Catastrophic Illness and Injury Bank (CIIB) Guidelines for What is CIIB anyway?

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1 Catastrophic Illness and Injury Bank (CIIB) Guidelines for 2015 What is CIIB anyway? CIIB is a bank of pooled leave contributed by regular full and part-time NHR employees. Participation in CIIB is voluntary and is elected by employees annually at Open Enrollment (or at time of hire). This bank allows employees to continue their wages and insurance benefits after they have exhausted their own PTO/PSB leave balances if they (or a family member they care for) are unable to work due to an illness or injury which keeps them out of work for 3 weeks or more. These guidelines are in effect for the period 1/1/15-12/31/15 and should answer most questions you have about CIIB. If you have any additional questions, please call Linda Milroy, Human Resources Coordinator at (845) Ext or her at lmilroy@nhrny.org. Who is Eligible to Apply for CIIB Benefits? 1. All of NHR s regular full and part-time employees are eligible for membership in the CIIB. 2. Membership is elected on an annual basis at Open Enrollment (or at time of hire) and requires the employee to donate leave (either PTO or PSB) to the CIIB. For 2014, employees will be required to donate 8 hours (if full-time) or 4 hours (if part-time). Full-time employees who so wish may elect to contribute an additional 8 hours (for a total of 16) to the CIIB. Part-time employees who so wish may elect to contribute an additional 4 hours (for a total of 8) to the CIIB. 3. Only members of the CIIB who have completed their probationary periods may request CIIB benefits. 4. All applicants must have exhausted all PTO/PSB leave before applying for CIIB benefits.

2 5. Only members who have an illness/injury which is expected to keep them away from work for at least 21 days (3 calendar weeks) are eligible to request CIIB benefits. If the employee is applying due to an illness or injury of a family member, then the family member must have an illness or injury which prevents them from working for at least 21 days (3 calendar weeks). This 21day (3 calendar week) period includes any time during which the employee was using PTO/PSB leave. 6. Members who have purchased voluntary short-term disability insurance are eligible to make requests on the same basis as other members. 7. Members are eligible for a maximum of 12 weeks of paid CIIB benefits (480 hours for full-time employees and 240 hours for part-time employees). Once the maximum benefit has been reached, members are not eligible to reapply for CIIB benefits until the CIIB has been fully reimbursed for the benefits granted. How Do I Apply For CIIB Benefits? 1. Complete a CIIB Request form and submit it along with required medical proof to the Director of Human Resources. 2. CIIB Request forms are available at each NHR site as well as the West Road administrative offices. 3. Medical proof must accompany the request for CIIB benefits. Required medical proof consists of a letter from the employee s (or family member s) treating physician which clearly provides the following: (1) diagnosis; (2) expected duration of disability with anticipated return date (if any); and, (3) a statement from the physician that the individual is unable to work. Only letters from medical doctors (an MD) will be accepted. Requests for CIIB benefits not accompanied by required medical proof will be denied. 4. If an employee is applying for CIIB leave in order to be the primary care giver to an immediate family member with a catastrophic illness or injury, the request must include a statement that the employee is the primary care giver to this person. How Are Requests Considered? Can I Appeal? 1. NHR shall reply to such requests within five (5) business days of NHR s receipt of a completed application for CIIB benefits. NHR may approve, deny or approve with modifications any request made to it in a manner consistent with these guidelines and the NHR Personnel Practices Manual and collective bargaining agreements. 2. If an employee is denied CIIB leave, that employee may appeal to the CIIB Committee for reconsideration should they believe that NHR erred in applying CIIB

3 guidelines and applicable provisions of NHR s Personnel Practices Manual or collective bargaining agreement or if the employee has additional proof to submit or the employee s circumstances have changed since NHR made its initial determination. The CIIB Committee shall respond to the employee s appeal within ten (10) business days of its receipt of the employee s written notice of appeal. This notice may be delivered to any member of the CIIB Committee. How Will CIIB Benefits Effect Other Benefits I Have? 1. Workers Compensation or NYS short-term disability short-term disability payments received by NHR while the employee is drawing time from bank will be converted (according to NHR s standard practices) into leave to replenish the CIIB bank. 2. If the employee is receiving voluntary short-term disability insurance benefits, the maximum CIIB benefit will be the sum necessary to bring the employee to 100% of their pre-disability earnings at NHR. It is the employee s responsibility to let Human Resources know that they have received a disability check. 3. While on CIIB leave, the employee will NOT accrue PTO leave. 4. While on CIIB leave, the employee s medical and other insurance shall continue as if the employee were actively at work (and any required payroll deductions will continue). 5. FMLA leave begins when an employee has exhausted all available PTO or PSB leave. FMLA leave may continue beyond the period of approved CIIB leave. The Human Resources Department will provide more information to employees on FMLA leave. 6. CIIB leave will run concurrently with approved Disability Leave, Family Care Leave and Workers Compensation Leave. See the applicable sections of the NHR Personnel Practices Manual or your collective bargaining agreement for more information. Will I Have to Contribute More Time into CIIB During 2015 and Beyond? 1. Initially, all members of the CIIB for will be asked to donate one day of leave (8 hours for full-time and 4 hours for part-time employees). 2. Should the balance of the CIIB bank fall to a level that the CIIB Committee determines threatens the solvency of the bank, the CIIB Committee may request that CIIB members contribute the greater of 1 additional hour (0.50 hours for part-time employees) of leave (PTO or PSB) or the minimum contribution necessary

4 to bring the CIIB into a solvent position. A CIIB member using CIIB leave when a call for an additional contribution is made will be allowed to make the contribution once they return to work following their CIIB leave. 3. Should an employee refuse to contribute leave when requested, that employee will cease to be a member of the CIIB. Such an employee could elect to rejoin the CIIB in future years (making the election at the annually held Open Enrollment meetings). 4. The CIIB Committee will establish a contribution rate for membership in CIIB on an annual basis. This rate will be disclosed at Open Enrollment information meetings. The Committee shall provide members with quarterly reports showing CIIB balances at the close of the previous calendar quarter. Will I Have to Pay Back The CIIB Bank If I Receive CIIB Benefits? 1. Employees who receive CIIB benefits shall reimburse the CIIB once they return to work at NHR. The reimbursement will be taken out of ongoing PTO accruals each pay period (including, if necessary, the PTO accrual occurring on 1/1 of each calendar year). During each pay period in which reimbursement to CIIB will be made, 50% of ongoing PTO accruals will be applied toward the reimbursement, the remaining 50% will be left in the employee s PTO bank for use by the employee. 2. Employees who wish to reimburse the CIIB on an accelerated basis from that described above, may make lump sum reimbursements or increase their reimbursement percentage from 50% of PTO accruals to a higher level. Employees must notify Human Resources should they wish to accelerate their reimbursement to CIIB. 3. In calculating how much an employee will need to reimburse CIIB, Human Resources shall reduce the employee s reimbursement obligations for each hour of time recovered through benefits paid to NHR by insurance carriers for Workers Compensation or disability claims for that employee while they were using CIIB benefits. 4. Should an employee s employment with NHR terminate prior to the time that the reimbursement obligation to the CIIB had been fully satisfied, any unused PTO/PSB leave shall be used to satisfy the departing employee s reimbursement obligations. If any PTO balance remains once reimbursement has been made, disposition will proceed in the manner specified by the NHR Personnel Practices Manual or collective bargaining agreement (if applicable).

5 REQUEST FOR CIIB BENEFITS Section 1 Employee Identification Section Employee Name: Employee Address: Employee Telephone Number: Worksite: Full or Part Time (circle one) 1. This request is made because of: Section 2 Description of Need my illness/injury the illness/injury of an immediate family member (circle one) 2. My relationship to the person with the catastrophic illness or injury is : child/step child grandparent parent/step parent/ mother-in law/ father-in-law sibling/step-sibling self spouse/domestic partner (circle one) 3. I have exhausted all paid leave (PTO and PSB) and request CIIB benefits. I request days of CIIB benefits (enter number of days requested). 4. I expect to be able to return to work on (enter date if known). 5. I am currently on: Family Care Leave Disability Leave Workers Compensation Leave Don t Know (circle one)

6 Section 3 Employee Representations 1. By submitting this application for CIIB benefits, I attest that all statements and/or information provided in this application and supporting documents are true to the best of my knowledge. I understand that making false statements in this application or supporting documents could result in discipline up to and including termination of my employment 2. I am a member of the CIIB Bank and have attached required proof from a medical doctor (MD) which provides: (a) a diagnosis for the person with the catastrophic illness or injury ; (b) estimates when I (or the person with the illness/injury) can return work (if at all); and, (c) states that I (or the person with the illness/injury) cannot presently work. 3. If I am applying for benefits as the primary care giver of an immediate family member, that the person I will be caring for is either my: child, step-child, grandparent, mother-in-law, father-in-law, parent, step-parent, sibling, step-sibling, or spouse/domestic partner. 4. If I am granted CIIB benefits, I agree to be bound by the terms of the CIIB bank as described in the NHR Personnel Practices Manual, collective bargaining agreements (if applicable) and the CIIB Guidelines. In particular, I understand that any reimbursements received by NHR from its Workers Compensation or mandatory short-term disability carriers while I am receiving CIIB benefits, will be reimbursed to the CIIB bank and not to me individually. 5. While receiving CIIB benefits, I will alert the Human Resource Coordinator or Director of Human Resources in a timely manner, should my circumstances change in a way which would allow me to return to work sooner than expected. Employee Signature Date Witness Signature Date