ARTICLE 4
HEALTH AND WELFARE

4.1 Health Benefit Plan

A.  Health Contribution Amounts

1.   Through December 31, 2003, the State agrees to pay the following contribution for health benefits. To be eligible for this contribution, an employee must positively enroll in a health plan administered or approved by CalPERS.

a.   The State shall pay up to $226 per month for coverage on an eligible employee.

b.   The State shall pay up to $450 per month for coverage of an eligible employee plus one dependent.

c.   The State shall pay up to $589 per month for coverage of an employee plus two or more dependents.

2.   Effective January 1, 2004 through December 31, 2005, the employer health benefits contribution for each employee shall be an amount equal to 80 percent of the weighted average of the Basic health benefit plan premiums for a State active civil service employee enrolled for self-alone, during the benefit year to which the formula is applied, for the four Basic health benefit plans that had the largest State active civil service enrollment, excluding family members, during the previous benefit year.  For each employee with enrolled family members, the employer shall contribute an additional 80 percent of the weighted average of the additional premiums required for enrollment of those family members, during the benefit year to which the formula is applied, in the four Basic health benefit plans that had the largest State active civil service enrollment, excluding family members, during the previous benefit year. 

      Effective January 1, 2006, the employer health benefits contribution for each employee shall be an amount equal to 85 percent of the weighted average of the Basic health benefit plan premiums for a State active civil service employee enrolled for self-alone, during the benefit year to which the formula is applied, for the four Basic health benefit plans that had the largest State active civil service enrollment, excluding family members, during the previous benefit year.  For each employee with enrolled family members, the employer shall contribute an additional 80 percent of the weighted average of the additional premiums required for enrollment of those family members, during the benefit year to which the formula is applied, in the four Basic health benefit plans that had the largest State active civil service enrollment, excluding family members, during the previous benefit year. 

3.   The parties agree to work cooperatively with CalPERS and the health plans to control premium increases.     

B.   Dental Benefits Plans

1.   Contribution Amounts

a.   Effective July 1, 2001, the State agrees to pay the following contributions for dental benefits. To be eligible for this contribution, an employee must positively enroll in a dental plan administered by the Department of Personnel Administration.

(1)  The State shall pay up to $30.70 per month for coverage of an eligible employee.

(2)  The State shall pay up to $55.60 per month for coverage of an eligible employee plus one dependent.

(3)  The State shall pay up to $81.38 per month for coverage of an eligible employee plus two or more dependents.

b.   The employee will pay any premium amount for the dental plan in excess of the State's contribution, except that the employee's share of the cost shall not exceed twenty-five percent (25%) of the total premium.

2.   Coverage During First 24 Months of Employment

      Employees appointed into State service who meet the above eligibility criteria, will not be eligible for enrollment in the State-sponsored indemnity or preferred provider option plan until they have completed twenty-four (24) months of employment without a permanent break in service, during the twenty-four (24) month qualifying period. However, if no alternative plan or prepaid plan is available within a fifty (50) mile radius of the employee's residence, the employee will be allowed to enroll in the indemnity or preferred provider option plan.

C. Vision Benefit Plan

      Program Description

      The employer agrees to provide a vision benefit to eligible employees and dependents.  The vision benefit provided by the State shall have an employee co-payment of ten dollars ($10) for the comprehensive annual eye examination and twenty-five dollars ($10) for the comprehensive annual eye examination and twenty-five dollars ($25) for materials.

4.2 Health Benefit Plan - Eligibility for Benefits

A. Health Benefits - Eligibility for Benefits

1.   Employee Eligibility

      For purposes of this section, 'eligible employee' shall be defined by the Public Employees' Medical and Hospital Care Act.

2.   Permanent Intermittent (PI) Employees

A.  Initial Eligibility

      A permanent intermittent employee will be eligible to enroll in health benefits during each calendar year if the employee has been credited with a minimum of 480 paid hours in one of two PI control periods. For purposes of this section, the control periods are January 1 through June 30 and July 1 through December 31 of each calendar year. An eligible permanent intermittent employee must enroll in a health benefit plan within sixty (60) days from the end of the qualifying control period.

B.   Continuing Eligibility

      To continue health benefits, a permanent intermittent employee must be credited with a minimum of 480 paid hours in a control period or nine hundred sixty (960) paid hours in two consecutive control periods.

3.   Family Member Eligibility

      For purposes of this section, 'eligible family member' shall be defined by the Public Employees' Medical and Hospital Care Act and includes domestic partners that have been certified with the Secretary of State's office in accordance with AB 26 (Chapter 588, Statutes of 1999).

B.   Dental Benefits - Eligibility for Benefits

1.   Employee Eligibility

      Employee eligibility for dental benefits is the same as that prescribed for health benefits under Section 4.2 A.1 and 2 of this agreement.

2.   Family Member Eligibility

      Family member eligibility for dental benefits is the same as that prescribed for health benefits under Section 4.2 A.3 of this agreement.

C.   Vision Benefit - Eligibility for Benefits

1.   Employee Eligibility

      Employee eligibility for vision benefits is the same as that prescribed for health benefits under Section 4.2 A.1. and 2. of this agreement.

2.   Family Member Eligibility

      Family member eligibility for vision benefits is the same as that prescribed for health benefits under Section 4.2. A.3 of this agreement.

4.3  Non-Industrial Disability Insurance

A.  Non-Industrial Disability Insurance (NDI) is a program for State employees who become disabled due to non-work related disabilities as defined by Section 2626 of the Unemployment Insurance Code.

B.   For periods of disability commencing on or after October 1, 1984, eligible employees shall receive NDI payments at 60% of their full pay, not to exceed $135 per week, payable monthly for a period not exceeding 26 weeks for any one disability benefit period. An employee is not eligible for a second disability benefit due to the same or related cause or condition unless they have returned to their regular time base, and work for at least ten (10) consecutive work days. Paid leave shall not be used to cover the ten (10) work days.

C.   The employee shall serve a ten (10) consecutive calendar day waiting period before NDI payments commence for each disability. Accrued vacation or sick leave balances may be used to cover this waiting period. The waiting period may be waived commencing with the first full day of confinement in a hospital or nursing home for at least one full day. A full day is defined as a 24-hour period starting at midnight.

D.  If the employee elects to use vacation, annual leave, personal leave or sick leave credits prior to receiving NDI payments, he or she is not required to exhaust the accrued leave balance.

E.   Following the start of NDI payments, an employee may, at any time, switch from NDI to sick leave, vacation leave, annual leave, personal leave, or catastrophic leave but may not return to NDI until that leave is exhausted.

F.   In accordance with the State's 'return to work' policy, an employee who is eligible to receive NDI benefits and who is medically certified as unable to return to full-time work during the period of his or her disability, may upon the discretion of his or her appointing power work those hours (in hour increments) which, when combined with the NDI benefit, will not exceed 100% of their regular 'full pay.' This does not qualify the employee for a new disability period under subsection B. of this section. The appointing power may require an employee to submit to a medical examination by a physician or physicians designated by the Director of the Employment Development Department for the purpose of evaluating the capacity of the employee to perform the work of his or her position.

G.   If an employee refuses to return to work in a position offered by the employer under the State's Injured State Worker Assistance Program, NDI benefits will be terminated effective the date of the offer.

H.  Where employment is intermittent or irregular, the payments shall be determined on the basis of the proportionate part of a monthly rate established by the total hours actually employed in the 18 monthly pay periods immediately preceding the pay period in which the disability begins as compared to the regular rate for a full-time employee in the same group or class. An employee will be eligible for NDI payments on the first day of the monthly pay period following completion of 960 hours of compensated work.

I.    All other applicable Department of Personnel Administration laws and regulations not superseded by these provisions will remain in effect.

J.    Upon approval of NDI benefits, the State may issue an employee a salary advance if the employee so requests.

K.  All appeals of a denial of an employee's NDI benefits shall only follow the procedures in the Unemployment Insurance Code and Title 22. All disputes relating to an employee's denial of benefits are not grievable or arbitrable. This does not change either party's contractual rights which are not related to the denial of an individual's benefits.

4.4 Enhanced Non-Industrial Disability Insurance - Annual Leave

A.  This ENDI provision is only applicable to employees participating in the annual leave program referenced in section 5.12.

B.   Enhanced Non-Industrial Disability Insurance (ENDI) is a program for State employees who become disabled due to non-work related disabilities as defined by Section 2626 of the Unemployment Insurance Code.

C.   For periods of disability commencing on or after January 1, 1989, eligible employees shall receive ENDI payments at 50% of their gross salary, payable monthly for a period not exceeding 26 weeks for any one disability benefit period. An employee is not eligible for a second disability benefit due to the same or related cause or condition unless they have returned to their regular time base, and work for at least ten (10) consecutive work days. Paid leave shall not be used to cover the ten (10) work days. Disability payments may be supplemented with annual leave, sick leave or partial payment to provide for up to 100% income replacement. At the time of an ENDI claim, an employee may elect either the 50% ENDI benefit rate or a supplementation level of 75% or 100% at gross pay. Once a claim for ENDI has been filed and the employee has determined the rate of supplementation, the supplemental rate shall be maintained throughout the disability period.

D.  The employee shall serve a seven (7) consecutive calendar day waiting period before ENDI payments commence for each disability. Accrued paid leave or CTO leave balances may be used to cover this waiting period. The waiting period may be waived commencing with the first full day of confinement in a hospital, nursing home, or emergency clinic for at least one full day. A full day is defined as a 24-hour period starting at midnight.

E.   If the employee elects to use annual leave or sick leave credits prior to receiving ENDI payments, he or she is not required to exhaust the accrued leave balance.

F.   Following the start of ENDI payments, an employee may at any time switch from ENDI to sick leave or annual leave, but may not return to ENDI until that leave is exhausted.

G.   In accordance with the State's 'return to work' policy, an employee who is eligible to receive ENDI benefits and who is medically certified as unable to return to their full-time work during the period of his or her disability, may upon the discretion of his or her appointing power, work those hours (in hour increments) which when combined with the ENDI benefit will not exceed 100% of their regular 'full pay.' This does not qualify the employee for a new disability period under C. of this section. The appointing power may require an employee to submit to a medical examination by a physician or physicians designated by the Director of the Employment Development Department for the purpose of evaluating the capacity of the employee to perform the work of his or her position.

H.  If an employee refuses to return to work in a position offered by the employer under the State's Injured State Worker Assistance Program, ENDI benefits will be terminated effective the date of the offer.

I.    Where employment is intermittent or irregular, the payments shall be determined on the basis of the proportionate part of a monthly rate established by the total hours actually employed in the 18 monthly pay periods immediately preceding the pay period in which the disability begins as compared to the regular rate for a full-time employee in the same group or class. An employee will be eligible for ENDI payments on the first day of the monthly pay period following completion of 960 hours of compensated work.

J.    All other applicable Department of Personnel Administration laws and regulations not superseded by these provisions will remain in effect.

K.  Upon approval of ENDI benefits, the State may issue an employee a salary advance if the employee so requests.

L.   All appeals of an employee's denial of ENDI benefits shall only follow the procedures in the Unemployment Insurance Code and Title 22. All disputes relating to an employee's denial of benefits are not grievable or arbitrable. This does not change either party's contractual rights which are not related to an individual's denial of benefits.

M.  Employees who become covered in the annual leave program while on an NDI claim shall continue to receive NDI pay at the old rate for the duration of the claim.

N.  Employees who do not elect the annual leave program will receive NDI benefits in accordance with the current program in section 4.3 and such benefits are limited to $135.00 per week.

4.5 Cost Containment Committee

The State and PECG agree to continue the Joint Labor/Management Benefits Committee. The committee shall consist of an equal number of labor and management representatives. The committee shall be advisory in nature. The purpose of the committee shall be to provide policy advice and recommendations on the health benefits program to the Public Employees' Retirement System (PERS) and on the dental, vision, employee assistance, and legal services benefits to the Department of Personnel Administration (DPA). This committee will not provide advice on the Worksite Health Promotion or Savings Plus Deferred Compensation programs.

PECG shall be entitled to one (1) representative who is qualified to provide policy advice and to commit his/her organization to a course of action decided by the committee. An appropriate number of management representatives shall be appointed by DPA.

Meetings shall be scheduled at least quarterly, and a specific agenda of issues to be discussed will be developed and distributed in advance of each meeting. Additional meetings may be scheduled on an as-needed basis.

The committee shall be co-chaired by a Labor representative selected by union committee members and a Management representative appointed by DPA.

PECG representatives shall serve without loss of compensation. All other expenses shall be the responsibility of each party participating on this committee.

4.6 Employee Assistance Program

A.  The State recognizes that alcohol, drug abuse, and stress may adversely affect job performance and are treatable conditions. As a means of correcting job performance problems, the State may offer referral to treatment for alcohol, drug and stress-related problems such as marital, family, emotional, financial, medical, legal or other personal problems. The intent of this Section is to assist an employee's voluntary efforts to treat alcoholism or a drug-related or stress related problem so as to retain or recover his/her value as an employee.

B.   Each department head or designee shall designate an Employee Assistance Program Coordinator who shall arrange for programs to implement this section. Employees who are to be referred to an Employee Assistance Program Coordinator will be referred by the appropriate management personnel, or may refer themselves on a voluntary basis. An employee undergoing alcohol, drug, or mental health treatment, upon approval, may use accrued sick leave, compensating time off credits and vacation leave credits for such a purpose. Leaves of absence without pay may be granted by the department head or designee upon the recommendation of the Employee Assistance Program Coordinator if all sick leave, vacation and compensating time off have been exhausted and the employee is not eligible to use Industrial Disability Leave or Non-Industrial Disability Insurance.

C.   Medical records concerning an employee's treatment for alcoholism, drug or stress-related problems shall remain confidential and shall remain separate from other personnel materials.

4.7 FlexElect Program

A.  Program Description

1.   The State agrees to provide a flexible benefits program (FlexElect) under Internal Revenue Code Section 125 and related Sections 105(b), 129, and 213(d). All participants in the FlexElect Program shall be subjected to all applicable Federal statutes and related administrative provisions adopted by DPA. The administrative fee paid by the participants will be determined each year by the Director of the Department of Personnel Administration.

2.   Employees who meet the eligibility criteria stated in Section 4.7 (B)(1) will be eligible to enroll into a Cash Option Program (a monthly cash payment) in lieu of health and/or dental coverage under the FlexElect Program.

3.   Employees who meet the eligibility criteria stated in Section 4.7 (B)(1) will be eligible to enroll into a Medical Reimbursement Account and/or a Dependent Care Reimbursement Account.

B.   Employee Eligibility

1.   All eligible employees must have a permanent appointment with a time-base of half time or more and have permanent status, or if a limited term or a temporary authorized (TAU) position, must have mandatory return rights to a permanent position.

2.   Permanent Intermittent (PI) employees shall only participate in the Cash Option and will be eligible to receive a six month cash payment for the first control period of each plan year. PI's choosing the Cash Option will qualify for the cash if they meet all of the following criteria:

a.   Must be eligible to enroll in health and/or dental coverage as of January 1 of the Plan Year for which they are enrolling; and,

b.   Must have a PI appointment which is effective from January 1 through June 30 of the Plan Year for which they are enrolling; and,

c.   Must be paid for at least four hundred eighty (480) hours during the January through June control period for the Plan Year in which they are enrolling; and,

d.   Must have completed an enrollment authorization during the FlexElect Open Enrollment Period or as newly eligible.

3.   Section 4.7 (B)(2) is not grievable or arbitrable.

4.8 Long-Term Care Insurance Plans

Employees in classes assigned to Bargaining Unit 9 are eligible to enroll in any long-term care insurance plan sponsored by the Public Employees Retirement Board. The employee's spouse, parents, and the spouse's parents are also eligible to enroll in the plans, subject to the underwriting criteria specified in the plan.

The long-term care insurance premiums and the administrative cost to the State shall be fully paid by the employee and are subject to payroll deductions. 

4.9 Pre-Tax of Health/Dental Premiums

Employees who are enrolled in any health and/or dental plan which requires a portion of the premium to be paid by the employee, will automatically have their out-of-pocket premium costs taken out of their paycheck before Federal, State and social security taxes are deducted. Employees who choose not to have their out-of-pocket costs pre-taxed, must make an election not to participate in this benefit.

4.10 Group Legal Services Plan

Bargaining Unit 9 employees shall be eligible to enroll in the State-sponsored Group Legal Services Plan. This plan is available on a voluntary, after-tax, payroll deduction basis, with all costs being paid by the employee, including a service charge for the costs of administering the plan.

4.11 1959 Survivors- Benefits - Fifth Level

A.  Employees in this unit who are members of the Public Employees' Retirement System (PERS) will be covered under the Fifth Level of the 1959 Survivors' Benefit, which provides a death benefit in the form of a monthly allowance to the eligible survivor in the event of death before retirement. This benefit will be payable to eligible survivors of current employees who are not covered by Social Security and whose death occurs on or after the effective date of the Memorandum of Understanding for this section.

B.   The contribution for employees covered under this new level of benefits will be $2 per month. The rate of contribution for the State will be determined by the PERS Board.

C.   The survivors' benefits are detailed in the following schedule:

1.   A spouse who has care of two or more eligible children, or three or more eligible children not in the care of spouse ' $1,800

2.   A spouse with one eligible child, or two eligible children not in the care of the spouse    ' $1,500

3.   One eligible child not in the care of the spouse; or the spouse, who had no eligible children at the time of the employee's death, upon reaching age 62  - $750.

4.12 Rural Subsidy Program

A.  The State shall continue a Rural Health Care Equity Program for Bargaining Unit 9 members, which may be administered in conjunction with a similar program for State employees in other bargaining units, for excluded employees and for annuitants. The Department of Personnel Administration (DPA) shall administer any fund involving Bargaining Unit 9 members.

B.   The program shall operate in the following fashion:

1.   The State shall contribute $1500 per year on behalf of each bargaining unit member (employee) who lives in a defined rural area, as more definitely described in Government Code Section 22825.01.

(a.) Payments shall be on a monthly basis.

(b.) For permanent employees, as in the 'Medical Reimbursement Account' situation, the employee does not have to wait for reimbursement of covered medical expenses until the full amount has been deposited.

2.   As to any employee who enters State service or leaves State service during a fiscal year, contributions for such employee shall be made on a pro rata basis. A similar computation shall be used for anyone entering or leaving the bargaining unit (e.g., promotion in mid-fiscal year).

3.   The money shall be available for use as defined in Government Code Section (GC) 22825.01.

4.   A Rural Healthcare Equity Program will be established with a separate account for Bargaining Unit 9 members, as one of several similar accounts.

5.   Each Unit 9 employee shall be able to utilize up to $1500 per fiscal year, pursuant to GC section 22825.01, but with the exceptions for greater utilization hereafter noted. The pro rata limitation pursuant to Section 4.12.B.2 is applicable here.

6.   If an employee does not utilize the complete $1500 pursuant to the procedures and limitations described in GC section 22825.01, then the unused monies shall be put in a 'same year pool.' That same year pool shall be utilized to pay those who have incurred eligible health care expenses in excess of the $1500, but again according to the procedures and limitations in GC section 22825.01. The monies in the same year pool would be distributed at the end, or even soon after, each fiscal year to that group of employees who had expenses in excess of $1500 in the relevant fiscal year. Those monies shall be distributed on a pro tanto (pro rata) basis.

(a.) Any employee not in Bargaining Unit 9 all year shall receive credit under this paragraph utilizing the same pro rata formula as in Section 4.12.B.2  above.

(b.) If an employee is entitled to less than twenty five dollars ($25) under Section 4.12.B.6, the money shall instead go into next year's fund pursuant to Section 4.12.B.7 hereafter.

7.   If monies still remain after a distribution to such employees (i.e., all employees who spent more than $1500 as provided in GC section 22825.01 were completely reimbursed), then those surplus monies shall be rolled over into the next fiscal year's funds available for distribution to employees whose expenses pursuant to the statute exceed $1500 in such subsequent year. Similar 'rollovers' would occur in any years where all employees were completely reimbursed (or had payments made on their behalf) pursuant to GC section 22825.01 and monies still remained in the pool.