum amount allowable under the 403 (b) Plan, the excess amount shall be payable to the 403 (b) plan in the subsequent calendar year up to the IRC Section 403 (b) limit for that calendar year; and if any excess still remains, it shall be paid to the retiring member in cash.
C. A retiring member who is a participant in the 403 (b) Plan shall designate the TSA provider who is to receive the contribution under the 403 (b) Plan; provided, however, that any such provider must be on the approved list of TSA providers that is in effect at the time of the member’s retirement; and the Board shall continue to have authority to continue to approve or disapprove of TSA contract providers.
D. If a retiring member is entitled to have a contribution paid to the 403 (b) Plan and dies prior to such contribution being paid to the 403 (b) Plan, the contribution shall nevertheless be paid to the 403 (b) Plan and shall be paid to a Beneficiary of the member in accordance with the terms of the TSA.
3. If a member who is entitled to severance pay is not required to be a participant in the 403 (b) Plan, the member’s severance pay shall be payable to the member in cash. However, in accordance with applicable law, a member may elect to have all or a portion of the member’s severance pay deferred into a TSA or under an IRC Section 457 Plan that is otherwise made available to members; provided, however, that the amount to be deferred to a TSA for any calendar year does not exceed the contribution limitations that apply under the federal tax law for that calendar year.
4. If a member is entitled to a cash payment of severance pay, and has elected to defer some or all of it to a TSA or Section 457 Plan, and dies prior to the date such amount is paid to a TSA or Section 457 Plan, the amount that the participant had elected to be paid to a TSA or Section 457 Plan shall nevertheless be paid to the TSA or Section 457 Plan. If the member had not designated a specific TSA, it shall be paid to the last TSA which had received contributions on behalf of the deceased member; provided, however, that if the member had no TSA, the deferred amount shall instead be paid to the deceased member’s estate.
If a member is entitled to a cash payment of severance pay, to the extent that the member has not elected to defer such amount to a TSA and dies prior to the date of such payment, the amount payable in cash shall be paid to the estate of the member.
5. All contributions to the 403 (b) Plan, all deferrals to a TSA or Section 457 Plan, and all cash payments to members, shall be subject to reduction for any tax withholding or other withholding that the Treasurer, in his or her sole discretion, determines is required by law. Neither the Board, nor the AEA, guarantee any tax results associated with the 403 (b) Plan, deferrals to a TSA or Section 457 Plan, or cash payments made to a member.
9.08 Dental Insurance
The Board shall provide, at no expense to members, a dental insurance plan for members and their dependents. Effective February 1, 1989, such coverage shall be at least the equivalent of Delta Dental Stance IV-B Dental Coverage.
Members shall have the option of improving their coverage to Delta Dental Stance IV-E through co-payment in conjunction with the Board, so long as the exercise of this option does not increase the Board’s cost. Members who wish to improve coverage shall notify the Board during the annual open enrollment period for health care coverage and make arrangements for payroll deduction of the additional cost of such coverage.
Members shall have the option of enrolling in a closed-panel dental maintenance organization. The cost to the Board of such coverage shall not exceed the cost of the current traditional dental insurance program as reported by the Treasurer’s Office.
9.09 Vision Insurance
An eye care insurance program shall be provided, at Board expense, for members and their dependents for the period July 1, 2005 through June 30, 2006. Such coverage shall include:
a. 100 percent of all usual, customary and reasonable charges for annual routine examination and testing, less a $5 deductible.
b. 100 percent of all usual, customary and reasonable charges for lens and frame combinations on a bi-annual basis, less a $15 deductible.
c. $75 maximum bi-annual benefit for contact lens when such are for non-major corrective and/or cosmetic purposes
9.10 Employee Assistance Programs
An Employee Assistance Program shall be made available.
9.11 Closed Panel HMO and Preferred Provider Organizations
Through June 30, 2006, the Board shall provide one closed panel Health Maintenance Organization with annual open enrollment in May of each calendar year. Kaiser Permanente HMO Option II will be offered without employee premium contribution.
Part-time members may elect to participate in an HMO at full member cost.
The Board shall provide three PPO programs available without employee premium contribution. An annual open enrollment shall be held in May of each year. Coverage shall be with Medical Mutual Super Med Plus, Summa Health Care and AultCare.
9.12 PPO Enhancement Program
Members participating in a PPO shall be provided at no cost with the following upgrades to their health care coverage:
a. A vision insurance program that shall include exams, lenses, and frames (at an increased reimbursement level) every 12 months. The program shall include tinted lenses and photochromic lenses at no additional charge. Deductibles of $5.00 for exams and $15.00 for frames/lenses shall apply.
b. A dental program which shall include provisions of the current STANCE IV-E Plan, converted to a UCR schedule (100%, 80%, 70%). Coverage shall also provide 100% reimbursement for sealants and adult fluoride treatments.
c. Coverage within the PPO shall also include annual check-ups, blood draws, EKG, PSA, Mammograms, flu shots, diabetes education, sigmoidoscopy, and colonoscopy.
d. When both spouses are employed by the Board and where both are members of the same PPO, the $10.00 office co-pay and the $50.00 emergency room co-pay - where an injury or medical condition requires immediate attention -- shall not apply.
9.13 Health Screening Program
The Board shall provide annual health screenings for all members at no cost.
9.14 Health Benefits Advisory Committee
The Superintendent shall establish a Health Benefits Advisory Committee composed of the Executive Director – Business Affairs, Executive Director – Human Resources; Director, Fringe Benefits; Treasurer and the President or his designate. The Superintendent shall offer membership on the committee to one representative from each of the other recognized bargaining units.
The purpose of the committee is to allow joint consultation on matters concerning hospitalization, major medical, prescription, dental, vision and term life insurance coverage.
Such consultation shall include, but is not limited to: monthly monitoring of all plan costs, including claims; quarterly reviews to insure effective and efficient fringe benefit expenditures; quarterly reviews of plan performance objectives; and, annual reviews of coverage options and utilization studies and claim audits.
The committee shall determine its own meeting schedule, and shall make annual recommendations to the Superintendent regarding any aspect of the fringe benefits package.
Information on new classifications of drugs shall be shared with the committee within thirty (30) days.
The AEA representative to the committee shall be consulted when a denied prescription is not overridden by Human Resources. If no agreement is reached regarding an override, the case shall be referred to the Joint Professional Problems Committee for consideration at the next scheduled meeting.
The parties agree that the health care coverage currently in effect shall remain in effect through the 2007-2008 school year.
The Health Benefits Advisory Committee (as defined by the MOU signed by the parties and dated August 4, 2005) shall meet regularly during the 2007-2008 school year. Not later than March 1, 2008, the Committee shall identify and approve changes in the health care plan, effective July 1, 2008, which amount to a projected savings to the Board of $1.5 million. These changes shall occur in one or a combination of the following areas: prescription co-pays, mandatory mail-in for maintenance drugs, office visit co-pays, single and family annual deductibles and monthly premiums (in dollar amounts). The Committee, by consensus, may expand the list of areas. The Board’s health care consultant shall participate in the meetings and shall provide estimates of cost savings to the Committee based on various changes to the plan similar in format to that provided during the 2005 negotiations. The data to be used by the Committee shall be finalized and provided to the Committee not later than November 30, 2007. The consultant shall provide the committee with data supporting the estimated savings as well as other information s/he may be expected to routinely keep in her/his capacity as the Board’s health care consultant.
Any Health Benefits Advisory Committee member organization may retain, at its own cost and for its own purposes, a health care consultant who may attend Committee meetings.
Should the Committee be unable to reach consensus (agreement by all members of the Committee) on what constitutes a savings in the prescribed amount, the matter shall be referred to the permanent mediator for hearing. One representative from management and one representative of the bargaining units may present to the mediator. The mediator shall use information provided by the Board’s insurance consultant in his deliberations. The mediator shall issue a finding not later than April 15, 2008 which shall be adopted by the Committee and implemented by the district effective July 1, 2008. In the event the permanent mediator is unable to conduct a hearing and issue a finding by April 15, the parties shall request from FMCS the assignment of an arbitrator to hear the matter under the FMCS’s rules for expedited arbitration, and the arbitrator’s findings shall be adopted by the Committee and implemented by the district effective July 1, 2008.
9.15 Section 125 Benefit Premium Only Plan
Effective January 1, 1994, or as soon thereafter as practicable, the Board shall make a Section 125 (IRS) Benefit Premium Only Plan available to all employees for the purpose of deducting employee premium contributions on a pre-tax basis for health benefits.
9.16 Theft and Vandalism Fund
The Board agrees to establish a Theft and Vandalism Fund in the amount of $10,000. This fund shall be maintained annually at the beginning of each school year at the above-stated amount.
Members may make application to the Theft and Vandalism Fund for reimbursement of any personal insurance deductibles resulting from claims submitted for job-related theft and/or vandalism. Members may also apply for reimbursement for any documented job-related theft or vandalism that has been submitted under an insurance policy and denied coverage under a specific exclusion.
Application for reimbursement shall be made to the Fringe Benefits Office, Department of Human Resources, which shall authorize payment through the Treasurer’s Office. Documentation of the deductible payments shall be submitted with the application for reimbursement. In the case of a claim specifically excluded by the member’s insurance policy, a statement from the insurance company stating the exclusion shall be submitted with the application.
In addition to theft and vandalism, the fund may be used to reimburse any property loss suffered by a member resulting from circumstances beyond the member’s control. Questions concerning the appropriateness of reimbursement under these circumstances shall be decided by the Joint Professional Problems Committee.
Reimbursement shall be made to members each year only so long as the fund is not depleted.
9.17 Early Retirement Announcement
A $500 payment shall be made to any member who, prior to April 1, submits in writing to the Executive Director – Human Resources, his or her intent to retire between the last work day in May and June 30, and who retires between the last work day in May and June 30. Said payment shall be made within fifteen (15) days of the Board’s acceptance of the member’s retirement.
9.18 Insurance Opt-Out
Members may elect to “opt-out” of the Board-provided hospitalization and major medical insurance coverage. A member who elects to opt-out shall be compensated as follows:
A. An employee whose spouse is also an Akron Public Schools employee may opt-out and be compensated in the amount of $1,000.00, less appropriate tax deductions, per year at the end of an entire year for which he/she did not have coverage.
B. An employee who can show proof of insurance coverage may elect not to be covered by Board insurance. The employee shall be compensated in the amount of $2,500.00, less appropriate tax deductions, per year at the end of an entire year for which he/she did not have coverage.
C. The opt-out shall occur during the open enrollment period (currently May) and can be rescinded before the next open enrollment only when a triggering event occurs (loss of coverage from the other source).
D. Members may elect to opt-out of the insurance program during the annual enrollment period for the succeeding fiscal year.