Select Page

District Policies

Viewing Policy: SP 4154 Health and Welfare Benefits



HEALTH AND WELFARE BENEFITS                                                                                                                         

 

The Department 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.

 

Employees who are not in bargaining units shall receive health and welfare benefits as specified by the County Superintendent.

 

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, 300.)

 

The Department shall offer full-time employees who work an average of 30 hours or more per week and their dependents up to age 26 years a health insurance plan that includes coverage for essential health benefits, pays at least 60 percent of the medical expenses covered under the terms of the plan, and meets all other requirements of the federal Patient Protection and Affordable Care Act.

 

The County Superintendent or designee shall not use or disclose any medical information the Department 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)

 

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 Department’s group health and welfare 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 Department in administering this program.

 

Legal Reference:

EDUCATION CODE

1350 Retiree benefit fund

7000-7008 Health and welfare benefits, retired certificated employees

44041-44042 Payroll deductions for collection of premiums  

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 Approved: 2-08-19