Benefits and beyond c. 12 govt sponsored and mandated
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Benefits and beyond c. 12 govt sponsored and mandated Benefits and beyond c. 12 govt sponsored and mandated Presentation Transcript

  • Benefits and Beyond, C. 12
    Gov’t Sponsored and Mandated
    Thomas E. Murphy
    12/07/10
    1
  • 12/07/10
    2
    A safety net for retirement and health
    Mandated
    Health Care
    2014
    Fit?
  • What is the life event?
    What is the benefit?
    How does one become a participant?
    How and when does one become eligible for a benefit?
    How is the plan designed?
    How is it funded?
    What are some contemporary issues?
    12/07/10
    3
    Social Security . . .
  • A defined benefit plan
    Funded by payroll taxes (6.2% from employer and employee – and 1.45% for Medicare (FICA)
    Cap on income that can be taxed ($106,800 in 2009).
    Monies collected are not invested – a “PAYGO” system.
    Up to February 2010, there was a surplus - taxes did cover benefits – no longer.
    12/07/10
    4
    Social Security . . .
  • By 2042 (or earlier) the plan will be unable to pay benefits. Converting bonds will no longer be sufficient to cover obligations.
    Problem: Baby boomers, declining current birth rate, fewer making contributions, and longevity.
    12/07/10
    5
    Social Security . . .
  • Work in covered employment.
    At least 40 quarters
    Earn at least $870 per year.
    12/07/10
    6
    Social Security - Participation
  • Based upon average life time earnings
    Earnings are indexed – Average Indexed Monthly Earnings (AIME)
    These are then divided into three brackets of earnings formed by applying “bend points.”
    The third bracket is capped by the maximum earnings subject to the tax.
    Each bracket is then multiplied by a different percentage and the three products are totaled to arrive at the Primary Insurance Amount.
    12/07/10
    7
    Social Security - Benefit
  • PIA will be the sum of: (a) 90 percent of the first $744 of his/her average indexed monthly earnings, plus (b) 32 percent of the average indexed monthly earnings over $744 and through $4,483, plus (c) 15 percent of his/her average indexed monthly earnings over $4,483.
    Up to maximum earnings subject to SSA tax ($106,800).
    12/07/10
    8
    Example of “Bend Points”
  • (http://www.ssa.gov/OACT/ProgData/retirebenefit1.html)
    Check this out and see how it works!
    Would changing the AIME represent an opportunity to “reform” SSA benefits? How?
    See the steps in the calculation at pages 357-358 in the Text.
    12/07/10
    9
    Average Indexed Monthly Earnings
  • The PIA is actuarially adjusted based upon when the participant chooses to retire.
    The earliest retirement date is age 62.
    Originally, normal retirement was 65. This has been extended for persons born after 1941.
    For example, a person born in 1942, cannot retire at full benefits until he is 65 and 10 months. Extension goes up to age 67.
    12/07/10
    10
    Social Security . . . When?
  • If one retires early under SSA, there is a lifetime actuarial reduction; (20% at 62 for those whose full age would be 65)
    But also, if he earns income, his benefit will be reduced by $1.00 for every $2.00 earned above the income limit of $12,960.
    All SSA benefits are adjusted after retirement with periodic COLAs.
    If one chooses to delay benefit beyond normal age, benefit will be increased by as much as 8% for each year up to age 70.
    12/07/10
    11
    Social Security . . .Adjustments
  • What factors should one consider in determining whether to retire early under SSA?
    See Exercise No. 1: www.socialsecurity.gov/OACT/quickcalc/
    Quick calculator, choose age 62 retirement and then full age (66 yrs.) Use as your final pay $100,000, and DOB of June 1950.
    What is the difference between this number and retirement at age 66?
    12/07/10
    12
    Query:
  • So, should you retire at age 62?
    Life expectancy relevant?
    See also Art Jones Vignette at pages 355 and 359
    Multiply years between age 62 and age 66 times the actual benefit received.
    How long will it take to make up this number if he had chosen a “full age retirement?”
    What about offsets?
    12/07/10
    13
  • Persons receiving full age retirement and earning above certain limits, must pay taxes on up to 85% of their SSA benefits.
    There are no reductions in benefits attributable to wages after full age retirement is reached.
    All amounts of early retirement are subject to ordinary income taxes
    12/07/10
    14
    Social Security . . .Adjustments
  • What are criteria one should consider in taking early retirement?
    Would it matter what age you took early retirement?
    See pages 359-360.
    12/07/10
    15
    Can you come up with a “rule?”
  • What are the advantages of deferring retirement under SSA?
    What if Joe is born in 1942, and “Full Age” is 65 and 10 months. Joe delays until age 70 and 10 months? (fn. 16, 359)
    12/07/10
    16
    Query
  • What if your father’s birth date places him in the age 67 Full Age Retirement bracket for SSA?
    His sister is older and her Full Age Retirement is 65 years under SSA.
    They both want to retire at age 62.
    Who will have the higher actuarial reduction?
    Explain.
    12/07/10
    17
    Query:
  • Survivor
    Children
    Spouse
    Disabled
    Excessive Fatigue after an outing . . .
    12/07/10
    18
    Social Security . . . Other benefits
  • 12/07/10
    19
    The Social Security Crisis
  • What factors would you use in calculating?
    What’s your formula? Assumptions?
    Opportunity costs?
    See footnote 7 at page 357.
    12/07/10
    20
    Is SSA a Good Deal- Past and future?
  • Replacement income percentage – higher for lower paid workers.
    High dependency – 65% depend on SSA benefit for 50% of their retirement income.
    Declining birth rates and the “Dependency Ratio” (ratio of younger than 18 and older than 65 to those between these ages)
    In the U.S. it is 5:1. By 2030 it will be 3:1. In Japan by 2030, 1 worker supporting 2 retirees)
    12/07/10
    21
    Social Security - Issues
  • So, the SSA system is no longer taking in more on a current basis than it is paying out. This was supposed to occur in 2018, but it just happened. SSA will not be able to pay benefits (only 75% of promised) by 2042.
    Question: what can be done to fix this?
    Most developed countries have the same SSA structure and are facing the same funding crisis.
    Get out your DBP tool box!
    12/07/10
    22
    Social Security Issues
  • 12/07/10
    23
    Think like an actuary!
  • What impact will it have on the SSA deficit?
    Should general tax revenue be considered as a source?
    Impact of failure.
    Policy issues?
    12/07/10
    24
    Note: calculate impact of each!
  • Increase payroll taxes or remove caps
    What would it take?
    Reduce benefits by further extending retirement age. What would it take and with what result?
    This would result in additional actuarial reductions for early retirement.
    Change how the AIME is calculated
    Means testing
    12/07/10
    25
    SSA Reform . . .
  • How would changing “bend points” reduce the costs?
    What about changing or limiting annual COLA increases?
    Should we look at entire pension landscape to make a determination as to the optimal reform choice?
    See discussion at pages 363- 365, and 366 - 368.
    12/07/10
    26
    Query:
  • Invest fund assets in capital markets (Problem?)
    Personal accounts (Chile, Sweden, Bush)
    Change to a nominal account where the participant directs investments and receives an annuity at retirement.
    Government guaranteed floor benefit?
    Re-evaluate SSA to be a supplemental benefit as originally intended.
    12/07/10
    27
    SSA Reform . . . Or . . .
  • 12/07/10
    28
    Bush Reform: Could A receive more?
  • http://www.heritage.org/Research/Reports/2005/04/The-Bush-Plan-To-Reform-Social-Security-Case-Studies-from-the-Heritage-PRA-Calculator/
    A must earn more than 3% (annually) on his PIA.
    How does this help the SSA financial crisis?
    Check out: www.socialsecurity.org (Cato Institute) or: http://www.socialsecurity.org/catoplan/
    12/07/10
    29
    Check these out:
  • Couple took their SSA contributions and invested in capital markets between 1965 to 2009 (retirement).
    Account: $900,000
    Earning: 6.75%
    Include market drop year.
    Earnings for SSA, would have been 1.5% to 0% had they stayed in System.
    This is a gap of 75%.
    Capital markets are used to grow most pension funds. (See: WSJ, Shipman, 10/27/10 p A17)
    12/07/10
    30
    Private Accounts
  • So what about Art Jones? (355)
    Note: income tax
    Go to pages 359-360
    Permanent actuarial reduction.
    Possible offset for earned wages.
    He would receive a benefit for an extra 5 years.
    How long would it take to make that up with a full age retirement?
    12/07/10
    31
  • Exercises: www.ssa.gov/
    Benefit/Survivor/Full Age
    Age 62 -Actuarial Reduction?
    Retirement
    Calculate your benefits
    Quick Calculator
    DOB: 17/07/1947
    Retire: 15/07/09
    Income: $120,000
    See your benefit
    Today’s dollars
    Benefits Online
    12/07/10
    32
  • Go to page 404 – Exercise #2
    Important Definitions
    Check the website
    What is AIME?
    How does it work?
    What are the latest “bend points?”
    Could changing these be an opportunity for SSA Reform?
    12/07/10
    33
  • 12/07/10
    34
    Gov’t. Health Care - Medicare
  • Employer sponsored retiree health care is disappearing as a benefit.
    This covered ages 55-65, and then a Medicare supplement.
    Persons with Medicare are expected to pay over $250,000 in out-of-pocket costs for their health care.
    12/07/10
    35
    Note – some policy issues
  • 12/07/10
    36
    Health care for those over 65 – an entitlement program
  • Persons who are participants in the Social Security retirement system are “covered.”
    A person who qualifies for a SS retirement benefit – including age 62 early retirement --is eligible to claim benefits when he or she reaches age 65, regardless of his full age retirement.
    Go to Vera Vignette at page 369
    12/07/10
    37
    Medicare – coverage and eligibility
  • A basic indemnity plan.
    Most of same cost sharing features – deductibles, co-pays, premiums. (fn. 53, 371)
    Financed by Medicare payroll tax.
    Part A – covers hospital care and there is no premium.
    Part B – covers doctor care with “means adjusted” premium.
    Part C – is supplemental health insurance that can be purchased by participant.
    And Part D is “drug plan.”
    12/07/10
    38
    Medicare – plan design
  • Part D is the prescription drug plan – a “stand alone” financed by Medicare, participant premiums and co-pays. Medicare does not administer the plan although it does set standards. (See: Terranova at page 373 and Max at page 374.)
    Medicare Advantage Plans - a TPA assumes all of the responsibilities under A,B,C, and D. The premium is paid to Medicare and is shared with the TPA. Include PPOs, HMOs.
    12/07/10
    39
    Medicare – plan design
  • 12/07/10
    40
    Medicare – Part D coverage gap
    Participant
    Must Pay 100%
    Of his own costs
    Until . . . . (Note: this
    will change with H.C. Reform Law)
  • The plan is approaching bankruptcy in 2019.
    The Dartmouth Study – inappropriate care
    Health Reform law is designed to take $550 billion out of budget. (Eliminate fraud and abuse and lower provider reimbursements)
    Some providers are declining to take Medicare patients.
    There is real threat of rationing.
    12/07/10
    41
    Medicare – Some Issues
  • Increase taxes (need 122% increase)
    Reduce benefits (need 51%)
    Reduce reimbursements to providers
    Prospective payment system
    Introduce value based market reform which will increase quality and reduce costs.
    Pay for bundled services.
    Extend it to everyone or to early retirees whose employers do not provide health care.
    Risk adjusted reimbursements
    Gov’t uses leverage to reduce reimbursements and also Rx prices.
    12/07/10
    42
    Medicare Reform . . Ideas!
  • Clinical outcomes data: www.hospitalcompare.hhs.gov/
    http://leapfroggroup.org/
    12/07/10
    43
    Quality and cost competition
  • Will these changes cause “cost shifting?”
    What about “rationing?”
    How could this be avoided?
    12/07/10
    44
    Query:
  • 12/07/10
    45
    Health care for the poor: Medicaid
  • Medicaid-Social Welfare Program
    State administered.
    Big Problem: LTC
    Health coverage for the poor (over 40 million).
    Also aligned with SCHIP to cover children whose families are not eligible for Medicaid.
    Funded by general revenue of States and Federal government.
    Standards set by Federal government but administered by the states.
    Long term care
    12/07/10
    46
  • Fee for service, indemnity plan – but not “insurance.” It is basically free health care.
    In patient and out-patient hospitalization
    Physician care
    Lab services
    Preventive care
    Well-baby and child immunizations
    Patients can see private physicians who are reimbursed by Medicaid
    Long term care for the poor (in all venues)
    12/07/10
    47
    Medicaid – plan design
  • Medicaid – some fiscal issues
    No systemic reform
    The causes
    Same problems as with other health care programs.
    Under the Affordable Health Care Act of March 2010, Medicaid continues.
    Rising health care costs.
    Increased number of eligible persons.
    Federal mandates
    Fleeing providers
    Long term care
    12/07/10
    48
  • Change reimbursements and base on quality.
    New universal medical records
    Eliminate inappropriate care
    Have parties put “some skin in the game.”
    Improve efficiencies of hospital and physician providers.
    Providers can decline patients.
    Is there cost shifting here?
    New eligibility standard – 133% FPL – with Patient Protection, Affordable H.C. Act of 2010.
    Conflict – who pays? Fed or state?
    12/07/10
    49
    Medicaid – Fiscal Survival
  • 12/07/10
    50
    Reform: affordability, then choose delivery system
  • H.C. Reform Law requires offering it to employees – at their costs
    Expand home care.
    Invest in medical research for a cure to Alzheimer Disease
    Consumer directed approach for Medicaid participants?
    Change or tighten eligibility – trust creations and spend downs.
    12/07/10
    51
    Long term care . . . 37% of budget
  • Covers active duty military veterans
    There is some cost sharing
    Comprehensive plan includes all diagnostic, primary, hospitalization, nursing home, and prescription care.
    The care is dispensed at Veteran Administration facilities.
    12/07/10
    52
    Veterans’ Health Care
  • Care is highly integrated.
    There is also a single, computerized medical record for each patient.
    Better tracking of patients and reduction of medical errors.
    Highly rated by Joint Commission on Accreditation of Health Care Organizations.
    Long term patient relationship means high payoff for preventive care.
    12/07/10
    53
    Veterans’ Health Care
  • What are they?
    12/07/10
    54
    Mandated Benefits
    See my Blog!
    Affordable
    Health Care Act of 2010
    FMLA
    HIPAA
    COBRA
    USERRA
  • What are they?
    Life Events of Employees
    And more . . .
    An extension of health care upon loss of job (COBRA)
    Mandated coverage for individuals and employers (H.C. Reform 2014)
    Must cover pre-existing conditions – currently HIPPA, later Patient Protection Act.
    Leaves of absence for sick employees and others.
    Persons in uniform guaranteed restoration of benefits and employment upon return.
    12/07/10
    55
  • 12/07/10
    56
    What are the life events?
  • 12/07/10
    57
    What are the policy objectives?
  • To extend health care coverage for a person who because of loss of job, divorce, or loss of dependent status, is no longer covered by health care plan.
    Key Provisions: Coverage (20 employees) and person must have been a participant in the plan.
    Note: this is affected by new H.C. Reform that requires dependent care for children up to age 26.
    12/07/10
    58
    COBRA Consolidated Omnibus Budget Reconciliation Act of 1986
  • Key Provisions: Not discharged for gross misconduct.
    Key Provisions: Continued coverage for 18 to 36 months.
    Key Provisions: Must pay 102% of total Health Care premium.
    If unemployed, must pay 35% of premium.
    Employer notice of coverage and availability!
    12/07/10
    59
    COBRA
  • John works for company and is discharged. He has not found a job and wants to continue his health care coverage. What are the issues and how would you resolve them?
    12/07/10
    60
    COBRA
  • Coverage
    Reasons for discharge
    Duration of continued coverage
    Required payment of premium
    What would be the consequences if John voluntarily quit his job?
    12/07/10
    61
    COBRA -Issues
  • What if John is divorcing his wife who has health care coverage from her employer? John wants to continue this coverage. What are John’s rights and how should he protect them?
    What if John’s wife died while employed and she had H.C. under which he was covered?
    What if John’s wife was reduced in hours and no longer covered because of her part time status?
    12/07/10
    62
    COBRA
  • Is wife’s employer covered by COBRA?
    If so, John must notify ex-wife’s employer within 60 days of his intent.
    He would be entitled to 36 months of continued coverage.
    He must pay 102% of full premium.
    Unless he is unemployed, in which case he must pay 35%.
    12/07/10
    63
    COBRA – the statutory framework
  • 12/07/10
    64
    What happens when you graduate?
  • Family dependent coverage extends until child reaches age 26, even if he has coverage from his employer – unless it’s a grandfathered plan. In 2014, this exception is no longer applicable. Also, he does not have to be a legal dependent.
    Student will then be entitled to COBRA coverage after. Period: 36 months.
    Unemployed: 35% of fee paid by participant, 65% paid by government.
    12/07/10
    65
    What are rules for students?
  • Buy a temporary, high deductible plan between the time period beginning at loss of student status and the date of new employer coverage. (See: www.ehealthinsurance.com/)
    Or, send her to Kroger’s Mini Clinic.
    12/07/10
    66
    Alternatives to COBRA
  • 12/07/10
    67
    Query? COBRA after PPACA?
  • 12/07/10
    68
    I really want to change jobs to get more free time to cycle..
  • Problem: I have diabetes
    Job Lock – if I leave . . .
    There’s no turning back
    II will not be able to get health care in a new job.
    They will exclude from coverage all medical expenses for my diabetes.
    So, I will just stay in my current, lousy job
    12/07/10
    69
  • There is a law that will protect you!
    Applies to Insurance!
    It’s “magic!”
    HIPPA, a class act since 1993 . . .
    Limits the application of pre-existing exclusions or waiting times.
    Also includes privacy provisions.
    12/07/10
    70
  • BUT WAIT! Patient Protection Act of 2010
    Let’s see what it does.
    We’ve got 4 years to go.
    Will change HIPAA and eventually eliminate any right of the insurer to exclude coverage for any pre-existing illness. (children now and others later)
    Is HIPAA still alive?
    12/07/10
    71
  • A law that insures patient medical record privacy.
    A law that removes a barrier to job mobility: fear of loss of health care coverage for a pre-existing condition.
    Coverage: Were you covered by a health care plan or COBRA?
    This has been in effect since 1993 for all plans and employers.
    12/07/10
    72
    HIPAA Health Insurance Portability and Accountability Act
  • What is a pre-existing condition -A condition for which you were treated within the last 6 months.
    No “break in coverage” > 63 days.
    Prohibits or limits a new employer from excluding coverage of a pre-existing health care condition.
    12/07/10
    73
    HIPAA
  • If the employee had “creditable coverage” for a period of 12 preceding months and there was no “break in coverage” of more than 63 days, there can be no exclusion of pre-existing condition.
    If the coverage was less than 12 months, the new employer can exclude on a pro-rated (1:1) basis.
    12/07/10
    74
    HIPAA
  • HYPO: John suffers from diabetes. He had health care coverage under previous employer (Company A) for 6 months. He quit this employer and accepted a new job at Company B. Can B exclude coverage for diabetes?
    What are the issues and how resolved?
    12/07/10
    75
    HIPAA
  • Is it a pre-existing condition?
    What was elapsed time of break in service?
    Was previous coverage “creditable?”
    What is maximum period employer B can exclude preexisting condition claims?
    For what condition?
    12/07/10
    76
    HIPAA Analytical Template:
  • You had coverage under your parents’ health care plan until your May graduation.
    You have a serious hypertension problem.
    You don’t start your new job until September.
    Can the new employer exclude any coverage for your hypertension problem?
    Does the up to age 26 continued coverage apply here? How?
    12/07/10
    77
    HIPAA - Student Hypo
  • Is there a “pre-existing condition?”
    How do you maintain creditable coverage without 63 day break?
    Will COBRA or a personal health care plan count as “creditable coverage?”
    Will there be any offset of coverage?
    12/07/10
    78
    Student Hypo - Issues
  • You have a pre-existing diabetic condition. Your last treatment date for the condition was 3 weeks ago. You have had creditable health care coverage for the past year. You have been offered a job at a new company. The problem is that they have a 90 day waiting period for health care coverage. What are issues?
    12/07/10
    79
    HIPAA -- HYPO
  • The issue is the 63 day break in service.
    The waiting period is longer than 63 days.
    Provided you were employed within 63 days of the lapse of the previous coverage, and you enroll on the first available date you can with the new employer, the 63 day break would not apply.
    12/07/10
    80
    HIPAA Hypo
  • You have had 6 months of creditable coverage before moving to a new job. You have been treated for a heart condition in the last 3 months. The new employer has a 90 day waiting period before coverage begins. Can the new employer exclude coverage for the heart condition? If so, for how long?
    12/07/10
    81
    HIPAA Hypo
  • The new employer can exclude coverage of the heart condition for a maximum of 6 months, because there is a 1:1 credit for the previous coverage. However, the 6 months period will begin on the date the waiting period begins. So, since this period is 90 days, they can only exclude coverage for an additional 90 days.
    12/07/10
    82
    HIPAA
  • There can be no exclusion of pre-existing condition for:
    Newborns who were covered previously
    Recently adopted who was also covered
    Pregnancy condition
    Genetic markers
    12/07/10
    83
    HIPAA Exclusions
  • 12/07/10
    84
    Query: What is future of HIPAA?
  • 12/07/10
    85
    Iraq and Afghanistan . . .
  • My Army reserve unit is called up!
    Job protection -
    Let’s get back to work.
    What happens to my full time job?
    Will I be able to return to employment?
    How long can I be on activated duty or deployment before I lose my job rights.
    What job do I get when I return?
    12/07/10
    86
  • To minimize the employment disadvantages of a person who must be absent from his civilian employment to serve his or her country in uniformed services.
    12/07/10
    87
    USERRA Uniformed Services Employment Employment and Re-employment Rights Act of 1994
  • Applies to active duty, training, and disaster assistance.
    Uniformed services include all military branches as well as National Guard and Public Health Service
    Insures re-employment rights, non-discrimination, and benefit continuation
    12/07/10
    88
    USERRA
  • Maximum cumulative period of absence is 5 years, but there are numerous exceptions for this: involuntary extensions of duty, continued service while at sea, war, and critical missions.
    No protection if dishonorable or less than honorable discharge.
    12/07/10
    89
    USERRA
  • Must report back to work within specific time limits: 1 to 30 days, 1 day; 31 to 180 days, 14 days after completion; service more than 181 days, 90 days after completion.
    Returning late subjects employee to employer’s rules on absence.
    12/07/10
    90
    USERRA
  • Employer must promptly re-employ.
    Upon return to work, the “escalator principle” may be applicable if employee is qualified. (seniority = passage of time)
    Employer must reasonably “accommodate” those returning with disabilities.
    12/07/10
    91
    USERRA
  • Pension rights are treated as “seniority” and no “breaks in service,” for vesting credit and benefit accrual.
    DCP’s treated differently. Why?
    Vacation: does it accrue during absence?
    What about health benefits?
    12/07/10
    92
    USERRA
  • Health care continuation if normal premiums are paid; provided leave is 30 or less days.
    If longer, then COBRA applies.
    No waiting period for coverage upon return.
    Only “Just cause” termination permitted up to one year after return from service.
    12/07/10
    93
    USERRA
  • USERRA
    What would you do?
    The family is covered.
    Armed forces makes health care plan available to dependents of reservist.
    Some employers are more generous than the law requires, especially with benefits.
    What are the risks here?
    12/07/10
    94
  • Joe, a National Guardsman, is called to active duty in Iraq. He has been employed as an apprentice electrician. His employer offers an HDHCP with an HSA and a Defined Benefit Pension Plan. He returns from active duty after one year. He has a wife and 2 children
    12/07/10
    95
    USERRA HYPO
  • When does he have to return to work?
    What are his reemployment rights?
    How will his benefits be treated?
    12/07/10
    96
    Issues for Joe?
    Hey Joe! Get home!
  • 12/07/10
    97
    I really don’t feel good today.
  • FMLA The Family and Medical Leave Act of 1993
    When?
    Pay, coverage, limits
    To provide time off from work without the risk of losing one’s job when: the employee is seriously ill, is a new parent, a member of his immediate family is seriously ill, or due to military deployment of family (see below)
    There is no requirement for pay. The employee must have worked for at least one year. Employer must have 50 employees
    The total leave cannot exceed 12 weeks in one year..
    12/07/10
    98
  • Now FMLA applies to eligible employee to take care of close family member who was injured while serving in the military. The term is 26 weeks.
    Also, when there is short notice of deployment and exigent circumstances arise, the eligible employee whose spouse, child, or parent is deployed may take up to 12 weeks leave to these related obligations.
    12/07/10
    99
    FMLA – new (2008) changes
  • 12/07/10
    100
    12 weeks for “qualifying exigency” arising because employee’s spouse, child, or parent has been called to active duty.
    Does not apply to family of military members in regular armed forces.
    Includes: 1) short-notice deployment (limited to seven calendar days from date notified of deployment); 2) military events and related activities; 3) childcare and school activities; 4) financial and legal arrangements; 5) counseling; 6) rest and recuperation (limited to five days of FMLA leave); 7) post-deployment activities; and 8) additional activities (must be agreed to by both employer and employee).
    Read the fine print!
  • What is “serious health condition?” Hospital, incapacity, chronic condition, continuing treatments, or condition lasting three or more days, and certain minimum doctor visits are required.
    Applies to immediate family care.
    Can be required to use vacation or other paid leave.
    Intermittent care is OK, but not for parental leave.
    12/07/10
    101
    FMLA
  • Employer can verify illness of employee but only agent can check illness of dependent.)
    Paid Leave (partial day sick leave, vacations)
    Bonuses/Perfect Attendance can be denied even if leave was FMLA
    Right to Request Recertification every 30 days
    Fitness-For-Duty Certification – the employee must be advised in advance of this requirement.
    Light Duty Not FMLA Leave!
    12/07/10
    102
    Read the fine print
  • FMLA
    Some exceptions
    Now let’s practice . . .
    Employer can refuse to reinstate highly paid “key” employees if prolonged leave will seriously disrupt operations.
    Are “No-fault“ attendance policies dead?”
    12/07/10
    103
  • Employer has “no fault” attendance policy allowing discipline of employee who misses more than 15 days over a 6 month period. Employer is not concerned about the reasons for the absence. The policy was enacted due to serious attendance problems that significantly increased the cost of operations.
    12/07/10
    104
    FMLA - HYPO
  • Joe has been absent the following days: 3 in September due to the “flu.” Then he missed 10 days in October due to “Shingles.” In November he missed 7 days due to a sprained ankle sustained while playing basketball with his family.
    What are the issues here and how would you resolve them?
    12/07/10
    105
    FMLA HYPO
  • Coverage?
    Is Joe protected?
    Has he violated policy?
    Does policy comply with FMLA?
    What will be likely outcome if he is discharged?
    12/07/10
    106
    FMLA HYPO
  • 12/07/10
    107
    Legislating Work-Life Balance
  • 12/07/10
    108
    Employer must comply and insure a safe landing!