[Adopted 11-24-1998 (P-16A)]
This Policy establishes a procedure for the filing of workers' compensation claims and continuation of employee benefits due to incapacity to work or disability caused by an on-the-job injury or job-related illness.
A. 
Coverage. As required by Chapter 23, Title 19 of the Delaware Code, Kent County Levy Court will provide workers' compensation coverage for its employees through a reputable insurance carrier conducting business within the State of Delaware, which at a minimum shall pay the costs attributed with the medical treatment of an on-the-job injury or job-related illness and 66 2/3% of the employee's average weekly wages, up to the maximum statutorily set by the State of Delaware for wages, after three days of job-related disability. If an employee continues to be out of work due to a job-related disability, on the seventh day, he or she will be eligible for lost wages at the 66 2/3% rate for the first, second, and third days of disability.
B. 
Reporting. An employee injured or suffering an illness arising out of and in the course of employment shall as promptly as possible report such injury, no matter how minor, to his or her supervisor and the Personnel Office. If the injury requires treatment by a licensed physician, the employee may visit his or her own doctor and advise the attending physician that the injury or illness is job-related or promptly seek treatment at a facility designated by the Personnel Office to care for such injuries. Any employee suffering an injury requiring emergency medical treatment while on the job should immediately go to a hospital emergency facility. When a physical injury requiring emergency medical treatment occurs, the department head, the supervisor, or the senior employee on site shall seek immediate medical assistance for the injured employee, secure the scene of the accident, and contact the County Safety Officer and Personnel Office.
C. 
Testing. Employees physically injured on the job and any other employee on the job site working with the injured employee are subject to immediate alcohol and/or substance abuse testing as directed by the Personnel Office.
D. 
Wages. Employees unable to work because of disability arising out of and in the course of employment shall continue to receive their full wages through the use of accrued sick leave less any wage replacement provided by the County's workers' compensation policy. If an employee has not yet received wage replacement and has exhausted his or her accrued sick leave, the Personnel Director may advance up to four weeks of sick leave to be paid back by monthly accrual upon the employee's return to work.
E. 
Benefits. Employees unable to work because of disability arising out of and in the course of employment shall be placed on family and medical leave (FMLA) as provided in County policy and shall continue to receive County employee benefits for up to 12 weeks, from the date of the incident. The Personnel Director may continue County benefits, during which all other accrued sick leave must be used, if a leave of absence is extended as provided in Subsection F.
F. 
Return to work. If an employee is unable to work because of disability arising out of or incurred during the course of his or her employment, and the employee does not or will not be able to return to work and perform the essential duties of his or her position after a maximum of 12 weeks of leave as provided by FMLA, the employee shall be laid off; provided, however, that the Personnel Director shall have the authority to extend the employee's leave of absence up to nine months from the date of disability if, in the judgment of the Personnel Director, there is a reasonable likelihood that the employee will be able to return to work after the extended leave of absence. An employee unable to return to his or her normal duties on a full-time basis may be transferred or reassigned to another vacant position for which he or she is qualified or laid off. Requests for temporary alternative duties shall be reviewed and accommodated as long as the employee can be productive at the discretion of the affected department head.
G. 
False claims. Employees filing false workers' compensation claims or employees intentionally failing to report work-related injuries or illnesses shall be subject to immediate disciplinary action up to and including termination.
[Adopted 9-25-1990 (P-42)].
A. 
The employee assistance program is established by Levy Court to provide limited and confidential assistance to employees and family members experiencing such matters as family or marital conflicts, divorce, death, serious financial difficulties, and chemical dependency.
(1) 
The program shall be available to employees and their family members, and shall be administered by the Personnel Office through a contracted service provider.
(2) 
The program is also intended to maintain compliance with the employee assistance provisions requirements for employers with employees with commercial driver's licenses.
(3) 
At a minimum the contracted service provider shall operate a twenty-four-hour toll-free telephone system to provide prompt assistance and indirect counseling to employees and family members in need. The provider shall also offer referrals to area professionals qualified to provide assistance in the problem area.
B. 
The program and all provisions therein are subject to change as part of the annual budget review and approval process.
[Adopted 3-23-2004 (P-72B); amended 9-27-2011 (P11-03); 4-23-2013 (P13-02)[1]]
This Policy establishes the employee health/medical and dental insurance programs for Kent County employees and retirees and provides guidelines for the appeal of denied or hardship claims.
A. 
Eligibility.
(1) 
Full-time employees, elected officials and their appointed deputies, former employees retired from active service, and COBRA-eligible former employees and their respective dependents shall be eligible to participate in the County's group health/medical and dental insurance programs. Covered retirees becoming Medicare-eligible shall use a supplemental health/medical insurance product offered through the County.
(2) 
Part-time employees, temporary or seasonal employees and similar positions working fewer than 30 hours per week on average over one full year are ineligible for any employee insurances or benefits.
(3) 
Employees are eligible to participate in the State Insurance Exchange, but health insurance coverage provided by the County to eligible employees meets or exceeds the minimum essential coverage and affordability requirements established by the Patient Protection and Affordable Care Act. Therefore, eligible employees would not be entitled to any subsidy or tax credits under the Act.
B. 
Employee coverage.
(1) 
The group health/medical insurance coverage shall at a minimum cover major medical, routine physician visits, and prescriptions at the levels and limits prescribed in the Plan. The group dental insurance coverage shall at a minimum cover preventative care, fillings, and extractions at the levels and limits prescribed in the Plan. Copayment, deductible, coinsurance and benefit limits shall be as established by the group health/medical and dental Plan(s) approved by the Levy Court.
(2) 
Insurance coverage for new employees shall be effective the first of the month following the date of hire, provided all requirements of the Plan(s) have been and continue to be met.
(3) 
Eligible employees will be automatically enrolled in the basic plan offered and must maintain individual medical/health insurance while actively employed by Kent County. Those employees declining coverage provided by the County must execute a waiver of insurance coverage and produce, as requested, verification of medical/health insurance coverage from another source.
C. 
Dependent coverage. Eligible employees and retirees may purchase medical/health insurance and dental insurance for eligible dependents at the costs approved by the Levy Court. The County will pay such costs as determined by Levy Court associated with the individual portion of the premium, and the employee shall pay the remainder for dependent coverage through payroll deduction, less any dependent contribution approved by the Levy Court. Premiums are paid in advance by a schedule approved by the Personnel Director.
(1) 
Employees serving on active duty as a member of the National Guard or military reserve shall not be required to pay any such premium normally due and payable for self or dependent coverage for any period of military service encompassing a full month when no hours of work are performed directly on behalf of the County.
D. 
Coverage costs.
(1) 
Group health/medical shall be provided to individual eligible active employees and retirees at no or reduced premium cost as determined from time to time by the Levy Court. The County's group health/medical coverage shall also be available to former employees and dependents for a specific period of time and at the established premiums required by the federal COBRA rules and regulations.
(2) 
The premium cost for individual and dependent health/medical insurance coverage is subject to change by the Levy Court.
(3) 
Group dental insurance shall be provided to individual eligible active employees and retirees at a nominal premium cost as determined from time to time by the Levy Court. The County's group dental insurance coverage shall also be available to former employees and dependents for a specific period of time and at the established premiums required by the federal COBRA rules and regulations.
(4) 
The premium cost for individual and dependent dental insurance coverage is subject to change by the Levy Court.
E. 
Medical incentives. In order to encourage employees to practice wellness and avoid costly health/medical treatments in the future, the County may offer financial or other incentives to promote wellness and healthier lifestyles. In compliance with cafeteria plan regulations, taxable medical cash-back will be provided to eligible employees and retirees waiving County health/medical insurance due to equal or better coverage provided by another source. If such other coverage lapses, the employee must promptly enroll with the County's health/medical insurance plan. Medical incentives are subject to change by the Levy Court.
F. 
Administration. The Personnel Office shall serve as administrator for all Kent County employee insurances and liaison between employees, retirees and their respective dependents and the group health/medical and dental insurance plan(s) carrier(s) or administrator(s). The Plan(s) documents shall be maintained in the Personnel Office and open for inspection by eligible employees, retirees, and dependents during regular office hours.
G. 
Appeals and hardship.
(1) 
The Personnel Director shall develop a form upon which eligible employees, eligible retirees, or eligible former employees may file an appeal when a medical or dental claim is denied or payment of a claim, coinsurance, deductible or other related cost is a personal financial hardship.
(2) 
Upon receipt of a claim appeal, the Personnel Director shall review the information and make a determination whether the appeal is or should be covered by the County's health/medical or dental insurance Plan(s) and pursue payment with the insurance carrier or administrator. The Personnel Director may authorize payment or reimbursement from the Medical Trust Fund of claims judged proper but denied by the carrier/administrator, up to a maximum of $500 per individual employee per calendar year incurred. Payments for claims exceeding $500 must be approved by the Employee Insurance Appeal Committee (EIAC).
(3) 
Upon receipt of a hardship appeal, the Personnel Director shall review the information and make a determination whether the appeal is justified. If it is determined that a true hardship exists, the Personnel Director may authorize payment of a claim or reimbursement from the Medical Insurance Trust Fund up to a maximum of $500 per individual employee per calendar year incurred. Payment for claims or reimbursement in excess of $500 must be approved by the Employee Insurance Appeal Committee. Hardship appeals denied by the Personnel Director may be further appealed to EIAC.
(4) 
Claim and/or hardship appeals shall be submitted to the Personnel Director for consideration for payment or reimbursement within one year of the original date of service or within 60 days of final denial by the insurance plan, whichever is later.
(5) 
The Employee Insurance Appeal Committee (EIAC) shall be composed of the Levy Court Administration Committee Chairman, County Administrator, Director of Finance, Director of Personnel and one employee member selected by the Employee Council and shall meet as required to determine if payment from the Medical Trust Fund should be made for claims exceeding $500 due to denial by the insurance carrier or plan administrator, personal financial hardship, or denial by the Personnel Director.
H. 
Medical trust fund. Necessary funds shall be budgeted and maintained in a Medical Trust Fund for payment of group medical/health and dental insurance premiums/claims and related costs as provided in this Policy. An annual report shall be provided to the Levy Court detailing expenditures.
I. 
Taxation. Employees are responsible for all federal, state, and/or any other taxes on medical incentives, hardship payments, and reimbursements.
J. 
Plan changes. The County's group health/medical and dental insurance Plan(s) shall be that determined solely by the Kent County Levy Court to meet the needs of the eligible employees, eligible retirees, and eligible former employees, and it reserves the right to make changes at any time and for any reason whatsoever to the approved Plan(s) or options and select a new Plan(s) or option(s), to change eligibility criteria, to change insurers, providers and networks, end coverage(s) for some or all employee groups, and/or to amend this Policy.
K. 
The Employee Insurance Appeals Committee shall develop appropriate guidelines, rules and forms as necessary to use in the decision-making process. The maximum annual cumulative payments and/or reimbursement per employee, retiree, or dependent shall be limited to $3,000, such amount may be adjusted from time to time by Levy Court as part of the annual budget review and approval process.
[1]
Editor's Note: This amendment provided that it shall be effective upon adoption, except where a later effective date is permitted under the Patient Protection and Affordable Care Act.
[Adopted 8-25-1998, effective 6-1-1998 (P-73)]
This Policy establishes the employee life with accidental death and dismemberment and long-term disability insurance programs for Kent County employees and retirees.
A. 
Eligibility.
(1) 
Full-time employees, elected officials and their appointed deputies, members of the Board of Assessment, and former employees retired from active service shall be eligible to participate at no cost in the County's group term life insurance program.
(2) 
Full-time employees, elected officials and their appointed deputies, and members of the Board of Assessment shall be eligible to participate at no cost in the County's group long-term disability insurance program. Retirees are not eligible for long-term disability insurance coverage.
(3) 
Part-time employees, temporary or seasonal employees, the Mortgage Commissioner, and like positions are ineligible for any employee insurances or benefits.
B. 
Employee coverage.
(1) 
Term life insurance coverage shall at a minimum provide a beneficiary a benefit equal to the annual salary of the eligible active employee with applicable age reduction. The beneficiary of an eligible retiree shall at a minimum receive $5,000 with applicable age reduction. Life and accidental death and dismemberment benefits shall be provided under the conditions and at the levels and limits prescribed in the Plan approved by the Levy Court. Employees are responsible for applicable taxes due to excess benefits.
(2) 
Long-term disability coverage shall at a minimum provide a disabled eligible employee a benefit equal to 60% of the annual salary ($36,000 maximum salary) until age 65 or recovery from the disability. Long-term disability benefits shall be provided under the conditions and at the levels and limits prescribed in the Plan approved by the Levy Court.
(3) 
Insurance coverage for new employees shall be effective the first of the month following the date of hire, provided all requirements of the Plan(s) have been and continue to be met.
C. 
Supplemental coverage. Eligible active employees may purchase supplemental life insurance at rates approved by the Levy Court. The employee must pay the full cost for any additional or supplemental insurance through payroll deduction, and failure to pay such premium shall cause the coverage to expire. Premiums are paid by a schedule approved by the Personnel Director.
D. 
Coverage costs.
(1) 
Eligible employees and retirees shall be covered by the County's group life insurance or long-term disability plans at the levels provided in the Plan document at no premium cost to the individual.
(2) 
The premium costs for supplemental or additional life insurance are subject to change by the Levy Court with or without notice.
E. 
Administration. The Personnel Office shall serve as administrator for all Kent County employee insurances and liaison between employees, retirees and their beneficiaries and the respective Plan carrier or administrator. The Plan documents shall be maintained in the Personnel Office and be open for inspection by eligible employees and beneficiaries during regular office hours.
F. 
Funding. The necessary funds shall be budgeted by department and dispersed for payment of life and long-term disability premiums as provided in this Policy. As part of the annual budget review and approval process, a report shall be provided to the Levy Court detailing expenditures.
G. 
Taxation. Employees and/or their beneficiaries are responsible for all federal, state, and/or any other taxes on claims or payments.
H. 
Plan changes. The County's group life and long-term disability insurance plan(s) shall be those determined solely by the Kent County Levy Court to meet the needs of the eligible employees and retirees, and it reserves the right to make changes to the approved Plan(s) or option(s), select a new Plan(s) or option(s), end coverage(s) for some or all employee groups, and/or amend this Policy at any time and for any reason whatsoever.