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(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 Workers' Compensation Laws of the State of Ohio will be eligible to participate in the City's Injury Pay Program.
(i) Employees sustaining a work related injury that requires medical attention at a medical facility (i.e., sprains, simple fractions, etc.) will be transported and tested 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; the plan will include the duration of any transitional work assignment not to exceed thirty (30) calendar days and indicate any physical therapy the injured employee may require. The program physician(s) may require follow-up medical evaluations.
(ii) Employees sustaining a work related emergency/trauma injury (i.e., life-threatening, severe bodily injury) may be treated at any medical 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; the plan will include the duration of any transitional work assignment not to exceed thirty (30) calendar days and indicate any physical therapy the injured employee may require. The program physician(s) may require follow-up medical evaluations.
(iii) 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 City's Department of Human Resources for up to sixty (60) calendar days.
Should such disability exceed sixty (60) calendar days, the Director of Human Resources for the City, 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 nature of the illness or injury and the need for additional time, must be presented to the Director of Human Resources no later than one (1) week after expiration of the original sixty (60) day disability period. If the above requirements are not fulfilled, the requests 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 employees' 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 third opinion shall be determinative of the employee's injury pay status 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 Workers' Compensation laws of the State of Ohio who choose not to be evaluated by the Program Physician or who choose not to follow the physician's recommended program and go only to the physician of their choice are not entitled to any paid injury leave benefits. 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 overtime, etc., since the employee is not fit to perform all of the duties of the classification. Transitional work assignments for Court employees will be identified by the Department of Human Resources in consultation with the Court Administrator. It is not the intent of this section to require the Court to provide transitional work where no such appropriate tasks have been identified and recognized. The Court shall supervise transitional work assignments.
A full-time employee of the Court shall be given bonus vacation days in accordance with the Bonus Day Table set forth below if he or she earned sick pay benefits in the previous year.
BONUS DAYS--CANCELLATION TABLE | |||||||||||
Months Worked | Sick Days Taken | ||||||||||
0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
| |
BONUS DAYS--CANCELLATION TABLE | |||||||||||
Months Worked | Sick Days Taken | ||||||||||
0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
| |
12 | 5 | 5 | 5 | 4½ | 4 | 3½ | 3 | 2 | 1 | ½ | 0 |
11 | 4½ | 4½ | 4½ | 4 | 3½ | 3 | 2½ | 1½ | ½ | 0 | |
10 | 4 | 4 | 4 | 3½ | 3 | 2½ | 2 | 1 | 0 | ||
9 | 3½ | 3½ | 3½ | 3 | 2½ | 2 | 1½ | ½ | 0 | ||
8 | 3 | 3 | 3 | 2½ | 2 | 1½ | 1 | 0 | |||
7 | 2½ | 2½ | 2½ | 2 | 1½ | 1 | ½ | 0 | |||
6 | 2 | 2 | 2 | 1½ | 1 | ½ | 0 | ||||
5 | 1½ | 1½ | 1½ | 1 | ½ | 0 | |||||
4 | 1 | 1 | 1 | ½ | 0 | ||||||
3 | ½ | ½ | ½ | 0 | |||||||
Bonus vacation time must be used by those in the Executive Group in the year provided; such time may not be carried forward.
(a) A death benefit as set forth in the schedule below shall be paid to the designated beneficiary of all full-time employees of the Court upon death, providing such death occurs after the employee has completed the probationary period. All full-time employees in Salary Groups 1 through 15, E1 through E4, and including full-time Magistrates shall be granted insurance coverage one and one half (1½) times their annual salary. Annual salary shall be calculated using the rate in place at the date of death. Sitting Judges, meaning all judges currently holding judicial office by reason of election or gubernatorial appointment, and the Clerk of Court shall be granted fifty thousand ($50,000.00) dollars insurance coverage.
(b) Each employee shall furnish the City with a designation of beneficiary. In the event the employee fails to designate a beneficiary, then the benefit shall be paid in accordance with the inheritance laws of the State of Ohio.
(c) Employees shall be permitted to convert this benefit at the time of their retirement from the City at their own expense.
(d) The Mayor shall be authorized to enter into in an agreement or agreements with a qualified insurance carrier or carriers to provide said death benefits herein set forth for Court officials and Court employees upon compliance with established City bidding procedures. The Director of Finance shall be authorized to issue his or her warrant or warrants in those amounts necessary to pay the cost of said death benefit insurance.
(a) GENERAL PROVISIONS: The City shall continue to provide hospital, medical, surgical, major medical, outpatient diagnostic laboratory services, prescription drug, dental care and benefits under the terms and conditions set forth below.
(i) 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. Spouses who are both employed by the City must jointly elect only one coverage. A new election may occur after an open enrollment due to circumstances such as layoff or other separation of one of the spouses, death, or divorce. Where spouses who are both employed have dependents from prior marriages for whose hospitalization coverage they are responsible they shall be exempt from this joint election requirement.
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.
(ii) Coverage for this purpose shall be furnished through the insurance carrier(s) selected exclusively by the City on a fair fee basis until such time as some other insurer may be selected or the City determines that it would be in its best interest to self insure these benefits.
(b) The following health care cost containment procedures shall be effective for all employees:
(i) Second surgical opinions, pre-admission notification or certification, emergency care limitations, 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. Failure to follow the procedures shall result in only eighty percent (80%) coverage for necessary care.
(ii) Full-time employees covered by another 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.
(iii) 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 (22) visits per year at fifty percent (50%) co-insurance.
(iv) Coverage for drug and alcoholism treatment is limited as follows. Inpatient care shall be maintained at a maximum of thirty-one (31) days per calendar year. Coverage is limited to a maximum of twenty-five thousand dollars ($25,000.00) lifetime benefits for all inpatient and outpatient care. 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 two thousand five hundred dollars ($2,500.00) per calendar year at fifty percent (50%) co-insurance. Employees using drug and alcoholism treatment benefits must use the City Employee Assistance Program.
(v) The panel of providers, and/or Preferred Provider Organization (P.P.O.), selected by the City for managing and providing nervous and mental, drug and alcohol treatment must be utilized. The City will request proposals toward a managed care plan for this purpose with an effective date of June 1, 1999. The schedule of benefits in effect as of February 9, 1999 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:
(i) There shall be a five hundred dollar ($500.00) annual per person maximum on chiropractic care and a one thousand three hundred dollar ($1,300.00) annual per person maximum on physical therapy, both subject to the major medical deductible ($100/individual and $200/family) and co-insurance (80%/20%).
(ii) 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 treatment is limited per paragraph (b)(iii).
(iii) There shall be one hundred dollar ($100.00) 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.
(iv) As a condition of continued coverage under the terms of this section, covered employees shall, beginning the first full pay period in January, 2013, be responsible for premium payments in accordance with the following schedule: Single employees receiving coverage under this section shall pay a monthly premium of forty-eight dollars ($48) per month; a single employee with one (1) dependent (e.g. "single + 1" coverage) shall pay a monthly premium of eighty dollars ($80) per month; an employee with more than one dependent (e.g. family coverage) shall pay a monthly premium of ninety-two dollars ($92) per month. Any employee eligible to receive coverage may waive such coverage.
Effective the first full pay period in June, 2013 the monthly premiums will be increased as follows: Single employees receiving coverage under this section shall pay a monthly premium of seventy-one dollars ($71) per month; a single employee with one (1) dependent shall pay a monthly premium of one hundred twenty dollars ($120) per month; an employee with more than one dependent (e.g. family coverage) shall pay a monthly premium of one hundred twenty-nine dollars ($129) per month.
Effective the first full pay period in June, 2014 the monthly premiums will be increased as follows: Single employees receiving coverage under this section shall pay a monthly premium of ninety-four dollars ($94) per month; a single employee with one (1) dependent shall pay a monthly premium of one hundred sixty dollars ($160) per month; an employee with more than one dependent (e.g. family coverage) shall pay a monthly premium of one hundred sixty six dollars ($166) per month.
The co-premium payments will be made by payroll deduction on a pre-tax basis. Spouses who are both employed by the City of Toledo will only pay one co-premium payment based on the level of coverage selected. The "Birthday Rule" and the spousal exclusion language in subsection (a) of this section continue to apply to coverage options.
(d) Medical providers shall be restricted to those hospitals, physicians, and other care providers designated in the plan as developed by the City.
(e) 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 immunizations for an infant until the infant's 1st birthday;
(ii) Pap tests as well as office fee will be paid in full once every twelve (12) months;
(iii) Office visits for routine wellness services and treatment of illness or injury rendered in the physician's 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). Payment for services under part (e)(i) and (iii) will be made for the first one hundred twenty-five dollars ($125.00) per single contract or three hundred dollars ($300.00) per family per calendar year collectively for well baby care (after the federally specified limits have been met) and for office visits. The ten dollar ($10.00) office visit co-pay shall not be counted toward the $125/300 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.
(f) The City shall continue to provide a major dental program which provides the following:
Type A Services: Preventative 100%
Type B Services: Major and minor restorative 80%
Type C Services: Orthodontia 60%
Deductible for Type B Services: $50.00 per person per year; maximum payment of $1,000.00 per year.
Maximum lifetime benefit for Type C Services for any covered person $1,000.00; coverage limited to dependent children under age 19.
(g) The City shall provide a prescriptive drug purchase program with a deductible of twenty percent (20%) of the cost for each brand name prescription, up to a maximum deductible of eight dollars ($8.00), and a two dollar ($2.00) deductible for generic drug prescriptions. This program will include a generic drug substitution option. The City may select an alternative carrier at its option.
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.
The coverages herein for dental and prescription drug shall be under either an individual or family contract as may be appropriate. The selection of the insurance carrier to provide the coverages herein is the exclusive right of the City.
(h) The City shall provide a vision care plan, which will contain a deductible plan. The City may select a carrier or become a self insurer as it deems necessary.
(a) The City shall continue to participate in the Public Employees Retirement System of Ohio as provided in the Ohio Revised Code.
(b) As long as the City participates in a pension "pick-up" plan in accordance with Internal Revenue Service regulations and Ohio Attorney General opinions, as permitted by law State and Federal Income Taxes on employee pension contributions by the Judges, Clerk of Court, and all Court employees may be deferred.
(c) Effective with the first full pay period of January 2013, the City will pay five percent (5.0%) of the employee's pension contribution and the employee shall be responsible for the remaining percentage (employee contribution increased from 1.5% to 5.0%). In the first full pay period of January, 2013, those employees receiving a reduction in pension pickup will receive a separate one time lump sum payment in the amount of six hundred and twenty-six dollars ($626). In the first full pay period of July, 2013, those employees receiving a reduction in pension pickup will receive a separate one time lump sum payment in the amount of six hundred and twenty four dollars ($624). Those employees unaffected by the pension pickup reduction are not eligible to receive the lump sum payments. Those permanent employees who are less than full-time employees who are affected by the pension pick-up reduction specified in paragraphs (c) through (e) will receive lump sum payments calculated on a pro-rata basis that is based upon actual hours worked during the previous calendar year.
(d) Effective with the first full pay period of March 2013, the City will pay two percent (2.0%) of the employee's pension contribution and the employee shall be responsible for the remaining percentage (employee contribution increased from 5.0% to 8.0%).
(e) Effective with the first full pay period of March 2014, the City will pay zero percent (0%) of the employee's pension contribution and the employee shall be responsible for the remaining percentage (employee contribution increased from 8.0% to 10%).
(f) In the event that the employee share of the pension payment increases due to a change in law or regulation, the employee shall be responsible for paying the entire amount of the increased employee contribution.
(g) Employees who were hired or reinstated after January 1, 2012, shall be required to pay the entire employee share of their pension and, furthermore, shall not receive any lump sum payments contained in this section.
(h) Except for the one time lump sum payments to those affected employees whose PERS pick-up is being reduced, employees who are eligible to have the City pick up a percentage of their employee share of pension are prohibited from receiving the payment specified in paragraphs (c) through (e) directly. The payments will be to each employee's individual P.E.R.S. account.
(i) Effective the first full pay period of March 2014, and pursuant to paragraph (e), the city's pension pick-up referred to in this article will terminate, and the City will no longer implement or participate in any pension pick-up plan.
The City shall provide an employee purchase plan whereby authorized employees will be able to purchase personal protective equipment (shoes, glasses), including prescriptive lenses, through a City program. The purchase program shall make these items available to the employee at forty (40%) percent of the cost with the City paying the remaining sixty (60%) percent. The Court Administrator shall determine which employees will be authorized to purchase equipment through this program.
The City shall continue to make available to an employee of the Toledo Municipal Court Judges' Division, after the employee has completed the probationary period, an opportunity to participate through payroll deduction in a Deferred Compensation Plan (Section 401-K or Section 457 Plan) developed and administered by a provider designated by the City.
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