Loading...
In the event of the extended illness of an employee and after having exhausted all accumulated sick days, bonus days and vacation days, then a request may be made to the Director of Human Resources for extended sick pay benefits. The employee's prior work record with regard to his usage of sick days and his seniority will be taken into account in determining eligibility for such extension. In the event the requested extension is denied, then the employee shall be placed on Personal Leave of Absence as provided in Section 2129.39, and the Association shall be notified.
(a) Employees injured in the course of and arising out of their employment under such circumstances as would cause such injury or disability to be compensable under the Worker's Compensation Laws of the State of Ohio will be eligible to participate in the City's injury pay program. The Cost Containment Committee referenced below will select the program physician(s) and medical facilities from submitted proposals.
(1) Employees sustaining a work related injury that requires medical attention at a medical treatment facility (i.e., sprains, simple fractures, etc.) will be transported to and treated by a program physician or medical facility. The program physician, along with rendering a diagnosis and prognosis, will determine if the employee is capable of returning to regular duties, whether a transitional work assignment is appropriate, and the necessary rehabilitation plan to be followed; this plan will include the duration of any transitional work assignment not to exceed 30 calendar days and indicate any physical therapy the injured employee may require. The program physician(s) may require follow-up medical evaluations.
(2) Employees sustaining a work related emergency/trauma injury (i.e., life threatening, severe body injury) may be treated at any medical treatment facility to which emergency medical personnel transport them. The employee will subsequently be examined by the program physician. The designated program physician will determine if the employee is capable of returning to regular duties or if a transitional work assignment is appropriate and the necessary rehabilitation plan to be followed; this opinion will include the duration of any transitional work assignment not to exceed 30 calendar days and indicate any physical therapy the injured employee may require. The program physician(s) may require follow-up medical evaluations.
(3) An employee may, after the initial evaluation by the program physician, elect to continue treatment with their personal physician provided the program physician's recommendations are followed. The employee will sign any necessary waivers to allow their personal physicians to release information to the program physician. The employee's personal physician will be the physician of record for Workers' Compensation purposes.
(b) Upon the program physician's determination that an injury requires the employee to be off work, wherein the employee reports said injury within twenty-four (24) hours of the incident of illness or injury, paid leave shall be granted by the Department of Human Resources for up to 60 days.
Should such disability exceed sixty (60) calendar days, the Department of Human Resources, on application therefor and proof of continued disability, may extend the period during which such person is carried on the regular payroll. The length of such extended period or periods shall not exceed two (2) years.
Injury pay extension requests, accompanied by a "Statement of Attending Physician" setting forth the illness or injury and the need for additional time, must be presented to the Department of Human Resources no later than one (1) week after the expiration of the original sixty (60) day disability period. If the above requirements are not fulfilled, the request for injury pay extension may not be considered.
(c) Workers' Compensation: At the expiration of the injury leave granted, if the employee is still unable to return to work, the employee may elect in writing to use accumulated sick and other accrued time. If the employee is still unable to return to work, payment of normal wages will be stopped and the Industrial Commission will be requested to begin weekly payment under the provisions of the Workers' Compensation Act.
(d) If the opinion of the employee's treating physician conflicts with that of the program physician and such opinion is presented to the City in seven (7) calendar days of the program physician's evaluation, and if the physicians cannot agree after consultation, the employee will be referred for a third opinion. The Cost Containment Committee referenced below will establish a panel of occupational health specialists for third opinions. The third opinion shall be determinative of the employee's injury pay status under the contract and shall not be subject to further appeal or review. If the third opinion is consistent with the program physician's plan and the employee fails to abide by the rehabilitation plan, or if the employee enters and later drops out of the plan, then the city can recoup injury pay advanced from the employee's sick time accumulation. If the employee does not have a sufficient sick time balance, the City shall recoup the injury pay by reducing future sick leave earnings by one-half until the injury pay is fully recouped.
(e) Employees who sustain injuries in the course of and arising out of their employment under such circumstances as would cause such injury or disability to be compensable under the Worker's Compensation Laws of the State of Ohio who choose not to be evaluated by the program physician or who choose not to follow that physician's recommended program and go only to the physician of their choice are not entitled to any paid injury leave benefits contained in this collective bargaining agreement. Notice of intent not to participate in the City's injury program must be given within three (3) work days of the injury. Any and all work-related injury claims will be processed through and conform with the Workers' Compensation Act.
(f) False Claim: The City reserves the right to recoup benefit payments to any employee who is guilty of submitting a false claim, or abuse of the privileges covered in this Section, or working for another employer while on injury leave, and may take disciplinary action.
(g) An employee working in a transitional work assignment will be compensated at their regular rate of pay. The employee will not be entitled to bid rights, overtime, etc., since the employee is not fit to perform all of the duties of the classification. With regard to the rights of other employees, the employee in the transitional assignment will be deemed not to be working out of classification.
Transitional work assignments will be identified by the Department of Human Resources in consultation with those Departments who have appropriate tasks available. The currently available assignments and the tasks involved in each Department will be provided in writing to the Union.
It is not the intent of this section to allow Departments to provide transitional work above that identified nor is a Department required to provide transitional work where no such appropriate tasks have been identified and recognized.
(h) With the intent of this injury program being to minimize time away from work and return the healthy employee to active employment as soon as possible, the Joint Labor-Management Health and Safety Committee (Section 2129.86) will also serve as a cost containment committee for Workers’ Compensation.
(a) A female Police Officer shall be entitled to sick pay for maternity to the extent of the total accumulated days to the credit of the employee. If the Police Officer has used all of the sick pay to which she is entitled and extended sick benefits have been denied, then the employee shall be placed on leave without pay as provided in Section 2129.39, "Personal Leave of Absence".
(b) All Police Officers shall be entitled to use up to ten (10) days from their accrued sick days for the purpose of parturient requirements. The ten (10) days when used in accordance with this section shall have no effect on Bonus Days as provided in Section 2129.58.
(c) Those officers on an approved FMLA (Family Medical Leave Act) leave may hold three (3) weeks vacation and 15 days sick time in abeyance for later use in accordance with the vacation and sick time provisions of this agreement.
In any case where an employee is required to report to a physician designated by the City, it shall be on City time, except in cases where he is off the payroll. After an employee is released for duty by his family physician, in the event the City requires the employee to report to a physician designated by the City before return to work, no additional sick time shall be charged against the employee pending his examination by the physician designated by the City.
When a disagreement exists between the family physician and the City physician, the City and the Association will mutually establish a list of acceptable physicians and the employee will be directed to a physician from the list in order to obtain a third opinion. This opinion will prevail. In the event a third opinion is required, no additional sick time shall be charged against the employee pending his examination by the physician jointly authorized in this matter.
The cost of the third opinion will be borne by the City. For the purpose of this contract, a physician will be defined as a person graduated from a recognized school of medicine and licensed by the State of Ohio to practice medicine.
A death benefit in the amount of fifty thousand ($50,000) dollars shall be paid to the designated beneficiary of an employee of the City of Toledo upon death. Each employee should furnish the City with a Designation of Beneficiary. In the event the employee has failed to designate a beneficiary, then the benefits shall be paid in accordance with the inheritance laws of the State of Ohio.
The amount of death benefits paid to the Designated Beneficiary shall be the same as that amount provided for persons defined as Sergeants in the Department of Police, for the term of the Agreement.
In the event an employee dies in the line of duty the city shall pay all funeral expenses not to exceed ten thousand dollars ($10,000).
(A) General Provisions
The City shall continue to provide hospital, medical, surgical, major medical, outpatient diagnostic laboratory services, prescriptive drug, dental care, and benefits under the terms and conditions set forth below.
(1) Coverage shall be provided to each employee, each employee's spouse, and all unmarried dependent members of the employee's family to age twenty-three (23) or other age as determined by applicable state or federal law.
Where the spouse of a City employee has health care coverage through a different employer, the spouse must enroll in his/her employer's plan. Dependents shall be covered as provided by the "Birthday Rule". Coordination of benefits shall be provided so that coverage is extended to the spouse and dependents that is not provided by the other employer's plan. In cases of demonstrated hardship due to excessive co-premiums (i.e. 40% co-premiums or premium payments equaling 30% or more of earnings) special consideration will occur.
(2) Coverage for this purpose shall be furnished through the insurance carrier(s) selected exclusively by the City on a fair fee or other basis until such time as some other insurer may be selected or the City determines that it would be in its best interest to insure these benefits. The Association shall receive advance notice of and the reasons for the change in carriers.
(3) Coverage shall be provided at the levels existing as of December 31, 2002 except as set forth in paragraphs (b) and (c) herein.
(B) The following health care cost containment procedures shall be effective for all employees enrolled under traditional coverage:
(1) Second surgical opinions, pre-admission notification or certification, emergency care limitations, concurrent review, post admission concurrent review, outpatient surgery, continued treatment and technological review, medical case management, planned discharge, and other procedures as may be established under the medical review programs established by the City shall be followed.
(2) Full time employees covered by another employer's health care program due to marriage or other reasons may waive their City of Toledo coverage and receive twenty-five thousand dollars ($25,000.00) in additional life insurance coverage. This shall also be extended to those employees whose spouses are also employed by the City.
(3) Coverage for nervous and mental treatment is limited as follows: inpatient care shall be maintained at a maximum of thirty-one (31) days per calendar year. Outpatient coverage shall be expanded to a maximum of twenty-two visits per year at fifty percent (50%) co-insurance.
(4) Coverage for Drug and Alcoholism treatment is limited to a maximum of twenty-five thousand dollars ($25,000.00) lifetime benefits for all in-patient and out-patient care. Inpatient care shall be maintained at a maximum of thirty-one (31) days per calendar year. Inpatient coverage shall be at one hundred percent (100%) for an individual's first admission, seventy-five percent (75%) for a second admission, and fifty percent (50%) for a third admission. No coverage shall be provided beyond three (3) admissions per lifetime or thirty-one (31) days per calendar year. Outpatient coverage shall be expanded to a maximum of twenty-five hundred dollars ($2,500.00) per calendar year at fifty percent (50%) co insurance. Employees using drug and alcohol treatment programs must use the Police Department Employee Assistance Program when one is available.
(5) The panel of providers and/or P.P.O. selected by the City for managing and providing nervous and mental, drug and alcohol treatment must be utilized. The City has the right to request proposals toward a managed care plan for this purpose with an effective date of June 1, 2000 or thereafter. The selection shall be by mutual agreement of both parties. The schedule of benefits in effect as of December 31, 2000 shall be maintained, without additional co-pays or deductibles.
(C) The following cost sharing plan and cost coverage restrictions shall be effective for all employees:
(1) There shall be a five hundred dollar ($500.00) annual per person maximum on chiropractic care in 2003, which shall increase to a one-thousand dollar maximum effective July 1 of 2004, and a thirteen hundred dollar (1,300.00) annual per person maximum on physical therapy, both subject to the major medical deductible (one hundred dollar ($100/individual) and two hundred dollar ($200.00/family) and co-insurance (80%/20%).
(2) Major Medical benefits shall be paid to a lifetime maximum of one million dollars ($1,000,000.00) per person with a one hundred dollar ($100.00)/individual and two hundred dollar ($200.00) /family deductible and 80%/20% co-payment; provided that coverage for nervous and mental, drug and alcoholism is limited per paragraph (b)(3) and (4).
(3) There shall be a sixty-five dollars ($65.00) co-pay for all emergency room visits, which shall be waived if the individual is admitted or if the visit is between the hours of 8:00 p.m. and 9:00 a.m., or on a Saturday after 12:00 noon, or on a Sunday.
(4) There shall be a monthly co-premium paid by each employee for hospitalization, prescriptive drug and dental insurance. Employees will pay the following monthly co-premiums:
Single Coverage | Single + 1 Coverage | Family Coverage | |
Effective with the first full pay period of July 2012 | $48 | $80 | $92 |
Effective with the first full pay period of July 2013 | $71 | $120 | $129 |
Effective with the first full pay period of July 2014 | $94 | $160 | $166 |
The co-premiums will be made by payroll deduction on a pre-tax basis. Spouses who are both employed by the City of Toledo will pay one co-premium payment based on the level of coverage selected. The "Birthday Rule" and the "Spousal Exclusion" language in Part A of this section continue to apply to coverage options.
(D) Effective March 1, 1994, the availability of Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) shall be discontinued. All employees, including those in the Traditional Plan, shall thereafter be enrolled in the Consortium Plan. Consortium Plan coverage and benefits shall be at the Traditional Plan levels as of December 31, 1993 except as otherwise provided herein. Consortium Plan Medical Providers shall be restricted to those hospitals, physicians, and other care providers designated in the plan as developed by the City in cooperation with the Cost Containment Committee. It is understood that the City will now be utilizing the hospital, physicians, and ancillary providers panels through the Western Lake Erie Employer's Cooperative (WLEC)/Cooperative Health Network (CHN).
(E) The Cost Containment Committee formed from among the representatives of the various bargaining units, including the Association, shall be maintained. The Committee shall develop other cost containment measures, which shall include: 1) enhanced managed care, such as pre-certification, concurrent review, and utilization review; 2) changes of coverage or benefits, such as increased deductibles, limitations on coverage, and contributions from employees; 3) increased claims control, such as coordination of benefits, subrogation, workers' compensation deferral, patient audits, and claim audits; 4) alternate delivery systems such as preferred provider organizations for specific benefits and direct provider negotiations; and 5) development of participative employee plan by which employees will be encouraged to contain costs, audit bills, correct lifestyles, maintain wellness, and undertake other cost savings measures. The committee shall meet regularly on at least a monthly basis and attendance shall be required. The committee shall develop annual goals, objectives, and timetables directly aimed at reducing health care costs. Subcommittees may be formed as deemed necessary by the co-chairpersons to study issues, develop reasonable solutions, and report back to the committee. Goals and objectives not met within the established time frames shall be critically reviewed by the Committee. No changes in benefits during the term of the contract as they affect TPPA shall be permitted unless the TPPA representative on the Cost Containment Committee is authorized to do so by the TPPA through its president. In the event any change in benefits is required by either federal or state law, the TPPA and City shall negotiate the replacement language. If no agreement is reached, the matter shall be subject to an interest arbitration. The parties shall use a panel of seven arbitrators with experience in interest arbitration.
(F) The union releases the City from any obligation to expend monies currently in the Healthcare Savings Fund created pursuant to former paragraph (g) of this Section on future cost increases or for wellness programming. The union further releases the City from any obligation to consult with the Cost Containment Committee relative to the transfer or expenditure of those funds. Annual reports from third party administrators of the City's health benefits, including any such reports showing costs and cost reductions, shall be shared with the Cost Containment Committee.
(G) Coverage for well baby care, pap tests, and office visits shall be offered to all employees enrolled under conventional coverage as follows:
(i) Well baby care limited to routine examinations and immunization for an infant until the infant's first birthday.
(ii) Pap tests as well as office fee will be paid in full once every twelve (12) months.
(iii) Office visits for routine services rendered in the physicians office, including physical examinations and family planning shall be subject to a ten dollar ($10.00) co-payment, which shall be counted toward the individual's major medical deductible.
Fees that the physician charges for the services under paragraphs (i), (ii), and (iii) shall be paid on the same basis as other covered services (e.g. usual, customary, and reasonable). Payments for services under part (G)(i) and (iii) of 100% will be made for the first three hundred ($300.00) per single contract or six hundred ($600.00) per family per calendar year. The ten-dollar ($10.00) office visit co-pay shall not be counted toward the $300/$600 limits. After deductibles are reached, payment shall then be under the major medical plan; provided, however, that the bill shall be reduced by the ten dollar ($10.00) office visit co-pay before the 80%/20% co-payment formula is applied.
(H) The City shall provide a three tier closed formulary prescriptive drug purchase program with a co-payment structure of a six dollar ($6.00) co-payment for tier 1 drugs (generics); a fifteen dollar ($15.00) co-payment for tier 2 drugs (preferred brand name drugs); and a thirty-dollar ($30.00) co-payment for tier 3 (non-preferred brand name drugs). This program will include a generic drug substitution option. The City shall select the provider for the formulary drug program, who shall group drugs according to determinations made by the provider's therapeutic committee as it deems necessary.
The city may implement managed care for the prescriptive drug program. This would allow for an evaluation of the interaction of an individual's different prescriptions on a voluntary basis. Recommendations could then be made to the individual and his/her physician for more effective drug therapy.
(I) The City shall continue to provide a major dental plan which provides the following:
Type A Services: Preventative 100%
Type B Services: Major and Minor Restorative 80%
Deductible for Type B Services $50.00 per person per year maximum payment of $1,300.00 per year.
Type C Services: Orthodontia 60%
Maximum lifetime benefit for Type C Services for any covered person $1,300.00 coverage limited to dependent children under age 19.
Such benefit shall continue in effect for the duration of this agreement. The City, however, may select an alternative carrier or become self-insured as it deems necessary. The coverage to be provided to each employee shall be either an individual or family contract, as may be appropriate. The selection of the insurance carrier to provide the coverage herein is the exclusive right of the City.
(J) Vision Care: Beginning in July, 2000, the City shall contribute fifteen dollars ($15.00) per employee per month for vision care benefits to the Toledo Police Patrolman's Association. Said amount shall be used by the Association to purchase whatever vision care benefits they will buy. The City shall have no responsibility relative to the administration of this vision care plan.
(K) The City agrees that all conditions and terms relating to the hospitalization-prescriptive drug-dental insurance shall be maintained at not less than the highest minimum standards in effect as of the effective date of this agreement as found in 2129.101 "Duration of Agreement". It is further agreed that any terms or conditions agreed to that are in excess of those established herein shall not be reduced.
(A) The City will continue to participate in the Police and Firemen's Disability and Pension Fund as provided in the Ohio Revised Code.
(B) The City will implement a pension "pick-up" plan in accordance with Internal Revenue Service regulations and Ohio Attorney General opinions, whereby State and Federal Income Taxes on employee pension contributions by all bargaining members may be deferred.
(C) Effective with the second full pay period of April 2012 the City will pay zero percent (0%) of the employee's pension contribution, and the employee shall be responsible for the remaining percentage (employee payment increased from 0% to 10%).
(D) By April 30, 2012 the employees whose pension pick-up has been reduced pursuant to sub-section (C) of this article will receive a separate lump sum check in the amount of one thousand five hundred dollars ($1,500).
(E) During the month of March, 2013, and in consideration for the employees whose pension pickup was eliminated in April of 2012, each employee whose pension pickup was eliminated will receive a separate lump sum check in the amount of one thousand dollars ($1,000).
(F) During the month of March, 2014, and in consideration for the employees whose pension pickup was eliminated in April of 2012, each employee whose pension pickup was eliminated will receive a separate lump sum check in the amount of one thousand dollars ($1,000).
(G) In the event the employee share of the pension contribution increases due to a change in law or regulation during the term of this agreement, the employee shall be responsible for paying the entire increase in the employee share.
(H) Employees are prohibited from receiving the pension pickup payments specified in sub-section (C) of this article directly instead of having them paid by the City to the pension plan.
(I) Police officers hired after January 1, 2009 will be required to pay the entire employee contribution to the Police and Firemen's Disability and Pension Fund and shall not be eligible for the lump sum payments prescribed in this section.
(J) Effective the second full pay period of April 2012, and pursuant to sub-section (C), the parties agree and understand that the City's pension pick-up plan referred to in this article will terminate, and the City will no longer implement or participate in any pension pick-up plan.
Loading...