Personnel Regulation 42: Benefits

PMR 42 - Form 1: Employee Accident/Injury/Illness Investigation Report

A. Eligibility. All full time probationary, regular, and provisional employees and at-will employees other than temporary (extra hire or special appointment and emergency employees) are eligible for full County contribution towards insurance and other benefits. Part-time, probationary, regular and provisional employees are eligible for prorated County benefit contributions if they work half time or more.

B. Group Insurance. The following coverage is offered:

The County also offers a Dependent Care Assistance Program and Medical Reimbursement Account for IRS approved pre-tax set-asides.

C. Mandatory Coverage. Medical, dental, vision and basic life insurance coverages are mandatory for all employees eligible for benefits. State Disability Insurance (SDI) is mandatory for certain bargaining units. For medical insurance only, the employee may waive the County’s coverage if he or she can show proof of equivalent creditable group coverage elsewhere, i.e., through a spouse’s or domestic partner’s group coverage.

D. Interaction with Section 125 of the IRS Code. The County’s benefit plans are guided by Section 125 of the IRS Tax Code and thus abide by certain rules established for pre-tax plans. All premiums paid by employees for their benefits are on a pre-tax basis, with the exception of life insurance premiums for coverage over $50,000, cash back received from their benefits package, and any County payment toward benefits of domestic partners. Employees eligible for cashback on their fringe benefit package are subject to IRS Section 125 regulations, as unused fringe is considered taxable income to the recipient. Section 125 requires that benefits which are selected at the time of employment may not be changed during the benefit year unless there is a change in employment status or life circumstances.

E. Medical Care Reimbursement Account/Dependent Care Assistance Program. Under Section 125 of the IRS Tax Code, the County also offers a Medical Care Reimbursement Account and a Dependent Care Assistance Program to benefits-eligible employees. The County's Medical Care Reimbursement Account (MRA) is a flexible spending account allowing employees to set aside pre-tax dollars up to $3,000 to pay for eligible medical, vision, and dental expenses not covered through the County health plans. The Dependent Care Assistance Program allows employees to set aside up to $5,000 to pay for eligible dependent care, including child and adult daycare. Employees are reimbursed for eligible expenses by submitting receipts to the County’s third party administrator. Administrative costs are borne by the employee.

F. Open Enrollment.

G. Long Term Care Insurance. Long term care insurance is offered once yearly to spouses, registered domestic partners, parents, parents-in-law, grandparents, grandparents-in-law, and children (at least 18 years of age) of eligible employees. This insurance provides an enhancement to medical insurance and Medicare in order to meet the costs of nursing home and in-home care for persons who are unable to care for themselves, whether due to age, disability or illness. Premiums are based on the enrollee’s age at the time of enrollment and the type of plan selected. Payroll deduction is available; however, the cost of the insurance is paid solely by the employee. This benefit is not part of the County’s Section 125 Plan.

A. Any County employee eligible for insurance benefits as set forth in 42.1.A, above, may enroll his or her dependents for coverage in any County medical, dental and/or vision insurance plan in which the employee is enrolled. Individuals who qualify as dependents on the employee’s insurance plans include the employee’s spouse, domestic partner (see Section 42.3, below) and the employee’s or their spouse’s unmarried natural born or adoptive children. Delta Dental considers dependent grandchildren to be children for coverage purposes. Newly acquired dependents, to be covered, must be enrolled within 30 days, or may apply during the annual open enrollment period for benefits (with the exclusion of dental and vision coverage for which there is not an annual open enrollment period).

B. Dependent family coverage is available for all medical, dental and vision plans and may be covered by the County’s bi-weekly family fringe benefit contribution to the employee’s benefit package. Dependent/family coverage is optional on all of the County’s health plans.

C. Children may be covered on benefits up to the end of their birthday month upon reaching age 19. Full-time students (carrying 12 or more units per semester) may stay on the County’s medical, vision, and dental plans until the end of their birthday month upon reaching age 24. Blue Cross Prudent Buyer plans allow children to remain on their parent’s plan until age 25 if they are IRS qualifying dependents, whether or not they are in school.

D. Employees are responsible for notifying the County upon a change in status of any covered dependents (i.e. divorce, child exceeding maximum eligible age, termination of a domestic partner relationship, etc.)

A. Eligibility. Any County employee eligible for insurance benefits as set forth in 42.1.A may enroll his or her registered domestic partner for coverage in any County health, dental and/or vision plan in which the employee is enrolled. A domestic partner may also participate in the County long term care insurance program. In order to qualify for coverage under the domestic partner provision, the employee and his or her domestic partner must file a Declaration of Domestic Partnership with the Secretary of State or County Clerk as noted below, and complete, sign, and file with the Human Resources Department an affidavit that includes the following basic requirements, among others:

B. Pre-Tax Treatment. Employees intending to cover a domestic partner under any of the County’s health, dental and/or vision plans should understand that as a result of applicable federal and state laws, coverage of the domestic partner may not be eligible for pre-tax treatment under Section 125 of the IRS Code and this may result in increased taxable income to the employee.

C. Enrollment. An employee and same sex domestic partner who wish to enroll in insurance benefits must file a Declaration of Domestic Partnership with the Secretary of the State. An employee and opposite sex domestic partner who wish to enroll in insurance benefits must file a Declaration of Domestic Partnership with the County Clerk of the county in which the domestic partners either live or work. An employee must also obtain from the Human Resources Department an Affidavit for Enrollment of a Domestic Partner and the applicable insurance enrollment forms. These forms must be completed and returned to the Human Resources Department, along with proof of the Declaration of Domestic Partnership during the open enrollment period or within 30 days of the Declaration of Domestic Partnership. There may be a requirement to show evidence of current coverage and/or to complete a health questionnaire. The domestic partner must enroll in the same plan(s) as the employee.

A. All employees are entitled to workers’ compensation benefits. This coverage is automatically applied and immediate and protects each employee from an illness or injury which both arises out of and occurs in the course and scope of County employment. If an employee cannot work due to a job related injury or illness, workers’ compensation insurance pays the medical bills and provides a portion of income until the employee can return to work.

B. All injuries or illness arising out of and occurring in the course and scope of employment must be reported immediately to the employee’s supervisor. Failure to report an injury may jeopardize entitlement to workers compensation. Upon notice or knowledge of an injury or illness, the supervisor will provide an employee a Workers’ Compensation Claim Form (DWC-1) within 24 hours. The supervisor will complete lines #1 and #12 on the form and retain a copy as proof of delivery. The supervisor will also complete the Employer’s Report of Occupational Injury or Illness Form (both available in the Risk Management Division of the County Administrator’s Office) and the Employee Accident Injury or Illness Investigation Report within 24 hours of the occurrence of the injury and submit them to the County Administrator’s Office, Risk Management Division, within 48 hours of the occurrence of injury or illness.

C. Marin County or its insurance carrier is not liable for the payment of workers' compensation benefits for any injury which arises out of an employee's voluntary participation in any off-duty recreational, social or athletic activity which is not a part of the employee's work-related duties. An employee may be required to sign an authorization of participation in the activity.

All probationary, regular, provisional and at-will employees other than temporary (extra hire, special appointment and emergency employees) working three-fourths time or greater are eligible for retirement benefits through the Marin County Employees’ Retirement System established under the County Employees’ Retirement Law of 1937.

Employees not eligible for retirement benefits through the Marin County Employees’ Retirement System, or elected officials who choose not to be covered by the Marin County Employees’ Retirement System, are required to participate in the alternative to social security established by the County. This program is titled the PST Retirement Program, referring to part-time, seasonal, and temporary employees,

A. Eligibility. All employees except temporary employees are eligible for tuition reimbursement. Probationary employees are eligible upon prior approval of the department head and the Director of Human Resources.

B. Eligible Courses. Eligible courses must be directly related to an employee’s current position, or to a position which may be reasonably anticipated within the near future to make a person more upwardly mobile in the County Merit System. Courses will be given by an accredited educational, technical, vocational, trade or business school or institution, whether public or private, including correspondence school.

C. Reimbursement. An employee may be reimbursed for up to 50% of the cost of tuition or registration, books and materials upon evidence of satisfactory completion of an approved course, provided funds are available in the appropriate budget category within the department.

D. Procedure. Before enrollment, an employee must complete the Request for Tuition Reimbursement Form. If the form is approved by the department head and the Director of Human Resources, the employee will receive a copy and the employee can enroll in the course and seek reimbursement. After completion of the course, the employee must furnish the department with: (1) evidence of successful course completion, i.e. copy of grade notification slip; and (2) evidence of payment of tuition, books, etc. The department submits the approval with attachments to the Auditor/Controller for payment.

E. Restrictions

A. Eligibility. Female employees holding regular positions in clerical, technical, paraprofessional, skilled craft, service – maintenance, and protective service job classes are eligible for release time for training classes if the training class lends itself to upward mobility. Such classes must increase the employee’s knowledge, skill, and/or abilities and, as a result, enhance the employee’s promotability or prepare the employee for career change with greater promotion potential. Personal enrichment classes do not qualify.

B. Release Time. Up to 20 hours per calendar year during regular work hours may be taken to attend training classes. Release time not used in the calendar year cannot be carried over.

C. Procedure. Release time must be approved in advance by the employee’s supervisor for scheduling purposes.

D. Payment Not Provided. This policy does not provide payment for any training or educational expenses resulting from NOW release time, and does not apply to training taken outside the regular work schedule.

A. Eligibility. All employees except temporary employees are eligible for participation in the Employee Assistance Program (EAP), as provided by the County. The employee’s lawful spouse or significant other, including domestic partner; unmarried, dependent children; immediate family members including parents, step-parents, siblings, grandparents, and in-laws are also eligible. Children are defined as natural, adopted, foster, or step-children age 18 or less, or age 24 or less if full-time students, or of any age if incapable of self-sustaining employment due to a mental or physical disability.

B. Confidentiality. The services are confidential. No information is reported to the County about any individual’s use of the EAP. The only report is an annual statistical Countywide utilization summary including the types of services used.

A. Eligibility. All County employees receiving insurance, covered spouses, covered domestic partners, and covered dependents are eligible for continued insurance benefits under the Consolidated Omnibus Budget Reconciliation Act (“COBRA”).

B. Coverage. An eligible employee or dependent can continue coverage in their current medical, dental and/or vision insurance plan, as well as the Medical Care Reimbursement Account, at the time of a qualifying event.

C. Qualifying Event and Period Coverage

D. Payment. Payment for coverage will be made by the employee, plus an additional 2% administrative fee. Payments are due according to the schedule determined by the Auditor/Controller’s Office. Failure to make timely payments will result in cancellation of coverage.

E. Employees over the age of 60. An employee who is over the age of 60 on the date employment ends and has worked for the County at least five years, may be eligible with his/her spouse for COBRA up to age 65.

F. Procedures. An employee must submit a COBRA coverage request form to the Human Resources Department no later than 60 days from the date of the qualifying event.

A. Insurance. Medical, dental and vision insurance, as well as the Medical Care Reimbursement Account, are available under COBRA, as set forth in Section 42.9, above. The basic life and supplemental life insurance for employee and spouse can be converted to an individual plan upon notice to the insurance carrier within 30 days of separation.

B. Retirement

C. Payment of Leave Balance

Temporary employees, defined as extra hire, special appointment and emergency employees are not eligible for any benefit other than as required by State and federal law, (e.g. worker’s compensation, alternative to Social Security, etc.).

Effective Date: January 2005
Revisions No. : 0
Prepared By: Laura Armor

Approved: ss/President, Board of Supervisors