4254
BP
Board Policy
Health And Welfare Benefits
Classified Staff
The Governing Board recognizes that health and welfare benefits are essential to promote employee health and productivity and are an important part of the compensation offered to employees. The district shall provide health and welfare benefits for employees in accordance with state and federal law and subject to negotiated employee agreements.
Certificated management, administrative, and supervisory employees who are not in bargaining units shall receive the same health and welfare benefits as those specified in the collective bargaining agreement for certificated employees. Classified management, administrative, and supervisory employees who are not in bargaining units shall receive the same health and welfare benefits as those specified in the collective bargaining agreement for classified employees.
For purposes of granting benefits, a registered domestic partner and their child shall have the same rights, protections, and benefits as a spouse and spouse's child. (Family Code 297.5, 300)
In accordance with the federal Patient Protection and Affordable Care Act, the district shall offer full-time employees who work an average of 30 hours or more per week and their dependents up to age 26 years access to 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.
With respect to eligibility to participate in the health benefits plan or the level of health benefits provided, the district shall not discriminate in favor of employees who are among the highest paid 25 percent of all district employees. (26 USC 105; 42 USC 300gg-16)
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 district's group health and welfare benefits in accordance with state and federal law.
Unless otherwise provided for in the applicable collective bargaining agreement, covered employees and their qualified beneficiaries may receive continuation coverage by paying the premiums, dues, and other charges, including any increases in premiums, dues, and costs incurred by the district in administering the program.
Confidentiality
The Superintendent or designee shall not use or disclose any employee's medical information the district possesses 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)
Legal & Management References
State
Civ. Code 56.10-56.16 - Disclosure of information by medical providers
Civ. Code 56.20-56.245 - Use and disclosure of medical information by employers
Ed. Code 17566 - Self-insurance fund
Ed. Code 35208 - Liability insurance
Ed. Code 35214 - Liability insurance (self-insurance or a combination of self-insurance and insurance through an insurance company)
Ed. Code 44041-44042 - Payroll deductions for collection of premiums
Ed. Code 44986 - Leave of absence; state disability benefits
Ed. Code 45136 - Benefits for classified employees
Ed. Code 7000-7008 - Health and welfare benefits; retired certificated employees
Fam. Code 297-297.5 - Rights, protections, benefits under the law; registered domestic partners
Fam. Code 300 - Definition of marriage
Gov. Code 12940 - Unlawful discriminatory employment practices
Gov. Code 22750-22944 - Public Employees' Medical and Hospital Care Act
Gov. Code 53200-53210 - Group insurance
H&S Code 1366.20-1366.29 - Cal-COBRA program; health insurance
H&S Code 1367.08 - Disclosure of fees and commissions paid related to health care service plan
H&S Code 1373 - Health services plan; coverage for dependent children
H&S Code 1373.621 - Continuation coverage; age 60 or older after five years with district
H&S Code 1374.58 - Coverage for registered domestic partners; health service plans and health insurers
Ins. Code 10116.5 - Continuation coverage; age 60 or older after five years with district
Ins. Code 10128.50-10128.59 - Cal-COBRA program; disability insurance
Ins. Code 10277-10278 - Group and individual health insurance; coverage for dependent children
Ins. Code 10604.5 - Annual disclosure of fees and commissions paid
Ins. Code 12670-12692.5 - Conversion coverage
Lab. Code 2800.2 - Notification of availability of continuation health coverage
Lab. Code 4856 - Health benefits for spouse of peace officer killed in performance of duties
Unemp. Ins. Code 2613 - Disability insurance; notice of rights and benefits
Federal
1 USC 7 - Definition of marriage and spouse
26 CFR 1.105-11 - Self-insured medical reimbursement plan
26 CFR 54.4980B-1-54.4980B-10 - COBRA continuation coverage
26 CFR 54.4980H-1-54.4980H-6 - Patient Protection and Affordable Care Act
26 USC 105 - Self-insured medical reimbursement plan; definition of highly compensated individual
26 USC 4980B - COBRA continuation coverage
26 USC 4980H - Penalty for noncompliance with employer-provided health care requirements
26 USC 5000A - Minimum essential coverage
26 USC 6056 - Report of health coverage provided to employees
29 USC 1161-1168 - COBRA continuation coverage
42 USC 1395-1395g - Medicare benefits
42 USC 300gg-16 - Group health plan; nondiscrimination in favor of highly compensated individuals
42 USC 300gg-300gg95 - Patient Protection and Affordable Care Act
45 CFR 164.500-164.534 - Privacy of individually identifiable health information
Management Resources
CSBA Publication - Health Policy: Implications of Covered California for School Boards, Districts and Personnel, Governance Brief, January 2013
Internal Revenue Service Notification - 2011-1 Affordable Care Act Nondiscrimination Provisions Applicable to Insured Group Health Plans
U.S. Department of Treasury Publication - Fact Sheet: Final Regulations Implementing Employer Shared Responsibility Under the Affordable Care Act (ACA) for 2015
Website - CSBA District and County Office of Education Legal Services
Website - U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services
Website - California Employment Development Department
Website - Internal Revenue Service
Website - U.S. Department of Labor
Website - CSBA
Cross References
1340 AR Access To District Records
2121 BP Superintendent's Contract
3100 AR Budget
3530 AR Risk Management/Insurance
4030 AR Nondiscrimination In Employment
4112.6 AR Personnel Files
4112.9 AR Employee Notifications
4121 AR Temporary/Substitute Personnel
4140 BP Bargaining Units
4141.6 BP Concerted Action/Work Stoppage
4151 BP Employee Compensation
4157.1 BP Work-Related Injuries
4161 BP Leaves
4161.8 AR Family Care And Medical Leave
4212.9 BP Employee Notifications
4241.6 BP Concerted Action/Work Stoppage
4251 BP Employee Compensation
4261 BP Leaves
4261.8 AR Family Care And Medical Leave
4312.9 BP Employee Notifications
4351 BP Employee Compensation
4361 BP Leaves
4361.8 AR Family Care And Medical Leave
9250-E(1) AR Remuneration, Reimbursement And Other Benefits