[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)]
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.
[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.