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HomeMy WebLinkAbout2012-014 Group Health Insurance Changes; YMC Addition 2.04.030 C; YMC Deletion 2.04.060ORDINANCE NO. 2012-14 AN ORDINANCE relating to Group Insurance for employees of the City of Yakima; amending Chapter 2.04 entitled "Group Insurance" of the City of Yakima Municipal Code, specifically by adding a new section 2.04.030 C on authority to exempt certain positions from the health care plan, and deleting 2.04.060 entitled "Physical Examination". BE IT ORDAINED BY THE CITY OF YAKIMA: Chapter 2.04 GROUP INSURANCE Sections: 2.04.010 Health care plan. 2.04.020 Definitions. 2:04.030 City contributions. 2.04.040 Hospital and medical insurance—Retired employee and dependent coverage. 2.04.050 Dental insurance plan—Retired employee coverage. 2.04.060 Physical examination. 2.04.100 Welfare benefit program. 2.04.010 Health care plan. The city is self-insured for its medical and dental insurance plans (hereafter referred to in YMC 2.04.010, 2.04.020 and 2.04.030 as the "health care plan"). The health care plan includes medical, dental and vision coverage for city employees as defined in the health care plan and for members of the city council. The medical and dental insurance plans are administered for the city by third party administrators. The city manager of the city of Yakima is authorized to enter into a contract or contracts with third party administrators to administer the medical and dental insurance plans. The health care plan shall be on file in the human resources division of the city. (Ord. 2008-57 § 1, 2008: Ord. 1757 § 1, 1975; Ord. 1750 § 1, 1975; Ord. 1744 § 1, 1975; Ord., 758, 1965: Ord. 149 § 1, 1960). 2.04.020 Definitions. "Cost of coverage" means the average monthly cost of coverage for the health care plan as determined from time to time by the city's health care administrator, the city's employee benefits broker; and/or the city manager. The final decision on the cost of coverage shall be made by the city: manager. Such determination shall be final and binding. (Ord. 2008-57 § 2, 2008). 2.04.030 City contributions. A. Life Insurance Plan. 1. Effective October 24, 1991, the city shall provide a fully paid life insurance policy in an amount equal to the annual salary for all management employees as defined in subsection B of this section, as well as for the chief, deputy chiefs and battalion chiefs of the Yakima fire department and the chief, deputy chief, captains and lieutenants of the Yakima police department. 2. For all employees covered by a collective bargaining agreement, the city shall provide a life insurance policy in the amount required in the applicable collective bargaining agreement. B. Health Care Plan. The city shall contribute toward the payment of the monthly cost of coverage of the health care plan in the following manner for each group of employees or positions, respectively: 1. Represented Employee Contributions. For all employees covered by a collective bargaining agreement, the city shall pay its portion of the total monthly cost of coverage under the health care plan as provided in the applicable collective bargaining agreement, and the employee shall pay his or her portion of the total monthly cost of coverage under the health care plan as provided in the applicable collective bargaining agreement. 2. Management Employee Contributions. a. "Management employee" means any nontemporary employee in the management series, executive support series and executive series as defined by YMC 2.20.100; in the public safety management series as defined by YMC 2.20.110; and any other nontemporary employee in YMC 2.20.100(D) who is not a member of any collective bargaining unit recognized by the city. b. "Member of the city council" means any person holding the office of city of Yakima council member, who elects to pay the entire cost of coverage of the city of Yakima health care plan. c. From January 1, 2009, on, except for the chief, deputy chiefs, and battalion chiefs in the fire department and the chief, deputy chief, captains and lieutenants in the police department, or unless otherwise provided in the applicable collective bargaining agreement, the following provisions apply: All management employees shall pay the first fifty dollars of the total monthly cost of coverage under the health care plan for the employee through a monthly payroll deduction. If an employee only is covered in the health care plan and the employee has no spouse or -2- dependents in the health care plan, then the city shall pay the balance of the employee -only unit cost in excess of the first fifty dollars that the employee pays. For a management employee with a spouse and/or dependents in the health care plan, any cost of coverage for the management employee with a spouse and/or dependents in the plan in excess of the first fifty dollars that the employee pays shall be paid by the management employee through a monthly payroll deduction based on the following percentages on the remaining balance above the first fifty dollars: the employee shall pay at the rate of twenty-five percent of the balance of the remaining total monthly cost of coverage, and the city shall contribute the remaining seventy-five percent of the balance of the total monthly cost of coverage. d. For the chief, deputy chief, captain and lieutenants of the Yakima police department and the chief, deputy chiefs and battalion chiefs of the Yakima fire department, unless otherwise provided in an applicable collective bargaining agreement, the city shall pay the total monthly cost of coverage under the health care plan for the employee. If the chief, deputy chief, captain and lieutenants of the Yakima police department and the chief, deputy chiefs and battalion chiefs of the Yakima fire department have a spouse and/or dependents in the health care plan, then the employee shall pay through a monthly payroll deduction at the rate of fifty percent of the monthly dependent unit cost of coverage for the employee's spouse and/or dependents, and the city shall contribute the remaining fifty percent of the total monthly dependent unit cost of coverage for the employee's spouse and/or dependents, unless otherwise provided in an applicable collective bargaining agreement. (Ord. 2008-57 § 3, 2008: Ord. 97-28 § 1, 1997; Ord. 96-66 § 1, 1996; Ord. 93-84 § 1, 1993: Ord. 3403 § 1, 1991; Ord. 3325 § 1, 1990; Ord. 3252 § 1, 1990; Ord. 2688 § 1, 1983; Ord. 2266 § 1, 1979; Ord. 2265 § 1, 1979; Ord. 2153 § 1, 1978; Ord. 1750 §§ 2, 3, 1975; Ord. 1744 §§ 2, 3, 1975; Ord. 1614 § 1, 1974: Ord. 1474 § 1, 1972: Ord. 1081 § 1, 1968: Ord. 758, 1965: Ord. 319 § 1, 1962: Ord. 149 § 3, 1960). C. Authority to Exempt Certain Positions from Health Care Plan. Pursuant to YMC Chapter 2.04, the city manager and the heads of the city departments are entitled to be covered by the city's employee health care plan. This section 2.04.030 C is limited to and for the purpose of recruitment only for the specific positions of city manager, chief of police, fire chief, city attorney, director of public works, director of community and economic development, and director of finance, when the person to whom an offer of employment is made has an existing health care plan from his or her former employment that he or she desires to maintain upon employment with the city. In that event, then the city council for the city manager position, and the city manager for the department head positions, have the authority to agree in writing to compensate that person for the cost to him or her to maintain his or her present health -3- care plan, up to but not to exceed the amount the city's health care plan would otherwise have contributed to his or her health care costs for similar coverage under the city's health care plan. This health care cost payment shall be included with the employee's monthly compensation amount as a separate item and shall be treated as a taxable benefit subject to normal withholding taxes.. The city's contribution for the health care allowance shall not be included in any calculations as base pay. If, and at such time as the city employee's prior health care plan becomes fully paid and no longer requires financial contributions from him or her to maintain his or her health care coverage, the city's obligation to contribute toward that health care coverage shall cease. In no event shall the city's contribution for the health care allowance be more than the city would have contributed if the employee had similar coverage under the city health care plan. In addition, in the event that the employee's prior health care coverage ends and the employee desires to enroll in the city health care plan, that employee may do so provided the employee complies with the enrollment requirements for the city health care plan. 2.04.040 Hospital and medical insurance—Retired employee and dependent coverage. A. Retired Employees. The following described retired city employees shall be eligible to remain enrolled in the group hospital and medical insurance plan and to obtain coverage for their eligible dependents until the retired employee reaches sixty-five years of age by paying a premium (including the premium for dependents, if enrolled) equal to the actual group rate for coverage of active city employees and enrolled dependents: 1. City employees who retire on or after January 1, 1982, and who at the time of their retirement work in positions within the bargaining unit of the American Federation of State, County and Municipal Employees, Local 1122; and 2. City employees who retire on or after January 1, 1983, and who at the time of their retirement work in any of the following positions: a. All fire department positions, b. AH commissioned police department officers, c. All employees in exempt classifications specified by YMC 2.20.100, and d. All other positions defined by the policy as being eligible for coverage. B. Spouses of Retired Employees. Spouses of retired commissioned police department officers, retired fire chiefs and deputy fire chiefs and retired employees who, at the time of retirement, were in exempt classifications specified by YMC 2.20.100, which spouses are otherwise eligible for coverage under provisions of the insurance policy, shall be eligible to remain enrolled in the group hospital and medical insurance plan until those spouses reach the age of sixty-five years (or in the case of spouses of deceased retirees, until the spouse -4- remarries) by paying a premium equal to the actual group rate for enrolled dependents. (Ord. 2835 § 1, 1985: Ord. 2749 § 1, 1984: Ord. 2686 § 2, 1983). 2.04.050 Dental insurance plan—Retired employee coverage. A. Retired Employees. The following described retired city employees who retire on or after January 1, 1983, shall be eligible to remain enrolled in the group dental insurance plan and to obtain coverage for their eligible dependents until the retired employee reaches sixty-five years of age by paying a premium (including the premium for dependents, if enrolled) equal to the actual group rate for coverage of active city employees and enrolled dependents: 1. Chief and deputy 'chief of Yakima fire department; 2. Chief, captains and lieutenants of the Yakima police department; and 3. All employees in exempt classifications specified by YMC 2.20.100. B. Spouses of employees retired from positions specified in subsection A of this section, which spouses are otherwise eligible for coverage under provisions of the insurance policy, shall be eligible to remain enrolled in the group dental insurance plan until those spouses reach the age of sixty-five years (or in the case of spouses of deceased retirees, until the spouse remarries) by paying a premium equal to the actual group rate for enrolled dependents. (Ord. 2835 § 2, 1986). 2.04.100 Welfare benefit program. A. The city of Yakima employees' welfare benefit program, attached as Appendix 1 to the ordinance codified in this section and incorporated herein by reference, is adopted and approved. B. The city manager, or his designee, shall be authorized and directed to perform all management, administration and other responsibilities of the city under the city of Yakima's employees' welfare benefit program, except as expressly provided by such program or as required by law. C. The participation agreements between the city and the Washington State Council of County and Municipal Employees, Washington State Council of County and City Employees, AFSCME, Local 1122, AFL-CIO ("AFSCME"); Yakima Police Patrolmans Association ("YPPA") and Local 469, International Association of Firefighters, AFL-CIO, attached to the ordinance codified in this section. as Appendices 2, 3, 4 and 5, respectively and incorporated herein by reference, are approved, and the city manager is authorized and directed to execute said participation agreement. -5- D. The Yakima Air Terminal may join the city's employee welfare benefit program and its management employees and duly represented employees may participate in plans thereunder by action of the airport terminal board. E. In the event that there is a conflict between any provision of this section or any provision of the employee welfare benefit program and any other section of this chapter, this section and the employee welfare benefit program shall take precedence. (Ord. 94-9 § 3, 1994). SECTION 1. If any section, subsection, paragraph, sentence, clause or phrase of this ordinance is declared invalid or unconstitutional for any reason, such decision shall not affect the validity of the remaining portions of this ordinance. SECTION 2. This ordinance shall be in full force and effect 30 days after its passage, approval, and publication as provided by law and by the City Charter. PASSED BY THE CITY COUNCIL, signed and approved this 3rd day of April, 2012. Ordinance No.: 2012-14 Publication Date: April 6, 2012 Effective Date: May 6, 2012 -6- AN ORDINANCE ORDINANCE NO. -2012-14 relating to Group Insurance for employees of the City of Yakima; amending Chapter 2.04 entitled "Group Insurance" of the City of Yakima Municipal Code, specifically by adding a new section 2.04.030 C on authority to exempt certain positions from the health care plan, and deleting 2.04.060 entitled "Physical Examination". BE IT ORDAINED BY THE CITY OF YAKIMA: Chapter 2.04 GROUP INSURANCE Sections: 2.04.010 Health care plan. 2.04.020 Definitions. 2.04.030 City contributions. 2.04.040 Hospital and medical insurance—Retired employee and dependent coverage. 2.04.050 Dental insurance plan—Retired employee coverage. 2.04.060 Physical examination. 2.04.100 Welfare benefit program. 2.04.010 Health care plan. The city is self-insured for its medical and dental insurance plans (hereafter referred to in YMC 2.04.010, 2.04.020 and 2.04.030 as the "health care plan"). The health care plan includes medical, dental and vision coverage for city employees as defined in the health care plan and for members of the city council. The medical and dental insurance plans are administered for the city by third party administrators. The city manager of the city of Yakima is authorized to enter into a contract or contracts with third party administrators to administer the medical and dental insurance plans. The health care plan shall be on file in the human resources division of the city. (Ord. 2008-57 § 1, 2008: Ord. 1757 § 1, 1975; Ord. 1750 § 1, 1975; Ord. 1744 § 1, 1975; Ord. 758, 1965: Ord. 149 § 1, 1960). 2.04.020 Definitions. "Cost of coverage" means the average monthly cost of coverage for the health care plan as determined from time to time by the city's health care administrator, the city's employee benefits broker, and/or the city manager. The final decision on the cost of coverage shall be made by the city manager. Such determination shall be final and binding. (Ord. 2008-57 § 2, 2008). SECTION 1. A new paragraph C is added to chapter 2.04.030 of the Yakima Municipal Code to read as follows: W� TRACK C I APGCS 2.04.030 City contributions. A. Life Insurance Plan. 1. Effective October 24, 1991, the city shall provide a fully paid life insurance policy in an amount equal to the annual salary for all management employees as defined in subsection B of this section, as well as for the chief, deputy chiefs and battalion chiefs of the Yakima fire department and the chief, deputy chief, captains and lieutenants of the Yakima police department. 2. For all employees covered by a collective bargaining agreement, the city shall provide a life insurance policy in the amount required in the applicable collective bargaining agreement. B. Health Care Plan. The city shall contribute toward the payment of the monthly cost of coverage of the health care plan in the following manner for each group of employees or positions, respectively: 1. Represented Employee Contributions. For all employees covered by a collective bargaining agreement, the city shall pay its portion of the total monthly cost of coverage under the health care plan as provided in the applicable collective bargaining agreement, and the employee shall pay his or her portion of the total monthly cost of coverage under the health care plan as provided in the applicable collective bargaining agreement. 2. Management Employee Contributions. a. "Management employee" means any nontemporary employee in the management series, executive support series and executive series as defined by YMC 2.20.100; in the public safety management series as defined by YMC• 2.20.110; and any other nontemporary employee in YMC 2.20.100(D) who is not a member of any collective bargaining unit recognized by the city. b. "Member of the city council" means any person holding the office of city of Yakima council member, who elects to pay the entire cost of coverage of the city of Yakima health care plan. c. From January 1, 2009, on, except for the chief, deputy chiefs, and battalion chiefs in the fire department and the chief, deputy chief, captains and lieutenants in the police,department, or unless otherwise provided in the applicable collective bargaining agreement, the following provisions apply: All management employees shall pay the first fifty dollars of the total monthly cost of coverage under the health care plan for the employee through a monthly payroll deduction. If an employee only is covered in the health care plan and the employee has no spouse or -2- C. dependents in the health care plan, then the city shall pay the balance of the employee -only unit cost in excess of the first fifty dollars that the employee pays. For a management employee with a spouse and/or dependents in the health care plan, any cost of coverage for the management employee with a spouse and/or dependents in the plan in excess of the first fifty dollars that the employee pays shall be paid by the management employee through a monthly payroll deduction based on the following percentages on the remaining balance above the first fifty dollars: the employee shall pay at the rate of twenty-five percent of the balance of the remaining total monthly cost of coverage, and the city shall contribute the remaining seventy-five percent of the balance of the total monthly cost of coverage. d. For the chief, deputy chief, captain and lieutenants of the Yakima police department and the chief, deputy chiefs and battalion chiefs of the Yakima fire department, unless otherwise provided in an applicable collective bargaining agreement, the city shall pay the total monthly cost of coverage under the health care plan for the employee. If the chief, deputy chief, captain and lieutenants of the Yakima police department and the chief, deputy chiefs and battalion chiefs of the Yakima fire department have a spouse and/or dependents in the health care plan, then the employee shall pay through a monthly payroll deduction at the rate of fifty percent of the monthly dependent unit cost of coverage for the employee's spouse and/or dependents, and the city shall contribute the remaining fifty percent of the total monthly dependent unit cost of coverage for the employee's spouse and/or dependents, unless otherwise provided in an applicable collective bargaining agreement. (Ord. 2008-57 § 3, 2008: Ord. 97-28 § 1, 1997; Ord. 96-66 § 1, 1996; Ord. 93-84 § 1, 1993: Ord. 3403 § 1, 1991; Ord. 3325 § 1, 1990; Ord. 3252 § 1, 1990; Ord. 2688 § 1, 1983; Ord. 2266 § 1, 1979; Ord. 2265 § 1, 1979; Ord. 2153 § 1, 1978; Ord. 1750 §§ 2, 3, 1975; Ord. 1744 §§ 2, 3, 1975; Ord. 1614 § 1, 1974: Ord. 1474 § 1, 1972: Ord. 1081 § 1, 1968: Ord. 758, 1965: Ord. 319 § 1, 1962: Ord. 149 § 3, 1960). /authority to Exempt Certain Positions from Health Care Plan. Pursuant to YMC Chapter 2.04, the city manager and the heads of the city_ departments are entitled to be covered by the cty's.employee health care plan. This section 2.04.030 C is limited to and for the purpose of recruitment only for the specific positions of city manager, chief of police, fire chief, city attorney, director of public works, director of community and economic development, and director of finance, when the person to whom an offer of employment is made has an existing health care plan from his or her former employment that he or she desires to maintain upon employment with the q[ty. In that event, then the city council for the qty manager position, and the city manager for the department head positions, have the authority to agree in writing to compensate that person for the cost to him or her to maintain his or her present health care -3- t Formatted: Right: 0.5" Formatted: Font: (Default) Arial Formatted: Indent: Left: 0.5", Right: 0.5" Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial !i( Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial • Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial ( Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial l Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial { Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial plan, up to but not to exceed the amount the cty's health care plan would otherwise have contributed to his or her health care costs for similar coverage under the city's health care plan. This health care cost payment shall be included with the employee's monthly compensation amount as a separate item and shall be treated as a taxable benefit subject to normal withholding taxes. The city's contribution for the health care allowance shall not.be included in any calculations as base pay. If, and at such time as the city employee's prior health care plan becomes fully paid and no longer requires financial contributions from him or her to maintain his or her health care coverage, the city's obligation to contribute toward that health care coverage shall cease. In no event shall the city's contribution for the health care allowance be more than the 5ity would have contributed if the employee had similar coverage under the City health care plan. In addition, in the event that the employee's prior health care coverage ends and the employee desires to enroll in the city health care plan, that employee may do so provided the employee complies with the enrollment requirements for the city health care plan. 2.04.040 Hospital and medical insurance—Retired employee and dependent coverage. A. Retired Employees. The following described retired city employees shall be eligible to remain enrolled in the group hospital and medical insurance plan and to obtain coverage for their eligible dependents until the retired employee reaches sixty-five years of age by paying a premium (including the premium for dependents, if enrolled) equal to the actual group rate for coverage of active city employees and enrolled dependents: 1. City employees who retire on or after January 1, 1982, and who at the time of their retirement work in positions within the bargaining unit of the American Federation of State, County and Municipal Employees, Local 1122; and 2. City employees who retire on or after January 1, 1983, and who at the time of their retirement work in any of the following positions: a. All fire department positions, b. All commissioned police department officers, c. All employees in exempt classifications specified by YMC 2.20.100, and d. All other positions defined by the policy as being eligible for coverage. B. Spouses of Retired Employees. Spouses of retired commissioned police department officers, retired fire chiefs and deputy fire chiefs and retired employees who, at the time of retirement, were in exempt classifications specified by YMC 2.20.100, which spouses are otherwise eligible for coverage under provisions of the insurance policy, shall be eligible to remain enrolled in the group hospital and medical insurance plan until those spouses reach the age of sixty-five years (or in the case of spouses of deceased retirees, until the spouse -4- Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial { Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial Formatted: Font: (Default) Arial remarries) by paying a premium equal to the actual group rate for enrolled dependents. (Ord. 2835 § 1, 1985: Ord. 2749 § 1, 1984: Ord. 2686 § 2, 1983). 2.04.050 Dental insurance plan—Retired employee coverage. A. Retired Employees. The following described retired city employees who retire on or after January 1, 1983, shall be eligible to remain enrolled in the group dental insurance plan and to obtain coverage for their eligible dependents until the retired employee reaches sixty-five years of age by paying a premium (including the premium for dependents, if enrolled) equal to the actual group rate for coverage of active city employees and enrolled dependents: 1. Chief and deputy chief of Yakima fire department; 2. Chief, captains and lieutenants of the Yakima police department; and 3. All employees in exempt classifications specified by YMC 2.20.100. B. Spouses of employees retired from positions specified in subsection A of this section, which spouses are otherwise eligible for coverage under provisions of the insurance policy, shall be eligible to remain enrolled in the group dental insurance plan until those spouses reach the age of sixty-five years (or in the case of spouses of deceased retirees, until the spouse remarries) by paying a premium equal to the actual group rate for enrolled dependents. (Ord. 2835 § 2, 1986). SECTION 2. Section 2.04.060 of the Yakima Municipal Code is deleted in its entirety from the Code: chief and chief of the Yakima fire department, and all management employees defined in subsection 2.01.030(0) of this code shall be eligible to voluntarily by the individual employee, the cost of which shall be shared equally by the exceed one hundred dollars for any such examination. (Ord. 3103 § 2, 1991: Ord. 2835 § 3, 1086)- 2.04.100 Welfare benefit program. A. The city of Yakima employees' welfare benefit program, attached as Appendix 1 to the ordinance codified in this section and incorporated herein by reference, is adopted and approved. -5- B. The city manager, or his designee, shall be authorized and directed to perform all management, administration and other responsibilities of the city under the city of Yakima's employees' welfare benefit program, except as expressly provided by such program or as required by law. C. The participation agreements between the city and the Washington State Council of County and Municipal Employees, Washington State Council of County and City Employees, AFSCME, Local 1122, AFL-CIO ("AFSCME"); Yakima Police Patrolmans Association ("YPPA") and Local 469, International Association of Firefighters, AFL-CIO, attached to the ordinance codified in this section as Appendices 2, 3, 4 and 5, respectively and incorporated herein by reference, are approved, and the city manager is authorized and directed to execute said participation agreement. D. The Yakima Air Terminal may join the city's employee welfare benefit program and its management employees and duly represented employees may participate in plans thereunder by action of the airport terminal board. E. In the event that there is a conflict between any provision of this section or any provision of the employee welfare benefit program and any other section of this chapter, this section and the employee welfare benefit program shall take precedence. (Ord. 94-9 § 3, 1994). SECTION 3. If any section, subsection, paragraph, sentence, clause or phrase of this ordinance is declared invalid or unconstitutional for any reason, such decision shall not affect the validity of the remaining portions of this ordinance. SECTION 4. This ordinance shall be in full force and effect 30 days after its passage, approval, and publication as provided by law and by the City Charter. PASSED BY THE CITY COUNCIL, signed and approved this 3rd day of April, 2012. /s/ Micah Cawley ATTEST: /s/ Sonya Claar Tee City Clerk Ordinance No.: 2012-14 Publication Date: April 6, 2012 Effective Date: May 6, 2012 -6- Micah Cawley, Mayor CITY OF YAKIMA EMPLOYEES' WELFARE BENEFIT PROGRAM TABLE OF CONTENTS Page INTRODUCTION 1 Article I Purpose and Term 1. Purpose 3 2. Term of Program 3 Article II Definitions Definitions 4 Article III The Board 1. The Program. 6 2. Number of Board Members 6 3. Appointment of Additional or Successor Board Members 7 4. Board Member Liability 7 5. Term of Appointment 7 6. Termination of Appointment by Employee Group 8 7. Recommendation for Termination of Appointment for Failure to Attend Meetings 8 8. Resignation of Appointment 8 9. Vacancies 8 10. Return of Books and Records 8 11. Manner of Voting 9 12. Super Majority Vote 9. 13. Constitution of a Quorum 9 14. Motions 9 15. Regular Meetings 9 16. Special Meetings 9 17. Appointment of Chairman and Vice -Chairman 10 18. Duties of Chairman and Vice -Chairman ... 10 19. Board Expenses 10 20. Benefits to Board Members Not Prohibited 10 a Article IV Allocation or Delegation of Board Responsibilities 1. Allocation of Responsibilities to Committees 10 Article V Board Responsibilities 1. General Responsibilities 11 2. Existing and Future Benefit Plans 11 3. Additional Benefit Plans 11 4. Design of the Benefit Plans 12 5. Means of Providing Benefits 12 6. Administrative Agent 12 7. Other Professional and Nonprofessional Help 12 8. Benefit Fund Amounts 13 9. Records 13 10. Procedure for Review of Benefit Claims 13 Article VI City Responsibilities 1. Program Administration 13 2. Contributions and Paid Benefits 13 3. Application of Benefit Fund Assets 14 4. Agents for Service of Process 14 5. Investment 14 6. Annual Audit 15 7. Program Description 15 8. Documents to be Examined or Furnished 15 9. All Records 15 Article VII Dispute Resolution Process 1. The Process 15 Asticle VIII Amendments and Termination 1. Amendments. 16 2. Termination .of Entire Agreement 17 3. Allocation Upon Termination. 17 4. -Withdrawal of a Participating Employee Group 17 5. Benefit Fund Reserves - Participating Employee Group Withdrawal 18 ll Article IX Enrollment into the Health Benefit Program 1. Initial Enrollment, Existing Employee Groups 18 2. Enrollment of Future Employee Groups 18 3. Enrollment of Withdrawn and Non -enrolled Employee Groups 18 Article X Severability Severability 19 CITY OF YAKIMA EMPLOYEES' WELFARE BENEFIT PROGRAM INTRODUCTION For years the City of Yakima has discussed the idea of the consolidation of all employee groups health and dental insurance plans into a smaller, more manageable number of plans and provide employees a larger group base to pool health and welfare benefit costs. As medical costs continued to spiral upwards, it was recognized that employees needed to be educated and better informed regarding the use and costs of health insurance. The continued rise in health care costs led to protracted contract negotiations between the City and the American Federation of' State, County and Municipal Employees ("AFSCME") bargaining unit including discussions regarding their leaving the City's self-insured program. With the settlement of the 1989-1991 AFSCME collective bargaining agreement, the first employee/employer joint health insurance committee was formed, the AFSCME Joint Committee on Health Insurance (the "Committee"). The Committee was comprised of four AFSCME members and four City representatives. The purpose of the committee was "to study and become informed regarding health insurance programs including the City's modified self-funded program; to identify perceived and real problems, and make recommendations to the City and the Union on ways to improve and enhance in an economical fashion the health insurance program." Further, the Committee was to explore the concept of a trust fund specifically for AFSCME employees and establishing a completely separate health insurance program for AFSCME employees. The AFSCME Joint Committee on Health Insurance began meeting late 1990 and met on a weekly basis carefully scrutinizing the benefits contained within City's Health Benefit Program, how the program is administered, how premium rates are established, trust insurance programs of other employers and studying health insurance as a whole. During the course of the committee's study, the topic of consolidating the seven divisions within the City's self-insured program was discussed at length. Through these discussions it became apparent to members of the Committee that it would be advantageous to Employees and the City to consolidate plans into one self insured program. Il-PERSNLL/amended 1 0/1 6/01 During the same time that the AFSCME Joint Committee on Health Insurance was meeting, the City and the Fire Law Enforcement Officer and Fire Fighter ("LEOFF") bargaining unit was embroiled in lengthy contract negotiations covering several years; the dispute centered on multiple topics one of which was health insurance and the LEOFF's ability to leave the City's self-insured health program. Settlement was reached in 1992 and the parties agreed to establish a Fire Health Insurance Committee to study the current program as well as alternative programs. The Committee was comprised of Fire LEOFF and Fire Public Employees Retirement System ("PERS") representatives and the City Management representatives. The City and AFSCME Joint Health Insurance Committee suggested that it would be beneficial to all parties if the Fire Health Conimittee could take advantage of what had been learned by the AFSCME Committee either by inviting some of the AFSCME members to participate in the meetings or possibly to link the two committees together. In light of the AFSCME discussion on consolidating the health care plans, it was suggested that the two Committees join forces to study health insurance as well as consolidation of the plans. At the same time an invitation was extended to the Yakima Police Patrolman's. Association to join the Committee and in late 1992 the City-wide joint health care committee began. On January 12, 1993 the AFSCME Joint Health Insurance Committee met with the City Council and explained the history of the Committee, its accomplishments and the future of the City's self-insured health care plan. Considerable time was spent discussing the consolidation of all employee groups and the concept was supported by the Council. On February 24, 1993 the City-wide Health Insurance Committee met, with Executive Board representatives of all organized employee groups: AFSCME, Yakima Police Patrolman's Association ("YPPA"), Fire LEOFF and Fire PERS plus representatives of the management group including Police, Fire and General Management, Supervisors and Confidential employees. The history of the AFSCME Committee was shared and how it evolved into a City-wide. Committee plus the accomplishments of the Committee up to February 1993. The need for consolidating all groups was explained and the administrative steps to accomplish that end was outlined. The City-wide Employees' Health &• Welfare Cot niitteee has, during 1993, drnfted a Program establishing a Board to assist in the management of the City's Employees' Health & Welfare program. Representatives from all recognized employee groups within the City of Yakima are included. The Committee has prepared reconunendations for benefits contained within the Health & Welfare Plan and along with this document are ready to share the new program with City employees. 2 B-PLRSAILL/amended 10/16/01 The Yakima Air Terminal is jointly operated by the City and Yakima County. Air Terminal employees currently participate in medical plans sponsored by the City, The City desires to permit the Yakima Air Terminal Board to adopt the Program and Plans so that its employees may participate in the Plans. Neither the Yakima Air Terminal nor Yakima County will have any control over the Program or Plans. THEREFORE, effective April 1, 1994, the City hereby adopts the following Employees' Welfare Benefit Program ("Program") to establish and maintain Employee Welfare Benefit Plans for the benefit of eligible employees and retirees of the City and of the Yakima Air Terminal, and the beneficiaries of all such employees and retirees: .Article I Purpose and Term 1. Purpose The purpose of the Employees' Welfare Benefit Program is to provide procedures for establishing and maintaining Employee welfare benefits for the City's and the Air Terminal's eligible employees and retirees and their beneficiaries. The Program itself is not an Employee Welfare Benefit Plan. The Program sets forth the rules for establishing and administering some of the City's Welfare Benefit Plans. In order for represented Employee Groups to participate in the Plans administered through the Program, the groups' collective bargaining agents must enter into Participation Agreements with the City agreeing to amend any underlying collective bargaining agreements so as to participate in the Plans established and maintained through the Program. The Program shall be administered and managed by the City, However, the Board established by this Program and comprised of employee representatives shall have the right, as set forth herein, to make recommendations to the City regarding the management of the Program. 2. Term of Program The Program shall be effective as of April 1 1994, and shall continue indefinitely until such time as it may be terminated in accordance with Article VIII herein. 3 II-PLRSNLL/amell ded 1 0/1 6/0 1 Article II Definitions The following definitions apply to this Program. 1. "Air Terminal" -- the entity jointly operated by the City and Yakima County pursuant to the Joint Air Terminal Operations Agreement between the City and Yakima County dated June 30, 1982, as amended ("Airport Agreement"). Neither the Air Terminal Board (as defined in the Airport Agreement) nor Yakima County shall participate in or have any authority with respect to the establishment, amendment or administration of the Program or Plans. 2. "Beneficiary" -- any dependent of a Participating Employee, who is entitled to benefits, as defined in a benefit plan; also, any person designated by a Participating Employee or dependent, or by the terms of a benefit plan, to receive benefits upon the death of such Participating Employee or dependent. 3. "Benefits" or "Plan benefits" or "Employee Welfare benefits" -- the benefits provided by a Plan. 4. "Benefit Fund" -- formerly called the Employees' Health Benefit Reserve Fund, now called the Employees' Welfare Benefit Reserve Fund, a separate account of the City designated by Chapter 3.10 of the Yakima Municipal Code as a source of funding for the Program's Plan benefits. The Benefit Fund is not a trust. 5. "Board" -- the body created under Article III of this Program representing Participating Employee Groups. 6. "City" -- the City of Yakima, a municipal corporation under the laws of the State of Washington. The City is the Plan Administrator, the entity responsible for managing and administering the Program and the Plans under the Program. As Plan Administrator, the City is responsible for the day to day functions and management of the Plans. The City may employ persons or firms to process claims and perform other Plan connected services. 4 13-PERSNLL/ameadcd 10/16/01 7. "Contributions" -- the payments of premiums required of the City or of the Air Terminal for their respective employees, or premiums by Participating Employees paid through payroll or pension deductions or otherwise, pursuant to the terms of a collective bargaining agreement, Participation Agreement, ordinance or resolution, for the purpose of providing Employee Welfare benefits to the employees and retirees covered by any such agreement, ordinance or resolution and their beneficiaries. The Participating Employee's portion of premiums for Welfare Benefit Plan coverage may be paid through a cafeteria plan pursuant to Section 125 of the Internal Revenue Code of 1986, as amended. The Board may recommend to the City which plans should be part of the cafeteria plan. 8. "Employee Group" -- a group of employees of the City or Air Terminal represented by a collective bargaining representative or that group of City or Air Terminal Management employees not covered by any collective bargaining agreement with the City or Air Terminal. 9. "Participating Employee" -- any individual employed by the City or the Air Terminal and for whom contributions are made to the Plans pursuant to the terms of a City ordinance or resolution, Air Terminal Board resolution, collective bargaining agreement or Participation Agreement and any eligible retirees. . 10. "Participating Employee Group" -- any represented or nonrepresented group of Participating Employees of the City or of the Air Terminal including employees represented by AFSCME 1122, IAFF 469, YPPA, and non -represented City Management employees. This is not an exclusive list and may be modified in the future as new employee groups are recognized by the City and elect to participate in the Program. For purposes of this Program and the Plans, members of the City's City Council and nonrepresented employees of the City and of the Air Terminal shall be treated as City Management employees. 11. "Participation Agreement" -- a written agreement entered into between the City and the union representing a Participating Employee Group, and any supplement, amendment, continuation, or renewal thereof, for the purpose of amending any underlying collective bargaining agreement to provide employee benefits under the Program to the eligible employees and retirees covered by the collective bargaining agreement, and their hene-finiaries. 5 B-PLRSNLL/am en dccl 10/16/01 12. "Plan" -- or "Employee Welfare Benefit Plan" or "Benefit Plan" -- any lawful employee welfare benefit plan including but not limited to medical, dental, vision, prescription drug, life insurance, disability income (salary insurance), preventative health care, and cafeteria plans. For each type of welfare benefit plan under the Program, there is a separate benefit plan for each Participating Employee Group (or subgroup thereof) which receives different benefits under the Plan or has different Contribution rates. Separate plans are established for each Participating Employee Group (or subgroup thereof) with different plan benefits or Contribution rates pursuant to Sections 105(h)(2) and (4) of the Internal Revenue Code of 1986. The initial Plans under the Program shall be substantially in the form attached hereto as Exhibit A, and may be amended from time to time. 13. "Plan Supervisor" -- the person or group providing administrative services to the City in connection with the operation of the Plan and performing such other functions, including processing and payment of claims, as may be delegated to it by the City. 14. 'Program" -- City of Yakima Employees' Welfare Benefit Program. .Article III The Board 1. The Program The Program shall be subject to ongoing review by the Board. The Board may make recommendations regarding Program and Plan management to the City. 2. Number of Board Members The Board may consist of both voting and nonvoting members ("Board Members"). Each Board Member must be a City employee. Upon termination of employment, the Board Member shall be replaced (See Section 3 in this Article). Effective December 1, 2001, the Board shall consist of ten (10) voting members: four (4) AFSCME representatives; two (2) IAFF representatives; two (2) YPPA representatives; one (1) City Man agemeta employee representative; and one (1) City municipal corporation representative. Each, represented Participating Employee Group, shall appoint (except the Management employee group) or elect its representative (if any) to the Board. The Management employee group shall elect its representative to the Board. The City municipal corporation representative shall be appointed by the City Manager. 6 B-PLRSNLL/amc"ded 10/16/01 In addition to the voting members of the Board, there shall be two (2) non-voting members: one (1) AFSCME'Transit member, and one (1) City municipal corporation non-voting member appointed by the City Manager. The number of Board Members representing each Participating Employee Group and the City as a municipal corporation shall remain as set forth above in this Section 2 until the Board agrees to change the number of Board Members for each group. The Board shall meet annually to reassess whether the number of Board Members which represent each Participating Employee Group should be changed. If a new Employee Group is recognized by the City, the Board shall meet within 30 calendar days of recognition to determine the group's representation on the Board, if any, including the number of voting or non-voting Board Members that will represent the group and, if voting representations is allowed, whether the group will be allowed to elect or appoint its own Board Member(s) or will be represented by current Board Members. 3. Appointment of Additional or Successor Board Members In the event of the termination of appointment, resignation, termination of employment or death of a Board Member, a successor Board Member shall be appointed or elected by the represented Participating Employee Group, or appointed by the City Manager with respect to a Board member representing the City as a municipal corporation. Such appointment shall be effective as of the date specified in a written notice of the appointment or the date of delivery of the written notice to the Board Chairman, whichever is later. 4. Board Member Liability Each Board Member who has accepted his/her appointment and agrees to abide by the terms and provisions of this Program is carrying out his or her duties as a City employee and, as such, will be covered by the City's indemnification provisions as set forth in City Council Resolution No. D- 5820. The City may in its discretion provide errors and omissions or personal liability coverage for Board Members by purchasing insurance. 5. Terre of Appointment Each Board Member shall serve until termination of appointment, resignation, termination of employment or death. 7 B-PERSIILL/amcndcd 10/16/0] 6. Termination of Appointment by Employee Group The appointment of a Board Member may be terminated, at any time, by their respective Participating Employee Group in accordance with its election or appointment procedures or by the City Manager with respect to the Board members representing the City as a municipal corporation. The termination of a Board Member's appointment shall be effective upon the termination date specified in a written notice of termination or the date of delivery of the notice of termination to the Board Chairman, whichever is later. 7. Recommendation for Termination of Appointment for Failure to Attend Meetings The Board may recommend that the appointment of a Board Member be terminated if such Board Member fails to attend three (3) consecutive meetings of the Board, without being excused from attendance by specific action of the remaining Board Members. The notification is to be forwarded to the appropriate Participating Employee Group and the City. 8. Resignation of Appointment A Board Member may resign his/her appointment at any time. Such resignation shall be effective upon the resignation date specified in a written notice of resignation or the date of delivery of the notice of termination to the Board Chairman, whichever is later. 9. Vacancies No vacancy in the position of Board Member shall impair the power of the remaining Board Members to take action so long as a quorum exists as specified. 10. Return of Books and Records In the event of the termination of appointment, resignation, termination of employment or death of a Board Member, the Board Member (or the Board Member's legal guardian, heirs or personal representative) shall, upon the request of the Chairman or the Secretary of the Board return to the Chairman or Secretary any and all records, books, documents, and other property regarding the Program in the possession of the Board Member. 8 B-PERSNLL/amcndcd 10/16/01 11, Manner of Voting .Any action to be taken by the Board at a meeting shall be determined by a majority vote of voting Board Members in attendance at the meeting except for actions requiring a super majority vote. 12. Super Majority Vote For purposes of this Program, a super majority vote requires the affirmative vote of a majority of all of the voting Board Members then serving as described in Article III, Section 2, plus one voting Board Member. Proxy voting will not be permitted for actions requiring a super majority vote. 13. Constitution of a Quorum To constitute a valid regular or special meeting of the Board, a quorum must be present. A quorum shall consist of' a simple majority plus one of the voting Board Members then serving as specified in Article III, Section 2. 14. Motions Any Board Member, including the Board Chairman, may offer or second any motion or resolution presented for the Board's consideration. 15. Regular Meetings The Board Members shall hold periodic meetings consistent with the needs of the Program, provided that there shall be at least one (1) regular meeting held during each quarter of the calendar year. The Board Members shall determine the time and place of all regular meetings. 16. Special Meetings Either the Chairman or any two (2) Board Members may call a special meeting of the Board by giving written notice to all the other Board Members of the time and place of the meeting at least two (2) calendar days before the date set for the meeting, provided that two (2) calendar days advance notice shall not be necessary if al] the Board Members are agreeable to an earlier meeting. 9 II-PERSNLL/amended 10/16/01 17, Appointment of Chairman and Vice -Chairman The Board shall appoint the Chair of the Board by simple majority vote of the voting Board Members in attendance at the first Board meeting held each calendar year, Similarly, the Vice -Chair shall be elected by the Board and shall serve as Secretary of the Board. 18. Duties of Chairman and Vice -Chairman The Chairman shall chair the meetings of the Board, shall appoint all committees, and shall carry out such other duties as the Board may assign. The Vice -Chair, in the absence of the Chairman, shall act in the place of the Chairman and perform the Chairman's duties. The Vice -Chair shall also advise the Board as to all correspondence pertaining to the Program and shall keep minutes or records of all meetings, proceedings, and actions of the Board, 19. Board Expenses Each Board Member shall be reimbursed out of the Benefit Fund for all expenses properly and actually incurred by such Board member in the management of the Program. 20. Benefits to Board Members Not Prohibited Nothing in this Program shall prohibit a Board Member from receiving any benefits under the terms of a Benefit Plan. Article IV Allocation or Delegation of Board Responsibilities 1. Allocation of Responsibilities to Committees The Board may establish one or more committees of the Board and assign to such committee(s) all or part of the Board's responsibilities, except actions that require a super majority vote. 10 B-PLRSNLL/amcndal 1 0/1 6/01 In the event the Board wishes to create a committee, it shall do so by the adoption of a motion or resolution calling for the appointment of a committee and specifying the particular responsibility that is being assigned. With respect to the responsibility that is allocated, the committee shall have all the powers of the full Board. Article V Board Responsibilities 1. General Responsibilities As described in this Program document, the Board shall make recommendations to the City regarding management of the Plans under the Program. The Board may suggest and recommend arrangements with other welfare providers to participate in their Plans as is further described in Section 5 of this Article. 2. Existing and Future Benefit Plans The types of Plans that are or may be made available through the Program are: medical, dental, vision, prescription drug, life insurance, disability income (salary insurance), preventative health care plans, a cafeteria plan, or other Plans that may be recommended in the future. The Board may make recommendations to the City regarding amendments to existing Plans, or any Plans hereafter adopted, including amendments that expand, restrict, or terminate all or part of the rules relating to eligibility for benefits, or to.the amount and nature of such benefits, as is further described in Section 4 of this Article. Amendments may be made on a prospective or retroactive basis, provided, however, that any such amendments must comply with applicable law. In making recommendations to the City, the Board may consider prevailing benefits practices and industry standards. The Board may consider the history of claims approvals and denials under the Plans in recornnending amendments to Plans. 3. Additional Benefit Plans The Board may recommend to the City the creation of additional Employee Welfare Benefit Plans. Each represented Participating Employee Group may enroll in any such additional Benefit Plan by executing a Participation Agreement for any such Benefit Plan. The City may enroll non - represented Management employees by resolution or ordinance. 11 13 -PL' RSNLL/mn click(' 1 0/1 6/01 4. Design of the Benefit Plans The Board may recommend to the City the design of the Plans in accordance with applicable law, including the determination of the rules under which Participating Employees shall be eligible for benefits and the nature and amount of such benefits. The Board may recommend whether benefits shall be extended to beneficiaries of Participating Employees and, if so, to determine which class or classes of beneficiaries shall be eligible for benefits, the eligibility rules which will apply to such class or classes of beneficiaries, and the nature and amount of such benefits. If there are different contribution rates, the Board may recommend the establishment of different eligibility rules for the Participating Employees and their beneficiaries who are affected thereby. 5. Means of Providing Benefits The Board may recommend to the City whether the benefits, in whole or in part, should be directly paid from the Benefit Fund or whether the City should contract with an insurance carrier, service organization, health maintenance organization, or other entity, to underwrite part or all of such benefits. 6. Administrative Agent The Board may recommend to the City whether to retain, at the expense of the Benefit Fund, one or more administrative agents to assist in the day-to-day administration of the Program. 7. Other Professional and Nonprofessional Help The Board may recommend to the City that it retain, at the expense of the Benefit Fund, outside consultants including without limitation one or more accountants, actuaries, attorneys, employee benefit plan consultants, third party claims administrators, auditors, and other professional or nonprofessional help, as the Board may deem necessary in the administration of the Program and the. Benefit Plans. The Board may periodically review and make recommendations to the City regarding performance of such outside consultants. 12 B-PERSNLL/nm ended 10/16/01 8. Benefit Fund Amounts The Board may recommend to the City the amount to be kept in the Benefit Fund as reserves for future contingencies or liabilities under the Program's Plans as it may deem necessary, provided, however, that the Board may not recommend a Benefit Fund amount that falls below or exceeds prevailing industry standards. Any recommendations on Benefit Fund levels shall be forwarded to the City by July 1 for the next calendar year. 9. Records The Board shall maintain the records of its actions and any correspondence it sends or receives. 10. Procedure for Review of Benefit Claims All benefit claims are adjudicated and reviewed by the Plan Supervisor. The Board may review benefit claims and make recommendations to the City regarding amendments to the Plans. Article VI City Responsibilities 1. Program Administration The City shall manage and administer the Program and design, adopt, amend and administer the Plans under the Program in accordance with all applicable federal, state and local laws. The City may, at the expense of the Benefit Fund, contract with agents to assist in the Program's Plan administration, program audit, claims adjudication and payments. 2. Contributions and Paid Benefits The basis on which Contributions of the City and Contributions of Participating Employees (if any) are made shall be as specified in the underlying collective bargaining agreement, Participation Agreement, ordinance or resolution covering the Participating Employee. The basis on which benefits are paid under the Program's Plans, including without limitation, deductibles, co-insurance, co- payments and maximum benefit limits, shall be as specified in the Employee Welfare Benefit Plans. 13 II-PL•RSNLLL/amell ded 1 0/1 6/01 3. Application of Benefit Fund .Assets The assets of the Benefit Fund shall be held for the exclusive purposes of providing welfare benefits to Participating Employees and their beneficiaries and defraying reasonable expenses of administering and managing the Program. The City may pay Program benefits with funds other than the Benefit Fund. In addition to the payment of Plan benefits, the City may pay from the Benefit Fund expenses directly or indirectly related to the Program or Plans. Expenses may also be paid out of the Benefit Fund which are not related to the Program or Plans as long as the amounts paid come from funds which were separately contributed to the Benefit Fund for that purpose, and not from funds contributed for Plan benefits. Examples of expenses which are directly or indirectly related to the Program or Plans include such things as plan summaries, claims audits, salaries and expenses for support personnel and other City overhead expenses related to the Program or Plans. The expenses, upon recommendation of the Board, may be included as Plan benefit costs. Examples of expenses that may be paid out of the Benefit Fund and that are not related to the Program or Plans include such things as the City's Wellness Program and its Employee Assistance Program. 4. Agents for Service of Process The City shall be the agent of the Program for the sole purpose of accepting service of legal process, provided that the City may designate its administrative agent or another person as agent of the Program for this purpose. 5. Investment The City may invest all or any portion of the Contributions to the Benefit Fund or other moneys in the Benefit Fund not required for the payment of current Plan benefits or Program expenses. The City may invest said funds as allowed for any municipal investments. Any investments of and returns on Benefit Fund monies not invested specifically in the name of the Benefit Fund, including City General Investments (Treasurer's Cash Investment), shall accrue to the Benefit Fund. Investments of the Benefit Fund may also include City interfund loans. Said loans will be repaid at the current market interest rates for term and amount as determined by the City's Office of Finance and Budget. 14 B-PBRSNLL/amended 10/16/01 6. Annual Audit The Benefit Fund may be audited as a part of the City's annual audit. Additionally, the City will engage an independent qualified professional and, at the expense of the Benefit Fund, shall authorize the professional to conduct an examination of the Program at a minimum of once every three years. A statement of the results of each examination shall be submitted to the City and Board for their review. 7. Program Description The City shall prepare a summary plan description for each Welfare Benefit Plan provided Under the Program for the Board's review and shall furnish copies of such summary plan descriptions and any material modifications or changes thereto to the Participating Employees covered by such Plans. 8. Documents to be Examined or Furnished The City shall make copies of: (a) this Program document; (b) the latest updated plan descriptions of the Plans; and (c) any other contracts or instruments under which a Benefit Plan is established or operated available for examination by Participating Employees or their beneficiaries in the City of Yakima Human Resources office or Administrator's office. 9. All Records All records pertaining to Program or Plan administration required by law or set forth in this document shall be maintained by the City. Article VII Dispute Resolution Process 1. The Process In the event the City is not in agreement with the Board's Program recommendations, the dispute resolution process may be invoked. The dispute resolution process shall be as follows: 15 I3-PERSNLL/amend ed 10/16/01 a, If the City disagrees with a recommendation of the Board, the City Manager or designee shall meet with the Board within 15 calendar days of the Board's recommendation to discuss reasons for the disagreement. b. If the disagreement over a recommendation continues to exist, then upon, and within 15 calendar days of, a super majority vote of the Board, a dispute resolution panel shall be appointed. The panel shall consist of three members who are neutral and independent from the City and the Participating Employee Groups. The panelists shall include one member appointed by the Board, one member appointed by the City, and one member appointed by the first two panelists. Unless the City and Board agree otherwise, the panelists shall have at least five years experience in one of the following fields: medicine, insurance, or employee welfare benefits consulting or administration. c. The panel shall meet within 15 calendar days of its formation to conduct a hearing. The hearing shall be conducted under the rules and regulations of the American. Arbitration Association, The submission of a dispute to the panel will be based on an agreed written submission of the Board and the City. The power and authority of the panel is limited by applicable law. The panel may consider the prevailing industry standards, The panel shall issue a written decision within 30 calendar days of the conclusion of the hearing. The decision of the panel shall be final and binding on all parties. The costs of arbitration shall be paid out of the Benefit Fund. If the parties resolve their dispute at any time prior to issuance of a decision by the panel, the dispute resolution process may be terminated. Any time period or deadline set forth in this Article VII may be extended as mutually agreed by the City and Board. Article VIII Amendments and Termination 1. Amendments This Program document may be amended at any time by agreement of the City and Board. Amendments must be approved by resolution of the City Council and by the super majority vote of the voting Board Members. Changes to the Plans and Exhibit A hereto shall not be considered amendments to the Program document, and do not require City Council approval. 16 II-PLRSNLL/mncndcd 10/16/01 2. Termination of Entire Agreement If timely notice of termination is not provided, the Program will continue from calendar year to calendar year. This Program may be terminated at any time upon notice of intent to terminate either by the City or by the Board Chairman and the City Manager, provided that notice of termination is delivered to the Board Chairman and the City Manager by April 1 of the year preceding termination. A decision by the Board to terminate the Program must be approved by a super majority vote. A decision by the City to terminate the Program must be approved by the City Council. The Program may be terminated without notice by agreement of the City and Board by resolution of the City Council and a super majority vote of the Board, or if required by law. 3. Allocation Upon Termination Upon the termination of this Program, the City shall conclude the affairs of the Benefit Fund. With respect to termination, any and all moneys and assets remaining in the Benefit Fund, after the payment of expenses, will be used for the continuance of the benefits provided by the then -existing Benefit Plans, or replacement Plans unless some other disposition is required by applicable law or is agreed to by the City and Board by resolution of the City Council and a super majority vote of the Board. 4. Withdrawal of a Participating Employee Group A Participating Employee Group may withdraw from the Program by giving written notice of intent to withdraw to the Board Chairman. The type and nature. of Plan benefits, including without limitation, benefit and Contribution formulas and levels for any, withdrawing Employee Group will remain unchanged from those available under the Program at the date of withdrawal until any underlying collective bargaining agreement expires and the parties negotiate a successor contract. Until the collective bargaining agreement is amended to revise the Contribution formula, the Contribution amounts paid by the City on behalf of the eligible employees in a withdrawn Employee Group shall be determined under the formula set forth in the collective bargaining agreement with that Group, provided, however, that the. maximum dollar amount the City must contribute for each eligible employee may not exceed the dollar amount the City was paying for each such employee under the Plans of the Program on the date of withdrawal. Any and all billings for medical, dental, vision or other covered benefits will be accepted for sixty (60) calendar days after the effective withdrawal date for services received prior to the withdrawal date. 13-PERSNLL/amended 10/16/01 5. Benefit Fund Reserves - Participating Employee Group Withdrawal All money and assets within the Benefit Fund classified as Reserves, or otherwise, will remain with the Benefit Fund upon withdrawal of a Participating Employee Group, except as stated in Article VIII, Section 4, "Withdrawal of a Participating Employee Group. " Article IX Enrollment into the Health Benefit Program 1. Initial Enrollment, Existing Employee Groups All existing Employee Groups within the City shall have until June 1, 1994 to enroll in the Program; the Board and the City may agree to grant an additional forty-five (45) calendar days to any group if deemed necessary. Should an existing Employee Group elect not to enroll in the Program by June 1, 1994, the next opportunity for enrollment shall be April 1, 1999 and require approval by a super majority vote of the Board (see Section 3 below). This Section applies to all Employee Groups that are in existence and recognized by the City prior to April 1, 1994. 2. Enrollment of Future Employee Groups Any represented Employee Group recognized by the City after April 1, 1994 shall have sixty (60) calendar days after recognition by the City to enroll in the Program. Should any such Employee Group elect not to enroll in the Program within the sixty (60) calendar days allowed for enrollment, the next opportunity for enrollment shall be five (5) years from the date of recognition of the Employee Group and will require a super majority vote of the Board (see Section 3 below). 3. Enrollment of Withdrawn and Non -enrolled Employee Groups Any Employee Group which elects to withdraw from or not enroll in the Program shall have the opportunity to enroll in the Program after the time periods specified in Sections 1 and 2 of this Article only if the enrollment is approved by a super majority vote of the Board (as defined in Article III, Section 13). is B-PERSNLL/am ended 10/16/01 Article X Severability The provisions of this Program document shall be deemed severable and the invalidity or unenforceability of any provision of this Program document shall not affect the validity and enforceability of any other provision hereof. If any provision of this Program document is unenforceable for any reason whatever, such provision shall be appropriately limited and given effect to the extent that it may be enforceable. 19 B-PLRSNLL/ninended 10/16/01 PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION FOR CITY OF YAKIMA EMPLOYEE MEDICAL BENEFITS PLAN EFFECTIVE: JANUARY 1, 1992 RESTATED: JANUARY 1, 2012 TABLE OF CONTENTS INTRODUCTION 1 SCHEDULE OF BENEFITS 2 POLICE PLAN 6 SPECIAL PROVISIONS 10 ELIGIBILITY, FUNDING, EFFECTIVE DATE AND TERMINATION PROVISIONS 12 MEDICAL BENEFITS 23 COST MANAGEMENT SERVICES 33 COORDINATED CARE 33 CASE MANAGEMENT 34 CareLink PRIORITY MATERNITY CARE 35 DEFINED TERMS 36 PLAN EXCLUSIONS 42 PRESCRIPTION DRUG BENEFITS 45 HOW TO SUBMIT A CLAIM 49 DENTAL CLAIMS 50 VISION CLAIMS 50 INTERNAL AND EXTERNAL CLAIMS REVIEW PROCEDURES 50 COORDINATION OF BENEFITS 55 THIRD PARTY RECOVERY PROVISION 58 COBRA CONTINUATION COVERAGE 61 COBRA CONTINUATION COVERAGE FOR RETIREES AND/OR THEIR DEPENDENTS 67 RESPONSIBILITIES FOR PLAN ADMINISTRATION 71 HIPAA PRIVACY STANDARDS 71 HIPAA SECURITY STANDARDS 73 GENERAL PLAN INFORMATION 75 INTRODUCTION This document is a description of City of Yakima Employee Medical Benefits Plan (the Plan) No oral interpretations can change this Plan. The Plan described is designed to protect Plan Participants against certain catastrophic health expenses. Coverage under the Plan will take effect for an eligible Employee and designated Dependents when the Employee and such Dependents satisfy the Waiting Period and all the eligibility requirements of the Plan The Employer fully intends to maintain this Plan indefinitely However, it reserves the right to terminate, suspend, discontinue or amend the Plan at any time and for any reason. Changes in the Plan may occur in any or all parts of the Plan including benefit coverage, deductibles, maximums, copayments, exclusions, limitations, definitions, eligibility and the like Failure to follow the eligibility or enrollment requirements of this Plan may result in delay of coverage or no coverage at all. Reimbursement from the Plan can be reduced or denied because of certain provisions in the Plan, such as coordination of benefits, subrogation, exclusions, timeliness of COBRA elections, utilization review or other cost management requirements, lack of Medical Necessity, lack of timely filing of claims or lack of coverage. The Plan will pay benefits only for the expenses incurred while this coverage is in force No benefits are payable for expenses incurred before coverage began or after coverage terminated An expense for a service or supply is incurred on the date the service or supply is furnished No action at law or in equity shall be brought to recover under any section of this Plan until the appeal rights provided have been exercised and the Plan benefits requested in such appeals have been denied in whole or in part. If the Plan is terminated, amended, or benefits are eliminated, the rights of Covered Persons are limited to Covered Charges incurred before termination, amendment or elimination This document summarizes the Plan rights and benefits for covered Employees and their Dependents and is divided into the following parts. Eligibility, Funding, Effective Date and Termination. Explains eligibility for coverage under the Plan, funding of the Plan and when the coverage takes effect and terminates Schedule of Benefits. Provides an outline of the Plan reimbursement formulas as well as payment limits on certain services. Benefit Descriptions. Explains when the benefit applies and the types of charges covered Cost Management Services. Explains the methods used to curb unnecessary and excessive charges Defined Terms. Defines those Plan terms that have a specific meaning. Plan Exclusions. Shows what charges are not covered. Claim Provisions. Explains the rules for filing claims and the claim appeal process Coordination of Benefits. Shows the Plan payment order when a person is covered under more than one plan. Third Party Recovery Provision. Explains the Plan's rights to recover payment of charges when a Covered Person has a claim against another person because of injuries sustained COBRA Continuation Coverage. Explains when a person's coverage under the Plan ceases and the continuation options which are available. City of Yakima Employee Health Plan 1 January 1, 2012 SCHEDULE OF BENEFITS MEDICAL BENEFITS All benefits described in this Schedule are subject to the exclusions and limitations described more fully herein including, but not limited to, the Plan Administrator's determination that. care and treatment is Medically Necessary, that charges are Usual and Reasonable, that services, supplies and care are not Experimental and/or Investigational. The meanings of these capitalized terms are in the Defined Terms section of this document Pre -notification of certain services is strongly recommended, but not required by the Plan Pre -notification provides information regarding coverage before the Covered Person receives treatment, services and/or supplies. A benefit determination on a Claim will be made only after the Claim has been submitted A pre -notification of services by CareLink is not a determination by the Plan that a Claim will be paid All Claims are subject to the terms and conditions, limitations and exclusions of the Plan at the time services are provided. A pre -notification is not required as a condition precedent to paying benefits, and cannot be appealed. This Plan has entered into an agreement with certain Hospitals, Physicians and other health care providers, which are called Participating Providers. Because these Participating Providers have agreed to charge reduced fees to persons covered under the Plan, the Plan can afford to reimburse a higher percentage of their fees. Therefore, when a Covered Person uses a Participating Provider, that Covered Person will receive better benefits from the Plan than when a Non -Participating Provider is used It is the Covered Person's choice as to which Provider to use Under the following circumstances, the higher Participating payment will be made for certain Non -Participating services. • If a Covered Person has no choice of Participating Providers in the specialty that the Covered Person is seeking within the PPO service area. • If a Covered Person is traveling outside of the PPO service area. • If the Covered Person resides outside of the PPO service area. • If the Covered Person has a Medical Emergency requiring immediate care • If a Covered Person receives ancillary services, including radiology, pathology, anesthesiology, emergency room Physician, and assistant surgeon(s) when provided by a non -Participating Provider at a PPO facility. • If the services are billed by a Participating Provider, Hospital or Medical Facility. To access a list of Network Providers, please refer to the Network website and/or toll free number listed on the back of the EBMS / City of Yakima Health Care Benefits Plan identification card. Pnor to receiving medical care services, the Covered Person should confirm with the provider and the Participating Provider Organization that the provider is a participant in this organization. In rare instances, an inpatient Hospital stay (reimbursed on a Diagnostic Related Grouping (DRG) or per diem PPO rate) can be repriced to exceed the billed amount. The Plan will be responsible for this overage. Deductibles/Copayments payable by Plan Participants Deductibles/Copayments are dollar amounts that the Covered Person must pay before the Plan pays. A deductible is an amount of money that is paid once a Calendar Year Typically, there is one deductible amount per Plan and it must be paid before any money is paid by the Plan for any Covered Charges Each January 1st, a new deductible amount is required Deductibles do not accrue towards the 100% maximum out-of-pocket payment. A copayment is the amount of money that is paid each time a particular service is used. Typically, there may be copayments on some services and other services will not have any copayments. Copayments do not accrue towards the 100% maximum out-of-pocketpayment. Copayments do not accrue towards the deductible. Copayments will continue to be required even after the 100% maximum out-of-pocket payment has been met. City of Yakima Employee Health Plan 2 January 1, 2012 MEDICAL BENEFITS SCHEDULE City of Yakima Employee Health Plan 3 January 1, 2012 PARTICIPATING PROVIDERS NON -PARTICIPATING PROVIDERS LEOFF 1 ACTIVE AND RETIRED EMPLOYEES HAVE NO OUT-OF-POCKET MEDICAL OR PRESCRIPTION DRUG EXPENSES, SUCH AS COPAYMENTS, DEDUCTIBLES OR COINSURANCE. BENEFITS ARE PAID AT 100% OF UCR, UNLESS SPECIFICALLY STATED OTHERWISE. THE COST SHARES NOTED IN THE SCHEDULE OF BENEFITS BELOW APPLY TO ACTIVE REGULAR EMPLOYEES, LEOFF 2 EMPLOYEES AND ALL ENROLLED DEPENDENTS. MAXIMUM BENEFIT AMOUNT PER CALENDAR YEAR $2,000,000 DEDUCTIBLE, PER CALENDAR YEAR Per Covered Person $400 Per Family Unit $800 MAXIMUM OUT-OF-POCKET AMOUNT, PER CALENDAR YEAR Per Covered Person $4,000 Per Family Unit $8,000 The Plan will pay the designated percentage of Covered Charges until out-of-pocket amounts are reached, at which time the Plan will pay 100% of the remainder of Covered Charges for the rest of the Calendar Year unless stated otherwise. The following charges do not apply toward the out-of-pocket maximum and are never paid at 100% • Deductible(s) • Copayments • Prescription Drugs COVERED CHARGES 1 Note: The maximums listed below are the total for Participating and Non -Participating expenses. For example, if a maximum of 60 days is listed twice under a service, the Calendar Year maximum is 60 days total which may be split between Participating and Non -Participating providers Hospital Services Room and Board 80% after deductible the semiprivate room rate 60% after deductible the semiprivate room rate Intensive Care Unit 80% after deductible Hospital's ICU Charge 60% after deductible Hospital's ICU Charge Emergency Room Services 80% after deductible and $200 copayment 80% after deductible and $200 copayment Note: The emergency room copayment will be waived if admitted or if services are deemed a Medical Emergency as defined by the Plan Outpatient Services 80% after deductible 60% after deductible Skilled Nursing Facility 80% after deductible the facility's semiprivate room rate 120 days per Lifetime maximum 60% after deductible the facility's semiprivate room rate 120 days per Lifetime maximum Physician Services Inpatient visits 80% after deductible 60% after deductible Office visits 100% after $25 copayment, no deductible applies 60% after deductible Note The office visa copayment will apply toward the office visit and any services rendered and billed by the Physician on the same day Surgery 80% after deductible 60% after deductible City of Yakima Employee Health Plan 3 January 1, 2012 City of Yakima Employee Health Plan 4 January 1, 2012 PARTICIPATING PROVIDERS NON -PARTICIPATING PROVIDERS Anesthesia Services 80% after deductible Preventive Care Routine Well Care 100%, no copayment or deductible applies 60%, no deductible applies Routine Well Care services including those recommended by the U.S. Preventive Services Task Force (USPSTF) and Health Resources and Services Administration (HRSA), which can be located using the following website. http.//www.healthcare.gov/center/regulations/prevention/taskforce.html Routine Well Care services will include, but will not be limited to, the following routine services. Routine office visits, physical examinations, gynecological exam, Pap smear, mammograms, PSA, immunizations/vaccinations (except influenza), routine well child care examinations, routine lab and x-ray services, screening visual acuity in covered Dependent children under 5 years, screening for hearing loss in covered newborn infants, routine colonoscopy and routine flexible sigmoidoscopy Influenza Vaccinations 100%, no copayment or deductible applies 100%, no deductible applies Diabetes Education 100%, no copayment or deductible applies 4 visits per Calendar Year maximum 60%, no deductible applies 4 visits per Calendar Year maximum Nutritional Education (other than for diabetic instruction) 100%, no copayment or deductible applies 4 visits per Calendar Year maximum 60%, no deductible applies 4 visits per Calendar Year maximum Tobacco Cessation Counseling 100%, no copayment or deductible applies 4 visits per Calendar Year maximum 60%, no deductible applies 4 visits per Calendar Year maximum Other Covered Charges Ambulance Service 80% after deductible Colonoscopy (Routine & Diagnostic) 100%, no deductible or copayment applies 60% after deductible Diagnostic Testing (X-ray & Lab) 80% after deductible 60% after deductible Durable Medical Equipment 80% after deductible 60% after deductible Home Health Care 80% after deductible 60% after deductible Home Infusion Therapy 80% after deductible 60% after deductible Hospice Care 80% after deductible 60% after deductible Inpatient Rehabilitation Therapy 80% after deductible 45 days per Calendar Year maximum 60% after deductible 45 days per Calendar Year maximum Kidney Dialysis First 42 treatments Thereafter 80% after deductible 100% payable at 150% of the Medicare allowable, no deductible applies 60% after deductible 100% payable at 150% of the Medicare allowable, no deductible applies City of Yakima Employee Health Plan 4 January 1, 2012 PARTICIPATING PROVIDERS NON -PARTICIPATING PROVIDERS Mental Disorders and Substance Abuse Treatment Inpatient Outpatient 80% after deductible 100% after $25 copayment, no deductible applies 60% after deductible 60% after deductible Neurodevelopmental Therapy — for covered Dependent children under 7 years of age Same as any other Covered Charge Same as any other Covered Charge Obesity 80% after deductible 60% after deductible Organ Transplants 80% after deductible $20,000 donor maximum per transplant 60% after deductible $20,000 donor maximum per transplant Orthotics 80% after deductible 60% after deductible Outpatient Rehabilitation — Includes: Occupational, Speech and Physical Therapy 80% after deductible 60% after deductible Pre -Admission Testing 100%, no deductible or copayment applies 60% after deductible Pregnancy Same as any other Covered Charge Same as any other Covered Charge Note Pregnancy of Dependent daughters (including complications) is not covered Prosthetics 80% after deductible 60% after deductible Routine Well Newborn Care Same as any other Covered Charge Same as any other Covered Charge Spinal Manipulation Chiropractic and Massage Therapy 100% after $25 copayment, no deductible applies 15 combined visits per Calendar Year maximum 60% after deductible 15 combined visits per Calendar Year maximum Wig after Chemotherapy 100%, no deductible applies $300 per Lifetime maximum 60% after deductible $300 per Lifetime maximum All other Covered Charges 80% after deductible 60% after deductible City of Yakima Employee Health Plan 5 January 1, 2012 MEDICAL BENEFITS - POLICE PLAN All benefits described in this Schedule are subject to the exclusions and limitations described more fully herein including, but not limited to, the Plan Administrator's determination that. care and treatment is Medically Necessary, that charges are Usual and Reasonable, that services, supplies and care are not Experimental and/or Investigational. The meanings of these capitalized terms are in the Defined Terms section of this document. Pre -notification of certain services is strongly recommended, but not required by the Plan Pre -notification provides information regarding coverage before the Covered Person receives treatment, services and/or supplies A benefit determination on a Claim will be made only after the Claim has been submitted. A pre -notification of services by CareLink is not a determination by the Plan that a Claim will be paid All Claims are subject to the terms and conditions, limitations and exclusions of the Plan at the time services are provided A pre -notification is not required as a condition precedent to paying benefits, and cannot be appealed This Plan is a traditional medical benefits plan Covered Persons may choose any Physician or Hospital without the reimbursement levels from the Plan being affected However, Covered Persons are encouraged to Network Providers for additional Plan discounts; otherwise UCR will be applied. To access a list of Network Providers, please refer to the Network website and/or toll free number listed on the back of the EBMS / City of Yakima Health Care Benefits Plan identification card. Pnor to receiving medical care services, the Covered Person should confirm with the provider and the Participating Provider Organization that the provider is a participant in this organization In rare instances, an inpatient Hospital stay (reimbursed on a Diagnostic Related Grouping (DRG) or per diem PPO rate) can be repriced to exceed the billed amount The Plan will be responsible for this overage Deductibles/Copayments payable by Plan Participants Deductibles/Copayments are dollar amounts that the Covered Person must pay before the Plan pays A deductible is an amount of money that is paid once a Calendar Year. Typically, there is one deductible amount per Plan and it must be paid before any money is paid by the Plan for any Covered Charges. Each January 1st, a new deductible amount is required Deductibles will accrue towards the 100% maximum out-of-pocket payment. A copayment is the amount of money that is paid each time a particular service is used Typically, there may be copayments on some services and other services will not have any copayments Copayments do not accrue towards the 100% maximum out-of-pocketpayment Copayments do not accrue towards the deductible Copayments will continue to be required even after the 100% maximum out-of-pocket payment has been met City of Yakima Employee Health Plan 6 January 1, 2012 LEOFF 1 ACTIVE AND RETIRED EMPLOYEES HAVE NO OUT-OF-POCKET MEDICAL OR PRESCRIPTION DRUG EXPENSES, SUCH AS COPAYMENTS, DEDUCTIBLES OR COINSURANCE. BENEFITS ARE PAID AT 100% OF UCR, UNLESS SPECIFICALLY STATED OTHERWISE. THE COST SHARES NOTED IN THE SCHEDULE OF BENEFITS BELOW APPLY TO ACTIVE YAKIMA POLICE PATROL ASSOCIATION (YPPA) EMPLOYEES, RETIREES AND ALL ENROLLED DEPENDENTS. MAXIMUM BENEFIT AMOUNT PER CALENDAR YEAR $2,000,000 DEDUCTIBLE, PER CALENDAR YEAR Per Covered Person $100 Per Family Unit $200 MAXIMUM OUT-OF-POCKET AMOUNT, PER CALENDAR YEAR Per Covered Person $600 City of Yakima Employee Health Plan 6 January 1, 2012 City of Yakima Employee Health Plan 7 January 1, 2012 Per Family Unit $1,200 The Plan will pay the designated percentage of Covered Charges until out-of-pocket amounts are reached, at which time the Plan will pay 100% of the remainder of Covered Charges for the rest of the Calendar Year unless stated otherwise. The following charges do not apply toward the out-of-pocket maximum and are never paid at 100%. • Copayments • Prescnption Drugs COVERED CHARGES Note The maximums listed below are the total for Participating and Non -Participating expenses For example, of a maximum of 60 days is listed twice under a service, the Calendar Year maximum is 60 days total which may be split between Participating and Non -Participating providers Hospital Services Room and Board 80% after deductible the semiprivate room rate Intensive Care Unit 80% after deductible Hospital's ICU Charge Emergency Room Services 80% after deductible and $25 copayment Note The emergency room copayment will be waived if admitted or of services are deemed a Medical Emergency as defined by the Plan Outpatient Services 80% after deductible Skilled Nursing Facility 80% after deductible the facility's semiprivate room rate 120 days per Lifetime maximum Physician Services Inpatient visits 80% after deductible Office visits First 5 visits combined with Mental Disorders and Substance Abuse treatment outpatient visits Thereafter 100%, no deductible applies 100% after $15 copayment, no deductible applies Note The office visa copayment will apply toward the office visit and any services rendered and billed by the Physician on the same day Surgery 80% after deductible Anesthesia Services 80% after deductible Preventive Care Routine Well Care 100%, no copayment or deductible applies Routine Well Care services including those recommended by the U.S. Preventive Services Task Force (USPSTF) and Health Resources and Services Administration (HRSA), which can be located using the following website http.//www healthcare gov/center/regulations/prevention/taskforce html Routine Well Care services will include, but will not be limited to, the following routine services. Routine office visits, physical examinations, gynecological exam, Pap smear, mammograms, PSA, immunizations/vaccinations (except influenza), routine well child care examinations, routine lab and x-ray services, screening visual acuity in covered Dependent children under 5 years, screening for hearing loss in covered newborn infants, routine colonoscopy and routine flexible sigmoidoscopy Influenza Vaccinations 100%, no copayment or deductible applies Diabetes Education 100%, no copayment or deductible applies 4 visits per Calendar Year maximum City of Yakima Employee Health Plan 7 January 1, 2012 City of Yakima Employee Health Plan 8 January 1, 2012 Nutritional Education (other than for diabetic instruction) 100%, no copayment or deductible applies 4 visits per Calendar Year maximum Tobacco Cessation Counseling 100%, no copayment or deductible applies 4 visits per Calendar Year maximum Other Covered Charges Ambulance Service 80% after deductible Colonoscopy (Routine and Diagnostic) 100% after $15 copayment, no deductible applies Diagnostic Testing (X-ray & Lab) 80% after deductible Durable Medical Equipment 80% after deductible Home Health Care 80% after deductible Home Infusion Therapy 80% after deductible Hospice Care 80% after deductible Inpatient Rehabilitation Therapy 80% after deductible 45 days per Calendar Year maximum Kidney Dialysis First 42 treatments Therafter 80% after deductible 100% payable at 150% of the Medicare allowable, no deductible applies Mental Disorders and Substance Inpatient Services Outpatient Visits First 5 visits combined with Physician office visits Thereafter 80% after deductible 100%, no deductible applies 100% after $15 copayment, no deductible applies Neurodevelopmental Therapy — for covered Dependent children under 7 years of age Same as any other Covered Charge Obesity 80% after deductible Organ Transplants 80% after deductible $20,000 donor maximum per transplant Orthotics 80% after deductible Outpatient Rehabilitation — Includes: Occupational, Speech and Physical Therapy 80% after deductible Pregnancy Same as any other Covered Charge Note: Pregnancy of Dependent daughters (including complications) is not covered. Prosthetics 80% after deductible Routine Well Newborn Care Same as any other Covered Charge Spinal Manipulation Chiropractic and Massage Therapy 80% after deductible 15 combined visits per Calendar Year maximum Wig after Chemotherapy 100%, no deductible applies $300 per Lifetime maximum All other Covered Charges 80% after deductible City of Yakima Employee Health Plan 8 January 1, 2012 PRESCRIPTION DRUG BENEFIT SCHEDULE PRESCRIPTION DRUG BENEFITS Note: For LEOFF 1 Active and Retired Employees, coverage for prescription drugs will be 100% with no copayment applied Pharmacy Option —Limited to a 34 -day supply Generic drugs Copayment $10 Formulary Brand Name drugs Copayment $20 Non -Formulary Brand Name drugs Copayment $40 At select participating pharmacies, the Covered Person will be able to obtain a 90 -day supply, per prescription, at the same copayment level as the mail order benefit For additional information or a current list of these select participating pharmacies, please contact the Claims Administrator or access the following Web site at www ebms com Mail Order Prescription Drug Option —Limited to a 90 -day supply Generic drugs Copayment $20 Formulary Brand Name drugs Copayment $40 Non -Formulary Brand Name drugs Copayment $80 Note: If a Generic drug equivalent is available and a Covered Person chooses to purchase a Brand Name drug, the Covered Person will be required to pay the Brand Name copayment amount plus the cost difference between the Brand Name drug and the Generic equivalent, unless the Physician's prescription indicates "Dispense as Written" or similar indication. Specialty Medications This Plan offers a program for specialty medications through CVS Caremark that can provide Covered Persons with greater convenience, including express delivery, follow-up care calls, expert counseling, and superior service. In order for these specialty medications to be covered under this Plan, these prescriptions must be filled through the CVS Caremark Specialty Pharmacy Program Refer to the Prescription Drug Section for additional details on the Prescription Drug benefits of this Plan. City of Yakima Employee Health Plan 9 January 1, 2012 SPECIAL PROVISIONS LEOFF I ACTIVE AND RETIRED EMPLOYEES LEOFF I Employees, defined as Law Enforcement Officers and Firefighters hired prior to October 1, 1977, who are not eligible for Washington State Industrial Compensation, are eligible for the following special benefits and provisions. (1) Eligibility date is date of hire (2) The medical deductible will be waived (3) Medical charges shall not be subject to Usual and Reasonable limitations as defined elsewhere in this booklet, except charges for semi -private room and board (4) The coinsurance level for medical coverage will be 100% (the 20%payment on covered charges by the Employee is waived) (5) Occupational injuries are covered (6) The Calendar Year medical benefit maximum will be $2,000,000 (7) Upon retirement, medical coverage is continued without any premium contribution requirements for the Lifetime of the Employee (8) Upon disability retirement, medical coverage is continued without premium contribution requirements for the disabled Employee (9) Retirees may elect to cover their eligible Dependents for medical and dental insurance upon payment of appropriate premium contribution until the Spouse reaches age 65 or when a Dependent no longer meets the definition of an eligible Dependent (10) Retirees may elect to continue dental benefits (as administered by Washington Dental Service) up to age 65 provided that they were enrolled with medical benefits at time of retirement (11) Coverage for prescription drugs will be 100% with no copayment under the prescription plans These special benefits are not available to LEOFF 1 Employees' Dependents and are subject to the schedules and limitations as described herein with respect to medical benefits. RCW 41.20 ACTIVE AND RETIRED EMPLOYEES Employees who were hired prior to October 1, 1977 and who are under the retirement system RCW 41.20 are eligible for the following special benefits and provisions. (1) Eligibility date is date of hire (2) The medical deductible will be waived (3) Medical charges will not be subject to Usual and Reasonable limitations as defined elsewhere in this Plan, except charges for semi -private room and board (4) The coinsurance level for medical coverage will be 100% (the 20%payment on covered charges by the Employee is waived). (5) Occupational injuries are covered (6) The Calendar Year medical benefit maximum will be $2,000,000 City of Yakima Employee Health Plan 10 January 1, 2012 (7) Upon retirement, medical coverage is continued without any premium contribution required for the Lifetime of the Employee (8) Upon disability retirement, medical coverage is continued without premium contribution requirements for the disabled Employee (9) Retirees may elect to cover their eligible Dependents for medical and dental insurance upon payment of the appropriate premium contribution until the Spouse reaches age 65 or Dependent no longer meets the definition of an eligible Dependent (10) Retirees may elect to continue dental benefits (as administered by Washington Dental Service) up to age 65 provided that they were enrolled with medical benefits at time of retirement These special benefits are not available to RCW 41 20 Employees' Dependents and are subject to the schedules and limitations as described herein with respect to medical benefits City of Yakima Employee Health Plan 11 January 1, 2012 ELIGIBILITY, FUNDING, EFFECTIVE DATE AND TERMINATION PROVISIONS A Plan Participant should contact the Claims Administrator to obtain additional information, free of charge, about Plan coverage of a specific benefit, particular drug, treatment, test or any other aspect of Plan benefits or requirements. ELIGIBILITY Eligible Classes of Employees. (1) (2) Retired Leoff 1 and Leoff 2 Employees of the Employer (3) Active Leoff 1 and Leoff 2 Employees of the Employer Active Regular Employees of the Employer including, but not limited to, the following classes of Employees. • Seasonal Employees • Active Permanent Transit Employees • City Council Members • Active Regular Police Employees of the Employer Note: Seasonal Employees are those hired on a regular basis, meaning they are not temporary employees. These positions are funded for less than 12 months a year but Employees work full-time while at work. The winter is considered off-season, and Employees are usually not terminated when their specific season ends for any Calendar Year, however, due to the reduction of hours they are terminated from the health plan and offered COBRA For Medicare -eligible Leoff 1Retirees, this Plan will provide reimbursement of the Medicare Part D copayment. Temporary employees are not eligible for coverage under this Plan. Eligibility Requirements for Employee Coverage. A person is eligible for Employee coverage from the first day of the Calendar month following the date of hire providing he or she. (1) is an Active Leoff 1 or Leoff 2 Employee of the Employer An Employee is considered to be eligible if he or she normally works at least 20 hours per week and is on the regular payroll of the Employer for that work (2) is an Active Regular (non-Leoff) Employee of the Employer. An Employee is considered to be eligible if he or she normally works at least 20 hours per week and is on the regular payroll of the Employer for that work. (3) is a Retired Employee (including Leoff 1 and Leoff 2 Retired Employees) Retirees eligible to receive payments under the Washington State Retirement System or at the date of separation from service, must be 62 years of age and have at least 10 years of service with the City of Yakima, or be a retiree eligible to receive payments under the International City Management Association Prototype Money Purchase Plan (Resolutions D-5307 and D-6138), up to Medicare eligible age. Retirees under the Washington State Retirement System (RCW 41.20) and LEOFF 1 are eligible for coverage under this Plan until age 65 at which time coverage under this Plan will cease, and members will be offered a Medicare Supplemental plan. In all cases, upon retirement, an Employee can choose between COBRA Continuation Coverage or continuing under the terms of the Plan as a Retired Employee if the Retired Employee satisfies the criteria as set forth above City of Yakima Employee Health Plan 12 January 1, 2012 If the Employee is eligible and chooses to continue coverage under the terms of the Plan as Retired Employee, he or she will forfeit his or her right to elect COBRA Continuation Coverage at a later date In the event the Employee chooses to continue under the terms of the Plan as a Retired Employee, the Employee and his or her Spouse and Dependent children who are active Plan Participants at the time of the Employee's retirement with the Employer, may remain eligible for coverage up to the limitations as stated under the Plan providing enrollment is made on a timely basis as defined in the section "Timely Enrollment" in the Enrollment section of this Plan. (4) 1s in a class eligible for coverage Eligibility Requirements for City Council Coverage. A Person is eligible for city council coverage from the first day of the month following the date they take office and throughout the time that he or she. (1) Officially functions in the office to which he or she was elected For purposes of this Plan, such an elected official shall be considered a Full -Time, Active Employee of the Employer Eligible Classes of Dependents. A Dependent is any one of the following persons. (1) A covered Employee's Spouse, Domestic Partner, and children from birth to the limiting age of 26 years, including adult children of the covered Employee. When the child reaches the limiting age, coverage will end on the last day of the month following the child's birthday The term "Spouse" shall mean a person of the opposite sex recognized as the covered Employee's husband or wife. The Plan Administrator may require documentation proving a legal marital relationship. Common law marriages are not recognized under this Plan. The term "Domestic Partner" shall mean. Domestic Partners are defined as two adults, of the same or opposite sex, and who are state -registered Domestic Partners (as defined in Chapter 156 Laws of 2007, SSB5336, of the State of Washington) and who are engaged in a spouse -like relationship. To qualify for Domestic Partner coverage, both individuals must meet the following qualifications. • Both persons share a common residence, • Both persons are at least eighteen years of age, • Neither person is married to someone other than the party to the domestic partnership and neither person is in a state registered domestic partnership with another person, • Both persons are capable of consenting to the domestic partnership, • Both of the following are true. (1) The persons are not nearer of kin to each other than second cousins, whether of the whole or half blood computing by the rules of the civil law; and (ii) Neither person is a sibling, child, grandchild, aunt, uncle, niece, or nephew to the other person; and • Either (a) both persons are members of the same sex; or (b) at least one of the persons is 62 years of age or older A Domestic Partner is equivalent to a spouse in regard to eligibility and receives benefits equivalent to those that would be provided to the spouse of a married Employee to the extent permissible by law, City of Yakima Employee Health Plan 13 January 1, 2012 except under COBRA. All terms, conditions, or administrative requirements of the Plan that apply to a spouse are similarly applicable to a domestic partner Coverage is available to the Dependent of one or both Domestic Partners provided that the children otherwise meet the Dependent child eligibility requirements of the Plan. Upon termination of a Domestic Partner relationship, an Employee must notify the City's Human Resources Department within 60 days, acknowledging that the relationship has ended Coverage for domestic partners and their Dependent children will cease on the last day of the month the Domestic Partner relationship has ended. In addition to completing the appropriate enrollment forms to add a Domestic Partner or child(ren) of a Domestic Partner to the Plan, the Employee will be required to complete and submit to the Plan a Declaration of Tax Dependent Status form Proof of domestic partnership can be demonstrated by providing the City's Human Resources Department with a copy of the domestic partnership's Certificate of State Registered Partnership Please Note: If an otherwise eligible Domestic Partner is not the covered Employee's true tax Dependent as defined by the Internal Revenue Service (IRS), benefits for that Domestic Partner will NOT be provided on a tax-free basis and therefore, the Employee may be required to pay the cost of the benefits on an after-tax basis and the Employee may be subject to additional tax consequences. The term "children" shall include natural children, step children, Foster Children, adopted children, or children placed with a covered Employee in anticipation of adoption If a covered Employee or Spouse or Domestic Partner is the Legal Guardian of a child or children, these children may be enrolled 111 this Plan as covered Dependents The phrase "child placed with a covered Employee in anticipation of adoption" refers to a child whom the Employee intends to adopt, whether or not the adoption has become final, who has not attained the age of 18 as of the date of such placement for adoption. The term "placed" means the assumption and retention by such Employee of a legal obligation for total or partial support of the child in anticipation of adoption of the child. The child must be available for adoption and the legal process must have commenced Any child of a Plan Participant who is an alternate recipient under a Qualified Medical Child Support Order (QMCSO) shall be considered as having a right to Dependent coverage under this Plan. A participant of this Plan may obtain, without charge, a copy of the procedures governing QMCSO determinations from the Plan Administrator The Plan Administrator may require documentation proving dependency, including birth certificates or initiation of legal proceedings severing parental rights. (2) A covered Dependent child who reaches the limiting age and is Totally Disabled, incapable of self-sustaining employment by reason of mental or physical handicap, primarily Dependent upon the covered Employee for support and maintenance and unmarried Proof of incapacity must be received within 120 days after the date on which the maximum age is attained Subsequent evidence of disability or dependency may be required as often as is reasonably necessary to verify continued eligibility for benefits. The Plan Administrator reserves the right to have such Dependent examined by a Physician of the Plan Administrator's choice, at the Plan's expense, to determine the existence of such incapacity These persons are excluded as Dependents: other individuals living in the covered Employee's home, but who are not eligible as defined, the legally separated or divorced former Spouse of the Employee, except in the case of a court order. City of Yakima Employee Health Plan 14 January 1, 2012 If a person covered under this Plan changes status from Employee to Dependent or Dependent to Employee, and the person is covered continuously under this Plan before, during and after the change in status, credit will be given for deductibles and all amounts applied to maximums Any individual who is covered as an Employee can also be covered as a Dependent. Dependents can be covered as a Dependent of more than one Employee. Eligibility Requirements for Dependent Coverage. A family member of an Employee will become eligible for Dependent coverage on the first day that the Employee is eligible for Employee coverage and the family member satisfies the requirements for Dependent coverage At any time, the Plan may require proof that a Spouse, Domestic Partner, Qualified Dependent or a Child qualifies or continues to qualify as a Dependent as defined by this Plan. FUNDING While medical benefits are nearly identical for all Employees of the City of Yakima, there are some differences between certain groups of Employees. Most of those differences are due to the fact that the amount of the total premium for coverage which the City pays on a Covered Person's behalf (referred to as the "Employer contribution") depends upon which group the Employee is in. In addition, certain Employee groups receive benefits which are different than the benefits that apply to most other Employees Those special benefit provisions are set forth in the Special Provisions section of this Plan Document Because each Employee group has a different Employer contribution, different benefit coverage, or both, there is a different plan for each Employee group pursuant to Section 105 (h) of the Internal Revenue Code of 1986. For plans covering Employees covered by a collective bargaining agreement, the Employer contribution is set forth in the collective bargaining agreement For non-union Employees, the Employer contribution is set forth in the applicable City ordinance or City Council resolution The special benefit provisions which apply to LEOFF I Employees, and active and retired Employees who are under the retirement system set forth in Section 41 20 of the Revised Code of Washington. These special provisions supersede any provisions in the rest of the Plan Document which are inconsistent with the special provisions. PRE-EXISTING CONDITIONS NOTE: The length of the Pre -Existing Conditions Limitation may be reduced or eliminated if an eligible person has Creditable Coverage from another health plan even if that coverage is still in effect The Plan will reduce the length of the Pre -Existing Condition Limitation period by each day of Creditable Coverage under this or a prior plan, however, if there was a significant break in the Creditable Coverage of 63 days or more, then only the coverage in effect after the break will be counted. An eligible person may request a certificate of Creditable Coverage from his or her prior plan within 24 months after losing coverage and the Employer will assist any eligible person in obtaining a certificate of Creditable Coverage from a prior plan. A Covered Person will be provided a certificate of Creditable Coverage from this Plan if he or she requests one either before losing coverage or within 24 months of coverage ceasing. If, after Creditable Coverage has been taken into account, there will still be a Pre -Existing Conditions Limitation imposed on an individual, that individual will be so notified All questions about the Pre -Existing Condition Limitation and Creditable Coverage should be directed to the Plan Administrator. Covered Charges incurred under Medical Benefits for Pre -Existing Conditions are not payable unless incurred six (6) consecutive months after the person's Enrollment Date This time, known as the Pre -Existing Conditions Limitation period, may be offset if the person has Creditable Coverage from his or her previous plan. City of Yakima Employee Health Plan 15 January 1, 2012 A Pre -Existing Condition is a condition for which medical advice, diagnosis, care or treatment was recommended or received within three (3) months prior to the person's Enrollment Date under this Plan Genetic Information is not, by itself, a condition Treatment includes receiving services and supplies, consultations, diagnostic tests or prescnbed medicines In order to be taken into account, the medical advice, diagnosis, care or treatment must have been recommended by, or received from, a Physician. The Pre -Existing Condition does not apply to Pregnancy or to a Covered Person under the age of 19. ENROLLMENT Enrollment Requirements. An Employee must enroll for coverage by filling out and signing an enrollment application. The covered Employee is required to enroll for Dependent coverage also if Dependent coverage is desired. Enrollment Requirements for Newborn Children. A newborn child of a covered Employee who has Dependent coverage is not automatically enrolled in this Plan If the newborn child is not enrolled in this Plan on a timely basis, as defined in the section "Timely Enrollment" following this section, there will be no payment from the Plan and the parents will be responsible for all costs. Children Acquired Through Legal Guardianship. Upon receipt of the completed enrollment application and a copy of the guardianship papers within 60 days of the date legal guardianship began with the subscnber, coverage for an otherwise eligible child will begin on the date legal guardianship began If the enrollment application is not received within 60 days of the date legal guardianship began, the child will be considered a Late Enrollee TIMELY OR LATE ENROLLMENT (1) Timely Enrollment - The enrollment will be "timely" if the completed form is received by the Plan Administrator no later than 31 days after the person becomes eligible for the coverage (60 days for newborn, adopted children, or children placed for adoption), either initially or under a Special Enrollment Period. If two Employees (husband and wife) are covered under the Plan and the Employee who is covering the Dependent children terminates coverage, the Dependent coverage may be continued by the other covered Employee with no Waiting Period as long as coverage has been continuous. The covered Employee is required to re -enroll the Dependent for coverage by filling out and signing an enrollment application and submitting it to the Plan Administrator within 31 days after the termination of coverage of the other parent (2) Late Enrollment - An enrollment is "late" if it is not made on a "timely basis" or during a Special Enrollment Period Late Enrollees and their Dependents who are not eligible to join the Plan during a Special Enrollment Penod may join only dunng open enrollment If an individual loses eligibility for coverage as a result of terminating employment, reduction of hours of employment or a general suspension of coverage under the Plan, then upon becoming eligible again due to resumption of employment or due to resumption of Plan coverage, only the most recent period of eligibility will be considered for purposes of determining whether the individual is a Late Enrollee. The time between the date a Late Enrollee first becomes eligible for enrollment under the Plan and the first day of coverage is not treated as a Waiting Period Coverage begins as stated in the Open Enrollment section City of Yakima Employee Health Plan 16 January 1, 2012 OPEN ENROLLMENT Every November, the annual open enrollment penod, Employees and their Dependents who are Late Enrollees will be able to enroll in the Plan. Benefit choices for Late Enrollees made during the open enrollment period will become effective January 1. Plan Participants will receive detailed information regarding open enrollment from their Employer SPECIAL ENROLLMENT RIGHTS Federal law provides Special Enrollment provisions under some circumstances. If an Employee is declining enrollment for himself or herself or his or her Dependents (including their spouse) because of other health insurance or group health plan coverage, there may be a nght to enroll in this Plan if there is a loss of eligibility for that other coverage (or if the employer stops contnbuting towards the other coverage) However, a request for enrollment must be made within 31 days after the coverage ends (or after the employer stops contributing towards the other coverage) In addition, in the case of a marriage or domestic partnership, there may be a right to enroll in this Plan. However, a request for enrollment must be made within 31 days after the marriage or certified state -registered domestic partnership. In addition, in the case of a birth, adoption or placement for adoption, there may be a right to enroll in this Plan However, a request for enrollment must be made within 60 days after the birth, adoption or placement for adoption The Special Enrollment rules are described in more detail below. To request Special Enrollment or obtain more detailed information of these portability provisions, contact the Plan Administrator. SPECIAL ENROLLMENT PERIODS The Enrollment Date for anyone who enrolls under a Special Enrollment Period is the first date of coverage. Thus, the time between the date a special enrollee first becomes eligible for enrollment under the Plan and the first day of coverage is not treated as a Waiting Period. This means that any Pre -Existing Condition will be determined on the basis of the look back period prior to the Enrollment Date, and the period of the Pre -Existing Conditions Limitation will start on the Enrollment Date (1) Individuals losing other coverage creating a Special Enrollment right. An Employee or Dependent, who is otherwise eligible, but not enrolled in this Plan, may enroll if loss of eligibility for coverage is due to each of the following conditions. (a) The Employee or Dependent was covered under a group health plan or had health insurance coverage at the time coverage under this Plan was previously offered to the individual (b) If required by the Plan Administrator, the Employee stated in writing at the time that coverage was offered that the other health coverage was the reason for declining enrollment (c) The coverage of the Employee or Dependent who had lost the coverage was under COBRA and the COBRA coverage was exhausted, or was not under COBRA and either the coverage was terminated as a result of loss of eligibility for the coverage or because employer contributions towards the coverage were terminated (d) The Employee or Dependent requests enrollment in this Plan not later than 31 days after the date of exhaustion of COBRA coverage or termination of non -COBRA coverage due to loss of eligibility or termination of employer contributions, as descnbed above Coverage will begin no later than the first day of the first calendar month following the date the completed enrollment form is received. City of Yakima Employee Health Plan 17 January 1, 2012 For purposes of these rules, a loss of eligibility occurs due to one of the following. (1) The Employee or Dependent has a loss of eligibility due to the plan no longer offering any benefits to a class of similarly situated individuals (e g , part-time Employees) (ii) The Employee or Dependent has a loss of eligibility as a result of legal separation, divorce, cessation of Dependent status (such as attaining the maximum age to be eligible as a Dependent child under the plan), death, termination of employment, or reduction in the number of hours of employment or contributions towards the coverage were terminated (iii) The Employee or Dependent has a loss of eligibility when coverage is offered through an HMO, or other arrangement, in the individual market that does not provide benefits to individuals who no longer reside, live or work in a service area, (whether or not within the choice of the individual) (iv) The Employee or Dependent has a loss of eligibility when coverage is offered through an HMO, or other arrangement, in the group market that does not provide benefits to individuals who no longer reside, live or work in a service area, (whether or not within the choice of the individual), and no other benefit package is available to the individual. If the Employee or Dependent lost the other coverage as a result of the individual's failure to pay premiums or required contributions or for cause (such as making a fraudulent claim or an intentional misrepresentation of a material fact in connection with the plan), that individual does not have a Special Enrollment right. (2) Dependent beneficiaries. If. (a) The Employee is a participant under this Plan (or has met the Waiting Period applicable to becoming a participant under this Plan and is eligible to be enrolled under this Plan but for a failure to enroll during a previous enrollment period), and (b) A person becomes a Dependent of the Employee through marriage, certified state -registered domestic partnership, birth, adoption or placement for adoption, then the Dependent (and if not otherwise enrolled, the Employee) may be enrolled under this Plan In the case of the birth or adoption of a child, the Spouse of the covered Employee may also be enrolled as a Dependent of the covered Employee if the Spouse is otherwise eligible for coverage. If the Employee is not enrolled at the time of the event, the Employee must enroll under this Special Enrollment Period in order for his eligible Dependents to enroll For marriage, the Dependent Special Enrollment Period is a penod of 31 days and begins on the date of the marriage. To be eligible for this Special Enrollment, the Dependent and/or Employee must request enrollment during this 31 -day period. For Domestic Partners, the Dependent Special Enrollment Period is a period of 31 days and begins on the date the Certificate of Registration of Domestic Partnership is executed To be eligible for this Special Enrollment, the Dependent and/or Employee must request enrollment during this 31 -day period For birth, adoption or placement for adoption, the Dependent Special Enrollment Period is a period of 60 days and begins on the date of the birth, adoption, or placement for adoption. To be eligible for this Special Enrollment, the Dependent and/or Employee must request enrollment during this 60 -day period. City of Yakima Employee Health Plan 18 January 1, 2012 The coverage of the Dependent and/or Employee enrolled in the Special Enrollment Period will be effective. (a) In the case of marriage, the date of marriage; (b) In the case of a Dependent's birth, as of the date of birth, or (c) In the case of a Dependent's adoption or placement for adoption, the date of the adoption or placement for adoption (d) In the case of a Domestic Partner, as of the date the Certificate of Registration of Domestic Partnership is executed. The Certificate of Registration of Domestic Partnership form is available from the Plan Administrator. Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Employees and their Dependents who are otherwise eligible for coverage under the Plan but who are not enrolled can enroll in the Plan provided that they request enrollment in writing within sixty (60) days from the date of the following loss of coverage or gain in eligibility. (1) The eligible person ceases to be eligible for Medicaid or State Children's Health Insurance Program (SCHIP) coverage; or (2) The eligible person becomes newly eligible for a premium subsidy under Medicaid or SCHIP. If eligible, the Dependent (and if not otherwise enrolled, the Employee) may be enrolled under this Plan. This Dependent Special Enrollment Penod is a period of 60 days and begins on the date of the loss of coverage under the Medicaid or SCHIP plan OR on the date of the determination of eligibility for a premium subsidy under Medicaid or SCHIP. To be eligible for this Special Enrollment, the Employee must request enrollment in writing during this 60 -day period. If a State in which the Employee lives offers any type of subsidy, this Plan shall also comply with any other State laws as set forth in statutes enacted by State legislature and amended from time to time, to the extent that the State law is applicable to the Plan, the Employer and its Employees EFFECTIVE DATE Effective Date of Employee Coverage. An Employee will be covered under this Plan as of the first day of the month following the date of hire providing the Employee satisfies all of the following. The Eligibility Requirement The Active Employee Requirement. The Enrollment Requirements of the Plan. Active Employee Requirement. An Employee must be an Active Employee (as defined by this Plan) for this coverage to take effect. Effective Date of Dependent Coverage. A Dependent's coverage will take effect on the day that the Eligibility Requirements are met; the Employee is covered under the Plan; and all Enrollment Requirements are met City of Yakima Employee Health Plan 19 January 1, 2012 TERMINATION OF COVERAGE When coverage under this Plan stops, Plan Participants will receive a certificate that will show the period of Creditable Coverage under this Plan. The Plan maintains written procedures that explain how to request this certificate. Please contact the Plan Administrator for a copy of these procedures and further details. The Employer or Plan has the right to rescind any coverage of the Employee and/or Retiree and/or Dependents for cause, making a fraudulent claim or an intentional material misrepresentation in applying for or obtaining coverage, or obtaining benefits under the Plan. The Employer or Plan may either void coverage for the Employee and/or covered Retirees and/or covered Dependents for the period of time coverage was in effect, may terminate coverage as of a date to be determined at the Plan's discretion, or may immediately terminate coverage The Employer will refund all contributions paid for any coverage rescinded, however, claims paid will be offset from this amount The Employer reserves the right to collect additional monies of claims are paid in excess of the Employee's and/or Retiree's and/or Dependent's paid contributions. When Employee Coverage Terminates. Employee coverage will terminate on the earliest of these dates. (1) (2) (3) The date the Plan is terminated, The date the covered Employee's Eligible Class is eliminated; The last day of the calendar month through which contributions have been paid when the covered Employee ceases to be in one of the Eligible Classes This includes death or termination of Active Employment of the covered Employee (See the section entitled COBRA Continuation Coverage ) (4) The end of the period for which the required contribution has been paid if the charge for the next period is not paid when due; (5) The first day an Employee fails to return to work following an approved leave of absence. (6) The last day of the month in which the Employee retires, unless otherwise eligible for coverage under a class of Retired Employees. If an Employee commits fraud or makes an intentional material misrepresentation in applying for or obtaining coverage, or obtaining benefits under the Plan, then the Employer or Plan may either void coverage for the Employee and covered Dependents for the period of time coverage was in effect, may terminate coverage as of a date to be determined at the Plan's discretion, or may immediately terminate coverage, or (7) (8) As otherwise specified in the Eligibility section Note: A covered Employee may be eligible for COBRA continuation coverage. For a complete explanation of when COBRA continuation coverage is available, what conditions apply and how to select it, see the section entitled COBRA Continuation Coverage Leave Without Pay Status (LWOP) The City may allow an Employee up to six (6) consecutive months of Leave Without Pay (LWOP) status. When on LWOP, an Employee will be allowed to self -pay his/her health care benefit premiums inclusive of the Employer and Employee contributions. If the Employee does not return to work before the six (6) month penod ends, at the seventh month of LWOP the Employee will be offered COBRA benefits If an Employee is in a LWOP status for more than six (6) months, it will be necessary for them to re -enroll in the Plan City of Yakima Employee Health Plan 20 January 1, 2012 Continuation During Family and Medical Leave. Regardless of the established leave policies mentioned above, this Plan shall at all times comply with the Family and Medical Leave Act of 1993 (FMLA) as promulgated in regulations issued by the Department of Labor, if, in fact, FMLA is applicable to the Employer and all of its Employees and locations This Plan shall also comply with any other State leave laws as set forth in statutes enacted by State legislature and amended from time to time, to the extent that the State leave law is applicable to the Employer and all of its Employees. Leave taken pursuant to any other State leave law shall run concurrently with leave taken under FMLA, to the extent consistent with applicable law. If applicable, dunng any leave taken under the FMLA and/or other State leave law, the Employer will maintain coverage under this Plan on the same conditions as coverage would have been provided if the covered Employee had been continuously employed during the entire leave period. If Plan coverage terminates during the FMLA, coverage will be reinstated for the Employee and his or her covered Dependents if the Employee returns to work in accordance with the terms of the FMLA and/or other State leave law Coverage will be reinstated only if the person(s) had coverage under this Plan when the FMLA leave started, and will be reinstated to the same extent that it was in force when that coverage terminated For example, Pre-existing Conditions limitations will not be issued unless they were in effect for the Employee and/or his or her Dependents when Plan coverage terminated. Rehiring a Terminated Employee. If an Employee or Dependent who was covered under this Plan terminates employment or loses eligibility for coverage and is rehired or again becomes eligible for coverage within six (6) months of the date of termination, any applicable Waiting Penod will be waived Credit will be given towards the deductible, out-of-pocket maximum, and Pre -Existing Condition Waiting Penod (including any creditable coverage acquired during the absence) for the time previously covered under this Plan if reinstated within six (6) months. An Employee will be eligible for reinstatement of coverage on the date he/she returns to work. Individuals continuously covered under the COBRA Continuation of Coverage of this Plan will be given credit for the time covered under this Plan toward meeting the Pre -Existing Condition requirement Individuals not reinstated on the Plan within six (6) months and not continuously covered under the COBRA Continuation of Coverage of this Plan will be treated as a new hire. Employees on Military Leave. Employees going into or returning from military service may elect to continue Plan coverage as mandated by the Uniformed Services Employment and Reemployment Rights Act (USERRA) under the following circumstances These nghts apply only to Employees and their Dependents covered under the Plan immediately before leaving for military service (1) The maximum period of coverage of a person and the person's Dependents under such an election shall be the lesser of. (a) The 24 month period beginning on the date on which the person's absence begins; or (b) The day after the date on which the person was required to apply for or return to a position of employment and fails to do so. (2) A person who elects to continue health plan coverage may be required to pay up to 1 02% of the full contribution under the Plan, except a person on active duty for 30 days or less cannot be required to pay more than the Employee's share, if any, for the coverage (3) An exclusion or Waiting Period may not be imposed in connection with the reinstatement of coverage upon reemployment if one would not have been imposed had coverage not been terminated because of service. However, an exclusion or Waiting Period may be imposed for coverage of any Illness or Injury determined by the Secretary of Veterans Affairs to have been incurred in, or aggravated during, the performance of uniformed service If the Employee wishes to elect this coverage or obtain more detailed information, contact the Plan Administrator. The Employee may also have continuation rights under USERRA. In general, the Employee must meet the same requirements for electing USERRA coverage as are required under COBRA continuation coverage requirements. City of Yakima Employee Health Plan 21 January 1, 2012 Coverage elected under these circumstances is concurrent not cumulative. The Employee may elect USERRA continuation coverage for the Employee and their Dependents Only the Employee has election rights Dependents do not have any independent right to elect USERRA health plan continuation When Retired Employee Coverage Terminates. Retired Employee coverage will terminate on the earliest of these dates. (1) (2) (3) The date the Plan is terminated; The date the covered Retired Employee's Eligible Class is eliminated, The date of the death of the covered Retired Employee; (4) The day the covered Retired Employee becomes a participant in another group health plan or becomes employed and therefore eligible to participate in another group plan; (5) The end of the period for which any required contribution has been paid if the charge for the next period is not paid when due; (6) When the Retired Employee reaches age 65, (7) If a Retired Employee commits fraud or makes an intentional material misrepresentation in applying for or obtaining coverage, or obtaining benefits under the Plan, then the Employer or Plan may either void coverage for the Retired Employee and covered Dependents for the period of time coverage was in effect, may terminate the coverage as of a date to be determined at the Plan's discretion, or may immediately terminate coverage, or (8) As otherwise specified in the Eligibility section of this Plan. Note: A covered Retired Employee may be eligible for COBRA continuation coverage. For a complete explanation of when COBRA continuation coverage is available, what conditions apply and how to select it, see the section entitled COBRA Continuation Coverage When Dependent Coverage Terminates. A Dependent's coverage will terminate on the earliest of these dates. (1) The date the Plan or Dependent coverage under the Plan is terminated, (2) The date that the Employee's coverage under the Plan terminates for any reason including death. (See the section entitled COBRA Continuation Coverage.), (3) The last day of the calendar month in which a covered Spouse loses coverage due to loss of dependency status (See the section entitled COBRA Continuation Coverage ); (4) For the Spouse of a Retiree, when the Spouse reaches age 65; (5) The last day of the calendar month through which contributions have been paid when a Dependent child ceases to be a Dependent as defined by the Plan. (See the section entitled COBRA Continuation Coverage ); (6) The end of the period for which the required contribution has been paid if the charge for the next period is not paid when due, (7) If a Dependent commits fraud or makes an intentional material misrepresentation in applying for or obtaining coverage, or obtaining benefits under the Plan, then the Employer or Plan may either void coverage for the Dependent for the period of time coverage was in effect, may terminate coverage as of a date to be determined at the Plan's discretion, or may immediately terminate coverage; or (8) As otherwise specified in the Eligibility Section. Note: A covered Dependent may be eligible for COBRA continuation coverage. For a complete explanation of when COBRA continuation coverage is available, what conditions apply and how to select it, see the section entitled COBRA Continuation Coverage City of Yakima Employee Health Plan 22 January 1, 2012 MEDICAL BENEFITS Medical Benefits apply when Covered Charges are incurred by a Covered Person for care of an Injury or Sickness and while the person is covered for these benefits under the Plan. DEDUCTIBLE Deductible Amount. This is an amount of Covered Charges for which no benefits will be paid Before benefits can be paid in a Calendar Year a Covered Person must meet the deductible shown in the Schedule of Benefits Family Unit Limit. When the maximum amount shown in the Schedule of Benefits has been incurred by members of a Family Unit toward their Calendar Year deductibles, the deductibles of all members of that Family Unit will be considered satisfied for that year BENEFIT PAYMENT Each Calendar Year, benefits will be paid for the Covered Charges of a Covered Person that are in excess of the deductible and any copayments. Payment will be made at the rate shown under reimbursement rate in the Schedule of Benefits. No benefits will be paid in excess of the Maximum Benefit Amount or any listed limit of the Plan. OUT-OF-POCKET LIMIT Covered Charges are payable at the percentages shown each Calendar Year until the out-of-pocket limit shown in the Schedule of Benefits is reached. Then, Covered Charges incurred by a Covered Person will be payable at 100% (except for the charges excluded) for the rest of the Calendar Year. When a Family Unit reaches the out-of-pocket limit, Covered Charges for that Family Unit will be payable at 1 00% (except for the charges excluded) for the rest of the Calendar Year MAXIMUM BENEFIT AMOUNT The Maximum Benefit Amount is shown in the Schedule of Benefits. It is the total amount of benefits that will be paid under the Plan for all Covered Charges (including Prescnption Drugs) incurred by a Covered Person for Essential Health Benefits during the Plan Year The Maximum Benefit applies to all plans and benefit options offered under the City of Yakima Employee Medical Benefits Plan, including the ones described in this document AUDIT INCENTIVE If a covered Employee or a Dependent discovers an error in the provider's medical billing which is subsequently recovered or if the benefits payable are reduced due to the identification of the error, the medical plan will reimburse the participant 50% of the recovered or reduced amount up to $200 per incident No benefit is payable for any errors made by the Plan Administrator in processing the claim. COVERED CHARGES Covered Charges are the Usual and Reasonable Charges that are incurred for the following items of service and supply These charges are subject to the benefit limits, exclusions and other provisions of this Plan A charge is incurred on the date that the service or supply is performed or furnished (1) Hospital Care. The medical services and supplies furnished by a Hospital or Ambulatory Surgical Center or a Birthing Center. Covered Charges for room and board will be payable as shown in the Schedule of Benefits After 23 observation hours, a confinement will be considered an inpatient confinement Room charges made by a Hospital having only private rooms will be payable at the average private room rate of that facility. City of Yakima Employee Health Plan 23 January 1, 2012 Charges for an Intensive Care Unit stay are payable as described in the Schedule of Benefits. (2) Coverage of Pregnancy. The Usual and Reasonable Charges for the care and treatment of Pregnancy are covered the same as any other Sickness for a covered Employee or covered Spouse or Domestic Partner. (3) Group health plans generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). There is no coverage of Pregnancy for a Dependent child Skilled Nursing Facility Care. The room and board and nursing care furnished by a Skilled Nursing Facility will be payable if and when. (a) the patient is confined as a bed patient in the facility, and (b) the attending Physician certifies that the confinement is needed for further care of the condition that caused the Hospital confinement; and (c) the attending Physician completes a treatment plan which includes a diagnosis, the proposed course of treatment and the projected date of discharge from the Skilled Nursing Facility. Covered Charges for a Covered Person's care in these facilities are payable as described in the Schedule of Benefits (4) Physician Care. The professional services of a Physician for surgical or medical services. (5) Charges for multiple surgical procedures will be a Covered Charge subject to the following provisions. (a) If bilateral or multiple surgical procedures are performed by one (1) surgeon, benefits will be determined based on the Usual and Reasonable Charge that is allowed for the primary procedures, 50% of the Usual and Reasonable Charge will be allowed for each additional procedure performed through the same incision or during the same operative session. Any procedure that would not be an integral part of the primary procedure or is unrelated to the diagnosis will be considered "incidental" and no benefits will be provided for such procedures; (b) If multiple unrelated surgical procedures are performed by two (2) or more surgeons on separate operative fields, benefits will be based on the Usual and Reasonable Charge for each surgeon's primary procedure. If two (2) or more surgeons perform a procedure that is normally performed by one (1) surgeon, benefits for all surgeons will not exceed the Usual and Reasonable percentage allowed for that procedure, and (c) If an assistant surgeon is required, the assistant surgeon's Covered Charge will not exceed 20% of the surgeon's Usual and Reasonable allowance Private Duty Nursing Care. The private duty nursing care by a licensed nurse (R.N., L.P.N. or L.V.N.). Covered Charges for this service will be included to this extent. (a) Inpatient Nursing Care. Charges are covered only when care is Medically Necessary or not Custodial in nature and the Hospital's Intensive Care Unit is filled or the Hospital has no Intensive Care Unit. City of Yakima Employee Health Plan 24 January 1, 2012 (b) Outpatient Nursing Care. Charges are covered only when care is Medically Necessary and not Custodial in nature The only charges covered for Outpatient nursing care are those shown below, under Home Health Care Services and Supplies Outpatient private duty nursing care on a 24 -hour -shift basis is not covered (6) Home Health Care Services and Supplies. Charges for Home Health Care Services and Supplies are covered only for care and treatment of an Injury or Sickness. The diagnosis, care and treatment must be certified by the attending Physician and be contained in a Home Health Care Plan (7) Benefit payment for nursing, home health aide and therapy services is subject to the Home Health Care limit shown in the Schedule of Benefits. A home health care visit will be considered a periodic visit by either a nurse or therapist, as the case may be, or four hours of home health aide services Hospice Care Services and Supplies. Charges for hospice care services and supplies are covered only when the attending Physician has diagnosed the Covered Person's condition as being terminal, determined that the person is not expected to live more than six months and placed the person under a Hospice Care Plan. Covered Charges for Hospice Care Services and Supplies are payable as described in the Schedule of Benefits Respite care up to a maximum of 120 hours in each three-month period of hospice care, to relieve anyone who lives with and cares for the terminally ill Plan Participant. The first three-month respite care period begins on the first day of covered hospice care. (8) Other Medical Services and Supplies. These services and supplies not otherwise included in the items above are covered as follows. (a) Allergy Injections/Testing. Eligible charges for the injections, testing, syringes and medication. (b) Local Medically Necessary professional land or air ambulance service. A charge for this item will be a Covered Charge only if the service is to the nearest Hospital or Skilled Nursing Facility where necessary treatment can be provided unless the Plan Administrator finds a longer trip was Medically Necessary (c) Anesthetic, oxygen, blood and blood derivatives that are not donated or replaced, intravenous injections and solutions. Administration of these items is included. Storage of any blood and its derivatives are not covered (d) Cardiac rehabilitation as deemed Medically Necessary provided services are rendered (a) under the supervision of a Physician, (b) in connection with a myocardial infarction, coronary occlusion or coronary bypass surgery, (c) initiated within 12 weeks after other treatment for the medical condition ends, and (d) in a Medical Care Facility as defined by this Plan. (e) Chemotherapy or radiation and treatment with radioactive substances The materials and services of technicians are included Pre -notification of services, by the Plan Participant, for cancer treatment services is strongly recommended. The pre -notification request to the Claims Administrator should include the Covered Person's plan of care and treatment protocol. Pre -notification of services should occur at least seven (7) days pnor to the initiation of treatment City of Yakima Employee Health Plan 25 January 1, 2012 For pre -notification of services, call the Claims Administrator at the following numbers. Toll Free in the United States. 1-866-894-1505 A pre -notification of services by the Claims Administrator is not a determination by the Plan that claims will be paid All claims are subject to the provisions of the Plan, including but not limited to medical necessity, exclusions and limitations in effect when services are provided. A pre -notification is not required as a condition to paying benefits, and cannot be appealed. Please refer to Cost Management Services section. Initial contact lenses or glasses required following cataract surgery. Diabetes Education benefit. Inpatient and outpatient self-management training and education services for the treatment of diabetes, provided by a licensed health care professional with expertise in diabetes (h) Rental of durable medical or surgical equipment if deemed Medically Necessary. These items may be bought rather than rented, with the cost not to exceed the fair market value of the equipment at the time of purchase, but only if agreed to in advance by the Plan Administrator. (1) (1) Home Infusion Therapy. The Plan will cover home infusion therapy services and supplies when provided by an accredited home infusion therapy agency, which is not a licensed Home Health Agency These services must be Medically Necessary and are required for the administration of a home infusion therapy regimen when ordered by and are part of a formal written plan prescribed by a Physician. The benefit will include all Medically Necessary services and supplies including the nursing services associated with patient and/or alternative care giver training, visits to monitor intravenous therapy regimen, emergency care, Prescription Drugs, administration of therapy and the collection, analysis and reporting of the results of laboratory testing services required to monitor a response to therapy Kidney Dialysis (Outpatient Services). Charges for professional treatment, supplies, medications, labs, and facility fees related to outpatient kidney dialysis are covered services under the Plan for up to the 1st 42 treatments, upon the completion of which your Dialysis benefits under this plan have been exhausted, for the remainder of the current treatment penod A Treatment penod is defined as the beginning and end of the prescribed dialysis treatment When kidney dialysis is recommended, the participant must first contact the Plan Supervisor's Health Services Department to pre -authorize the treatment. Eligible services during the 1st 42 treatments received will be covered as stated in the Schedule of Benefits. Eligible services include, but are not limited to, hemodialysis, peritoneal dialysis, and hemofiltration Eligible expenses include the first forty-two treatments received, starting from the initial kidney dialysis treatment Treatments received prior to becoming eligible under the Plan, are counted toward the first forty-two treatments, however, they are not covered expenses under the Plan. Supplemental Coverage For any subsequent kidney dialysis treatment (beyond the first forty-two treatments), the Plan will provide additional supplemental coverage for Kidney Dialysis treatment and related services Charges for professional treatment, supplies, medications, labs, and facility fees related to outpatient kidney dialysis are covered services under this benefit. Eligible services include, but are not limited to, hemodialysis, peritoneal dialysis, and hemofiltration. The Plan's preauthorization requirements apply. This Supplemental Coverage benefit does not access any provider agreements for pricing and applies to any provider the member receives services from Dunng this subsequent period of treatment, the supplemental coverage will be paid as shown in the Schedule of Benefits. Standard coordination of benefit provisions will apply. In addition, all plan participants with ESRD will be eligible to have their Medicare Part B premiums reimbursed by the Plan as an eligible Plan expense for the duration of their ESRD treatment, as City of Yakima Employee Health Plan 26 January 1, 2012 long as they continue to be covered under the Part B coverage and continue to be eligible for coverage under this Plan (proof of payment of the Part B premium will be required pnor to reimbursement) Please contact the Plan Supervisor's Customer Service Department for additional information regarding reimbursement of Medicare premiums Eligible services received under the Supplemental Coverage provision of this Plan (after the 42nd treatment) will be paid at 150% of the current Medicare allowable for the same or similar service Deductible Waived Notwithstanding the above, in the event that the Provider accepts Medicare Assignment as payment in full, then Eligible Expenses shall mean the lesser of the total amount of charges allowable by Medicare, whether the plan participant is enrolled for Medicare coverage or not, and the total eligible expenses allowable under this Plan exclusive of coinsurance. (k) Laboratory studies. Covered Charges for diagnostic and preventive lab testing and services (1) Massage therapy, up to the limits as stated in the Schedule of Benefits. (m) Treatment of Mental Disorders and Substance Abuse. Covered Charges are payable for care, supplies and treatment of Mental Disorders and Substance Abuse. (n) Injury to or care of mouth, teeth and gums Charges for Injury to or care of the mouth, teeth, gums and alveolar processes will be Covered Charges under Medical Benefits only if that care is for the following oral surgical procedures. • Excision of tumors and cysts of the jaws, cheeks, lips, tongue, roof and floor of the mouth. • Emergency repair due to Injury to sound natural teeth, within 24 months of the Injury If services cannot be completed within 24 months of an Injury, coverage may be extended when deemed Medically Necessary • Surgery needed to correct accidental injuries to the jaws, cheeks, lips, tongue, floor and roof of the mouth. • Excision of benign bony growths of the jaw and hard palate. • External incision and drainage of cellulitis. • Incision of sensory sinuses, salivary glands or ducts • Removal of impacted teeth General anesthesia and related facility services for dental procedures are covered when Medically Necessary for 1 of 3 reasons. • The Covered Person is disabled physically or developmentally and has a dental condition that can't be safely and effectively treated in a dental office • The Covered Person has a medical condition in addition to the dental condition needing treatment that the attending provider finds would create an undue medical risk if the treatment weren't done in a hospital or ambulatory surgical center • The Covered Person is emotionally unstable, uncooperative, or a combative patient where treatment is extensive and impossible to accomplish in the office. City of Yakima Employee Health Plan 27 January 1, 2012 This benefit will not cover the dentist's services unless the services are to treat a dental Injury and meet the requirements descnbed above No charge will be covered under Medical Benefits for dental and oral surgical procedures involving orthodontic care of the teeth, periodontal disease and preparing the mouth for the fitting of or continued use of dentures. (o) Neurodevelopmental therapy. Benefits will be provided for Medically Necessary neurodevelopmental therapy treatment to restore and improve bodily function for children to age seven (7) This benefit includes maintenance services where significant deterioration of the patient's condition would result without the service. (P) (q) Neurodevelopmental therapy means therapy designed to treat structural or functional abnormalities of the central or penpheral nervous system Its purpose is to restore, maintain, or develop age appropnate functions in a child Such therapy includes occupational therapy, physical therapy, and speech therapy. The services of a physician, physical therapist, speech therapist, or occupational therapist will be provided in the provider's office, medical facility, or hospital outpatient department. Inpatient hospital, medical facility, or skilled nursing facility expenses will be eligible when care cannot be safely provided on an outpatient basis Benefits are payable as stated in the Schedule of Benefits Benefits for rehabilitative services or other treatment programs will not be available for the same condition. Nutritional Education Benefit. Care, treatment, and services when provided by either a registered dietician or licensed nutritionist This benefit will not include weight loss medications or nutritional supplements whether or not prescribed by a Physician. Obesity treatment. If a participant is morbidly obese (as defined by the Plan), the Plan covers office visits and related laboratory tests for the treatment of obesity Treatment must be provided by a Physician on an outpatient basis according to a wntten treatment plan The benefit is limited to one course of treatment. A course of treatment begins and ends as specified in the treatment plan, or sooner if the participant discontinues treatment. Medically Necessary non-surgical charges for Morbid Obesity will be covered Medically Necessary surgical charges for Morbid Obesity (including complications) will also be covered up to the limits as stated in the Schedule of Benefits. The measurement of Body Mass Index (BMI) as defined under this Plan or a BMI of 35 or greater with any co morbid conditions that are expected to improve, reverse or be limited by this surgical treatment and which must be documented in a record or letter of medical necessity must demonstrate the diagnosis of Morbid Obesity A pre -notification of services, by the Plan Participant is strongly recommended for either inpatient or outpatient surgical procedures and will require the following documentation including, but not limited to, a written treatment plan by the attending Physician and documentation that all required medical criteria in advance of any surgical treatment has been met Please contact the Claims Administrator for further information regarding pre -notification procedures and requirements A PRE -NOTIFICATION OF SERVICES BY THE CLAIMS ADMINISTRATOR IS NOT A DETERMINATION BY THE PLAN THAT CLAIMS WILL BE PAID. ALL CLAIMS ARE City of Yakima Employee Health Plan 28 January 1, 2012 SUBJECT TO THE PROVISIONS OF THE PLAN INCLUDING, BUT NOT LIMITED TO, MEDICAL NECESSITY, EXCLUSIONS, AND LIMITATIONS IN EFFECT WHEN CHARGES ARE INCURRED. A PRE -NOTIFICATION IS NOT REQUIRED AS A CONDITION TO PAYING BENEFITS AND CANNOT BE APPEALED. The Plan does not pay for anything not included in the written treatment plan. In addition, the plan does not pay for appetite or weight control drugs, dietary supplements, special foods or food supplements, health and weight control centers or resorts, health club memberships or exercise equipment. (r) Occupational therapy by a licensed occupational therapist. Therapy must be ordered by a Physician, result from an Injury or Sickness and improve a body function. Covered Charges do not include recreational programs, maintenance therapy or supplies used in occupational therapy (s) Organ transplant benefits. Medically Necessary charges incurred for the care and treatment due to an organ or tissue transplant, which are not considered Experimental or Investigational, are subject to the following criteria (and are subject to the limits as stated in the Schedule of Benefits)• • The transplant must be performed to replace an organ or tissue. • Organ transplant benefit period. A period of 365 continuous days beginning five (5) days immediately prior to an approved organ transplant procedure. In the case of a bone marrow transplant, the date the transplant begins will be defined as either the earlier of the date of the beginning of the preparatory regimen (marrow ablation therapy) or the date the marrow/stem cells is/are infused • Organ procurement limits Charges for obtaining donor organs or tissues are Covered Charges under the Plan only when the recipient is a Covered Person When the donor has medical coverage, his or her plan will pay first. The donor benefits under this Plan will be reduced by those payable under the donor's plan. Donor charges include those for. (1) Initial testing/screening of potential organ or tissue donor; subsequent or secondary testing/screening of potential organ or tissue donor; and organ acquisition/procurement of the approved organ or tissue donor (ii) Evaluating the organ or tissue, (iii) Removing the organ or tissue from the donor, and (iv) Transportation of the organ or tissue from within the United States or Canada to the facility where the transplant is to be performed Note: Expenses related to the purchase of any organ will not be covered. As soon as reasonably possible, but in no event more than ten (10) days after a Covered Person's attending Physician has indicated that the Covered Person is a potential candidate for a transplant, the Covered Person or his or her Physician must contact CareLink at (866) 894-1505. • In the event a Participating Provider transplant facility is utilized, benefits will be payable at the Participating Provider benefit level. • In the event a Participating Provider transplant facility is unavailable and the providing transplant facility is a Center of Excellence facility, benefits will be payable at the Participating Provider benefit level. City of Yakima Employee Health Plan 29 January 1, 2012 • In the event a non -Participating Provider transplant facility is utilized and the providing transplant facility is not a Center of Excellence facility, benefits will be payable at the non - Participating Provider benefit level. There is no obligation to the Covered Person to use either a Participating Provider or a Center of Excellence facility; however, benefits for the transplant and related expenses will vary depending upon whether services are provided by a Participating Provider or a non -Participating Provider and whether or not a Center of Excellence facility is utilized. A Center of Excellence is a licensed healthcare facility that has entered into a participation agreement with a national transplant Participating to provide approved transplant services, at a negotiated rate, to which the Plan has access A Covered Person may contact CareLink to determine whether or not a facility is considered a Center of Excellence Special Transplant Benefit Under certain circumstances, there may be special transplant benefits available when the group health plan and/or a Covered Person participates in a special transplant program and/or contracts with a specific transplant network Therefore, it is very important to contact CareLink at (866) 894-1505 as soon as reasonably possible so that the Plan can advise the Covered Person or his or her Physician of the transplant benefits that may be available. Transplant Exclusions Coverage for the above procedures, when Medically Necessary, will be provided under the regular medical benefits provision under this Plan, subject to any Plan provisions and applicable benefits limitations as stated in the Schedule of Benefits. (1) Cornea transplantation (2) Skin grafts (3) Artery (4) Vein (5) Valve (6) Transplantation of blood or blood derivatives (except for bone marrow or stem cells) (t) The initial purchase, fitting and repair of orthotic appliances such as braces, splints or other appliances which are required for support for an injured or deformed part of the body as a result of a disabling congenital condition or an Injury or Sickness Note Foot orthotics or other similar supportive devices for the feet are not covered under this Plan (u) Physical therapy by a licensed physical therapist The therapy must be in accord with a Physician's exact orders as to type, frequency and duration and for conditions which are subject to significant improvement through short-term therapy (v) Phenylketonuria (PKU) dietary formula, which is Medically Necessary for the treatment of phenylketonuria. (w) Prescription Drugs (as defined) Outpatient Prescription Drugs will be payable under the separate Prescription Drug Benefit section under this Plan. City of Yakima Employee Health Plan 30 January 1, 2012 (x) (y) Routine Preventive Care. Covered Charges under Medical Benefits are payable for routine Preventive Care as described in the Schedule of Benefits Additional preventive care shall be provided as required by applicable law A current listing of required preventive care can be accessed at www HealthCare goy/center/regulations/prevention html Charges for Routine Well Care. Routine well care is care by a Physician that is not for an Injury or Sickness. The initial purchase, fitting and repair of fitted prosthetic devices which replace body parts Benefits are provided for artificial devices which are Medically Necessary to replace a missing or defective body part, including (but not limited to) artificial limbs, eyes, artificial hip, cochlear implant, and bone anchored hearing aids (BAHA) . Benefits will also be payable for an external breast prosthesis following a mastectomy. External breast prostheses are limited to one replacement every three calendar years A prosthesis ordered before your effective date of coverage will not be covered A prosthesis ordered while your coverage is in effect and delivered within 30 days after termination of coverage will be covered. (z) Reconstructive Surgery. Correction of abnormal congenital conditions and reconstructive mammoplasties will be considered Covered Charges This mammoplasty coverage will include reimbursement for. • reconstruction of the breast on which a mastectomy has been performed, • surgery and reconstruction of the other breast to produce a symmetrical appearance, and • coverage of prostheses and physical complications dunng all stages of mastectomy, including lymphedemas, in a manner determined in consultation with the attending Physician and the patient. (al) Charges for Rehabilitation therapy up to the limits stated in the Schedule of Benefits. Services must be Medically Necessary to restore and improve a bodily or cognitive function that was previously normal but was lost as a result of an accidental Injury, illness, or surgery Inpatient Care Services must be furnished in a specialized rehabilitative unit of a Hospital and billed by the Hospital or be furnished and billed by a rehabilitation facility approved by the Plan. This benefit only covers care the Covered Person received within 24 months from the onset of the Injury or Illness or from the date of the surgery that made rehabilitation necessary. The care must also be part of a written plan of multidisciplinary treatment prescribed and penodically reviewed by a physiatrist (a Physician specializing in rehabilitative medicine) (bl) Speech therapy by a licensed speech therapist. Therapy must be ordered by a Physician and follow either. • Surgery for correction of a congenital condition of the oral cavity, throat or nasal complex (other than a frenectomy) of a person, • An Injury, or • A Sickness that is other than a learning or Mental Disorder (el) Spinal Manipulation/Chiropractic services by a licensed M.D., D.O. or D.C., up to the limits as stated in the Schedule of Benefits. City of Yakima Employee Health Plan 31 January 1, 2012 (d1) Sterilization procedures. (el) Surgical dressings, splints, casts and other devices used in the reduction of fractures and dislocations and other Medically Necessary medical supplies (fl) Tobacco Cessation. Tobacco cessation counseling. Physician prescribed medication for tobacco cessation are payable under the Prescription Drug Benefits section of this Plan (gl) Coverage of Well Newborn Nursery/Physician Care Charges for Routine Nursery Care. Routine well newborn nursery care is care while the newborn is Hospital -confined after birth and includes room, board and other normal care for which a Hospital makes a charge. In addition, Phenylketonuria (PKU) testing within the first seven days of life and a circumcision performed in an outpatient setting within 31 days of the birth of the baby will be covered under this benefit This coverage is only provided if the newborn child is an eligible and enrolled Dependent, who is neither injured nor ill, and a parent (1) is a Covered Person who was covered under the Plan at the time of the birth, or (2) enrolls himself or herself (as well as the newborn child if required) in accordance with the Special Enrollment provisions with coverage effective as of the date of birth The benefit is limited to Usual and Reasonable Charges for nursery care for the newborn child while Hospital confined as a result of the child's birth. Charges for covered routine nursery care will be applied toward the Plan of the newborn child. Group health plans generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for prescnbing a length of stay not in excess of 48 hours (or 96 hours) Charges for Routine Physician Care. The benefit is limited to the Usual and Reasonable Charges made by a Physician for the newborn child while Hospital confined as a result of the child's birth. Charges for covered routine Physician care will be applied toward the Plan of the newborn child (h1) Diagnostic x-rays. City of Yakima Employee Health Plan 32 January 1, 2012 COST MANAGEMENT SERVICES COORDINATED CARE Coordinated Care is a program designed to assist Covered Persons in understanding and becoming involved with their diagnosis and medical plan of care, and advocates patient involvement in choosing a medical plan of care. Coordinated Care begins with the pre -notification process. Pre -notification of certain services is strongly recommended, but not required by the Plan Pre -notification provides information regarding coverage before the Covered Person receives treatment, services and/or supplies A benefit determination on a Claim will be made only after the Claim has been submitted A pre -notification of services by CareLink is not a determination by the Plan that a Claim will be paid All Claims are subject to the terms and conditions, limitations and exclusions of the Plan at the time services are provided A pre -notification is not required as a condition precedent to paying benefits, and cannot be appealed. Examples of when the Physician and Covered Person should contact CareLink prior to treatment include: • Inpatient admissions to a Hospital • Inpatient admissions to free-standing chemical dependency, mental health, and rehabilitation facilities • Cancer treatment programs, administered on an inpatient or outpatient basis • Inpatient or outpatient surgeries relating to, but not limited to, hysterectomies, back surgery, or bariatric surgery. All Claims are subject to the terms and conditions, limitations and exclusions of the Plan at the time services are provided The Physician or Covered Person should notify CareLink at least seven (7) days before services are scheduled to be rendered with the following information. • The name of the patient and relationship to the covered Employee • The name, Employee identification number and address of the Covered Person • The name of the Employer • The name and telephone number of the attending Physician • The name of the Hospital, proposed date of admission, and proposed length of stay • The diagnosis and/or type of surgery • The plan of care, treatment protocol and/or informed consent, if applicable If there is an emergency admission to the Hospital, the Covered Person, Covered Person's family member, Hospital or attending Physician should notify CareLink within two (2) business days after the admission Hospital Observation Room stays in excess of 23 hours are considered an admission for purposes of this program, therefore CareLink should be notified. City of Yakima Employee Health Plan 33 January 1, 2012 Contact the Coordinated Care administrator at: CareLink 1-866-894-1505 Monday through Thursday, 6:00 a.m. to 6:00 p.m. (Pacific Time) Friday, 6:00 a.m. to 5:00 p.m. (Pacific Time) A CareLmk nurse will contact the Covered Person to provide health education, pre -surgical counseling, inpatient care coordination, facilitation of discharge plan and post -discharge follow-up PRE -NOTIFICATION DETERMINATION AND REVIEW PROCESS The Claims Administrator, on the Plan's behalf, will review the submitted information and make a determination on a pre -notification request within fifteen (15) days of receipt of the pre -notification request and all supporting documentation If additional records are necessary to process the pre -notification request, the Claims Administrator will notify the Covered Person or the Physician The time for making a determination on the request will be tolled from the date that the additional information is requested until the date that the information is received. The Physician and Covered Person will be provided notice of the Plan's determination. If the pre -notification request is denied, written notice will provide the reason for the denial The Plan offers a one -level review procedure for pre -notification denials The request for reconsideration must be submitted in writing within thirty (30) days of the receipt of the pre -notification denial and include a statement as to why the Covered Person disagrees with the pre -notification denial. The Covered Person may include any additional documentation, medical records, and/or letters from the Covered Person's treating Physician(s). The request for reconsideration should be addressed to. Plan Administrator c/o Employee Benefit Management Services, Inc (EBMS) Attn. Claims Appeals PO Box 21367 Billings, Montana 59104 The Plan Administrator or its designee will perform the reconsideration review The Plan Administrator or its designee will review the information initially received and any additional information provided by the Covered Person, and determine if the pre -notification determination was appropriate. If the pre -notification denial was based upon the medical necessity, the Experimental/ Investigational nature of the treatment, service or supply or an equivalent exclusion, the Plan may consult with a health care professional who has the appropriate training and expenence in the applicable field of medicine Written or electronic notice of the determination upon reconsideration will be provided within thirty (30) days of the receipt of the request for reconsideration CASE MANAGEMENT If a Covered Person has an ongoing medical condition or catastrophic Illness, a Case Manager may be assigned to monitor this Covered Person, and to work with the attending Physician and Covered Person to design a treatment plan and coordinate appropnate Medically Necessary care The Case Manager will consult with the Covered Person, the family, and the attending Physician in order to assist in coordinating the plan of care approved by the Covered Person's attending Physician and the Covered Person This plan of care may include some or all of the following. • Individualized support to the patient, • Contacting the family to offer assistance for coordination of medical care needs, • Monitoring response to treatment, • Evaluating outcomes; and • Assisting in obtaining any necessary equipment and services City of Yakima Employee Health Plan 34 January 1, 2012 Case Management is not a requirement of the Plan. There are no reductions of benefits or penalties if the Covered Person and family choose not to participate. Each treatment plan is individualized to a specific Covered Person and is not appropriate or recommended for any other patient, even one with the same diagnosis. All treatment and care decisions will be the sole determination of the Covered Person and the attending Physician. TELEPHONE CONSULTATION Nurses are available by a toll-free line during CareLink normal working hours to answer a Covered Person's health- related questions. Assistance ranges from providing a better understanding of specific medical procedures, to plain English translations of medical terminology and help in locating community support services. CareLink PRIORITY MATERNITY CARE Priority Maternity Care is an educational and empowerment program for eligible female Employees and Dependent Spouse or Domestic Partner. This program provides a means to positively affect a Pregnancy and the health of the baby. A CareLink nurse will set up a confidential, personal telephone interview to identify medical history and lifestyles that could have an impact on the outcome of the Pregnancy A CareLink nurse is available to assist and coordinate high risk aspects of maternity care. This includes providing information such as access to educational programs and community resources designed to meet the needs identified by the patient or Physician. Certification Requirements. The Covered Person needs to notify CareLink during the first trimester of her Pregnancy City of Yakima Employee Health Plan 35 January 1, 2012 DEFINED TERMS The following terms have special meanings and when used in this Plan will be capitalized Active Employee is an Employee who is on the regular payroll of the Employer and who has begun to perform the duties of his or her job with the Employer on a full-time or part-time basis. Ambulatory Surgical Center is a licensed facility that is used mainly for performing outpatient surgery, has a staff of Physicians, has continuous Physician and nursing care by registered nurses (R N s) and does not provide for overnight stays Biofeedback Therapy is an electronic method which allows the patient to monitor the functioning of the body's autonomic systems (e.g., body temperature, heart rate) that were previously thought to be involuntary. Birthing Center means any freestanding health facility, place, professional office or institution which is not a Hospital or in a Hospital, where births occur in a home -like atmosphere This facility must be licensed and operated in accordance with the laws pertaining to Birthing Centers in the jurisdiction where the facility is located. The Birthing Center must provide facilities for obstetrical delivery and short-term recovery after delivery, provide care under the full-time supervision of a Physician and either a registered nurse (R.N.) or a licensed nurse -midwife, and have a wntten agreement with a Hospital in the same locality for immediate acceptance of patients who develop complications or require pre- or post -delivery confinement Brand Name means a trade name medication. Calendar Year means January 1st through December 31st of the same year. COBRA means the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended Covered Charge(s) means those Medically Necessary services or supplies that are covered under this Plan. Covered Person is an Employee, Retiree or Dependent who is covered under this Plan. Creditable Coverage includes most health coverage, such as coverage under a group health plan (including COBRA continuation coverage), HMO membership, an individual health insurance policy, Medicaid, Medicare or public health plans Creditable Coverage does not include coverage consisting solely of dental or vision benefits. Creditable Coverage does not include coverage that was in place before a significant break of coverage of 63 days or more With respect to the Trade Act of 2002, when determining whether a significant break in coverage has occurred, the period between the trade related coverage loss and the start of the special second COBRA election period under the Trade Act, does not count. Custodial Care is care (including Room and Board needed to provide that care) that is given principally for personal hygiene or for assistance in daily activities and can, according to generally accepted medical standards, be performed by persons who have no medical training Examples of Custodial Care are help in walking and getting out of bed; assistance in bathing, dressing, feeding; or supervision over medication which could normally be self-administered Durable Medical Equipment means equipment which (a) can withstand repeated use, (b) is primarily and customarily used to serve a medical purpose, (c) generally is not useful to a person in the absence of an Illness or Injury and (d) is appropriate for use in the home. Emergency Services means a medical screening examination (as required under Section 1867 of the Social Security Act (EMTALA)) within the capability of the Hospital emergency department, including routine ancillary services, to evaluate a Medical Emergency and such further medical examination and treatment as are within the capabilities of the staff and facilities of the Hospital and required under EMTALA to stabilize the patient. City of Yakima Employee Health Plan 36 January 1, 2012 Employee means a person who is an Active, regular Employee of the Employer, regularly scheduled to work for the Employer in an Employee/Employer relationship Employer is City of Yakima Enrollment Date is the first day of coverage or, if there is a Waiting Period, the first day of the Waiting Period. Essential Health Benefits include, to the extent they are covered under the Plan, ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care. Experimental and/or Investigational means services, supplies, care and treatment which does not constitute accepted medical practice properly within the range of appropriate medical practice under the standards of the case and by the standards of a reasonably substantial, qualified, responsible, relevant segment of the medical community or government oversight agencies at the time services were rendered. The Plan Administrator must make an independent evaluation of the experimental/nonexperimental standings of specific technologies. The Plan Administrator shall be guided by a reasonable interpretation of Plan provisions. The decisions shall be made in good faith and rendered following a detailed factual background investigation of the claim and the proposed treatment The decision of the Plan Administrator will be final and binding on the Plan The Plan Administrator will be guided by the following principles. (1) if the drug or device cannot be lawfully marketed without approval of the U.S. Food and Drug Administration and approval for marketing has not been given at the time the drug or device is furnished, or (2) if the drug, device, medical treatment or procedure, or the patient informed consent document utilized with the drug, device, treatment or procedure, was reviewed and approved by the treating facility's Institutional Review Board or other body serving a similar function, or if federal law requires such review or approval, or (3) if Reliable Evidence shows that the drug, device, medical treatment or procedure is the subject of on-going phase I or phase II clinical trials, is the research, experimental, study or Investigational arm of on-going phase III clinical trials, or is otherwise under study to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or diagnosis, or (4) if Reliable Evidence shows that the prevailing opinion among experts regarding the drug, device, medical treatment or procedure is that further studies or clinical trials are necessary to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or diagnosis. Reliable Evidence shall mean only published reports and articles in the authoritative medical and scientific literature, the written protocol or protocols used by the treating facility or the protocol(s) of another facility studying substantially the same drug, service, medical treatment or procedure; or the written informed consent used by the treating facility or by another facility studying substantially the same drug, device, medical treatment or procedure Drugs are considered Experimental if they are not commercially available for purchase and/or they are not approved by the Food and Drug Administration for general use. Foster Child means a child who meets the eligibility requirements shown in the Dependent Eligibility Section of this Plan for whom a covered Employee has assumed a legal obligation in connection with the child's placement with a state, county or private foster care agency City of Yakima Employee Health Plan 37 January 1, 2012 A covered Foster Child is not a child temporarily living in the covered Employee's home; one placed in the covered Employee's home by a social service agency which retains control of the child; or whose natural parent(s) may exercise or share parental responsibility and control. Generic drug means a Prescription Drug which has the equivalency of the brand name drug with the same use and metabolic disintegration. This Plan will consider as a Generic drug any Food and Drug Administration approved generic pharmaceutical dispensed according to the professional standards of a licensed pharmacist and clearly designated by the pharmacist as being generic Genetic Information means information about the genetic tests of an individual or his family members, and information about the manifestations of disease or disorder in family members of the individual. A "genetic test" means an analysis of human DNA, RNA, chromosomes, proteins or metabolites, which detects genotypes, mutations or chromosomal changes. It does not mean an analysis of proteins or metabolites that is directly related to a manifested disease, disorder or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved Genetic information does not include information about the age or gender of an individual Home Health Care Agency is an organization that meets all of these tests. its main function is to provide Home Health Care Services and Supplies, it is federally certified as a Home Health Care Agency, and it is licensed by the state in which it is located, if licensing is required. Home Health Care Plan must meet these tests. it must be a formal written plan made by the patient's attending Physician which is reviewed at least every 30 days; it must state the diagnosis; and it must specify the type and extent of Home Health Care required for the treatment of the patient. Home Health Care Services and Supplies include. part-time or intermittent nursing care by or under the supervision of a registered nurse (R N ); part-time or intermittent home health aide services provided through a Home Health Care Agency (this does not include general housekeeping services); physical, occupational and speech therapy; medical supplies; and laboratory services by or on behalf of the Hospital Hospice Agency is an organization where its main function is to provide Hospice Care Services and Supplies and it is licensed by the state in which it is located, if licensing is required. Hospice Care Plan is a plan of terminal patient care that is established and conducted by a Hospice Agency and supervised by a Physician Hospice Care Services and Supplies are those provided through a Hospice Agency and under a Hospice Care Plan and include inpatient care in a Hospice Unit or other licensed facility, and home care. Hospice Unit is a facility or separate Hospital Unit that provides treatment under a Hospice Care Plan and admits at least two unrelated persons who are expected to die within six months Hospital is an institution that is engaged primarily in providing medical care and treatment of sick and injured persons on an inpatient basis at the patient's expense and that fully meets these tests. it is approved by Medicare as a Hospital, it maintains diagnostic and therapeutic facilities on the premises for surgical and medical diagnosis and treatment of sick and injured persons by or under the supervision of a staff of Physicians, it continuously provides on the premises 24-hour nursing services by or under the supervision of registered nurses (R N s); and it is operated continuously with organized facilities for operative surgery on the premises The definition of "Hospital" shall be expanded to include the following. • A facility operating legally as a psychiatric Hospital or residential treatment facility for mental health and licensed as such by the state in which the facility operates. • A facility operating primarily for the treatment of Substance Abuse if it has received accreditation from CARF (Commission of Accreditation of Rehabilitation Facilities) or JCAHO (Joint Commission of Accreditation of Hospital Organizations) or if it meets these tests. maintains permanent and full-time facilities for bed care and full-time confinement of at least 15 resident patients, has a Physician in regular City of Yakima Employee Health Plan 38 January 1, 2012 attendance, continuously provides 24-hour nursing service by a registered nurse (R.N.), has a full-time psychiatrist or psychologist on the staff; and is primarily engaged in providing diagnostic and therapeutic services and facilities for treatment of Substance Abuse Illness means a bodily disorder, disease, physical sickness or Mental Disorder. Illness includes Pregnancy, childbirth, miscarriage or complications of Pregnancy. Injury means an accidental physical Injury to the body caused by unexpected external means Intensive Care Unit is defined as a separate, clearly designated service area which is maintained within a Hospital solely for the care and treatment of patients who are critically ill. This also includes what is referred to as a "coronary care unit" or an "acute care unit." It has. facilities for special nursing care not available in regular rooms and wards of the Hospital, special life saving equipment which is immediately available at all times, at least two beds for the accommodation of the critically ill; and at least one registered nurse (R N ) in continuous and constant attendance 24 hours a day Late Enrollee means a Plan Participant who enrolls under the Plan other than during the first 30 -day period in which the individual is eligible to enroll under the Plan or during a Special Enrollment Period. Legal Guardian means a person recognized by a court of law as having the duty of taking care of the person and managing the property and rights of a minor child Medical Care Facility means a Hospital, a facility that treats one or more specific ailments or any type of Skilled Nursing Facility. Medical Emergency means a medical condition manifesting itself by acute symptoms of sufficient severity including severe pain such that a prudent layperson with average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in (1) serious jeopardy to the health of an individual (or, in the case of a pregnant woman, the health of the woman or her unborn child), (2) serious impairment to body functions, or (3) serious dysfunction of any body organ or part. A Medical Emergency includes such conditions as heart attacks, cardiovascular accidents, poisonings, loss of consciousness or respiration, convulsions or other such acute medical conditions. Medical Non -Emergency Care means care which can safely and adequately be provided other than in a Hospital Medically Necessary care and treatment is recommended or approved by a Physician; is consistent with the patient's condition or accepted standards of good medical practice, is medically proven to be effective treatment of the condition, is not performed mainly for the convenience of the patient or provider of medical services, and is the most appropriate level of services which can be safely provided to the patient. All of these cntena must be met; merely because a Physician recommends or approves certain care does not mean that it is Medically Necessary The Plan Administrator has the discretionary authority to decide whether care or treatment is Medically Necessary. Medicare is the Health Insurance For The Aged and Disabled program under Title XVIII of the Social Security Act, as amended Mental Disorder means any disease or condition, regardless of whether the cause is organic, that is classified as a Mental Disorder in the current edition of International Classification of Diseases, published by the U S Department of Health and Human Services or is listed in the current edition of Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. Morbid Obesity is a serious disease associated with a high incidence of medical complications and a significantly shortened life span The current clinical standard measure for Morbid Obesity is a Body Mass Index (BMI) of 40+ The BMI is a factor produced by dividing a person's weight (in kilograms) by his or her height squared (in meters). City of Yakima Employee Health Plan 39 January 1, 2012 No -Fault Auto Insurance is the basic reparations provision of a law providing for payments without determining fault in connection with automobile accidents Outpatient Care and/or Services is treatment including services, supplies and medicines provided and used at a Hospital under the direction of a Physician to a person not admitted as a registered bed patient, or services rendered in a Physician's office, laboratory or X-ray facility, an Ambulatory Surgical Center, or the patient's home. Pharmacy means a licensed establishment where covered Prescription Drugs are filled and dispensed by a pharmacist licensed under the laws of the state where he or she practices Physician means a Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), Doctor of Podiatry (D.P.M.), Doctor of Chiropractic (D.C.), Doctor of Naturopathy (N.D.), Audiologist, Certified Nurse Anesthetist, Licensed Professional Counselor, Licensed Professional Physical Therapist, Master of Social Work (M.S.W.), Licensed Massage Therapist, Midwife, Occupational Therapist, Physiotherapist, Psychiatrist, Psychologist (Ph D ), Speech Language Pathologist and any other practitioner of the healing arts who is licensed and regulated by a state or federal agency and is acting within the scope of his or her license Plan means City of Yakima Employee Medical Benefits Plan, which is a benefits plan for certain Employees of City of Yakima and is described in this document. Plan Participant is any Employee, Retiree or Dependent who is covered under this Plan Plan Year is the 12 -month period beginning on either the effective date of the Plan or on the day following the end of the first Plan Year which is a short Plan Year. Pregnancy is childbirth and conditions associated with Pregnancy, including complications. Prescription Drug means any of the following. a Food and Drug Administration -approved drug or medicine which, under federal law, is required to bear the legend. "Caution. federal law prohibits dispensing without prescription"; injectable insulin, hypodermic needles or syringes, but only when dispensed upon a written prescription of a licensed Physician. Such drug must be Medically Necessary in the treatment of a Sickness or Injury. Retired Employee/Retiree is a former Employee of the Employer who was retired while employed by the Employer under the formal written plan of the Employer Sickness is. For a covered Employee and covered Spouse. Illness, disease or Pregnancy. For a covered Dependent other than Spouse. Illness or disease, not including Pregnancy or its complications Skilled Nursing Facility is a facility that fully meets all of these tests. (1) It is licensed to provide professional nursing services on an inpatient basis to persons convalescing from Injury or Sickness. The service must be rendered by a registered nurse (R.N.) or by a licensed practical nurse (L.P.N.) under the direction of a registered nurse. Services to help restore patients to self-care in essential daily living activities must be provided (2) Its services are provided for compensation and under the full-time supervision of a Physician (3) It provides 24 hour per day nursing services by licensed nurses, under the direction of a full-time registered nurse. (4) It maintains a complete medical record on each patient (5) It has an effective utilization review plan. City of Yakima Employee Health Plan 40 January 1, 2012 (6) It is not, other than incidentally, a place for rest, the aged, drug addicts, alcoholics, mentally disabled, Custodial or educational care or care of Mental Disorders (7) It is approved and licensed by Medicare This term also applies to charges incurred in a facility referring to itself as an extended care facility, convalescent nursing home, rehabilitation hospital, long-term acute care facility or any other similar nomenclature. Spinal Manipulation/Chiropractic Care means skeletal adjustments, manipulation or other treatment in connection with the detection and correction by manual or mechanical means of structural imbalance or subluxation in the human body. Such treatment is done by a Physician to remove nerve interference resulting from, or related to, distortion, misalignment or subluxation of, or in, the vertebral column. Substance Abuse is regular excessive compulsive dunking of alcohol and/or physical habitual dependence on drugs This does not include dependence on tobacco and ordinary caffeine -containing drinks Total Disability (Totally Disabled) means. In the case of a Dependent, the complete inability as a result of Injury or Sickness to perform the normal activities of a person of like age and sex in good health. Usual and Reasonable Charge is a charge which is not higher than the usual charge made by the provider of the care or supply and does not exceed the usual charge made by most providers of like service in the same area This test will consider the nature and seventy of the condition being treated It will also consider medical complications or unusual circumstances that require more time, skill or experience For Participating Provider charges, the Usual and Reasonable Charge will be the contracted rate. The Plan will pay benefits on the basis of the actual charge billed if it is less than the Usual and Reasonable Charge. The Plan Administrator has the discretionary authority to decide whether a charge is Usual and Reasonable City of Yakima Employee Health Plan 41 January 1, 2012 PLAN EXCLUSIONS Note: All exclusions related to Prescription Drugs are shown in the Prescription Drug Plan. For all Medical Benefits shown in the Schedule of Benefits, a charge for the following is not covered: (1) Abortion. Services, supplies, care or treatment in connection with an abortion unless the life of the mother is endangered by the continued Pregnancy or the Pregnancy is the result of rape or incest (2) Alternative Medicine - . Services rendered by homeopath, herbalist, acupuncturist, or acupressurist Services for acupuncture, acupressure, rolfing, faith healing services, or reflexology. (3) Biofeedback. Charges for biofeedback. (4) Coding Guidelines Charges for mappropnate coding in accordance to the industry standard guidelines in effect (5) Complications of non -covered treatments. Care, services or treatment required as a result of complications from a treatment not covered under the Plan are not covered. (6) Contraceptives. Except as provided under the Prescription Drug Benefits of this Plan Examples of what is not covered include, but are not limited to, the following. oral contraceptives; intrauterine devices (IUDs); intervaginal rings; diaphragms; condoms; sponges; contraceptive foam, jelly or other spermicidal item, implants and injections and any related Physician charges. (7) Counseling. Care and treatment for marital or pre -marital counseling, non-medical, self-help programs such as Outward Bound or Wilderness Survival, recreational or educational therapy (8) Court ordered. Services and supplies that are court-ordered or are related to deferred prosecution, deferred or suspended sentencing, or driving rights, if those services are not deemed Medically Necessary under the Plan. (9) Custodial care. Services or supplies provided mainly as a rest cure, maintenance or Custodial Care, except as specifically stated as a benefit under this Plan (10) Educational or vocational testing. Services for educational or vocational testing or training, except as specifically stated as a benefit of this Plan." (11) Environmental Services - Milieu therapy and any other treatment designed to provide a change in environment or a controlled environment (12) Excess charges. The part of an expense for care and treatment of an Injury or Sickness that is in excess of the Usual and Reasonable Charge. (13) Exercise programs. Exercise programs for treatment of any condition, except for Physician -supervised cardiac rehabilitation, occupational or physical therapy if covered by this Plan. (14) Experimental or not Medically Necessary. Care and treatment that is either Expenmental/Investigational or not Medically Necessary (15) Eye care. Radial keratotomy or other eye surgery to correct refractive disorders. Also, routine eye examinations, including refractions, lenses for the eyes and exams for their fitting. This exclusion does not apply to aphakic patients and soft lenses or sclera shells intended for use as corneal bandages (16) Routine foot care. Treatment of weak, strained, flat, unstable or unbalanced feet, metatarsalgia or bunions (except open cutting operations), and treatment of corns, calluses or toenails (unless needed in treatment of a metabolic or peripheral -vascular disease or as otherwise deemed Medically Necessary). City of Yakima Employee Health Plan 42 January 1, 2012 (17) Foreign travel. Care, treatment or supplies out of the U.S. if travel is for the sole purpose of obtaining medical services (18) Government coverage. Care, treatment or supplies furnished by a program or agency funded by any government. This exclusion does not apply to Medicaid or when otherwise prohibited by applicable law. (19) Hair loss. Care and treatment for hair loss including wigs, hair transplants or any drug that promises hair growth, whether or not prescnbed by a Physician, except as specifically stated as a benefit under this Plan (20) Hearing aids and exams. Charges for services or supplies in connection with hearing aids or exams for their fitting, except specifically stated as a benefit of this Plan under the prosthesis benefit. (21) Hospice bereavement treatment (22) Hospital employees. Professional services billed by a Physician or nurse who is an employee of a Hospital or Skilled Nursing Facility and paid by the Hospital or facility for the service. (23) Illegal acts. Charges for services received as a result of an Illness or Injury occurring directly, or indirectly as a result of a serious criminal act, or a riot or public disturbance, or regardless of causation, if such Illness or Injury occurs in connection with, or while engaged in, or attempting to engage in, a senous cnminal act, or a riot or public disturbance For the purposes of this exclusion, the term "senous criminal act" shall mean any act or senes of acts by the Plan Participant, or by the Plan Participant in concert with another or others, for which, if prosecuted as a criminal offense, a sentence to a term of imprisonment in excess of one year could be imposed. For this exclusion to apply, it is not necessary that criminal charges be filed, or if filed, that a conviction result, or that a sentence of imprisonment for a term in excess of one year be imposed This exclusion does not apply if the Injury resulted from an act of domestic violence or a medical (including both physical and mental health) condition (24) Impotence/Sexual Dysfunction. Care, treatment, services, supplies or medication in connection with treatment for sexual dysfunction including impotence. (25) Infertility. Care, supplies, services and treatment for infertility, artificial insemination, or in vitro fertilization (26) Mailing or Sales Tax Charges for mailing, shipping, handling, conveyance and sales tax (27) Medical Records and Reports - Expenses for preparing medical reports, itemized bills, or claim forms, except as expressly requested by or on behalf of the Plan. (28) No charge. Care and treatment for which there would not have been a charge if no coverage had been in force (29) Non -emergency Hospital admissions. Care and treatment billed by a Hospital for non -Medical Emergency admissions on a Friday or a Saturday. This does not apply if surgery is performed within 24 hours of admission. (30) No obligation to pay. Charges incurred for which the Plan has no legal obligation to pay (31) No Physician recommendation. Care, treatment, services or supplies not recommended and approved by a Physician, or treatment, services or supplies when the Covered Person is not under the regular care of a Physician. Regular care means ongoing medical supervision or treatment which is appropriate care for the Injury or Sickness (32) Not specified as covered. Non-traditional medical services, treatments and supplies which are not specified as covered under this Plan. City of Yakima Employee Health Plan 43 January 1, 2012 (33) Occupational Injury. Care and treatment of an Injury or Sickness that is occupational -- that is, arises from work for wage or profit and for which the Plan Participant is eligible to receive benefits under any Worker's Compensation or occupational disease law However, this exclusion will also apply in the event the Plan Participant was eligible to receive such Worker's Compensation benefits and failed to properly file a claim for such benefits or to comply with any other provision of the law to obtain such benefits. Note: See the Special Provisions section of this Plan for classes of Employees to which this exclusion does not apply. (34) Personal comfort items. Personal comfort items or other equipment for patient convenience, such as, but not limited to, air conditioners, air -purification units, humidifiers, electric heating units, orthopedic mattresses, blood pressure instruments, scales, elastic bandages or stockings, nonprescription drugs and medicines, and first-aid supplies and nonhospital adjustable beds (35) Plan design excludes. Charges excluded by the Plan design as mentioned in this document. (36) Pregnancy of daughter. Care and treatment of Pregnancy and Complications of Pregnancy for a Covered Dependent daughter. (37) Relative giving services. Professional services performed by a person who ordinarily resides in the Covered Person's home or is related to the Covered Person as a Spouse, parent, child, brother or sister, whether the relationship is by blood or exists in law. (38) Replacement braces. Replacement of braces of the leg, arm, back, neck, or artificial arms or legs, unless there is sufficient change in the Covered Person's physical condition to make the original device no longer functional (39) Routine care. Charges for routine or periodic examinations, screening examinations, evaluation procedures, preventive medical care, or treatment or services not directly related to the diagnosis or treatment of a specific Injury, Sickness or Pregnancy -related condition which is known or reasonably suspected, unless such care is specifically covered in the Schedule of Benefits or required by applicable law (40) Services before or after coverage. Care, treatment or supplies for which a charge was incurred before a person was covered under this Plan or after coverage ceased under this Plan. (41) Sex changes. Care, services or treatment for non -congenital transsexualism, gender dysphoria or sexual reassignment or change This exclusion includes medications, implants, hormone therapy, surgery, medical or psychiatric treatment (42) Surgical sterilization reversal. Care and treatment for reversal of surgical sterilization. (43) Temporomandibular Joint Syndrome and orthognathic surgery. All diagnostic and treatment services related to the treatment of jaw joint problems including temporomandibular joint (TMJ) syndrome The Plan does not cover congenital reconstructive or cosmetic upper or lower jaw augmentation or reduction procedures (44) Travel or accommodations. Charges for travel or accommodations, whether or not recommended by a Physician, except as specifically stated as a benefit of this Plan. (45) War. Any loss that is due to a declared or undeclared act of war City of Yakima Employee Health Plan 44 January 1, 2012 PRESCRIPTION DRUG BENEFITS The Pre -Existing Limitation and Coordination of Benefits provisions will not apply to prescriptions purchased at a participating pharmacy. Pharmacy Drug Charge Participating pharmacies have contracted with the Plan to charge Covered Persons reduced fees for covered Prescription Drugs. EBMS Rx Preferred Prescriptions is the administrator of the pharmacy drug plan Copayments The copayment is applied to each covered pharmacy drug charge and is shown in the Schedule of Benefits. The copayment amount is not a Covered Charge under the medical Plan Any one pharmacy prescription is limited to a 34 -day supply. If a drug is purchased from a non -participating pharmacy, or a participating pharmacy when the Covered Person's ID card is not used, the Covered Person will be required to pay 100% of the total cost at the point of sale, no discount will be given, and the Covered Person will be required to submit the prescription receipt to the Claims Administrator for reimbursement (minus any applicable copayment as shown in the Schedule of Benefits). At select participating pharmacies, the Covered Person will be able to obtain a 90 -day supply, per prescription, at the same copayment level as the mail order benefit (as shown in the Schedule of Benefits). For additional information or a current list of these select participating pharmacies, please contact the Claims Administrator or access the following Web site at www.ebms.com. Mail Order Drug Benefit Option The mail order drug benefit option is available for maintenance medications (those that are taken for long penods of time, such as drugs sometimes prescribed for heart disease, high blood pressure, asthma, etc.). Because of volume buying, the mail order pharmacy is able to offer Covered Persons significant savings on their prescriptions. The mail order pharmacy is subject to change. Please contact the Claims Administrator for more information concerning the mail order pharmacy. Copayments The copayment is applied to each covered mail order drug charge and is shown in the Schedule of Benefits. The copayment amount is not a Covered Charge under the medical Plan. Any one mail order prescription is limited to a 90 -day supply The CVS Caremark Specialty Pharmacy Program Specialty medications are high-cost injectables, infused, oral, or inhaled medications prescribed in the treatment of chronic disease conditions (e.g., Chronic Kidney Disease, Crohn's Disease, Multiple Sclerosis, or Osteoarthritis). CVS Caremark offers a program for specialty medications that can provide Covered Persons with greater convenience, including express delivery, follow-up care calls, expert counseling, and superior service In order for these specialty medications to be covered under this Plan, these prescriptions must be filled through the CVS Caremark Specialty Pharmacy Program. The first prescription will be allowed through the regular Pharmacy Option under this Plan; however, any subsequent refills must be filled through the CVS Caremark Specialty Pharmacy Program Covered Persons will be notified by mail to enroll in the CVS Caremark Specialty Pharmacy Program in order to continue the specialty medication benefit. All prescriptions are subject to the terms, limitations, and exclusions as set forth this Plan City of Yakima Employee Health Plan 45 January 1, 2012 To enroll in the program or for more information, Covered Persons can contact the CVS Caremark Specialty Pharmacy Program toll-free at 1-800-238-7828 or visit their Web site at www cvscaremark com A CVS Caremark Representative will be able to confirm during the initial enrollment process whether or not a Covered Person will be eligible for this program Covered Prescription Drugs Note: Some quantity limitations and /or prior authorization may apply. (1) All drugs prescnbed by a Physician that require a prescription either by federal or state law This excludes any drugs stated as not covered under this Plan. (2) All compounded prescriptions containing at least one prescription ingredient in a therapeutic quantity. (3) Insulin and other diabetic supplies when prescribed by a Physician (4) Injectable drugs or any prescription directing administration by injection. Disposable needles/syringes. (5) Contraceptives. Contraceptive vaginal rings and legend oral and transdermal contraceptives are covered for Employees and/or their Spouses or Domestic Partners. (Contraceptives are covered for Dependent Children under age 19 only when Medically Necessary. (6) Topical patch (Ortho-Evra) and vaginal ring (Nuvanng) (7) Drugs used for the treatment of ADD/ADHD and narcolepsy (e.g., Dexedrine, Ritalin, Cylert, Adderall) for individuals through the age of 18 years, thereafter, prior authorization required. (8) Drugs used for the treatment of sleep disorders (e g , Ambien, Restoril, Sonata) (9) Drugs used for the treatment of migraines (e.g., Imitrex, Migranal, Maxalt, Zomig) (10) Hematinics (11) Tretinoin, all dosage forms (e g , Retin-A), for individuals through the age of 18 years; thereafter pnor authorization required (12) Emergency allergy kits (e.g., Epi -pen, Glucagon) (13) Pigmenting and depigmenting agents The following will be covered at 100%, no copayment required. (1) Tobacco cessation products. Limited a two cycles (12 weeks per cycle) of Physician -prescribed tobacco cessation products each 365 days. (2) Physician -prescribed folic acid for covered female Employees or covered Dependents planning or capable of Pregnancy; (3) Physician -prescribed aspinn to prevent cardiovascular disease (CVD) in adult men and women; (4) Physician -prescribed iron supplements for asymptomatic covered Dependent children aged 6 to 12 months who are at increased risk for iron deficiency anemia. (5) Physician -prescribed fluonde supplements for covered Dependent children ages 5 years and under City of Yakima Employee Health Plan 46 January 1, 2012 Limits To This Benefit This benefit applies only when a Covered Person incurs a covered Prescription Drug charge The covered drug charge for any one prescription will be limited to. (1) Refills only up to the number of times specified by a Physician. (2) Refills up to one year from the date of order by a Physician Expenses Not Covered This benefit will not cover a charge for any of the following. (1) (2) Appetite suppressants. A charge for appetite suppressants, dietary supplements or vitamin supplements, except for prenatal vitamins requiring a prescription. Administration. Any charge for the administration of a covered Prescription Drug (3) Consumed on premises. Any drug or medicine that is consumed or administered at the place where it is dispensed. (4) Contraceptives not specifically listed as covered, regardless of intended use (5) Devices. Devices of any type, even though such devices may require a prescription. These include (but are not limited to) therapeutic devices, blood glucose monitoring machines, insulin pumps and supplies, artificial appliances, braces, support garments, or any similar device. These may be considered Covered Charges under the Medical Benefits section of this Plan. (6) Drugs used for cosmetic purposes. Charges for drugs used for cosmetic purposes, such as anabolic steroids or medications for hair growth or removal. (7) Experimental. Experimental drugs and medicines, even though a charge is made to the Covered Person. (8) FDA. Any drug not approved by the Food and Drug Administration (9) Growth hormones. Charges for drugs to enhance physical growth or athletic performance or appearance. (10) Immunization. Immunization agents or biological sera. (11) Impotence/sexual dysfunction. A charge for impotence/sexual dysfunction medication (12) Infertility. A charge for infertility medication. (13) Inpatient medication. A drug or medicine that is to be taken by the Covered Person, in whole or in part, while Hospital confined. This includes being confined in any institution that has a facility for the dispensing of drugs and medicines on its premises (14) Investigational. A drug or medicine labeled. "Caution - limited by federal law to investigational use" (15) Medical exclusions. A charge excluded under Medical Plan Exclusions. (16) No charge. A charge for Prescription Drugs which may be properly received without charge under local, state or federal programs (17) Non -legend drugs. A charge for FDA -approved drugs that are prescribed for non -FDA -approved uses. City of Yakima Employee Health Plan 47 January 1, 2012 (18) No prescription. A drug or medicine that can legally be bought without a written prescription. This does not apply to injectable insulin (19) Refills. Any refill that is requested more than one year after the prescription was written or any refill that is more than the number of refills ordered by the Physician. City of Yakima Employee Health Plan 48 January 1, 2012 HOW TO SUBMIT CLAIMS When services are received from a health care provider, a Plan Participant should show his or her EBMS/ City of Yakima. Identification card to the provider. Participating Providers may submit claims on a Plan Participant's behalf. If it is necessary for a Plan Participant to submit a claim, he or she should request an itemized bill which includes procedure (CPT) and diagnostic (ICD-9) codes from his or her health care provider. To assist the Claims Administrator in processing the claim, the following information must be provided when submitting the claim for processing • A copy of the itemized bill • Group name and number (City of Yakima, Group 0000218) • Provider Billing Identification Number • Employee's name and Identification Number • Name of patient • Name, address, telephone number of the provider of care • Date of service(s) • Place of service • Amount billed Note: A Plan Participant can obtain a claim form from the Plan Administrator or the Claims Administrator. Claim forms are also available at http //www ebms com HOW TO SUBMIT PHARMACY CLAIMS When obtaining a prescription, a Plan Participant should show his or her EBMS/City of Yakima Identification card to the pharmacist Participating Pharmacies may submit claims on a Plan Participant's behalf If the pharmacy provider is unable to submit the claim, the Plan Participant should request a receipt. To assist the Claims Administrator in processing a claim, the following information must be provided when submitting the claim for processing • A copy of the receipt • Group name and number (City of Yakima, Group 0000218) • Employee's name and Identification Number • Provider Billing Identification Number • Name of patient • The prescribing Physician • The prescription name • An itemization for each separate prescription • The date of purchase WHERE TO SUBMIT MEDICAL AND PRESCRIPTION DRUG CLAIMS Employee Benefit Management Services, Inc , is the Claims Administrator Claims for expenses should be submitted to the Claims Administrator at the address below. Employee Benefit Management Services, Inc. P O Box 21367 Billings, Montana 59104 (406) 245-3575 or (800) 777-3575 City of Yakima Employee Health Plan 49 January 1, 2012 DENTAL BENEFITS Routine dental coverage is administered by Washington Dental Service (WDS) Please contact WDS directly (see below) to obtain information pertaining to your routine dental coverage. WDS 800/554-1907 800/833-6384 TTD/TTY www deltadentalwa com VISION BENEFITS Vision benefits are administered by Vision Service Plan (VSP) Please contact VSP directly (see below) to obtain information pertaining to your vision coverage VSP 800/877-7195 800/428-4833 TTD/TTY www.vsp.com WHEN CLAIMS SHOULD BE FILED Claims should be filed with the Claims Administrator within 365 days from the date charges for the services were incurred. Benefits are based on the Plan's provisions in effect at the time the charges were incurred. Claims filed later than that date will be denied. The Plan Participant must provide sufficient documentation (as determined by the Claims Administrator) to support a Claim for benefits The Plan reserves the fight to have a Plan Participant seek a second medical opinion INTERNAL AND EXTERNAL CLAIMS REVIEW PROCEDURES A Claim means a request for a Plan benefit, made by a Claimant (Plan Participant or by an authorized representative of a Plan Participant that complies with the Plan's reasonable procedures for filing benefit Claims) A Claim does not include an inquiry on a Claimant's eligibility for benefits, or a request by a Claimant or his Physician for a pre- notification of benefits on a medical treatment Pre -notification of certain services is strongly recommended, but not required by the Plan. A pre -notification of services by CareLink is not a determination by the Plan that a Claim will be paid. A benefit determination on a Claim will be made only after the Claim has been submitted. A pre -notification is not required as a condition precedent to paying benefits, and cannot be appealed under this section. Please refer to the Cost Management Services Section A Claimant may appoint an authorized representative to act upon his or her behalf with respect to the Claim Only those individuals who satisfy the Plan's requirements to be an authorized representative will be considered an authorized representative. A healthcare provider is not an authorized representative simply by virtue of an assignment of benefits. Contact the Claims Administrator for information on the Plan's procedures for authorized representatives. There are two types of claims Concurrent Care Determination A Concurrent Care Determination is a reduction or termination of a previously approved course of treatment that is to be provided over a period of time or for a previously approved number of treatments If Case Management is appropriate for a Plan participant, Case Management is not considered a Concurrent Care Determination. Please refer to the Cost Management Services Section. City of Yakima Employee Health Plan 50 January 1, 2012 Post -Service Claim A Post -Service Claim is a Claim for medical care, treatment, or services that a Claimant has already received. All questions regarding Claims should be directed to the Claims Administrator. All Claims will be considered for payment according to the Plan's terms and conditions, limitations and exclusions, and industry standard guidelines in effect at the time charges were incurred The Plan may, when appropnate or when required by law, consult with relevant health care professionals and access professional industry resources in making decisions about Claims involving specialized medical knowledge or judgment A Claim will not be deemed submitted until it is received by the Claims Administrator. Initial Benefit Determination The initial benefit determination on a Claim will be made within 30 days of the Claim Administrator's receipt of the Claim (or 15 days if the Claim is a Concurrent Care Determination). If additional information is necessary to process the Claim, the Claims Administrator will make a written request to the Claimant for the additional information within this initial period. The Claimant must submit the requested information within 45 days of receipt of the request from the Claims Administrator. Failure to submit the requested information within the 45 -day period may result in a denial of the Claim or a reduction in benefits If additional information is requested, the Plan's time period for making a determination is suspended until such time as the Claimant provides the information, or the end of the 45 day penod, whichever occurs earlier A benefit determination on the Claim will be made within 15 days of the Plan's receipt of the additional information. Notice of Adverse Benefit Determination If a Claim is denied in whole or in part, the Plan shall provide written or electronic notice of the determination that will include the following• • Information to identify the claim involved • Specific reason(s) for the denial, including the denial code and its meaning. • Reference to the specific Plan provisions on which the denial was based • Description of any additional information necessary for the Claimant to perfect the Claim and an explanation of why such information is necessary. • Description of the Plan's Internal Appeal Procedures and External Review Procedure and the applicable time limits This will include a statement of the Claimant's right to bring a civil action once Claimant has exhausted all available internal and external review procedures. • Statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claim. If applicable. • Any internal rule, guideline, protocol, or other similar cnterion that was relied upon in making the determination on the Claim • If the Adverse Benefit Determination is based on the Medical Necessity or Expenmental or Investigational exclusion or similar such exclusion, an explanation of the scientific or clinical judgment for the determination applying the terms of the Plan to the Claim. • Identification of medical or vocational experts, whose advice was obtained on behalf of the Plan in connection with a Claim. City of Yakima Employee Health Plan 51 January 1, 2012 If the Claimant has questions about the denial, the Claimant may contact the Claims Administrator at the address or telephone number printed on the Notice of Determination An Adverse Benefit Determination also includes a rescission of coverage, which is a retroactive cancellation or discontinuance of coverage due to fraud or intentional misrepresentation. A rescission of coverage does not include a cancellation or discontinuance of coverage that takes effect prospectively, or is a retroactive cancellation or discontinuance because of the Plan participant's failure to timely pay required premiums. Claims Review Procedure - General A Claimant may appeal an Adverse Benefit Determination The Plan offers a two-level internal review procedure and an external review procedure to provide the Claimant with a full and fair review of the Adverse Benefit Determination. The Plan will provide for a review that does not give deference to the previous Adverse Benefit Determination and that is conducted by an individual who is neither the individual who made the determination on a prior level of review, nor a subordinate of that individual. Additionally, if an External Review is requested, that review will be conducted by an Independent Review Organization that was not involved in any of the prior determinations. In addition, the Plan Administrator may. • Take into account all comments, documents, records and other information submitted by the Claimant related to the claim, without regard as to whether this information was submitted or considered in a prior level of review. • Provide to the Claimant, free of charge, any new or additional information or rationale considered, relied upon or created by the Plan in connection with the Claim. This information or new rationale will be provided sufficiently in advance of the response deadline for the final Adverse Benefit Determination so that the Claimant has a reasonable amount of time to respond • Consult with an independent health care professional who has the appropriate training and experience in the applicable field of medicine related to the Claimant's Adverse Benefit Determination if that determination was based in whole or in part on medical judgment, including determinations on whether a treatment, drug, or other item is Experimental and/or Investigational, or not Medically Necessary. A health care professional is "independent" to the extent the health care professional was not consulted on a prior level of review or is a subordinate of a health care professional who was consulted on a prior level of review. The Plan may consult with vocational or other experts regarding the Initial Benefit Determination Internal Appeal Procedure First Level of Internal Review The written request for review must be submitted within 180 days of the Claimant's receipt of a Notice of the Initial Benefit Determination (or 15 days for an appeal of a Concurrent Care Determination) The Claimant should include in the appeal letter his or her name, ID number, group health plan name, and a statement of why the Claimant disagrees with the Adverse Benefit Determination The Claimant may include any additional supporting information, even if not initially submitted with the Claim. The appeal should be addressed to. Plan Administrator Employee Benefit Management Services, Inc. (EBMS) P O Box 21367 Billings, Montana 59104 Attn. Claims Appeals An appeal will not be deemed submitted until it is received by the Plan Administrator. The Claimant cannot proceed to the next level of internal or external review if the Claimant fails to submit a timely appeal. The first level of review will be performed by the Claims Administrator on the Plan's behalf The Claims Administrator will review the information initially received and any additional information provided by the Claimant, City of Yakima Employee Health Plan 52 January 1, 2012 and determine if the Initial Benefit Determination was appropriate based upon the terms and conditions of the Plan and other relevant information The Claims Administrator will send a written or electronic Notice of Determination to the Claimant within 30 days of the receipt of the appeal (or 15 days for an appeal of a Concurrent Care Determination) The Notice of Determination shall meet the requirements as stated above Second Level of Internal Review If the Claimant does not agree with the Claims Administrator's determination from the first Level of Internal Review, the Claimant may submit a second level appeal in wnting within 60 days of the Claimant's receipt of the Notice of Determination from the First Level of Internal Review (or 15 days for an appeal of a Concurrent Care Determination), along with any additional supporting information to. Plan Administrator Employee Benefit Management Services, Inc. (EBMS) P O Box 21367 Billings, Montana 59104 Attn. Claims Appeals An appeal will not be deemed submitted until it is received by the Plan Administrator or the Claims Administrator on the Plan Administrator's behalf. The Claimant cannot proceed to an external review or file suit if the Claimant fails to submit a timely appeal The Second Level of Internal Review will be done by the Plan Administrator The Plan Administrator will review the information initially received and any additional information provided by the Claimant, and make a determination on the appeal based upon the terms and conditions of the Plan and other relevant information. The Plan Administrator will send a written or electronic Notice of Determination for the second level of review to the Claimant within 30 days of receipt of the appeal (or 15 days for an appeal of a Concurrent Care Determination) The Notice of Determination shall meet the requirements as stated above If the Claimant is not satisfied with the outcome of the final determination on the Second Level of Internal Review, the Claimant may request an External Review. The claimant must exhaust both levels of the Internal Review Procedure before requesting an External Review, unless the Plan Administrator did not comply fully with the Plan's Internal Review Procedure for the first level of review. In certain circumstances as described below, the Claimant may also request an expedited External Review External Review Procedure This Plan has an External Review Procedure that provides for a review conducted by a qualified Independent Review Organization (IRO) that shall be assigned on a random basis. A Claimant may, by wntten request made to the Plan within 4 months from the date of receipt of the notice of the final internal adverse benefit determination or the 1st of the fifth month following receipt of such notice, whichever occurs later, request a review by an IRO of a final Adverse Benefit Determination of a Claim, except where such request is limited by applicable law For an Adverse Benefit Determination to be eligible for external review, the Claimant must complete the required forms to process an External Review The Claimant may contact the Claims Administrator for additional information The Claimant will be notified in writing within 6 business days as to whether Claimant's request is eligible for external review and if additional information is necessary to process Claimant's request. If Claimant's request is determined ineligible for external review, notice will include the reasons for ineligibility and contact information for the appropriate oversight agency. If additional information is required to process Claimant's request, Claimant may submit the additional information within the four month filing penod, or 48 hours, whichever occurs later Claimant should receive wntten notice from the assigned IRO of Claimant's right to submit additional information to the IRO and the time periods and procedures to submit this additional information. The IRO will make a final determination and provide written notice to the Claimant and the Plan no later than 45 days from the date the IRO receives Claimant's request for External Review. The notice from the IRO should contain a discussion of its reason(s) City of Yakima Employee Health Plan 53 January 1, 2012 and rationale for the decision, including any applicable evidence -based standards used, and references to evidence or documentation considered in reaching its decision The decision of the IRO is binding upon the Plan and the Claimant, except to the extent other remedies may be available under applicable law. Before filing a lawsuit, the Claimant must exhaust all available levels of review as described in this section, unless an exception under applicable law applies A legal action to obtain benefits must be commenced within one (1) year of the date of the Notice of Determination on the final level of internal or external review, whichever is applicable. City of Yakima Employee Health Plan 54 January 1, 2012 COORDINATION OF BENEFITS Coordination of the benefit plans. The Plan's Coordination of Benefits provision sets forth rules for the order of payment of Covered Charges when two or more plans — including Medicare — are paying. The Plan has adopted the order of benefits as set forth in the National Association of Insurance Commissioners (NAIC) Model COB Regulations, as amended. When a Covered Person is covered by this Plan and another plan, or the Covered Person's Spouse is covered by this Plan and by another plan, or the couple's Covered children are covered under two or more plans the plans will coordinate benefits when a claim is received The plan that pays first according to the rules will pay as if there were no other plan involved The secondary and subsequent plans will pay the balance due up to 100% of the total Allowable Charges. Benefit plan. This provision will coordinate the medical and dental benefits of a benefit plan. The term benefit plan means this Plan or any one of the following plans Group or group -type plans, including franchise or blanket benefit plans Blue Cross and Blue Shield group plans. Group practice and other group prepayment plans. Federal government plans or programs This includes, but is not limited to Medicare and Tricare Other plans required or provided by law. This does not include Medicaid or any benefit plan like it that, by its terms, does not allow coordination. (6) Any automobile insurance, including but not limited to, No Fault Auto Insurance, by whatever name it is called, when not prohibited by law (7) Any third -party liability insurance, including but not limited to, homeowners liability insurance, umbrella insurance and premises liability insurance, whether individual or commercial, or on an insured, uninsured, under -insured or self-insured basis. If the Covered Person, or someone on behalf of the Covered Person, has received any compensation and/or benefits from any third -party source, this compensation and/or benefits shall be primary and shall be coordinated with the benefits that they may be eligible to receive through this Plan before they may receive any benefits from this Plan Allowable Charge(s). For a charge to be allowable it must be a Usual, Customary, and Reasonable Charge and at least part of it must be covered under this Plan. In the case of HMO (Health Maintenance Organization) or other in -network only plans This Plan will not consider any charges in excess of what an HMO or network provider has agreed to accept as payment in full Also, when an HMO or network plan is primary and the Covered Person does not use an HMO or network provider, this Plan will not consider as an Allowable Charge any charge that would have been covered by the HMO or network plan had the Covered Person used the services of an HMO or network provider. In the case of service type plans where services are provided as benefits, the reasonable cash value of each service will be the Allowable Charge Automobile limitations. When any payments are available under vehicle insurance, the Plan shall pay excess benefits only, without reimbursement for vehicle plan deductibles. This Plan shall always be considered the secondary carrier regardless of the individual's election under PIP (personal Injury protection) coverage with the auto Garner Benefit plan payment order When two or more plans provide benefits for the same Allowable Charge, benefit payment will follow these rules. City of Yakima Employee Health Plan 55 January 1, 2012 (A) Plans that do not have a coordination provision, or one like it, will pay first. Plans with such a provision will be considered after those without one (B) Plans with a coordination provision will pay their benefits up to the Allowable Charge The first rule that describes which plan is primary is the rule that applies. (1) The benefits of the plan which covers the person directly (that is, as a Member/Employee, Retiree, or subscriber) ("Plan A") are determined before those of the plan which covers the person as a Dependent ("Plan B") For Qualified Beneficiaries, coordination is determined based on the person's status prior to the Qualifying Event. Special rule If (i) the person covered directly is a Medicare beneficiary, and (n) Medicare is secondary to Plan B, and (in) Medicare is pnmary to Plan A (for example, if the person is retired), THEN Plan B will pay first (2) Unless there is a court decree stating otherwise, when a child is covered as a Dependent by more than one plan the order of benefits is determined as follows. When a child is covered as a Dependent and the parents are married or living together, these rules will apply • The benefits of the benefit plan of the parent whose birthday falls earlier in a year are determined before those of the benefit plan of the parent whose birthday falls later in that year, • If both parents have the same birthday, the benefits of the benefit plan which has covered the parent for the longer time are determined before those of the benefit plan which covers the other parent. When a child's parents are divorced, legally separated or not living together, whether or not they have ever been married, these rules will apply • A court decree may state which parent is financially responsible for medical and dental benefits of the child In this case, the benefit plan of that parent will be considered before other plans that cover the child as a Dependent This rule applies beginning the first of the month after the plan is given notice of the court decree. • A court decree may state both parents will be responsible for the Dependent child's health care expenses. In this case, the plans covering the child shall follow order of benefit determination rules outlined above when the parents are married or living together (as detailed above), • If the specific terms of the court decree state that the parents shall share joint custody, without stating that one of the parents is responsible for the health care expenses of the child, the plans covenng the child shall follow the order of benefit determination rules outlined above when a child is covered as a Dependent and the parents are married or living together If there is no court decree allocating responsibility for the Dependent child's health care expenses, the order of benefits are as follows. 1st The plan covenng the custodial parent, 2nd The plan covering the spouse of the custodial parent, City of Yakima Employee Health Plan 56 January 1, 2012 (3) 3rd 4th The plan covering the non-custodial parent, and The plan covering the spouse of the non-custodial parent The benefits of a benefit plan which covers a person as a Member/Employee who is neither laid off nor retired are determined before those of a benefit plan which covers that person as a laid -off or Retired Member/Employee. The benefits of a benefit plan which covers a person as a Dependent of a Member/Employee who is neither laid off nor retired are determined before those of a benefit plan which covers a person as a Dependent of a laid off or Retired Member/Employee If the other benefit plan does not have this rule, and if, as a result, the plans do not agree on the order of benefits, this rule does not apply (4) The benefits of a benefit plan which covers a person as a Member/Employee who is neither laid off nor retired or a Dependent of a Member/Employee who is neither laid off nor retired are determined before those of a plan which covers the person as a COBRA beneficiary This rule does not apply if rule #1 can be used to determine the order of benefits (5) If there is still a conflict after these rules have been applied, the benefit plan which has covered the patient for the longer time will be considered first. When there is a conflict in coordination of benefit rules, the Plan will never pay more than 50% of Allowable Charges when paying secondary. (C) Medicare will pay primary, secondary or last to the extent stated in federal law When Medicare is to be the primary payer, this Plan will base its payment upon benefits that would have been paid by Medicare under Parts A and B, regardless of whether or not the person was enrolled under both of these parts. The Plan reserves the right to coordinate benefits with respect to Medicare Part D. (D) If a Plan Participant is under a disability extension from a previous benefit plan, that benefit plan will pay first and this Plan will pay second (E) The Plan will pay primary to Tricare to the extent required by federal law. Claims determination period. Benefits will be coordinated on a Calendar Year basis. This is called the claims determination period. Right to receive or release necessary information To make this provision work, this Plan may give or obtain needed information from another insurer or any other organization or person This information may be given or obtained without the consent of or notice to any other person. A Covered Person will give this Plan the information it asks for about other plans and their payment of Allowable Charges. Facility of payment This Plan may repay other plans for benefits paid that the Plan Administrator determines it should have paid That repayment will count as a valid payment under this Plan Right of recovery. This Plan may pay benefits that should be paid by another benefit plan. In this case this Plan may recover the amount paid from the other benefit plan or the Covered Person. That repayment will count as a valid payment under the other benefit plan. Further, this Plan may pay benefits that are later found to be greater than the Allowable Charge In this case, this Plan may recover the amount of the overpayment from the source to which it was paid Exception to Medicaid. The Plan shall not take into consideration the fact that an individual is eligible for or is provided medical assistance through Medicaid when enrolling an individual in the Plan or making a determination about the payments for benefits received by a Covered Person under the Plan. City of Yakima Employee Health Plan 57 January 1, 2012 THIRD PARTY RECOVERY PROVISION By enrollment in the Plan, a Covered Person agrees to the provisions of this Section as a condition precedent to receiving benefits under this Plan. If the Covered Person fails to comply with the requirements of this Section, the Plan may reduce or deny benefits otherwise available under the Plan. Defined Terms "Covered Person" means anyone covered under the Plan, including but not limited to minor Dependents and deceased Covered Persons Covered Person shall include the parents, trustee, guardian, heir, personal representative or other representative of a Covered Person, regardless of applicable law and whether or not such representative has access or control of the Recovery. "Recover," "Recovered," "Recovery" means all monies recovered by way of judgment, settlement, reimbursement, or otherwise to compensate for any loss related to any Injury, Sickness, condition, and/or accident where a Third Party is or may be responsible "Recovery" includes, but is not limited to, recovenes for medical or dental expenses, attorneys' fees, costs and expenses, pain and suffering, loss of consortium, wrongful death, wages and/or any other recovery of any form of damages or compensation whatsoever. "Subrogation" means the Plan's right to exercise the Covered Person's rights to Recover or pursue Recovery from a Third Party who is liable to the Covered Person for expenses for which the Plan has paid or may agree to pay benefits "Third Party" means any third party including but not limited to another person, any business entity, insurance policy or any other policy or plan, including but not limited to uninsured or underinsured coverage, self-insured coverage, no-fault coverage, automobile coverage, premises liability (homeowners or business), umbrella policy. Right to Reimbursement This provision applies when the Covered Person incurs medical or dental expenses due to an Injury, Sickness, condition, and/or accident which may be caused by the act or omission of a Third Party or a Third Party may be responsible for payment. In such circumstances, the Covered Person may have a claim against a Third Party for payment of such expenses. To the extent the Plan paid benefits on the Covered Person's behalf, the Covered Person agrees that the Plan has an equitable lien on any Recovery whether or not such Recovery(s) is designated as payment for such expenses This lien shall remain in effect until the Plan is repaid in full The Covered Person, and/or anyone on his or her behalf, agrees to hold in trust for the benefit of the Plan, that portion of any Recovery received or that may be received from a Third Party and to which the Plan is entitled for reimbursement of benefits paid by the Plan on the Covered Person's behalf. The Covered Person shall promptly reimburse the Plan out of such Recovery, in first priority for the full amount of the Plan's lien The Covered Person will reimburse the Plan first, even if the Covered Person has not been fully compensated or "made whole" and/or the Recovery is called something other than a Recovery for healthcare, medical and/or dental expenses The Plan will not pay or be responsible for attorney fees and/or costs of recovery associated with a Covered Person pursuing a claim against a Third Party, unless the Plan agrees in writing to such a reduction in its equitable lien, or subject to the terms of a court order. Right to Subrogation This provision applies when the Covered Person incurs medical or dental expenses due to an Injury, Sickness, condition, and/or accident which may be caused by the act or omission of a Third Party or a Third Party may be responsible for payment. In such circumstances, the Covered Person may have a claim against a Third Party for payment of such expenses The Covered Person agrees that the Plan is subrogated to any and all claims, causes of action or rights that the Covered Person may have now or in the future against a Third Party who has or may have caused, contributed, aggravated, and/or been responsible for the Covered Person's Injury, Sickness, condition, and/or accident to the extent the Plan has paid benefits or has agreed to pay benefits. The Covered Person further agrees that the Plan is City of Yakima Employee Health Plan 58 January 1, 2012 subrogated to any and all claims or rights that the Covered Person may have against any Recovery, including the Covered Person's rights under the Plan to bring an action to clarify his nghts under the Plan The Plan may assert this Right of Subrogation independently of the Covered Person The Plan is not obligated to pursue this right independently or on behalf of the Covered Person, but may choose to exercise this nght, m its sole discretion Provisions Applicable to Both the Right to Reimbursement and Right to Subrogation The Covered Person automatically assigns to the Plan any and all rights he or she has or may have against any Third Party to the full extent of the Plan's equitable lien The Covered Person agrees to. (1) Cooperate fully with the Plan and its agents, regarding the Plan's rights under this section, (2) Advise the Plan of any right or potential right to reimbursement and/or subrogation on the Plan's behalf, (3) Provide to the Plan in a timely manner any and all facts, documents, papers, information or other data reasonably related to the Covered Person's Injury, Sickness, condition, and/or accident, including any efforts by another individual to Recover on the Covered Person's behalf, (4) Execute all assignments, liens, or other documents that the Plan or its agents may request to protect the Plan's rights under this section, (5) Obtain the Plan's consent before releasing a Third Party from liability for payment of expenses related to the Covered Person's Injury, Sickness, condition, and/or accident; (6) Hold in trust that portion of any Recovery received by the Covered Person or on the Covered Person's behalf equal to the Plan's equitable lien until such time as the Plan is repaid in full, (7) Agree not to impair, impede or prejudice in any way, the nghts of the Plan under this section; and (8) Do whatever else the Plan deems reasonably necessary to secure the Plan's rights under this section. The Plan may take one or more of the following actions to enforce its rights under this section. (1) The Plan may require the Covered Person as a condition of paying benefits for the Covered Person's Injury, Sickness, condition, or accident, to execute documentation acknowledging the Plan's nghts under this section; (2) The Plan may withhold payment of benefits to the extent of any Recovery received by or on behalf of a Covered Person, (3) The Plan may, to the extent of any benefits paid by the Plan, exercise its Right of Reimbursement against any Recovery received, or that will be received, by or on behalf of Covered Person; (4) The Plan may, to the extent of any benefits paid by the Plan, exercise its Right of Subrogation directly against a Third Party who is or may be responsible, or (5) The Plan may, to the extent of any benefits paid by the Plan which have not otherwise been reimbursed to the Plan, offset any future benefits otherwise payable under the Plan to the Covered Person or on the Covered Person's behalf The Plan Administrator is vested with full discretionary authority to interpret and apply the provisions of this section. In addition, the Plan Administrator is vested with the discretionary authority to waive or compromise any of the Plan's nghts under this section Any decision of the Plan Administrator made in good faith will be final and binding The Plan Administrator is authonzed to adopt such procedures as deemed necessary and appropnate to administrate the Plan's rights under this section City of Yakima Employee Health Plan 59 January 1, 2012 Right to Recover Benefits Paid in Error The Plan has the right to recover any benefits the Plan paid in error to the Covered Person or on behalf of a Covered Person to which the Covered Person is not entitled, for services which were not covered under the Plan, or for benefits paid in excess of the Plan's allowable charges. The Plan may recover benefits paid in error from the Covered Person, the provider who received a payment from the Plan on the Covered Person's behalf, or from any person who may have benefited. The Plan may also offset any future benefits otherwise payable to or on the Covered Person's behalf, or from any other Covered Person enrolled through the same covered Employee City of Yakima Employee Health Plan 60 January 1, 2012 COBRA CONTINUATION COVERAGE Introduction The right to COBRA Continuation Coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended ("COBRA"). COBRA Continuation Coverage can become available to you when you otherwise would lose your group health coverage. It also can become available to other members of your family who are covered under the Plan when they otherwise would lose their group health coverage The entire cost (plus a reasonable administration fee) must be paid by the Covered Employee (or former Employee), Qualified Beneficiary, or any representative acting on behalf thereof Coverage will end in certain instances, including, but not limited to, if you or your Dependents fail to make timely payment of premiums. You should check with your Employer to see if COBRA applies to you and your Dependents. What is COBRA Continuation Coverage? "COBRA Continuation Coverage" is a continuation of Plan coverage when coverage otherwise would end because of a life event known as a "Qualifying Event " Life insurance, accidental death and dismemberment benefits and weekly income or long-term disability benefits (if a part of your Employer's plan) are not considered for continuation under COBRA. What is a Qualifying Event? Specific Qualifying Events are listed below After a Qualifying Event, COBRA Continuation Coverage must be offered to each person who is a "Qualified Beneficiary " You, your Spouse, and your Dependent children could become Qualified Beneficiaries if coverage under the Plan is lost because of the Qualifying Event Domestic Partners and Children of a covered Employee's Domestic Partner, who otherwise satisfy the Eligibility requirements set forth in the Eligibility provision and are covered under this Plan, will also be offered the opportunity to make an independent election to receive COBRA Continuation Coverage All references to Spouse will also be applicable to a Domestic Partner, unless otherwise indicated If you are a Covered Employee (meaning that you are an Employee and are covered under the Plan), you will become a Qualified Beneficiary if you lose your coverage under the Plan due to one of the following Qualifying Events. • Your hours of employment are reduced; or • Your employment ends for any reason other than your gross misconduct If you are the Spouse of a Covered Employee, you will become a Qualified Beneficiary if you lose your coverage under the Plan due to one of the following Qualifying Events. • Your Spouse dies, • Your Spouse's hours of employment are reduced, • Your Spouse's employment ends for any reason other than his or her gross misconduct; • Your Spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); • You become divorced or legally separated from your Spouse; or • In certain circumstances, you are no longer eligible for coverage under the Plan Note. Medicare entitlement means that you are eligible for and enrolled in Medicare Your Dependent children will become Qualified Beneficiaries if they lose coverage under the Plan due to one of the following Qualifying Events. • The parent -Covered Employee dies, City of Yakima Employee Health Plan 61 January 1, 2012 • The parent -Covered Employee's hours of employment are reduced; • The parent -Covered Employee's employment ends for any reason other than his or her gross misconduct, • The parent -Covered Employee becomes entitled to Medicare benefits (Part A, Part B, or both); • The parents become divorced or legally separated; or • The child is no longer eligible for coverage under the plan as a "Dependent child " If this Plan provides retiree health coverage, sometimes, filing a proceeding in bankruptcy under Title 11 of the United States Code can be a Qualifying Event. If a proceeding in bankruptcy is filed with respect to the Employer, and that bankruptcy results in the loss of coverage of any retired Employee covered under the Plan, the retired Employee will become a Qualified Beneficiary with respect to the bankruptcy. The retired Employee's Spouse, surviving Spouse, and Dependent children also will become Qualified Beneficianes if bankruptcy results in the loss of their coverage under the Plan The Employer must give notice of some Qualifying Events When the Qualifying Event is the end of employment, reduction of hours of employment, death of the Covered Employee, commencement of proceeding in bankruptcy with respect to the Employer, or the Covered Employee's becoming entitled to Medicare benefits (under Part A, Part B, or both), the Plan Administrator must be notified of the Qualifying Event You must give notice of some Qualifying Events Each Covered Employee or Qualified Beneficiary is responsible for providing the Plan Administrator with the following notices, in writing, either by U.S. First Class Mail or hand delivery. (1) Notice of the occurrence of a Qualifying Event that is a divorce or legal separation of a Covered Employee (or former Employee) from his or her Spouse; (2) Notice of the occurrence of a Qualifying Event that is an individual's ceasing to be eligible as a Dependent child under the terms of the Plan, (3) Notice of the occurrence of a second Qualifying Event after a Qualified Beneficiary has become entitled to COBRA Continuation Coverage with a maximum duration of 18 (or 29) months; (4) Notice that a Qualified Beneficiary entitled to receive Continuation Coverage with a maximum duration of 18 months has been determined by the Social Security Administration ("SSA") to be disabled at any time during the first 60 days of Continuation Coverage, and (5) Notice that a Qualified Beneficiary, with respect to whom a notice described in (4) above has been provided, has subsequently been determined by the SSA to no longer be disabled The Plan Administrator is. City of Yakima 129 North 2nd Street Yakima, Washington 98901 (509) 575-6090 A form of notice is available, free of charge, from the (Plan or COBRA) Administrator and must be used when providing the notice. City of Yakima Employee Health Plan 62 January 1, 2012 Deadline for providing the notice For Qualifying Events descnbed in (1), (2) or (3) above, the notice must be furnished by the date that is 60 days after the latest of • The date on which the relevant Qualifying Event occurs; • The date on which the Qualified Beneficiary loses (or would lose) coverage under the Plan as a result of the Qualifying Event; or • The date on which the Qualified Beneficiary is informed, through the furnishing of the Plan's SPD or the general notice, of both the responsibility to provide the notice and the Plan's procedures for providing such notice to the Plan Administrator For the disability determination described in (4) above, the notice must be furnished by the date that is 60 days after the latest of. • The date of the disability determination by the SSA, • The date on which a Qualifying Event occurs, • The date on which the Qualified Beneficiary loses (or would lose) coverage under the Plan as a result of the Qualifying Event, or • The date on which the Qualified Beneficiary is informed, through the furnishing of the Plan's SPD or the general notice, of both the responsibility to provide the notice and the Plan's procedures for providing such notice to the Plan Administrator. In any event, this notice must be furnished before the end of the first 18 months of Continuation Coverage For a change in disability status described in (5) above, the notice must be furnished by the date that is 30 days after the later of. • The date of the final determination by the SSA that the Qualified Beneficiary is no longer disabled; or • The date on which the Qualified Beneficiary is informed, through the furnishing of the Plan's SPD or the general notice, of both the responsibility to provide the notice and the Plan's procedures for providing such notice to the Plan Administrator. The notice must be postmarked (if mailed), or received by the Plan Administrator (if hand delivered), by the deadline set forth above If the notice is late, the opportunity to elect or extend COBRA Continuation Coverage is lost, and if you are electing COBRA Continuation Coverage, your coverage under the Plan will terminate on the last date for which you are eligible under the terms of the Plan, or if you are extending COBRA Continuation Coverage, such Coverage will end on the last day of the initial 18 -month COBRA coverage period. Who can provide the notice? Any individual who is the Covered Employee (or former Employee), a Qualified Beneficiary with respect to the Qualifying Event, or any representative acting on behalf of the Covered Employee (or former Employee) or Qualified Beneficiary, may provide the notice, and the provision of notice by one individual shall satisfy any responsibility to provide notice on behalf of all related Qualified Beneficiaries with respect to the Qualifying Event. Required contents of the notice. The notice must contain the following information. • Name and address of the Covered Employee or former Employee, • If you already are receiving COBRA Continuation Coverage and wish to extend the maximum coverage period, identification of the initial Qualifying Event and its date of occurrence; City of Yakima Employee Health Plan 63 January 1, 2012 • A description of the Qualifying Event (for example, divorce, legal separation, cessation of Dependent status, entitlement to Medicare by the Covered Employee or former Employee, death of the Covered Employee or former Employee, disability of a Qualified Beneficiary or loss of disability status), • In the case of a Qualifying Event that is divorce or legal separation, name(s) and address(es) of Spouse and Dependent child(ren) covered under the Plan, date of divorce or legal separation, and a copy of the decree of divorce or legal separation; • In the case of a Qualifying Event that is Medicare entitlement of the Covered Employee or former Employee (or in certain circumstances, the Spouse), date of entitlement, and name(s) and address(es) of Spouse and Dependent child(ren) covered under the Plan, • In the case of a Qualifying Event that is a Dependent child's cessation of Dependent status under the Plan, name and address of the child, reason the child ceased to be an eligible Dependent (for example, attained limiting age, lost student status, married or other); • In the case of a Qualifying Event that is the death of the Covered Employee or former Employee, the date of death, and name(s) and address(es) of Spouse and Dependent child(ren) covered under the Plan; • In the case of a Qualifying Event that is disability of a Qualified Beneficiary, name and address of the disabled Qualified Beneficiary, name(s) and address(es) of other family members covered under the Plan, the date the disability began, the date of the SSA's determination, and a copy of the SSA's Notice of Award letter, • In the case of a Qualifying Event that is loss of disability status, name and address of the Qualified Beneficiary who is no longer disabled, name(s) and address(es) of other family members covered under the Plan, the date the disability ended and the date of the SSA's determination; and • A certification that the information is true and correct, a signature and date If you cannot provide a copy of the decree of divorce, legal separation or the SSA's Notice of Award letter by the deadline for providing the notice, complete and provide the notice, as instructed, by the deadline and submit the copy of the decree of divorce, legal separation, or the SSA's Notice of Award letter within 30 days after the deadline. The notice will be timely if you do so. However, no COBRA Continuation Coverage, or extension of such Coverage, will be available until the copy of the decree of divorce or legal separation, or the SSA's Notice of Award letter is provided If the notice does not contain all of the required information, the Plan Administrator may request additional information. If the individual fails to provide such information within the time period specified by the Plan Administrator in the request, the Plan Administrator may reject the notice if it does not contain enough information for the Plan Administrator to identify the plan, the Covered Employee (or former Employee), the Qualified Beneficianes, the Qualifying Event or disability, and the date on which the Qualifying Event, if any, occurred Electing COBRA Continuation Coverage Complete instructions on how to elect COBRA Continuation Coverage will be provided by the COBRA Administrator within 14 days of receiving the notice of your Qualifying Event. You then have 60 days in which to elect COBRA Continuation Coverage. The 60 -day period is measured from the later of the date coverage terminates or the date of the notice containing the instructions If COBRA Continuation Coverage is not elected in that 60 -day period, then the nght to elect it ceases Each Qualified Beneficiary will have an independent right to elect COBRA Continuation Coverage. Covered Employees may elect COBRA Continuation Coverage on behalf of their Spouses, and parents may elect COBRA Continuation Coverage on behalf of their children. In the event that the COBRA Administrator determines that the individual is not entitled to COBRA Continuation Coverage, the COBRA Administrator will provide to the individual an explanation as to why he or she is not entitled to COBRA Continuation Coverage. How long does COBRA Continuation Coverage last? COBRA Continuation Coverage will be available up to the maximum time period shown below. Generally, multiple Qualifying Events which may be combined under COBRA will not continue coverage for more than 36 months beyond the date of the onginal Qualifying Event However, if, pursuant to the Plan, the first Qualifying Event is the City of Yakima Employee Health Plan 64 January 1, 2012 Covered Employee's entitlement to Medicare benefits, followed by termination or reduction of hours, then the maximum coverage period for Qualified Beneficianes other than the Covered Employee ends on the later of (i) 36 months after the date the Covered Employee became entitled to Medicare benefits, and (n) 18 months (or 29 months if there is a disability extension) after the date of the termination or reduction of hours For all other Qualifying Events, the continuation period is measured from the date of the Qualifying Event, not the date of loss of coverage. If, pursuant to the Plan, the Qualifying Event is the death of the Covered Employee (or former Employee), the Covered Employee's (or former Employee's) becoming entitled to Medicare benefits (under Part A, Part B, or both), your divorce or legal separation, or a Dependent child's losing eligibility as a Dependent child, COBRA Continuation Coverage lasts for up to a total of 36 months If the Qualifying Event is the end of employment or reduction of the Covered Employee's hours of employment, and the Covered Employee became entitled to Medicare benefits less than 18 months before the Qualifying Event, COBRA Continuation Coverage for Qualified Beneficianes other than the Covered Employee lasts until 36 months after the date of Medicare entitlement For example, if a Covered Employee becomes entitled to Medicare 8 months before the date on which his employment terminates, COBRA Continuation Coverage for his Spouse and children can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months after the date of the Qualifying Event (36 months minus 8 months). Otherwise, when the Qualifying Event is the end of employment (for reasons other than gross misconduct) or reduction of the Covered Employee's hours of employment, COBRA Continuation Coverage generally lasts for only up to a total of 18 months There are two ways in which this 18 -month penod of COBRA Continuation Coverage can be extended Disability extension of 18 -month period of COBRA Continuation Coverage If you or anyone in your family covered under the Plan is determined by the SSA to be disabled and you notify the Plan Administrator as set forth above, you and your entire family may be entitled to receive up to an additional 11 months of COBRA Continuation Coverage, for a total maximum of 29 months The disability would have to have started at some time before the 60th day of COBRA Continuation Coverage and must last at least until the end of the 18 -month period of COBRA Continuation Coverage. An extra fee will be charged for this extended COBRA Continuation Coverage. Second Qualifying Event extension of 18 -month period of COBRA Continuation Coverage If your family experiences another Qualifying Event while receiving 18 months of COBRA Continuation Coverage, the Spouse and Dependent children in your family can get up to 18 additional months of COBRA Continuation Coverage, for a maximum of 36 months, if notice of the second Qualifying Event properly is given to the Plan as set forth above. This extension may be available to the Spouse and any Dependent children receiving COBRA Continuation Coverage if the Covered Employee or former Employee dies, becomes entitled to Medicare benefits (under Part A, Part B, or both), or gets divorced or legally separated, or if the Dependent child stops being eligible under the Plan as a Dependent child, but only if the event would have caused the Spouse or Dependent child to lose coverage under the Plan had the first Qualifying Event not occurred Does COBRA Continuation Coverage ever end earlier than the maximum periods above? COBRA Continuation Coverage also may end before the end of the maximum period on the earliest of the following dates. • The date your Employer ceases to provide a group health plan to any Employee, • The date on which coverage ceases by reason of the Qualified Beneficiary's failure to make timely payment of any required premium, • The date that the Qualified Beneficiary first becomes, after the date of election, covered under any other group health plan (as an Employee or otherwise), or entitled to either Medicare Part A or Part B (whichever comes first), except as stated under COBRA's special bankruptcy rules However, a Qualified Beneficiary who becomes covered under a group health plan which has a Pre -Existing Condition limit must be allowed to continue COBRA Continuation Coverage for the length of a Pre - Existing Condition or to the COBRA maximum time period, if less, City of Yakima Employee Health Plan 65 January 1, 2012 • The first day of the month that begins more than 30 days after the date of the SSA's determination that the Qualified Beneficiary is no longer disabled, but in no event before the end of the maximum coverage period that applied without taking into consideration the disability extension, or • On the same basis that the Plan can terminate for cause the coverage of a similarly situated non - COBRA participant Payment for COBRA Continuation Coverage Once COBRA Continuation Coverage is elected, you must pay for the cost of the initial period of coverage within 45 days. Payments then are due on the first day of each month to continue coverage for that month. If a payment is not received and/or post -marked within 30 days of the due date, COBRA Continuation Coverage will be canceled and will not be reinstated Two provisions under the Trade Act affect the benefits received under COBRA First, certain eligible individuals who lose their jobs due to international trade agreements may receive a 65% tax credit for premiums paid for certain types of health insurance, including COBRA premiums. Second, eligible individuals under the Trade Act who do not elect COBRA Continuation Coverage within the election period will be allowed an additional 60 -day period to elect COBRA Continuation Coverage If the Qualified Beneficiary elects COBRA Continuation Coverage during this second election period, the coverage period will run from the beginning date of the second election penod You should consult the Plan Administrator if you believe the Trade Act applies to you Additional Information Additional information about the Plan and COBRA Continuation Coverage is available from the Plan Administrator and COBRA Administrator. Plan Administrator City of Yakima 129 North 2nd Street Yakima, Washington 98901 (509) 575-6090 COBRA Administrator Employee Benefit Management Services P O Box 21367 Billings, MT 59104 For more information about your rights under COBRA and other laws affecting group health plans, contact the U.S. Department of Labor's Employee Benefits Secunty Administration (EBSA) at 1-866-444-3272 or visit the EBSA Web site at www dol gov/ebsa Current Addresses In order to protect your family's rights, you should keep the Plan Administrator (who is identified above) informed of any changes in the addresses of family members. City of Yakima Employee Health Plan 66 January 1, 2012 COBRA CONTINUATION COVERAGE FOR RETIRED EMPLOYEES AND/OR THEIR DEPENDENTS COBRA Continuation Coverage will not be available to those Retired Employees that elected, at the time of retirement, to continue coverage under the terms of the Plan as a Retired Employee However, the following COBRA Continuation Coverage may apply to a Retired Employee's Qualified Beneficiaries. Introduction The right to COBRA Continuation Coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended ("COBRA"). COBRA Continuation Coverage can become available to Qualified Beneficiaries when they otherwise would lose group health coverage. The entire cost (plus a reasonable administration fee) must be paid by the Qualified Beneficiary, or any representative acting on behalf thereof. Coverage will end in certain instances, including, but not limited to, if you or your Dependents fail to make timely payment of premiums COBRA Continuation Coverage will not be available to the Retired Employee However, COBRA Continuation Coverage may apply to a covered Retired Employee's Qualifying Beneficiaries. What is COBRA Continuation Coverage? "COBRA Continuation Coverage" is a continuation of Plan coverage when coverage otherwise would end because of a life event known as a "Qualifying Event " Life insurance, accidental death and dismemberment benefits and weekly income or long-term disability benefits (if a part of your Employer's plan) are not considered for continuation under COBRA. What is a Qualifyint Event? Specific Qualifying Events are listed below After a Qualifying Event, COBRA Continuation Coverage must be offered to each person who is a "Qualified Beneficiary." Your Spouse and your Dependent children could become Qualified Beneficiaries if coverage under the Plan is lost because of the Qualifying Event. A domestic partner is not a Qualified Beneficiary If you are the Spouse of a Retired Employee, you will become a Qualified Beneficiary if you lose your coverage under the Plan due to one of the following Qualifying Events. • The Retired Employee dies; • You become divorced or legally separated from the Retired Employee; or • Your Spouse (Retired Employee) becomes entitled to Medicare. Note: Medicare entitlement means that you are eligible for and enrolled in Medicare Your Dependent children will become Qualified Beneficianes if they lose coverage under the Plan due to one of the following Qualifying Events. • The parent -Retired Employee dies; • The parents become divorced or legally separated; • The child is no longer eligible for coverage under the plan as a "Dependent child", or • The parent -Retired Employee becomes entitled to Medicare benefits (Part A, Part B, or both). You must live notice of some Qualifyint Events Each Qualified Beneficiary is responsible for providing the Plan Administrator with the following notices, in writing, either by U.S. First Class Mail or hand delivery. 1 Notice of the occurrence of a Qualifying Event that is a divorce or legal separation of a Retired Employee from his or her Spouse; 2. Notice of the occurrence of a Qualifying Event that is an individual's ceasing to be eligible as a Dependent child under the terms of the Plan, City of Yakima Employee Health Plan 67 January 1, 2012 3 Notice of the occurrence of a Qualifying Event that is the death of the Retired Employee The Plan Administrator is. City of Yakima 129 North 2nd Street Yakima, Washington 98901 (509) 575-6090 A form of notice is available, free of charge, from the Plan Administrator and must be used when providing the notice. Deadline for providing the notice For Qualifying Events descnbed in (1) or (2) above, the notice must be furnished by the date that is 60 days after the latest of. • The date on which the relevant Qualifying Event occurs; • The date on which the Qualified Beneficiary loses (or would lose) coverage under the Plan as a result of the Qualifying Event; or • The date on which the Qualified Beneficiary is informed, through the furnishing of the Plan's SPD or the general notice, of both the responsibility to provide the notice and the Plan's procedures for providing such notice to the Plan Administrator. The notice must be postmarked (if mailed), or received by the Plan Administrator (if hand delivered), by the deadline set forth above If the notice is late, the opportunity to elect COBRA Continuation Coverage is lost, and if you are electing COBRA Continuation Coverage, your coverage under the Plan will terminate on the last date for which you are eligible under the terms of the Plan. Who can provide the notice? Any individual who is the Qualified Beneficiary with respect to the Qualifying Event, or any representative acting on behalf of the Retired Employee or Qualified Beneficiary, may provide the notice, and the provision of notice by one individual shall satisfy any responsibility to provide notice on behalf of all related Qualified Beneficiaries with respect to the Qualifying Event Required contents of the notice The notice must contain the following information. • Name and address of the Retired Employee, • A description of the Qualifying Event (for example, divorce, legal separation, cessation of Dependent status, death of the Retired Employee, disability of a Qualified Beneficiary or loss of disability status), • In the case of a Qualifying Event that is divorce or legal separation, name(s) and address(es) of Spouse and Dependent child(ren) covered under the Plan, date of divorce or legal separation, and a copy of the decree of divorce or legal separation; • In the case of a Qualifying Event that is a Dependent child's cessation of Dependent status under the Plan, name and address of the child, reason the child ceased to be an eligible Dependent (for example, attained limiting age), • In the case of a Qualifying Event that is the death of the Retired Employee, the date of death, and name(s) and address(es) of Spouse and Dependent child(ren) covered under the Plan; and • A certification that the information is true and correct, a signature and date If you cannot provide a copy of the decree of divorce or legal separation by the deadline for providing the notice, complete and provide the notice, as instructed, by the deadline and submit the copy of the decree of divorce or legal City of Yakima Employee Health Plan 68 January 1, 2012 separation within 30 days after the deadline. The notice will be timely if you do so. However, no COBRA Continuation Coverage will be available until the copy of the decree of divorce or legal separation letter is provided If the notice does not contain all of the required information, the Plan Administrator may request additional information. If the individual fails to provide such information within the time period specified by the Plan Administrator in the request, the Plan Administrator may reject the notice if it does not contain enough information for the Plan Administrator to identify the plan, the Retired Employee, the Qualified Beneficiaries, the Qualifying Event, and the date on which the Qualifying Event, if any, occurred Electing COBRA Continuation Coverate Complete instructions on how to elect COBRA Continuation Coverage will be provided by the COBRA Administrator within 14 days of receiving the notice of your Qualifying Event. You then have 60 days in which to elect COBRA Continuation Coverage The 60 -day period is measured from the later of the date coverage terminates or the date of the notice containing the instructions If COBRA Continuation Coverage is not elected in that 60 -day period, then the right to elect it ceases. Each Qualified Beneficiary will have an independent right to elect COBRA Continuation Coverage. Retired Employees may elect COBRA Continuation Coverage on behalf of their Spouses, and parents may elect COBRA Continuation Coverage on behalf of their children In the event that the COBRA Administrator determines that the individual is not entitled to COBRA Continuation Coverage, the COBRA Administrator will provide to the individual an explanation as to why he or she is not entitled to COBRA Continuation Coverage. How Tont does COBRA Continuation Coverate last? COBRA Continuation Coverage will be available up to the maximum time period shown below Generally, coverage will not be continued for more than 36 months beyond the date of the original Qualifying Event. For all Qualifying Events, the continuation period is measured from the date of the original Qualifying Event. If, pursuant to the Plan, the Qualifying Event is the death of the Retired Employee, your divorce or legal separation, or a Dependent child's losing eligibility as a Dependent child, COBRA Continuation Coverage lasts for up to a total of 36 months. Does COBRA Continuation Coverate ever end earlier than the maximum periods above? COBRA Continuation Coverage also may end before the end of the maximum period on the earliest of the following dates • The date your Employer ceases to provide a group health plan to any Retired Employee; • The date on which coverage ceases by reason of the Qualified Beneficiary's failure to make timely payment of any required premium; or • The date that the Qualified Beneficiary first becomes, after the date of election, covered under any other group health plan (as an Employee or otherwise), except as stated under COBRA's special bankruptcy rules. However, a Qualified Beneficiary who becomes covered under a group health plan which has a Pre -Existing Condition limit must be allowed to continue COBRA Continuation Coverage for the length of a Pre -Existing Condition or to the COBRA maximum time penod, if less Payment for COBRA Continuation Coverate Once COBRA Continuation Coverage is elected, you must pay for the cost of the initial period of coverage within 45 days Payments then are due on the first day of each month to continue coverage for that month If a payment is not received and/or post -marked within 30 days of the due date, COBRA Continuation Coverage will be canceled and will not be reinstated. Two provisions under the Trade Act affect the benefits received under COBRA. First, certain eligible individuals who lose their jobs due to international trade agreements may receive a 65% tax credit for premiums paid for certain types of health insurance, including COBRA premiums Second, eligible individuals under the Trade Act who do not City of Yakima Employee Health Plan 69 January 1, 2012 elect COBRA Continuation Coverage within the election period will be allowed an additional 60 -day period to elect COBRA Continuation Coverage If the Qualified Beneficiary elects COBRA Continuation Coverage dunng this second election period, the coverage period will run from the beginning date of the second election penod You should consult the Plan Administrator if you believe the Trade Act applies to you Additional Information Additional information about the Plan and COBRA Continuation Coverage is available from the Plan Administrator and COBRA Administrator City of Yakima 129 North 2nd Street Yakima, Washington 98901 (509) 575-6090 COBRA Administrator Employee Benefit Management Services P.O. Box 21367 Billings, MT 59104 For more information about your nghts under COBRA and other laws affecting group health plans, contact the U S Department of Labor's Employee Benefits Secunty Administration (EBSA) at 1-866-444-3272 or visit the EBSA website at www.dol.gov/ebsa. Current Addresses In order to protect your family's rights, you should keep the Plan Administrator (who is identified above) informed of any changes in the addresses of family members City of Yakima Employee Health Plan 70 January 1, 2012 RESPONSIBILITIES FOR PLAN ADMINISTRATION PLAN ADMINISTRATOR. City of Yakima Health Care Benefits Plan is the benefit plan of City of Yakima, the Plan Administrator, also called the Plan Sponsor. An individual or committee may be appointed by City of Yakima to be Plan Administrator and serve at the convenience of the Employer. If the Plan Administrator or a committee member resigns, dies or is otherwise removed from the position, City of Yakima shall appoint a new Plan Administrator as soon as reasonably possible. The Plan Administrator shall administer this Plan in accordance with its terms and establish its policies, interpretations, practices, and procedures It is the express intent of this Plan that the Plan Administrator shall have maximum legal discretionary authority to construe and interpret the terms and provisions of the Plan, to make determinations regarding issues which relate to eligibility for benefits, to decide disputes which may arise relative to a Plan Participant's rights, and to decide questions of Plan interpretation and those of fact relating to the Plan. The decisions of the Plan Administrator will be final and binding on all interested parties DUTIES OF THE PLAN ADMINISTRATOR. To administer the Plan in accordance with its terms. To interpret the Plan, including the right to remedy possible ambiguities, inconsistencies or omissions. To decide disputes which may anse relative to a Plan Participant's rights To prescribe procedures for filing a claim for benefits and to review claim denials. To keep and maintain the Plan documents and all other records pertaining to the Plan. To appoint a Claims Administrator to pay claims To delegate to any person or entity such powers, duties and responsibilities as it deems appropriate. PLAN ADMINISTRATOR COMPENSATION. The Plan Administrator serves without compensation, however, all expenses for plan administration, including compensation for hired services, will be paid by the Plan. CLAIMS ADMINISTRATOR IS NOT A FIDUCIARY. A Claims Administrator is not a fiduciary under the Plan by virtue of paying claims in accordance with the Plan's rules as established by the Plan Administrator. STANDARDS FOR PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (THE "PRIVACY STANDARDS") ISSUES PURSUANT TO THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996, AS AMENDED (HIPAA) Disclosure of Summary Health Information to the Plan Sponsor In accordance with the Privacy Standards, the Plan may disclose Summary Health Information to the Plan Sponsor, if the Plan Sponsor requests the Summary Health Information for the purpose of (a) obtaining premium bids from health plans for providing health insurance coverage under this Plan or (b) modifying, amending or terminating the Plan. "Summary Health Information" may be mdividually identifiable health information and it summarizes the claims history, claims expenses or the type of claims expenenced by individuals m the plan, but it excludes all identifiers that must be removed for the information to be de -identified, except that it may contain geographic information to the extent that it is aggregated by five -digit zip code. Disclosure of Protected Health Information (PHI) to the Plan Sponsor for Plan Administration Purposes "Protected Health Information" (PHI) means individually identifiable health information, created or received by a health care provider, health plan, employer, or health care clearinghouse; and relates to the past, present, or future physical or mental health condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and is transmitted or maintained in any form or medium. City of Yakima Employee Health Plan 71 January 1, 2012 In order that the Plan Sponsor may receive and use PHI for Plan Administration purposes, the Plan Sponsor agrees to. (1) Not use or further disclose PHI other than as permitted or required by the Plan Documents or as Required by Law (as defined in the Pnvacy Standards); (2) Ensure that any agents, including a subcontractor, to whom the Plan Sponsor provides PHI received from the Plan agree to the same restrictions and conditions that apply to the Plan Sponsor with respect to such PHI, (3) Not use or disclose PHI for employment-related actions and decisions or in connection with any other benefit or employee benefit plan of the Plan Sponsor, except pursuant to an authorization which meets the requirements of the Privacy Standards, (4) Report to the Plan any PHI use or disclosure that is inconsistent with the uses or disclosures provided for of which the Plan Sponsor becomes aware; (5) Make available PHI m accordance with Section 164 524 of the Pnvacy Standards (45 CFR 164 524); (6) Make available PHI for amendment and incorporate any amendments to PHI in accordance with Section 164.526 of the Privacy Standards (45 CFR 164.526), (7) Make available the mformation required to provide an accountmg of disclosures in accordance with Section 164 528 of the Pnvacy Standards (45 CFR 164 528); (8) Make its internal practices, books and records relating to the use and disclosure of PHI received from the Plan available to the Secretary of the U.S. Department of Health and Human Services ("HHS"), or any other officer or employee of HHS to whom the authority involved has been delegated, for purposes of determining compliance by the Plan with Part 164, Subpart E, of the Privacy Standards (45 CFR 164 500 et seq); (9) If feasible, return or destroy all PHI received from the Plan that the Plan Sponsor still mamtams in any form and retain no copies of such PHI when no longer needed for the purpose for which disclosure was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction of the PHI infeasible, and (10) Ensure that adequate separation between the Plan and the Plan Sponsor, as required m Section 164 504(f)(2)(in) of the Pnvacy Standards (45 CFR 164 504(f)(2)(m)), is established as follows • (a) The following Employees, or classes of Employees, or other persons under control of the Plan Sponsor, shall be given access to the PHI to be disclosed. Deputy Human Resources Manager City Manager Assistant City Manager Human Resources Support and Staff City Attorney or Designee Director of Finance and Budget Deputy Director of Accounting and Budgeting City Clerk (Privacy Officer) (b) The access to and use of PHI by the mdividuals descnbed in subsection (a) above shall be restricted to the Plan Administration functions that the Plan Sponsor performs for the Plan. (c) In the event any of the individuals described in subsection (a) above do not comply with the provisions of the Plan Documents relatmg to use and disclosure of PHI, the Plan Administrator shall impose reasonable sanctions as necessary, in its discretion, to ensure that no further non-comphance occurs Such sanctions shall be imposed progressively (for example, an oral warning, a written warning, time off without pay and termination), if appropriate, and shall be imposed so that they are commensurate with the severity of the violation. City of Yakima Employee Health Plan 72 January 1, 2012 "Plan Administration" activities are limited to activities that would meet the definition of payment or health care operations, but do not mclude functions to modify, amend or terminate the Plan or solicit bids from prospective issuers "Plan Administration" functions include quality assurance, claims processing, auditing, monitonng and management of carve -out plans, such as vision and dental. It does not include any employment-related functions or functions in connection with any other benefit or benefit plans. The Plan shall disclose PHI to the Plan Sponsor only upon receipt of a certification by the Plan Sponsor that (a) the Plan Documents have been amended to incorporate the above provisions and (b) the Plan Sponsor agrees to comply with such provisions Disclosure of Certain Enrollment Information to the Plan Sponsor Pursuant to Section 164.504(f)(1)(iii) of the Privacy Standards (45 CFR 164.504(f)(1)(iii)), the Plan may disclose to the Plan Sponsor information on whether an individual is participating in the Plan or is enrolled in or has disenrolled from a health insurance issuer or health maintenance organization offered by the Plan to the Plan Sponsor Disclosure of PHI to Obtain Stop -loss or Excess Loss Coverage The Plan Sponsor hereby authorizes and directs the Plan, through the Plan Administrator or the Claims Administrator, to disclose PHI to stop -loss carriers, excess loss carriers or managing general underwriters (MGUs) for underwriting and other purposes m order to obtain and maintain stop -loss or excess loss coverage related to benefit claims under the Plan. Such disclosures shall be made m accordance with the Pnvacy Standards and any applicable Busmess Associate Agreement(s) Other Disclosures and Uses of PHI With respect to all other uses and disclosures of PHI, the Plan shall comply with the Privacy Standards. STANDARDS FOR SECURITY OF ELECTRONIC PROTECTED HEALTH INFORMATION (THE "PRIVACY STANDARDS") ISSUES PURSUANT TO THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996, AS AMENDED (HIPAA) Disclosure of Electronic Protected Health Information ("Electronic PHI") to the Plan Sponsor for Plan Administration Functions To enable the Plan Sponsor to receive and use Electronic PHI for Plan Administration Functions (as defined in 45 CFR § 164 504(a)), the Plan Sponsor agrees to. (a) Implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the Electronic PHI that it creates, receives, maintains, or transmits on behalf of the Plan, (b) Ensure that adequate separation between the Plan and the Plan Sponsor, as required in 45 CFR § 164 504(f)(2)(m), is supported by reasonable and appropriate security measures (c) Ensure that any agent, including a subcontractor, to whom the Plan Sponsor provides Electronic PHI created, received, maintained, or transmitted on behalf of the Plan, agrees to implement reasonable and appropriate security measures to protect the Electronic PHI, and (d) Report to the Plan any secunty incident of which it becomes aware FUNDING THE PLAN AND PAYMENT OF BENEFITS The cost of the Plan is funded as follows. The level of any Employee contributions will be set by the Plan Administrator These Employee contributions will be used in funding the cost of the Plan as soon as practicable after they have been received from the Employee or withheld from the Employee's pay through payroll deduction. Benefits are paid directly from the Plan through the Claims Administrator. City of Yakima Employee Health Plan 73 January 1, 2012 PLAN IS NOT AN EMPLOYMENT CONTRACT The Plan is not to be construed as a contract for or of employment CLERICAL ERROR Any clerical error by the Plan Administrator or an agent of the Plan Administrator in keeping pertinent records or a delay in making any changes will not invalidate coverage otherwise validly in force or continue coverage validly terminated An equitable adjustment of contributions will be made when the error or delay is discovered If, due to a clerical error, an overpayment occurs in a Plan reimbursement amount, the Plan retains a contractual right to the overpayment. The person or institution receiving the overpayment will be required to return the incorrect amount of money In the case of a Plan Participant, if it is requested, the amount of overpayment will be deducted from future benefits payable AMENDING AND TERMINATING THE PLAN If the Plan is terminated, the rights of the Plan Participants are limited to expenses incurred before termination. The Employer intends to maintain this Plan indefinitely; however, it reserves the nght, at any time, to amend, suspend or terminate the Plan in whole or in part This includes amending the benefits under the Plan or the Trust agreement (if any) City of Yakima Employee Health Plan 74 January 1, 2012 GENERAL PLAN INFORMATION TYPE OF ADMINISTRATION The Plan is a self-funded group health Plan and the administration is provided through a Third Party Claims Administrator. The funding for the benefits is derived from the funds of the Employer and contributions made by covered Employees. The Plan is not insured. PLAN NAME City of Yakima Employee Medical Benefits Plan PLAN NUMBER: 501 TAX ID NUMBER: 91-6001293 PLAN EFFECTIVE DATE: January 1, 1992 PLAN YEAR ENDS: December 31 EMPLOYER INFORMATION City of Yakima 129 North 2nd Street Yakima, Washington 98901 (509) 575-6090 PLAN ADMINISTRATOR City of Yakima 129 North 2nd Street Yakima, Washington 98901 (509) 575-6090 CLAIMS ADMINISTRATOR Employee Benefit Management Services, Inc. P.O. Box 21367 Billings, Montana 59104 (800) 777-3575 or (406) 245-3575 City of Yakima Employee Health Plan 75 January 1, 2012 2012-2014 COLLECTIVE BARGAINING AGREEMENT Between CITY OF YAKIMA, WASHINGTON and COUNCIL 2, WASHINGTON STATE COUNCIL OF COUNTY AND CITY EMPLOYEES REPRESENTING LOCAL 1122 Municipal Employees AMERICAN FEDERATION OF STATE, COUNTY AND MUNICIPAL EMPLOYEES, AFL-CIO EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2014 TABLE OF CONTENTS PREAMBLE: 2 ARTICLE 1 - RECOGNITION OF UNION BARGAINING UNIT 3 ARTICLE 2 - UNION MEMBERSHIP 4 ARTICLE 3 - COLLECTIVE BARGAINING 5 ARTICLE 4 - CODE PROVISIONS 6 ARTICLE 5 - IMPASSE 7 ARTICLE 6 - GRIEVANCE PROCEDURE 8 ARTICLE 7 - BUSINESS LEAVE 11 ARTICLE 8 - EMPLOYEE RIGHTS 12 ARTICLE 9 - MANAGEMENT RIGHTS 13 ARTICLE 10 - LABOR/MANAGEMENT COMMITTEE 14 ARTICLE 11 - SOCIAL SECURITY 15 ARTICLE 12 - EQUAL OPPORTUNITY CLAUSE 15 ARTICLE 13 - CONTRACTING WORK 16 ARTICLE 14 - STRIKES AND LOCKOUTS PROHIBITED 16 ARTICLE 15 - UNION CONSTITUTION AND BY LAWS 17 ARTICLE 16 - MATERNITY / PATERNITY LEAVE 17 ARTICLE 17 - SALARIES, LONGEVITY & DEFERRED COMPENSATION 17 ARTICLE 18 - HEALTH CARE 18 ARTICLE 19 - LIFE INSURANCE 21 ARTICLE 20 - SICK LEAVE 21 ARTICLE 21 - LAYOFF 26 ARTICLE 22 - VACATION LEAVE 27 ARTICLE 23 - HOLIDAYS 28 ARTICLE 24 - WORK DAY / WORK WEEK PROVISIONS 31 ARTICLE 25 - OVERTIME AND COMPENSATORY TIME 35 ARTICLE 26 - BILINGUAL SPECIAL PAY 36 ARTICLE 27 - CALL OUT PAY 37 ARTICLE 28 - STANDBY PAY 37 ARTICLE 29 - SHIFT DIFFERENTIAL 37 ARTICLE 30 - FIELD TRAINING OFFICER PAY 38 ARTICLE 31 - SPECIAL ASSIGNMENT PAY 38 ARTICLE 32 - LICENSING AND LICENSING RENEWALS 39 ARTICLE 33 - PERMANENT PART-TIME EMPLOYEES, ON-CALL EMPLOYEES, AND PERMANENT SEASONAL EMPLOYEES 39 ARTICLE 34 - TEMPORARY EMPLOYEES 40 ARTICLE 35 - ENTIRE COLLECTIVELY BARGAINED AGREEMENT 41 ARTICLE 36 - SAVINGS CLAUSE 41 ARTICLE 37 - TERMINATION 42 1 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 PREAMBLE: P-1 Collective Bargaining Agreement: THIS COLLECTIVELY BARGAINED AGREEMENT, hereinafter called the CBA, made and entered into the 1st day of January, 2012 by and between the City of Yakima, Washington, hereinafter called the City, and the Council 2, Washington State Council of County and City Employees, representing Local 1122 of the American Federation of State, County and Municipal Employees, AFL-CIO, hereinafter called the Union P-2 WITNESSETH: A) WHEREAS, Chapter 41.56 of the Revised Code of Washington contemplates the execution of collective bargaining Agreements between cities and unions representing government employees, the intent and purpose of such act being the promotion of the continued improvement of the relationship between public employers and their employees by providing a uniform basis for implementing the right of employees to join labor organizations of their own choosing and to be represented by such organizations in matters concerning their employment relations with public employers, and B) WHEREAS, the parties to this CBA recognize that benefits accrue to general government employees of the City by virtue of union membership, and that the best interests of the citizens of the City of Yakima are served by the City's official recognition of the City's general government employees' Union. C) NOW, THEREFORE, pursuant to Chapter 41.56 of the Revised Code of Washington, and in accordance with the intent and purpose thereof, and for the purpose of promoting the morale, well being and security of the general government employees of the City, and for the purpose of promoting the general efficiency of the government of the City of Yakima, the parties hereto agree as follows: 2 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 ARTICLE 1 - RECOGNITION OF UNION BARGAINING UNIT 1.1 The City recognizes the Union as the exclusive bargaining representative of the bargaining unit consisting of all permanent City employees except the following Commissioned employees of the Police Department The Police Department Administrative Assistant All employees of the Fire Department All employees of the Human Resources Division All employees of the Legal Department All employees of the Yakima Municipal Court The City Manager and members of his/her staff including the Administrative Secretary and Executive Assistant Senior Analyst Payroll Officer Accountant Financial Services Officer Treasury Services Officer Financial Services Technician — Payroll Deputy City Clerk Utility and Finance Assistant Engineering Contracts Specialist Engineering Office Assistant Construction Supervisor Utility Engineer Supervising Traffic Engineer Senior Engineer Water/Irrigation Engineer Surface Water Engineer Supervising Planner Supervising Project Planner (Transit) Supervising Code Inspector Traffic Operations Supervisor Senior Program Supervisor Neighborhood Development Services Operations Supervisor Recreation Program Supervisor Aquatics Program Supervisor Recreation Supervisor Community and Economic Development Office Administrator Code Inspection Office Supervisor Public Works Office Assistant Parks and Recreation Administrative Associate Police Services Supervisor Corrections Sergeant Administrative Assistant to the Director of Public Works Supervising Senior Analyst Lead Applications Systems Designer Equipment Maintenance Supervisor 3 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 Mechanic II Equipment Supervisor Industrial Maintenance Supervisor Parks Operations Supervisor Parks Superintendent Cemetery Supervisor Sewer Maintenance Supervisor Street Supervisor Street Maintenance Supervisor Irrigations Supervisor Water Distribution Supervisor Building Superintendent Traffic sign Supervisor Solid Waste Supervisor Transit Operations supervisor Utility Service Supervisor Assistant Wastewater Manager Wastewater Treatment Plant Process Control Supervisor Wastewater Treatment Plan Chief Operator Environmental Analyst Water Treatment Plant supervisor Lab Coordinator All other Department Heads and Division Managers Any other classification covered by Section 2.20.100 D of the Yakima Municipal Code ARTICLE 2 - UNION MEMBERSHIP 2.1 Union Membership: All employees in the bargaining unit shall, within thirty (30) days after hiring, as a condition of employment, become members of the Union, provided that exceptions to membership shall be subject to the provisions of RCW 41 56 122 (1) 2.2 Union Insignia: Union Members may wear official AFSCME lapel/stick pins (tie tacks) while on duty 2.3 Payroll Deductions: The City agrees to deduct Union fees, dues and other assessments by the Union against its members within the bargaining unit from the pay of employees who authorize the City to do so, which authorization shall be in writing and signed by each person authorizing such deductions, and filed with the City. The Secretary of the Union shall notify the Finance Director, or their designee, of the City of Yakima of amounts to be deducted from the pay of each such person. The City shall transmit to the Washington State Council of County and City Employees, P 0 Box 750, Everett, Washington, 98206 the aggregate of such deductions, together with an itemized statement, on or before the 20th day of each month following the month for which deductions are made 4 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 2.4 Indemnification: The Union agrees to defend, indemnify and hold harmless the City for any loss or damage arising from the operation of this Article knowingly caused by the Union. It is also agreed that neither any employee nor the Union shall have any claim against the City for any deductions made or not made unless a claim of error is made in writing to the City within forty-five (45) calendar days after the date such deductions were or should have been made. ARTICLE 3 - COLLECTIVE BARGAINING 3.1 Bargaining Teams: Collective bargaining between the parties shall be carried out by the City Manager, or his representatives, on behalf of the City Council, and a person or persons representing the Union Said collective bargaining committees shall include the City Manager or his designee, the Union staff representative, and not more than seven (7) additional members from each party without mutual consent of the parties The Union staff representative and the City Manager shall exchange in writing the names of the person or persons representing the respective parties for collective bargaining purposes prior to the first bargaining session. 3.2 Wages Hours and Working Conditions: Where negotiable matters pertaining to wages, hours and working conditions are fixed by various City Ordinances, the City Manager shall give notice to the Secretary of the Union with a copy to the staff representative of any proposed enactment or repeal of, or any amendments to, any such ordinance applicable to members of the bargaining unit Such notice shall be given no less than ten (10) working days prior to the first meeting of the City Council where such ordinance is considered, and shall be in writing and contain a copy of the ordinance proposed to be enacted or of the proposed amendment, or shall refer by code number to any ordinance proposed to be repealed No ordinance affecting wages, hours or working conditions of members of the bargaining unit shall be enacted by the City Council unless mutually agreed upon between the City Manager (or designee) and the collective bargaining committee of the Union. 3.3 Negotiations Timetable: A) Prior to the termination of this CBA, the Union and the City shall exchange written proposals for any changes in negotiable matters pertaining to wages, hours and working conditions sought for the subsequent year(s), specifying all sought changes B) During the City Manager's preparation of the annual budget while negotiations are occurring for a new CBA, the City Manager or his designee shall consider the Union's proposals and negotiate with the Union's collective bargaining representatives. Any agreement reached in negotiations shall be reduced to writing in a memorandum of agreement which shall be signed by the City Manager and the Union's representative. 5 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 C) In the event of disagreement between the collective bargaining committees concerning any Union recommendation and before impasse procedures are invoked the City's representative and the representative of the Union shall each set out in writing, and furnish a copy thereof to the other party, a brief signed statement containing the subject of disagreement as understood by the party writing the statement and the position on that subject of the other party as understood by the party writing the statement D) Nothing herein shall be construed so as to require approval by the Union of any budget, nor any portion thereof, before its submission to and adoption by the City Council. ARTICLE 4 - CODE PROVISIONS 4.1 Incorporation By Reference: The following sections of the Yakima Municipal Code are hereby incorporated by reference and made a part of this CBA. All sections listed shall be in accord with the terms of this CBA and in the event of a conflict the terms of the CBA shall prevail A) Section 2 04 030 B) Section 2 20 010 C) Section 2.20.020 D) Section 2.20.040 E) Section 2 20 050 F) Section 2.20.060 G) Section 2 20 070 II) Section 2 20 085 I) Section 2.20.088 City Contributions A, B-4, C-2 Persons Subject to Plan Content of Plan. Policy for Pay Steps. Policy for Present Employees Subparagraph (a) Transfer, Promotion, Reclassification, Demotion, or Reinstatement of Employees. Reduction of Salary Reimbursement for Expenditures Subparagraph 1. Uniform Allowance Special Assignment Pay, Subparagraphs B and C Classification Plan, Subparagraph (b) Compensation Plan, Subparagraph (e). Shift Differential. Longevity Plan, Eligibility Restrictions, Subparagraphs A, C, D Vacation Leave, Subparagraphs A, Section 1, and Subparagraphs B, C, D, E. Sick Leave Leave Without Pay Unauthorized Absences. J) Section 2 20 100 K) Section 2.20.110 L) Section 2.20.120 M) Section 2 24 010 N) Section 2.40.020 0) Section 2 40 030 P) Section 2 40 060 Q) Section 2.40.070 6 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 R) Section 2.40.080 Holidays with Pay, Subparagraphs A, B, C, D, E, F, G, H, J, K. S) Section 2 40 090 Work Week T) Section 2.40.100 Overtime Pay, Subparagraphs A-4, B, C, D, E. U) Section 2.40.120 Shared Leave-AFSCME employees. ARTICLE 5 - IMPASSE 5.1 Consideration by City Council: In the event the Union and the City Manager are unable to resolve any negotiable matter relating to wages, hours or working conditions, either party may request that the matter be submitted to the Yakima City Council for preliminary discussion and consideration by that body in an effort to satisfactorily settle such unresolved matter prior to any final City Council action by ordinance, resolution or otherwise Such consideration by the Council shall be made after reasonable notice to the parties, who shall have the right to be in attendance and to be heard 5.2 Mediation: In the event the Union and the City Manager are unable to resolve any negotiable matter relating to wages, hours and working conditions, either party may request mediation. Before mediation is requested, the unresolved matter must be reduced to writing and reasonable notice given to the other party of intentions to seek mediation. Mediation shall be conducted by an appointee of the Washington State Public Employment Relations Commission (PERC), or the Federal Mediation Conciliatory Service (FMCS). The parties shall attempt to agree as to whether to request a mediator from PERC or FMCS, however if the parties cannot agree, a mediator shall be requested from PERC. 5.3 Fact Finding: In the event the Union and the City Manager are unable to resolve any negotiable matter relating to wages, hours and working conditions, either party may request fact finding Before fact finding is requested, the unresolved matter must be reduced to writing and reasonable notice given to the other party of intentions to seek fact finding Fact finding shall be conducted by a committee of citizens of the City who are not employees of the City, one of whom shall be selected by the City Manager, one of whom shall be selected by the Union, and the third chosen by the two so selected. The conclusions of the fact finding committee shall be made public 5.4 Impasse Procedure: The impasse procedure contemplated by Article 5 - Impasse, Sections 5 1, 5 2, and 5 3, hereinabove are not mutually exclusive, and any one or all such procedures may be invoked by either party in the event the Union's collective bargaining committee and the City Manager are unable to resolve any negotiable matter relating to wages, hours or working conditions 7 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 5.5 Public Disclosure: Neither party shall independently issue releases to any news media, nor otherwise make public disclosure, during pre -impasse negotiations for a collective bargaining agreement. ARTICLE 6 - GRIEVANCE PROCEDURE 6.1 Policy: The parties recognize that the most effective accomplishment of the work of the City requires prompt consideration and equitable adjustments of employee grievances. It is the desire of the parties to resolve grievances informally whenever possible, and both supervisors and employees are expected to make every effort to resolve problems as they arise However, it is recognized that there may be grievances which can be resolved only after a formal review. Accordingly, the following procedure is hereby established in order that grievances of employees covered by this CBA may be resolved as fairly and expeditiously as possible. 6.2 Remedies: The Union may either grieve matters according to this Article or the Union may appeal to the Yakima Charter Civil Service Commission according to the Commission's Rules and Regulations. However, the Union may not exercise both approaches but must choose one or the other 6.3 Definitions: A) A "grievance" is a dispute concerning the interpretation, application, or alleged violation of any provision of this Agreement B) The term "working day" as used in this Article means Monday through Friday excluding holidays C) The term "employee" as used in this Article means a permanent, permanent part time, permanent seasonal, or probationary employee who is a member of the bargaining unit or group of such employees, accompanied by a representative if so desired. 6.4 Special Provisions: A) The aggrieved party and his or her chosen representative shall be granted time off without loss of pay for the purpose of processing a grievance. City employees attending hearings as a witness for the aggrieved party shall be granted time off without loss of pay for the purpose of providing testimony, including Civil Service Commission meetings. The aggrieved party's representative may, after making advance notification in writing as soon as possible to the relevant Division Manager(s), visit the work location of employees covered by this CBA for the purpose of investigating a grievance Said investigation shall be conducted so as not to disturb the work of uninvolved employees. 8 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 B) Grievances on behalf of one individual employee may not be initiated or pursued without the employee's written consent C) Grievances on behalf of more than one individual employee may be initiated or pursued without the employees' written consent D) A grievance may be entertained in or advanced to any step in the grievance procedure if requested by one party in writing and agreed to by the other party in writing E) The time limits within which action must be taken or a decision made as specified in this procedure may be extended by mutual written consent of the parties involved A statement of the duration of such extension of time must be signed by both parties involved at the step to be extended Failure of either party to meet the time limit or extended time limit for responses or appeals at any step in the process shall render the decision in favor of the other party 6.5 Procedure: To be reviewable under this procedure a Union grievance must be filed in writing within thirty (30) calendar days after the action or decision giving rise to the grievance and must comply with the following: A) Be filed upon an AFSCME Form F-29 B) Identify an alleged act or omission by management concerning this CBA. C) Identify the specific provisions of this CBA alleged to have been violated D) Specify the relief sought. 6.6 STEP I: Informal Discussion with Immediate Supervisor: Prior to filing a written grievance as described in Step 11 below, the employee shall meet with his or her immediate supervisor to discuss the subject of dispute If the subject of dispute is the immediate supervisor, the employee shall meet with the Division Manager. 6.7 STEP II: Grievance Filed with Division Manager: The affected employee shall pose the question of the grievance in writing to his or her Division Manager within 30 calendar days of the action or decision giving rise to the grievance The Division Manager shall answer the question of the misunderstanding and/or dispute in writing within 15 working days 6.8 STEP III: Grievance Appealed to Department Head: An employee who is dissatisfied with the decision of the Division Manager may submit the grievance in writing to the Department Head within fifteen (15) working days after receipt of the Division Manager's decision The Department Head shall make a separate investigation and notify the employee in writing of the decision, and the reasons therefore, within fifteen (15) working days after receipt of the employee's grievance 9 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 6.9 STEP IV: Grievance Appealed to City Manager: If the employee is dissatisfied with the decision of the Department Head, the employee may obtain a review by the City Manager by submitting a written request to the City Manager within fifteen (15) working days after receipt of the decision of the Department Head. The City Manager shall make such investigation and conduct such hearings as is deemed necessary, and shall, within fifteen (15) working days after receipt of the employee's request for review, inform the employee in writing of the City Manager's findings and decision 6.10 Management Grievance: Any grievance by the City against the Union shall be reduced to writing and submitted, no later than thirty (30) calendar days after having been made aware of the issue, to the President of the Union Local with a copy to the WSCCCE staff representative The Union President shall make an investigation of the relevant facts and shall, within fifteen (15) working days, provide a written decision, and the reasons therefore If the matter is not satisfactorily settled, an appeal may be instituted as set forth in 6.11 below. 6.11 STEP V: Final Resolution of Grievance: A) Either party to this CBA may refer unsettled grievances to Arbitration B) 1) A request for Arbitration shall be in writing and shall be submitted to the other party not more than thirty (30) working days after the reply of the City Manager, or the Union President, respectively, unless the time shall be extended by written mutual agreement. 2) Such request shall identify the previously filed grievance which is the basis for the request for Arbitration and shall set forth the issue or issues which the party making the request seeks to resolve C) 1) The Arbitrator may be selected by mutual agreement between the City Manager and the Union Alternatively, the parties may mutually request a list of nine (9) Arbitrators from the Public Employment Relations Commission (PERC), the American Arbitration Association (AAA), or the Federal Mediation and Conciliation Service (FMCS) In the event the parties cannot agree on what agency to request a list from within fifteen (15) working days, then either the City Manager or the Union may request a list of nine (9) Arbitrators from PERC. 2) Within fifteen (15) working days from the receipt of the list the parties shall alternately strike names from the list until one (1) name remains, who shall serve as Arbitrator. The party to strike the first name shall be determined by a coin flip D) The Arbitrator shall be limited to determining whether the City or the Union has violated or failed to apply properly the terms and conditions of this CBA The Arbitrator shall have no power to destroy, change, delete from or add to the terms of this CBA. E) PERC rules and procedures shall govern the hearing 10 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 F) The parties agree that the decision of the Arbitrator shall be final and binding and implemented within thirty (30) calendar days following the rendering of the decision G) The Arbitrator's fees and expenses, room rental, if any, and cost of the transcript(s) shall be shared equally by the parties FI) Each party shall bear the remaining costs of the preparation and presentation of its own case, including attorneys' fees, regardless of the outcome ARTICLE 7 - BUSINESS LEAVE 7.1 Contract Administration: Members representing the Union, not exceeding seven (7) in number, shall be granted leave from duty without any loss of pay for actual time spent for all meetings between the City and the Union for the purpose of negotiating wages, hours and working conditions and the terms of a contract and up to four (4) members for meetings between the City and the Union for the purpose of processing grievances when such meetings take place at a time during which any such members are scheduled to be on duty Actual time spent for meetings shall be limited to time spent in meetings and travel time. The Union may choose which union members to send to contract administration meetings, provided it gives the members' immediate supervisor(s) reasonable notice. 7.2 Other Union Business: A) The City of Yakima will maintain a standard for the accounting of Union business leave. B) Such officers and members of the Union as may be designated by the Union, not to exceed four (4) in number at any one time (except for attending labor conventions when the number shall not exceed seven (7) at any one time), shall be granted leave from duty with pay for union business other than that provided in Articles 7.1 and 7.3 herein including, but not limited to attending labor conventions and educational conferences regarding collective bargaining and civil service, provided that notice of such leave shall be given in writing at least one week prior thereto (emergencies excepted), and approval obtained from the Department Head, and provided further that the total leave for the bargaining unit for the purpose set forth in this section shall not exceed 135 hours in any calendar year. 7.3 Shop Stewards: Shop Stewards shall be allowed up to one (1) hour per month with pay for Shop Stewards meetings conducted during the steward's work shift The number of Shop Stewards shall not exceed five (5) per City department or a City-wide total of twenty (20). The Union shall keep the City informed, in writing, of the current Shop Stewards and Local Union Officers and shall provide at least seven calendar days advance notice of regular meetings in writing to the affected Division Managers in order to properly schedule staff coverage 11 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 ARTICLE 8 - EMPLOYEE RIGHTS 8.1 Personnel Files: Employees shall have the right, upon request, to inspect their personnel file No material referring to an employee's job competence or conduct shall be placed in the file without the employee's knowledge and the employee's opportunity to attach his or her comments A copy of any entry pertaining to job competence or conduct will be given to the employee 8.2 Performance Evaluations: A) The initial discussion regarding a probationary, special or annual performance evaluation shall take place solely between an employee and his or her immediate rating supervisor. Thereafter, an employee may be accompanied by a Union representative where job conduct or said performance evaluation is reviewed in a conference with management. On-the-job discussions between employee(s) and supervisor(s) regarding job duties, assignments, or performance shall not be considered disciplinary action and shall not be subject to this provision. B) Appeals of performance evaluations shall be made in accordance with Charter Civil Service Rules and Regulations. 8.3 Probationary Period: A) Police Department Positions The probationary period for all Police Department positions, including new hires and promotions, shall be twelve (12) months. B) Non -Police Department Positions The probationary period for all other bargaining unit positions shall be as follows The probationary period for promotions shall be six (6) months The probationary period for new hires shall be twelve (12) months, provided that probationary employees may use vacation leave and are eligible for step increases after six (6) months of employment, subject to and in accordance with all other rules, policies, the Yakima Municipal Code, and this CBA 8.4 Off Duty Actions: Off-duty activities shall be cause for disciplinary action in accordance with state and local law and the Charter Civil Service Commission Rules and Regulations. 8.5 Work Rules: Work rules and policy shall be posted for employees and be in writing. They shall be 12 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 uniformly applied When existing work rules, policy or procedure are changed or new rules or procedures established, employees whose work assignment is affected shall be notified in writing (that is, by circulating memoranda) and the new rule or procedure shall be posted prominently on appropriate bulletin boards for a period of fourteen (14) calendar days before becoming effective, except for changes of an emergency nature 8.6 Compliance: Employees shall comply with all existing rules that are not in conflict with the express items of this CBA, provided that rules are uniformly applied and uniformly enforced, and provided that reasonable notice has been given of the existence of the rule 8.7 Safety and Health Committee: A) The City has established a City-wide Safety and Health Committee in accordance with state law Such committee shall receive and investigate complaints of unsafe or unhealthy working conditions and shall recommend appropriate remedies to the City. B) Unresolved complaints of violations of Washington Industrial Safety and Health laws may be referred to the Washington State Department of Labor and Industries, Industrial Safety Division, for investigation C) The City and the Union agree to form a Labor -Management Task Force to study safety and health issues and make recommendations to the Safety and Health Committee 8.8 Union Participation: An employee has the right to hold Union office, seek Union assistance, file a grievance or use other benefits of this CBA according to the terms set forth without reprisal, repression, intimidation, prejudice or discrimination 8.9 Working Environment: The City shall provide the members of the bargaining unit with safe and healthy working environments. These working environments shall follow Federal and State law, and shall be free from discrimination, harassment, disparate treatment, and non-professional management practices. ARTICLE 9 - MANAGEMENT RIGHTS 9.1 Management Rights Exclusive of the CBA: Except as specifically abridged, granted, delegated or modified by this CBA, including amendments, the City retains all legal and inherent exclusive rights with respect to matters of legislative and managerial policy Furthermore, the City reserves all customary management prerogatives including, but not limited to, the right to: 13 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 A) Establish, plan for, and direct the work force toward the organizational goals of the municipal government B) Determine the organization, and the merits, necessity and level of activity or service provided to the public C) Determine the City budget and financial policies including accounting procedures. D) Establish, regulate and administer a personnel system, in conformity with the City Charter and Charter Civil Service Rules and Regulations, which provides for all types of personnel transactions including determining the procedures and standards for hiring, promotion, transfer, assignment, lay off, discipline, retention and classification of positions E) Discipline or discharge of employees for cause as provided by the General Rules and Regulations of the Charter Civil Service Commission and in conformity with this CBA. F) Determine the methods, means, equipment, numbers and kinds of personnel and the job or position content required to accomplish governmental operations and maintain the efficiency thereof G) Determine and change the number and locations and types of operations, processes and materials to be used in carrying out all City functions FI) Assign work to and schedule employees in accordance with Civil Service classifications and position descriptions, and to establish and change work schedules in accordance with Article XXIV-Work Day, Work Week Provisions, Section 24.6. I) Relieve any employees from duty due to a lack of work or insufficient funds J) Take all actions necessary to carry out the mission of the City in emergencies. 9.2 Scope of Management Rights: The above-cited management rights are not to be interpreted as being all inclusive, but merely indicate the type of rights which belong to the City It is understood that any of the rights, power and authority the City had prior to the signing of this CBA are retained by the City ARTICLE 10 - LABOR / MANAGEMENT COMMITTEE 10.1 Intent: The City and the Union shall cooperate to provide the public with efficient and courteous service, encourage good attendance of employees, and promote a climate of labor relations that will aid in achieving a high level of efficiency and productivity in all 14 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 departments of City government 10.2 Makeup: In order to accomplish these goals, a Labor/Management Committee shall be established consisting of up to eight (8) individuals: three (3) Union members chosen by the Union, the Union staff representative, the City Manager or his/her designee, and three (3) individuals selected by the City Manager from the management team and/or the City Council 10.3 Time Frame: The Labor/Management Committee shall schedule meetings at mutually agreeable times, but not later than fifteen (15) working days from the date of a request for a meeting by a party to this CBA Requests shall be in writing and contain the item(s) or topic(s) at issue. 10.4 Agenda: At least ten (10) working days prior to the meeting, a written agenda shall be prepared by the party requesting the meeting and may be supplemented by additions made by the other parties. A final agenda shall be established and distributed to all parties at least three (3) working days prior to the date of the meeting Items not on the agenda are not required to be discussed at the meeting unless mutually agreed by all parties at the beginning of the meeting 10.5 Resolution: Should the Labor/Management process result in a particular change in wages, hours and working conditions or otherwise supplement or modify this CBA, the change shall be reduced to writing in the form of a Letter of Understanding or Memorandum of Agreement and shall be executed by the parties. ARTICLE 11 - SOCIAL SECURITY The City will continue to provide the employer's share of Medicare and FICA (Social Security) for bargaining unit members. ARTICLE 12 - EQUAL OPPORTUNITY CLAUSE 12.1 It is the policy that the City of Yakima will comply with Revised Order No. 4 implementing U S Executive Order 11246, Equal Employment Opportunity Act of 1972, the Vocational Rehabilitation Act of 1973 as amended and implementing regulations, and the "Americans with Disabilities Act" (ADA) of 1991 as is mandated by these provisions and regulations. 15 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 12.2 It is the policy of the City of Yakima and the Union to not discriminate against any employee or applicant for employment because of race, color, religion, age, sex, national origin, marital status or disability. ARTICLE 13 - CONTRACTING WORK The City retains the right to continue currently contracted out work and retains the right to contract out any other positions or services deemed desirable or necessary. The City further retains the exclusive right to lay off employees at the discretion of the City, due to the lack of funds, in accordance with Chapter XI — Separation From Service, of the Charter Civil Service Rules In the event the City is considering contracting out work/services in the future, due to fiscal distress, the determination will be made during the annual budget process. When fiscal distress is identified, for a specific service or program (loss of grant funds, revenue shortfall, etc ), the city will consult with AFSCME to identify potential cost saving and service delivery alternative for the affected service only If it is determined that no other viable alternative is available to address the fiscal distress, they may elect to contract out the service. The city, will provide the Union with forty-five (45) days notice prior to the effective date of its final decision The parties agree that the City expressly reserves and retains the exclusive right to decide whether to subcontract out the work/services after consideration of the information provided by the Union Additionally, and in the event the City decides to contract out work/services in the future that are not related to budgetary issues and that do not result in layoffs, it will provide the Union with forty-five (45) days advance notice to bargain any effects of the subcontract upon the bargaining unit. The parties shall make a good faith effort to resolve any such issues within the forty-five (45) day time period After forty-five (45) days, the City may implement the subcontract even though the effects of bargaining are not concluded. ARTICLE 14 - STRIKES AND LOCKOUTS PROHIBITED 14.1 Strikes: The Union shall neither cause, encourage nor counsel employees within the bargaining unit to strike, nor shall it in any manner cause, encourage nor counsel any such employee or employees to directly or indirectly commit any concerted acts of work stoppage, slow -down or refusal to perform any customarily assigned duties; provided, however, in the event the laws of the State of Washington should be changed so as to allow the right to strike, or to substitute therefore any other right in its place, this CBA shall be construed so as to allow the Union to exercise any such right that is hereafter provided by law or change of law, and the parties to this Agreement hereby agree to be bound by the terms of any such law or change of law. 14.2 Lockouts: The City agrees that during the term of this CBA, there will be no lockouts. However, a complete or partial reduction of operations for economic or other compelling business reasons 16 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 shall not be considered a lockout In addition, if an employee is unable to perform his or her duties because equipment or facilities are not available due to a strike, work stoppage or slowdown by any other employees, such inability to provide work shall not be deemed a lockout ARTICLE 15 - UNION CONSTITUTION AND BY LAWS Upon request of the City Manager or his or her designee, the Union promptly shall furnish to the City Manager a current copy of the constitution, by laws and any other rules or regulations of the Union, including any revisions thereto. ARTICLE 16 - MATERNITY / PATERNITY LEAVE 16.1 Maternity Leave: Pregnancy will be treated in accordance with the Municipal Code as governed by RCW Chapter 49.60, WAC 162-30-120, and the Family Medical Leave Act (FMLA). 16.2 Paternity Leave: Paternity Leave granted by the City under the FMLA is subject to the specific Paternity Leave tenets of that act The intent of this CBA is not to add to, delete from, or otherwise interfere with employee rights under this law. ARTICLE 17 - SALARIES AND LONGEVITY AND DEFERRED COMPENSATION Effective January 1, 2012, the City and the AFSCME Municipal bargaining unit agree to a different benefit package for all new employees hired into this bargaining group. The separate benefit package includes but is not limited to: Longevity; Deferred compensation; Health Plan premium contribution. 17.1 Salaries: A) Effective January 1, 2012: The compensation plan for the bargaining unit in effect December 31, 2011 will be increased by zero percent (0%) B) Effective January 1, 2013 and 2014: The parties agree to a wage and economic opener for 2013 and 2014. 17 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 17.2 Longevity defined: Effective January 1, 2012, newly hired employees of this bargaining unit will not be eligible for longevity compensation. For bargaining unit hired prior to January 1, 2012, Longevity Compensation shall be in accordance with Yakima Municipal Code Section 2 24 010, Subparagraph "A" as amended, effective January 1, 1984. 17.3 Longevity Accruals: Years Service Longevity Compensation Percentage of Base Pay At least 60 months and less than 120 months 1 5% At least 120 months and less than 180 months 3% At least 180 months and less than 240 months 4 5% 240 months or more 6% 17.4: Deferred Compensation: Effective January 1, 2012, newly hired employees of this bargaining unit will not be eligible for deferred compensation. Bargaining unit member hired prior to January 1, 2012 shall be paid, in addition to that employee's monthly salary, deferred earned compensation each month in an amount equal to a percentage of said monthly salary as provided below. The deferred compensation contribution is separate pay and is not part of base monthly salary as codified in the Yakima Municipal Code Pay and Compensation Ordinance 2.20.110. This provision is subject to the City's deferred compensation rules and regulations and IRS regulations The computation of retirement contributions and pension benefits shall be governed by applicable state law. The City will contribute 3% of each employee's (hired prior to January 1, 2012) base monthly salary to a deferred compensation plan ARTICLE 18 - HEALTH CARE 18.1 Availability: Medical, Dental, and Vision insurance is provided by the City through the Health Care Trust 18 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 Covered bargaining unit employees, retirees and their dependents shall participate in the "City of Yakima Employees' Health and Welfare Plans " Eligibility rules, types and levels of benefits, payment of premiums through a cafeteria plan, co -payment, co- insurance and deductibility requirements and all other terms and conditions for the provision of these health benefits shall be governed by the "City of Yakima Employees' Welfare Benefit Program " 18.2 Health Care, Dental, and Life Premium Contributions: All insurance premium base rates shall be determined annually by the applicable broker of record and the formulas described below shall apply. A) Employee Only Premium Contribution: The City shall pay the monthly employee only health care premium as set by the City of Yakima Employees' Welfare Benefit Board B) Employee and Family Premium Contribution: For bargaining unit members hired after January 1, 2012, the employee contribution will be in accordance with the "Management Tiered Rates" as outlines in the Payroll Insurance Rate Schedule. For bargaining unit members hired prior to January 1, 2012, the City and employees shall share the monthly dependent unit health insurance premiums on a 50% by the employer and 50% by the employee basis as outlined in the Payroll Insurance Rate Schedule. For 2012 only, the city will absorb 1/2 of the scheduled Health Plan increase for the AFSCME Municipal unit Employee and Family premium C) Dental Insurance Premium Contribution: The City shall pay the premium for the employee and dependent family dental insurance D) Permanent Seasonal Employees: Permanent seasonal employees may extend health benefits for the first month after their routine seasonal layoff. The employee must have and must use forty (40) hours of accrued compensatory or vacation time in the month after the routine seasonal layoff to be eligible for this extension. The employee must use accrued compensatory time before using accrued vacation time 18.3 Retiree Medical, Dental, and Vision Coverage: A) Upon payment of the full premium as required in 18.2 herein above, retirees may elect to remain in the group medical, dental, vision plan until they reach age 65 19 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 B) Spouses of retirees may remain in the group medical plan until they reach age 65 or in the case of spouses of deceased retirees, until the spouse reaches the age of age 65, or remarries, whichever occurs first. C) Other dependents of retirees may remain in the group medical plan as long as they remain eligible under the provisions of the plan or until coverage for the retiree and spouse, or, the spouse of a deceased retiree terminates, at which time such dependent insurance coverage ceases regardless of the age of the dependents. Premiums shall be paid by deduction from retirement checks paid to retired employees or their beneficiary D) Retirees, or spouses of deceased retirees, shall pay the full premium (including dependents if enrolled) which shall be the same as the normal group rate assessed for coverage of active municipal employees and dependents as applicable. Premiums shall be paid by deduction from retirement checks paid to retired employees or their beneficiary. 18.4 Long Term Disability: The City agrees to continue to deduct voluntary long-term disability premiums through payroll deduction Employees shall authorize the City to do so in writing 18.5 Wellness Committee: Union representatives from this bargaining unit will be selected by the Union to serve on the Wellness Committee. The Committee will discuss such topics as heart programs, life programs, and physical examination coverage 18.6 Health Hazards/Inoculations: For employees who are exposed to health hazards by direct contact with raw sewage, industrial waste, human waste, or animal waste, the City will arrange and provide for inoculations or vaccines as recommended by the Yakima County Health Officer or other governing regulations. 18.8 Employee Health and Welfare Benefit Board: A) The Union will select four (4) representative board members Along with representatives from the City and other bargaining units, these representatives will serve on the City of Yakima Employee Health and Welfare Benefit Board, hereinafter referred to as the "Board." B) The purpose of the Board shall be to study and become informed regarding Health Insurance Programs, including the City's modified self-funded program; to identify perceived and real problems, and make recommendations to the City and to the Union on ways to improve and enhance, in an economical fashion, the Health Care Insurance Program C) To enable the Board to become knowledgeable and to make reasonable and objective 20 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 recommendations for change, the City agrees to the following 1) There shall be complete and open disclosure within the limits of medical confidentially to the board by City staff and Insurance Providers on information necessary for the board to complete its duties. 2) The Board shall be permanent. Any member(s) of the board who for any reason step down as a Board Member shall be replaced by the same selection process hereinabove. 18.9 Right of Withdrawal: The Union shall have the right to withdraw from the City's self-insured program by notifying the City in writing six (6) months in advance 18.10 VEBA: The Union has the option to participate as a group in the VEBA program set up by the City of Yakima upon 90 days advance written notice to the City. ARTICLE 19 - LIFE INSURANCE 19.1 Employee Life Insurance Benefit: The City shall provide a life insurance policy to bargaining unit member with a face value of One Hundred Thousand Dollars ($100,000). The life insurance premiums shall be paid in full by the City ARTICLE 20 - SICK LEAVE 20.1 Sick Leave: Sick leave with pay is established as an insurance program for salary continuation during periods of illness, and particularly extended illness as follows A) Accrual: All full-time employees shall accrue sick leave with pay at the rate of eight (8) hours per month for each full calendar month of the eligible employee's continuous service with the City Said accrual shall be prorated for partial months worked, as well as prorated for permanent part-time employees. B) Use: Effective June 1, 2005, sick leave cannot be used during the month of accrual. 21 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 C) Sick Leave Not Used/Capped: Unused sick leave shall accumulate to a maximum of 1040 hours Employees whose sick leave balance exceeded the aforementioned maximum as of December 31, 1981 shall be permitted to exceed the maximum until such time as their use reduces the balance below 1040 hours. No additional credits will be subsequently earned or allowed to accumulate above the cap of 1040 hours 20.2 Permissible Use of Sick Leave: An employee eligible for sick leave with pay, shall be granted such leave for the following reasons: A) Instances of personal illness or physical incapacity resulting from causes beyond employee's control; B) To care for a child of the employee with a health condition that requires treatment or supervision; "child" as used herein means a biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in the place of a parent ("in loco parentis" as legally defined) who is (a) under eighteen years of age or (b) eighteen years of age or older and incapable of self-care because of a mental or physical disability, C) To care for a spouse, parent, parent -in-law, or grandparent of an employee who has a serious health condition or an emergency condition, "parent" as used herein includes an individual who stood in the place of a parent ("in loco parentis" as legally defined) to an employee when the employee was a child D) For verifiable visits to a health care provider, for the employee, or for the employee's immediate family 1) For the intent of this CBA, the "Immediate Family" is defined as persons related by blood, marriage, legal guardianship or adoption such as any wife, husband, parent, grandparent, brother, sister, child, recognized foster child, or grandchild of the employee 2) The term immediate family does not include persons sharing the same general household when the living style is primarily that of a dormitory or commune. E) Quarantine of employee due to exposure to a contagious disease F) On the Job injuries: The sick leave buy back program for work related injuries is eliminated and time loss compensation will be paid in accordance with City of Yakima Administrative Policy PER 405 and in compliance with State of Washington Labor and Industries industrial insurance laws. 22 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 A member who is receiving industrial insurance benefits and whose authorized leave of absence for the injury exceeds 12 -weeks covered by the federal Family and Medical Leave Act shall be required to pay only the employee's portion of the health insurance premium for an additional 12 -week period. At the end of the second 12 -week period and if the employee has not returned to work, the employee shall be required to pay for both the employee and the City's portions of the applicable health insurance premium. 20.3 Bereavement Leave: A) Employees who are eligible for sick leave under this CBA shall 1) In the event of each death in the employee's immediate family, employees may consume up to three (3) days bereavement leave, per year, without loss of pay. These three (3) days shall not be credited against their sick leave accrual. 2) In the event of any days beyond the initial three (3) bereavement days per year, additional leave days will be debited against the employee's sick leave accrual 20.4 Exception: Employees are not allowed to report to work at another job during the same hours that sick leave is claimed. Violations shall be treated in accordance with Section 20.7 B of this CBA 20.5 Sick Leave Exhausted: Employees who have exhausted all accumulated sick leave may use accumulated vacation leave, compensatory, in -lieu time, or their personal holiday in lieu of sick leave subject to the requirements of Article 20 -Sick Leave, Section 20 2 -Permissible Use of Sick Leave, herein above. 20.6 Requirements for Paid Sick Leave Usage: A) Absence Reported: (1) Unless otherwise provided herein, every employee must report to the representative designated by his or her Department Head the reason for the absence as far in advance of the starting of their scheduled work day as possible Generally, this report should be made no later than fifteen (15) minutes before the starting time of the shift on the first day of absence (2) Police Services employees must report the reason for any unscheduled absence due to illness or injury to the representative designated by the employee's Division Manager at least one (1) hour before the starting time of the shift on each day of an absence of less than three (3) days For incidents more than three (3) days, Section 20.6(B) shall apply. 23 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 B) Incidents Greater Than Three Days: For incidents of sick leave use lasting longer than three (3) working days, the Department Head may require the employee to submit a written explanation for the leave and may also require the employee to submit a written statement by the employee's health care provider confirming the need for such leave. Requests for written statements from the employee's health care provider will be made prior to the employee's return to work C) Home Visits: Employees may choose to permit home visits by the Employer In the event that home visits are requested by the employer and denied by the employee, the sick leave usage may be denied as unverifiable D) Designated Medical Examinations: The Employee must permit medical examinations as designated by the City, at the expense of the City. Scheduling of these medical examinations will be at the mutual convenience of the City and the employee 20.7 Enforcement of Sick Leave Provisions: A) Failure to Comply: Any failure to comply with the provisions of Article 20 - Sick Leave, Section 20 6 -- Requirements for Paid Sick Leave Usage, hereinabove, shall be grounds for denial of sick leave with pay or other paid leave taken in lieu of sick leave for the period of absence B) Disciplinary Action: Misrepresentation of any material facts in connection with paid sick leave or other paid leave taken in lieu of sick leave by an employee shall constitute grounds for disciplinary action, including suspension or discharge C) Review, Investigation, Disciplinary Action: It shall be the responsibility of the Department Head or his/her designee to do the following: 1) Review all sick leave or other paid leave taken in lieu of sick leave and approve that which is bonafide and complies with the provisions of this section and forward approved time cards to the Payroll Officer The Payroll Officer shall not certify the payment of sick leave or other paid leave taken in lieu of sick leave until the approved applications have been received, except that employees still absent at the end of a pay period may be certified for payment of sick leave or other paid leave taken in lieu of sick leave by the Payroll Officer upon recommendation of the Department Head as indicated by his/her signature on the time sheet and subject to the receipt of an approved application for sick leave pay or other paid leave taken in lieu of sick leave immediately upon the employee's return to work, 2) Investigate any suspected abuse of sick leave or other paid leave taken in 24 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 lieu of sick leave, 3) Withhold approval of sick leave pay or pay for other leave taken in lieu of sick leave in the event of unauthorized use, 4) Initiate disciplinary action if, as a result of investigation, it is determined that an employee has been guilty of willful misrepresentation in a request for sick leave pay or other pay taken in lieu of sick leave pay. 20.8 Sick Leave Exchange: Up to 719 Hours: A) Employees who have accrued up to 719 hours of sick leave may exchange sick leave as follows: 1) Additional Vacation Days: Employees who have accrued up to 719 hours of sick leave hours may exchange sick leave hours for vacation days in accordance with Yakima Municipal Code 2.40.030 E -C. 2) Upon Retirement/Death: Upon retirement or death, the employee's accrued sick leave up to and including 719 hours will be exchanged for pay at the rate of 50% of the employee's current base pay. The maximum payment shall be $9,000. 3) Upon Termination: Upon termination under honorable conditions, as distinct from retirement or death, the employee's accrued sick leave up to and including 719 hours or less will be exchanged for pay at the rate of 25% of the employee's current base pay. Honorable termination includes layoff for budget reasons, as well as resignation with at least fourteen (14) calendar days notice. The maximum payment shall be $7,500 20.9 Sick Leave Exchanged: 720 Hours or More: A) Employees who have accrued 720 or more hours of sick leave may exchange sick leave for additional vacation days or for pay subject to the following provisions 1) Upon Retirement/Death: Upon retirement or death, the employee's accrued sick leave up through a maximum of 720 hours will be exchanged for pay at the rate of 100% of the employee's current base pay The maximum payment shall be $17,500 2) Upon Termination: Upon termination under honorable conditions, as distinct from death or retirement, the employee's accrued sick leave up to a maximum of 720 hours will be exchanged for pay at the rate of 50% of the employee's current base pay The maximum payment shall be $7,500. 25 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 3) Additional Vacation Days: Employees who have accrued 720 or more hours of sick leave may exchange such sick leave for bonus (additional) leave days, at the rate of 32 hours of sick leave for each additional 8 hours of leave, not to exceed a total of 40 added leave hours annually, utilization of which would be subject to the scheduling and approval by the Department Head 20.10 Sick Leave Exchange Procedure: A) Any permanent employee may exchange accrued sick leave as provided in Article 20 - Sick Leave, Sections 20 8 or 20 9 hereinabove, at the option of the employee, subject to the following conditions and provisions: 1) A request for such an exchange shall be made to the Finance Director, or his/her designee. All requests shall be in writing and shall be signed by the employee making the request 2) Requests will be accepted only during the first five (5) working days of each month with exchanged leave to be available within fifteen (15) calendar days of the date the request is received by the office of the Finance Director, or his/her designee Exceptions to the above will be made for termination, layoff or disability retirement. 3) No request will be granted for less than eight (8) hours pay or a minimum of three (3) days leave. 4) No exchange will be granted to an employee who has been terminated for cause. 5) In the event of a Reduction in Force (RIF), in accordance with Civil Service Rules Chapter XI — Separation from Service, the exchange will be seventy-five (75%) of the employees sick leave balance 20.11 Sick Leave Pool: The three (3) days unpaid leave waiting period shall be eliminated for an employee to be eligible for the sick leave pool, as per the City of Yakima Municipal Code provision in 2 40 120 Shared Leave -- AFSCME Employees, #6, and in this agreement per Article 4 - Code Provision 6. ARTICLE 21 - LAYOFF In the event that it becomes necessary to amend the layoff procedure in the Charter Civil Service Rules, the City and the Union shall cooperate to develop layoff procedures which shall be mutually acceptable for submission to the Yakima Charter Civil Service Commission 26 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 ARTICLE 22 - VACATION LEAVE 22.1 Vacation Leave Accrual: Employees shall be granted annual vacation pursuant to the following conditions A) All full-time employees shall accrue vacation with pay as follows: YEARS OF SERVICE ACCRUAL RATE 0-24 months 7 67 hours per month (92 hours per year, 40 hours may be taken after 6 months) After two (2) full years 9 0 hours per month (108 hours per year) After five (5) full years 11.0 hours per month (132 hours per year) After ten (10) full years 13 67 hours per month (165 hours per year) After fifteen (15) full years 15.67 hours per month (188 hours per year) After twenty (20) full years 17 00 hours per month (204 hours per year) B) These accruals shall be prorated on actual hours worked for permanent, permanent part-time, and permanent seasonal employees. 22.2 Capped Vacation Accruals: Employees shall be allowed to accrue a total amount of vacation time equal to the amount which can be earned in two (2) years 22.3 Illness During Vacation Leave: Employees who become ill while on approved vacation may utilize sick leave for the period of illness subject to the provisions of Article 20, Section 20.2, Paragraph B, provided the following conditions are met 1 Immediately upon becoming ill, the employee notifies the Division Manager, and 27 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 2 Upon returning to work, the employee presents to the Division Manager a certificate from a health care provider stating the date and nature of the illness and the length of the incapacity 22.4 Vacation Leave Use: Vacation leave cannot be used during the month of accrual ARTICLE 23 - HOLIDAYS 23.1 Paid Holidays Recognized: The following shall be recognized and observed as paid holidays: New Year's Day January 1 Martin Luther King, Jr. Day 3rd Monday in January Presidents' Day 3rd Monday in February Memorial Day Last Monday in May Independence Day July 4 Labor Day 1st Monday in September Veterans' Day November 11 Thanksgiving Day 4th Thursday in November Day after Thanksgiving Day 4th Friday in November Christmas Day December 25 23.2 Personal Holiday: Employees have the availability of two (2) personal holidays per year, to be taken at least 30 days apart. Personal Holidays not taken prior to December 31st of each calendar year will be forfeited 23.3 Personal Holiday Taken: The personal holiday may be taken subject to the following conditions A) The employee has been or is scheduled to be continuously employed by the City for more than six (6) months B) The employee has given not less than 14 calendar days of written notice to the Division Manager, provided, however, the employee and the Division Manager may agree on an earlier day. 28 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 C) The Division Manager has approved the day. D) The day selected does not prevent a department from providing continued public service and does not interfere with the efficient operation of the department, and E) The personal day must be taken during the calendar year of entitlement or the day will lapse except when an employee has requested a personal holiday and the request has been denied 23.4 General Holidays: Whenever any holiday specified by State law falls on Saturday, the preceding Friday shall be the holiday. Employees who work Friday in such case shall be paid according to City Code Section 2 40 080 Subsection E Whenever any holiday specified by State law falls on Sunday the following Monday shall be the holiday. Employees who work Monday in such case shall be paid according to City Code Section 2 40 080 Subsection E At the employee's option, the employee may be paid at straight time with the equivalent of one and one-half (1-1/2) days being granted off within ninety (90) days in lieu of the premium holiday pay. 23.5 Weekend - Workers: Whenever a holiday falls on a Saturday, the holiday shall be observed Saturday or if a holiday falls on Sunday, the holiday shall be observed Sunday for those employees regularly scheduled to work on Saturday or Sunday unless otherwise provided herein. 23.6 Release from Holiday Duty: Requests for release from holiday duty will be acted upon by the Division Manager at least ten (10) days prior to the holiday unless otherwise provided herein However, management may cancel an approved request if unforeseen events create a staffing vacancy which must be covered, or in case of an emergency Subsequent to approval of holiday time off, employees may not demand to work the holiday. 23.7 Equivalent Day Off: A) If a holiday falls on an employee's normal day off, an equivalent day off will be granted to the employee to be scheduled within ninety (90) days of the holiday. The employee may express a preference on the equivalent day to take off, however, the ultimate decision will be made by the Division Manager. B) Whatever the employee's scheduled work day period may be, the holiday(s) taken are worth the same number of hours as the employee's regularly scheduled work day. 23.8 Wastewater Division Holidays: Due to the around-the-clock nature of services provided by the Wastewater Division, it is often necessary to assign holiday work shifts to members of the bargaining unit 29 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 A) Holiday shifts shall be worked as assigned In the instances of holiday shifts, relevant staffing levels will be determined by operational circumstances. B) Requests for release from holiday duty shall be submitted to the Wastewater Division Manager as early as possible, but no later than thirty (30) days prior to the holiday Approval of holiday time off is at the discretion of management, and is dependent upon operational requirements. 23.9 Refuse Division Holidays: Holidays shall be worked as assigned except as modified herein below. A) In addition to Thanksgiving, Christmas, and New Year's Day, which shall be non- working holidays, employees of the Refuse Division shall not work on any contract holiday when the County landfill is closed 1) Provided, however, that when those holidays fall within the work week, uncollected refuse on those days will be collected on a weekend or other alternate day to be set by the Division Manager. 2) Employees working the alternate day will be paid at the overtime rate for all hours over 40. 23.10 Police Department Holidays: Due to the critical nature of the public safety services provided by the Police Department, the following provisions apply to members of the bargaining unit assigned to all Police Divisions, in lieu of and notwithstanding any other provision of this contract to the contrary A) Holiday shifts shall be worked as assigned. Relevant staffing levels will be determined by the Department in accordance with operational requirements B) Requests for release from holiday duty shall be submitted to the employee's supervisor at least thirty (30) calendar days prior to the holiday C) Time off shall be granted in order of first come / first serve within a squad or work unit If there is a conflict, seniority prevails D) In lieu of overtime payment for holidays worked, employees of the Police Department receive a bank of eighty-eight (88) hours of holiday time on January 1 of each calendar year which they may use at their discretion, subject to the supervisor approving the time off E) If a holiday occurs on a day the employee is not scheduled to work, no time is deducted from the employee's in -lieu holiday bank 30 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 F) If a holiday occurs on a day the employee is scheduled to work, but the employee requests and is granted the day off, the time is deducted from the employee's in -lieu holiday bank. G) All in -lieu holiday hours must be taken during the calendar year of entitlement H) An employee who uses up their 88 hours of holidays and leaves the Department before December 31 shall have 8 hours removed from their earned leave account or final pay for each holiday remaining in the calendar year. 23.11 Permanent Seasonal Employees - Thanksgiving Holiday A) Seasonal Employees that are in a pay status the workday before the Thanksgiving Holiday but will be in a "Leave Without Pay" status because of the end of the work season remain eligible to receive the Thanksgiving holiday pay ARTICLE 24 - WORK DAY / WORK WEEK PROVISIONS 24.1 Work Day, Work Week: Employees shall be scheduled to work regular hours for each work day and each work week in accordance with the provisions established below Employees' schedules will conform to the provisions of this CBA unless specifically modified by an Addendum to this contract 24.2 Permanent Full -Time and Permanent Seasonal Employees: The following provisions apply to Permanent Full -Time and Permanent Seasonal Employees, unless otherwise provided herein: A) Work Day: Employees will be scheduled to work a day of eight (8), nine (9), ten (10) or twelve (12) consecutive hours within a 24 hour period At the discretion of Management, if it works for the division for sound business needs and with prior supervisor/manager approval, the appropriate option(s) will be selected B) Work Week: 1) The work week may consist of five (5) consecutive eight (8) hour days with two (2) consecutive days off; 2) The work week may consist of four (4) consecutive ten (10) hour days with three (3) consecutive days off; 3) The work week may consist of five (5) consecutive nine (9) hour days, with two (2) consecutive days off, alternating with three (3) consecutive nine (9) hour days and one (1) eight (8) hour day followed by three (3) consecutive days 31 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 off 4) The work week may consist of four (4) ten (10) hour shifts with four (4) consecutive days off, alternating with four (4) ten (10) hour shifts with two (2) consecutive days off. C) Regular Hours: The City shall establish each work schedule which shall provide for regular starting and quitting times for each work day, and shall provide for the work week to begin and end on regularly established days of the week D) Meal Periods: The work day will provide for at least one 30 minute unpaid meal period to be scheduled as near mid -shift as possible If an employee works 2 hours or more beyond a normal work day, the City shall grant the employee at least one additional 30 minute unpaid meal period prior to or during the overtime period The City shall grant 30 unpaid minutes to eat every 4 hours thereafter while the employee continues to work. E) Rest Periods: The City shall provide employees with a 15 minute rest period for each one-half (1/2) shift provided the scheduled half shift exceeds a period of three (3) hours. The City shall establish when the rest period shall be scheduled and rest periods will be scheduled as near the middle of each half shift as reasonably possible. 24.3 Permanent Part -Time Employees: The following provisions apply to Permanent Part -Time Employees unless otherwise provided herein: A) Schedules: Permanent part-time employees will be assigned to schedules which may consist of a part-time work day, a part-time work week or a combination thereof. Whenever possible, permanent part-time employees shall be assigned to a specific work schedule not requiring split days off in a calendar week. However, permanent part-time employees may be assigned work to fill-in while permanent full-time employees are absent due to vacation, illness, or other cause that may preclude the assignment of a specific work schedule for that time period B) Work Day: Permanent part-time employees may be assigned to a work day of eight (8) hours or less and scheduled for consecutive hours of work. C) Work Week: Permanent part-time employees' work week may be scheduled for consecutive or non - 32 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 consecutive days For example an employee may be scheduled to work on Monday, Wednesday and Friday; or, an employee may work Monday, Tuesday, Wednesday and Thursday Work weeks shall be scheduled to meet the needs of the division/department D) Regular Hours: Permanent part-time employees will be scheduled to a work day with regular starting and ending times. E) Meal Periods: Permanent part-time employees will be entitled to at least one 30 minute unpaid meal period after four (4) hours of work F) Rest Periods: Permanent part-time employees will be provided a 15 minute paid rest period for each continuous four (4) hour period the employee works, provided that no permanent part- time employee shall be required to work more than 3 hours without a rest period The City shall establish when the rest period shall be scheduled and rest periods will be scheduled as near the middle of each half shift as reasonably possible 24.4 On -Call Employees: On-call employees will not be scheduled to work a regular set shift, but rather, will be called to work to fill-in during the absence of another employee. On-call employees will be entitled to the meal and rest periods provided for in the scheduled shift for which they are called out. 24.5 Minimum and Maximum Shift: No employee will be scheduled to a regular shift of less than four (4) consecutive hours. No employee shall be scheduled to a regular shift of greater than 12 consecutive hours A) Minimum Exception: The Parks and Recreation Division may in fact have the need to schedule pieces of regular shifts in segments less than four (4) consecutive hours due to the nature of classes, activities, and seasons 24.6 Work Schedule Changes: A) Any overall, long-term change in work schedules will be discussed between the City and the Union prior to implementation The City shall provide written notice to the Union and the employees outlining work schedule changes. The City may change the regular starting and quitting times and the days worked in a week with ten (10) working day notice prior to the effective date of the new schedule. The ten (10) work day notice may be waived upon written mutual agreement between Management and 33 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 the affected employees and AFSCME Local 1122 B) Although reasonable warning will be given whenever possible, the ten (10) work day notice provision will not be required for temporary individual shift assignment changes which may be made only to cover for the absences of another employee. C) Other than the reasons cited hereinabove, an employee's work shift shall not be changed to avoid payment of overtime when an employee is called to work outside that employee's regular work shift or called to work before the regular starting time or retained to work beyond the regular quitting time. 24.7 Emergency Situations: A) The City shall determine when an emergency situation exists B) An emergency is a sudden, unexpected event which creates a situation endangering the public or employee's health and/or safety C) In the case of emergencies, management may make schedule changes as required to protect the public or employees without discussion with the Union or notice to the employees. D) However, management will endeavor to preserve employee work schedules whenever possible. 24.8 Parks and Recreation: Employees of the Parks and Recreation Division may be scheduled for split work days and split work weeks when necessary All work schedules shall have established starting and quitting times for each day, shift or shift part. 24.9 Water Treatment Plant: A) Water Treatment Plant Chief Operators hired before January 1, 1996, at the City's Water Treatment Plant will rotate every twenty-eight (28) days from days to nights and nights to days, as applicable B) Water Treatment Plant Chief Operators hired after January 1, 1996, will work a straight night shift schedule (limited to 2 operators) The relief operator responsibilities will rotate every three (3) months. C) All of the Water Treatment Plant Chief Operators, including the night operator(s), will work the relief rotation. As the rotating shift schedule progresses into a shift partnership with the straight night shift operator, the operators hired before January 1, 1996 will work day shift. The work week begins 6:00 a.m. each Sunday. D) Employees hired before January 1, 2005, will continue to be given the choice of being either salaried or hourly. 34 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 1) Salaried employees will earn nine (9) hours of compensatory time (six hours at time and one-half) during their 46 -hour workweek, which shall be taken as nine (9) hours of compensatory time during their thirty-one (31) hour workweek. 2) Hourly employees will be paid overtime for six (6) overtime hours worked in the 46 -hour workweek. The next week they will be paid for thirty-one (31) scheduled hours worked E) Employees hired after December 31, 2004, will be hourly and will be paid overtime for six (6) hours overtime hours worked in the 46 -hour workweek The next week they will be paid for thirty-one (31) scheduled hours worked. 24.10 Police Department Work Day, Meal and Rest Periods: The following provisions apply to members of the bargaining unit assigned to the Police Department in lieu of and notwithstanding any other provision of this contract to the contrary: A) The work day for Police Department employees shall be either eight (8), ten (10), or twelve (12) hours within a twenty-four (24) hour period, at the discretion of management B) Due to the critical public -safety nature of the services performed by Police Department employees, it is occasionally not possible to relieve employees from their work stations for meal and rest periods. C) The length of the meal period for corrections officers in the Police Department shall be 40 minutes. Given the unique nature of duties performed by corrections officers, their meal period shall be paid D) The length of the meal period for service employees in the Police Department shall be 30 minutes. The meal period for service employees in the Police Department shall be paid ARTICLE 25 - OVERTIME AND COMPENSATORY TIME 25.1 Overtime Pay: Employees who are required to work more than forty (40) hours in any work week shall be paid one and one-half (1-1/2) times the regular rate of pay for credited time in excess of forty (40) hours per week Credited time shall be in fifteen (15) minute increments 25.2 Compensatory Time: Compensatory time off at the time and one-half (1-1/2) rate in lieu of overtime pay may 35 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 be requested by the affected employee In that event, compensatory time may be taken at such time as is agreed upon by the employer and the employee, but may not be imposed by the employer upon any employee who has not so requested such compensatory time off. 25.3 Compensatory Time Accrual: Compensatory time off may be accrued to a maximum of sixty (60) hours. Compensatory time must be taken prior to the use of accrued vacation leave until the compensatory time balance is twenty (20) hours or less. 25.4 Mandatory Training Time/Overtime: Time spent by an employee beyond the normal working day for training classes required by the Division Manager shall be paid at the overtime rate of time and one-half (1-1/2) times the employee's regular rate of pay, or compensatory time earned at one and one-half (1-1/2) times the employee's regular rate of pay 25.5 Travel Time: Travel time for City business during regular working hours shall be considered compensable if approved in advance Travel time outside of regular business hours on City business shall be compensable time if the intended travel is required by the Division Manager. If traveling by car outside of regular business hours for training not required but approved by the Division Manager, only the driver shall be compensated for travel time 25.6 City Provided Meals: In the event an employee is unable to provide or obtain the meal(s) due to location or time of day or emergency, the division head shall insure the employee obtains a meal provided by the City ARTICLE 26 - BILINGUAL SPECIAL PAY Employees who have Spanish bilingual capacity shall receive 3% of their base pay per month for their work in that capacity subject to prior written approval from their respective Department Head and subject to achieving a passing score on the bilingual skills examination conducted under the Charter Civil Service Rules and Regulations and administered by the Civil Service Chief Examiner. The Chief Examiner may waive this testing requirement if the employee can demonstrate to the satisfaction of the Chief Examiner, through documentation (i e court interpreter certification from the State of Washington) that the employee has sufficient bilingual skills in the Spanish language Once certified and compensated for the bilingual special pay the employee can only stop providing the service if the Department head determines the sill is no longer needed 36 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 ARTICLE 27 - CALL OUT PAY Employees who are called back to work after completing their regular shift or who are called to work on a day off shall be paid a minimum of two (2) hours pay at the time and one-half rate for all time worked up to two (2) hours Any time worked in excess of two (2) hours shall be paid at the time and one half rate. This Article shall apply to all bargaining unit members, including employees in the Police Department subpoenaed to testify in their official capacity For example 30 minutes call out = 2 hours at 11/2 4 hours call out = minimum of 2 hours at 11/2 plus 2 additional hours at 11/2 ARTICLE 28 - STANDBY PAY 28.1 Standby Availability: The determination of the need for and assignment of standby time is a responsibility of Management. Employees will have the opportunity to volunteer or exchange for standby prior to being made a required assignment The employee must notify his/her supervisor in writing by the end of the previous shift of an exchange with another employee for assigned standby 28.2 Standby Pay: Compensation for assigned standby time is Two Dollars and fifty cents ($2 50) per hour 28.3 Maintenance of Physical and Mental Capacity Employees, when on assigned standby time, are required to maintain the same required physical and mental capacity that is required during regular scheduled work hours and are to be reachable if called. ARTICLE 29 - SHIFT DIFFERENTIAL 29.1 Differential Pay for Alternate Shifts: A) This article applies to hours worked between 6:00 p,m, and 6:00 a.m. on weekdays. Employees who work after 6 00 p m due to an extended work shift shall receive an additional five percent (5%) per hour over base pay for the hours worked within the stipulated period to the nearest one-half (1/2) hour B) For those employees who are regularly scheduled to work an alternate shift where all or part of the shift hours fall between 6 00 p m and 6 00 a m weekdays or on Saturday and Sunday at anytime shall be entitled to the differential pay as described in 37 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 Section A Such employees shall receive the differential pay when utilizing accrued vacation, sick leave, holiday, personal holiday or bereavement leave, provided that the leave is preceded and succeeded by a regularly scheduled alternate shift C) Those employees who are called back to work after completing their regular shift or who are called to work on a day off (per Article 27 — Call Out Pay) shall be paid an additional five percent (5%) for any time worked in excess of one (1) hour between the hours of600pm and600am D) This article does not apply to Standby Pay that will be paid in accordance with Article 28 — Standby Pay, of the Collective Bargaining Agreement ARTICLE 30 — FIELD TRAINING OFFICER PAY 30.1 Corrections officers assigned to train newly hired corrections officers and actually engaged in the same shall receive Field Training Officer (FTO) Pay equal to Five Percent (5%) of their normal rate of pay per hour for time spent engaged in the same Officers assigned such duty for periods of less than forty (40) hours during the pay period shall not be eligible for FTO pay The City retains the exclusive right to select Field Training Officers and determine the duration of assignment. ARTICLE 31— SPECIAL ASSIGNMENT PAY 31.1 Pursuant to Yakima Municipal Code 2.20.088, when a salaried permanent employee represented by AFSCME Local 1122 works for one hour or longer in a higher classification and in a different classification series from which the employee is regularly employed and performs substantially all of the duties of such higher classification and is not actually receiving supervised training for such position, the employee shall be paid at the pay step in the higher classification which is next higher in amount above the employee's pay in the lower classification for all such hours consecutively worked in the higher classification 31.2 Pursuant to Yakima Municipal Code 2.20.088, when a salaried permanent employee represented by AFSCME Local 1122 works four consecutive hours or longer in a higher classification in the same classification series in which the employee is regularly employed and performs substantially all of the duties of such higher classification and is not actually receiving supervised training for such position, the employee shall be paid at the pay step in the higher classification which is next higher in amount above the employee's pay in the lower classification for all such hours consecutively worked in the higher classification 38 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 ARTICLE 32 - LICENSING AND LICENSING RENEWALS 32.1 Licensing and Licensing Renewals: Except for a basic Washington State driver's license, the City of Yakima will pay initial and all required renewal fees for any license/certificate required by the City after becoming a permanent employee to hold any given position as a condition of employment. If licenses are initial conditions of employment, the prospective employee will be required to pay for such licenses before becoming a permanent employee Effective January 1, 2011: A) Employees may elect to renew their Commercial Drivers License (CDL) medical certification through their regular attending physician at their own expense or at the medical clinic authorized by the City at the City's expense. B) The employee will sign a waiver agreeing to hold the city harmless to liability if they purposely misrepresent or do not accurately disclose medical conditions to their physician during the CDL medical certification process The employee and physician waivers are incorporated into this Agreement as Appendix A. 32.2 Changes of Status: Employees shall immediately report to their supervisor any change in status, expiration, or loss of any required license or certificate, including but not limited to Medical Examiner's Certificates. 32.3 Employee -Caused Licensing Reinstatements: Failure to maintain required license/certificates may lead to a change in employment status Employee -caused license/certificate reinstatement costs shall be born by that employee. ARTICLE 33 - PERMANENT PART-TIME EMPLOYEES, ON-CALL EMPLOYEES, AND PERMANENT SEASONAL EMPLOYEES 33.1 Permanent Part -Time Employee On Call/Call Out: A) Permanent part-time employees may work on an "on-call" basis and may be asked to report daily to their duty station to determine if their services are needed for that work day. 1) Such employee will receive compensation only if their services are needed 33.2 Required Residential Phones: 39 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 Permanent part-time employees may, as a condition of their employment, be required to have a telephone in their personal residence so that they may be notified if they are needed to work on a particular day 33.3 Earned Leave in Lieu of Work: If called to report for work in their assigned job classification, permanent part-time, on- call, or seasonal employees shall report to work or utilize vacation, sick leave, or other earned time off in accordance with the provisions of this CBA 33.4 Overtime/Permanent Part -Time: Permanent part-time employees will be eligible to receive overtime payments in accordance with Article 24 only if they work more than forty (40) hours in any work week No overtime compensation will be paid if such employee exceeds the regularly scheduled workday unless such work causes the employee to work more than forty (40) hours in the work week 33.5 Call Out Pay for Permanent Part -Time, On Call, and Seasonal Employees: The provisions of Article 27 -Call Out Pay, shall not apply to permanent part-time, or on- call employees 33.6 Actual Percentage of Time Worked: A) Permanent part-time employees shall accrue all earned benefits including, but not limited to vacation leave, sick leave, and longevity B) Permanent part-time employees shall be compensated for all earned benefits at the accrual rate prescribed in this CBA prorated to reflect the actual percentage of time worked. C) Employees' benefit accruals will be adjusted monthly to reflect actual benefit accrual rates. ARTICLE 34 - TEMPORARY EMPLOYEES 34.1 Temporary Employees: In the event the City deems it necessary to employ temporary employees, the following shall apply: A) The City shall regulate and administer the procedures and standards for hiring temporary employees. B) Temporary employees shall not be allowed to work more than 866 hours in a calendar 40 AFSCME Municipal Employees January 1, 2012 - December 31, 2014 year C) The City shall provide a temporary employees report, on a quarterly basis, for AFSCME Local 1122 reflecting Hire Dates and Termination Dates by Division and/or Department. 34.2 The City and the Union agree to establish a Labor Management Task Force to study temporary hiring practices in the City and negotiate in good faith possible changes. ARTICLE 35 - ENTIRE COLLECTIVELY BARGAINED AGREEMENT: [CBA] 35.1 Entire CBA: This CBA constitutes the complete and entire Agreement between the parties and neither the City nor the Union shall be bound by any requirement not specifically stated in this CBA or applicable Charter Civil Service Rules. The parties are not bound by the past practices or understandings of the City or the Union unless such past practices or understandings are incorporated in this CBA. 35.2 Process: A) The City and the Union acknowledge that each party has had ample opportunity to submit proposals with respect to any subject or matter not removed from the collective bargaining process by law and regarding wages, hours, and working conditions They further agree that all said proposals have been negotiated during the negotiations leading to this CBA B) The parties further agree that negotiations will not be reopened on any item during the life of this CBA except by the mutual consent or as provided in Article 10 - Labor/Management Committee. ARTICLE 36 - SAVINGS CLAUSE 36.1 Applicable Laws: It is understood and agreed that all provisions of this CBA are subject to applicable laws, and if any provision of any Article of this CBA is held or found to be in conflict therewith, said Article shall be void and shall not bind either of the parties hereto, however, such invalidity shall not affect the remaining Articles of this CBA. 36.2 ADA/FMLA Compliance: Notwithstanding any other provisions of this CBA the parties may take all actions reasonable to comply with the Americans with Disability Act and the Family Medical Leave Act. 41 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 36.3 Mandated Changes: If the Washington State Health Services Act of 1993 or Federal Health Care legislation mandates changes to the Health Care Article of this CBA, then the parties agree to negotiate about those mandated changes. ARTICLE 37 - TERMINATION This CBA shall be deemed effective from and after the 1st day of January 2012 and shall terminate on December 31, 2014 provided, however, that this CBA shall be subject to such periodic changes or modifications as may be voluntarily and mutually agreed upon by the parties hereto during the term hereof. EXECUTION FOR THE UNION: FOR THE CITY OF YAKIMA Yvette Lewis, Staff Representative Council 2, WSCCCE Donald B Cooper, City Manager Gary Hill, President Michael A. Morales Local 1122 Bargaining Team Assistant City Manager Mike Haider Local 1122 Bargaining Team Mike Nugent Local 1122 Bargaining Team Mary Hurst Local 1122 Bargaining Team 42 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 Dave Williams Local 1122 Bargaining Team Eric Arreola Local 1122 Bargaining Team Ron Elkan Local 1122 Bargaining Team ATTEST: Deborah Kloster City Clerk AFSCME Municipal Employees January 1, 2012 — December 31, 2014 Appendix A Page 1 of 2 City of Yakima AFSCME Commercial Driver License Medical Examination Declaration MEDICAL EXAMINER DECLARATION The City of Yakima provides paid medical examination services to all employees who are required to have a Commercial Drivers License endorsement as an essential function of their job. Your patient has selected to have you, their regular physician, complete this examination, at their own expense. I am a licensed physician in and conducted an examination of , a patient known to me, in order to determine their physical qualification for operating a commercial vehicle in accordance with the requirements of 49 CFR 391 41 -49 By signing below, I declare that I am familiar with the requirements and guidelines developed by the Federal Motor Carrier Safety Regulations in making my determination of qualification, as well as the driver's responsibilities and work environment outlined in the introductory comments under "The Driver's Role" to 49 CFR 391 41 I further declare that I have read and understand the "Instructions to the Medical Examiner" section of 49 CFR 391 41 including both the General Information and Interpretation of Medical Standards paragraphs Signature of Physician Printed name of Physician 44 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 Date Appendix A Page 2 of 2 City of Yakima AFSCME Commercial Driver License Medical Examination Liability Waiver RELEASE OF ALL CLAIMS, WAIVER OF LIABILITY, AND HOLD HARMLESS AGREEMENT I am an AFSCME employee for the City of Yakima who must maintain a valid Commercial Driver's License (CDL) in order to operate any commercial motor vehicle. I understand that I must be physically qualified to do so in accordance with the Physical Qualifications for Drivers standards as set forth in 49 CFR 391 31, and must obtain a medical examiner's certificate initially and for subsequent license renewals The City of Yakima provides paid medical examination services for this purpose. As an alternative to the City provided examination, I am electing to utilize my regular physician for the screening and certificate at my own expense. I acknowledge my obligation to fully represent all medical information to my evaluating physician, and to accurately disclose any medical information or condition to the physician, requested or not, to the best of my ability. I FURTHER AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CITY OF YAKIMA, AND ITS ELECTED OR APPOINTED OFFICIALS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS FROM ANY CLAIM, DAMAGE, COST OR LIABILITY RESULTING FROM, OR RELATED TO, ANY INTENTIONAL MISPRESENTATION OR ANY FAILURE TO ACCURATELY DISCLOSE WHAT I KNOW TO BE RELEVANT MEDICAL INFORMATION TO MY EXAMINING PHYSICIAN. I agree to all of these terms on behalf of myself, my child (if applicable), my spouse (if applicable), my family, my heirs, my executors and personal representatives of my estate, and this Release of All Claims, Waiver of Liability, and Hold Harmless Agreement is binding on them. I have read and understand the information in this Release of All Claims, Waiver of Liability, and Hold Harmless Agreement. Signature of Operator Printed name of Operator 45 AFSCME Municipal Employees January 1, 2012 — December 31, 2014 Date: 2013 —2015 COLLECTIVE BARGAINING AGREEMENT Between City of Yakima, Washington And Council 2 Washington State Council of County and City Employees Representing Local 1122 Uniformed Transit Employees American Federation of State County and Municipal Employees, AFL-CIO Effective January 1, 2013 through December 31, 2015 1.1 PREAMBLE This Agreement made and entered into by and between the City of Yakima, Washington, hereinafter called the Employer and Council 2, Washington State Council of County and City Employees, representing Local 1122, Bargaining Unit, Uniformed Transit Employees, of the American Federation of State, County and Municipal Employees, AFL-CIO, hereinafter called the Union. WITNESSETH: WHEREAS, Chapter 41 56 of the Revised Code of Washington contemplates the execution of collective bargaining agreements between cities and unions representing government employees, the intent and purpose of such act being the promotion of the continued improvement of the relationship between public employers and their employees by providing a uniform basis for implementing the right of employees to join labor organizations of their own choosing and to be represented by such organizations matters concerning their employment relations with public employers, and WHEREAS, the parties to this agreement recognize that benefits accrue to Union employees of the City by virtue of union membership, and that the best interests of the citizens of the City of Yakima are served by the City's official recognition of the Union. NOW, THEREFORE, pursuant to Chapter 41.56 of the Revised Code of Washington, and in accordance with the intent and purpose thereof, and for the purpose of promoting the morale, well being and security of the Union employees of the City, and for the purpose of promoting the general efficiency of the government of the City of Yakima, the parties hereto agree as follows: ARTICLE 1 - RECOGNITION OF UNION BARGAINING UNIT The City recognizes the Union as the exclusive bargaining representative of the bargaining unit consisting of all permanent Regular and Extra board transit operators, Transit Dispatchers, Transit Service Workers, the Transit Project Planner, the Transit Route Supervisor, the Transit Office Assistant DA II, Transit Vehicle Cleaner, and the Marketing/Program Administrator 1.2 In accordance with RCW 41.56.050 through RCW 41.56.080, an application for certification as exclusive bargaining representative for an appropriate unit may be filed with the Public Employment Relations Commission during a period of not more than ninety (90) days nor less than sixty (60) days prior to the expiration date of this agreement. AFSCME Local 1122 —Transit / 2013 - 2015 Page 2 of 44 ARTICLE 2 - UNION MEMBERSHIP 2.1 Union Membership: All employees in the bargaining unit shall, within thirty (30) days after hiring, as a condition of employment, become members of the Union, provided that exceptions to membership shall be subject to the provisions of RCW 41.56.122(1). 2.2 Payroll Deductions: The City agrees to deduct Union fees, dues and other assessments by the Union against its members within the bargaining unit from the pay of employees who authorize the City to do so, which authorization shall be in writing and signed by each person authorizing such deductions, and filed with the City. The Union shall notify the Employer's Finance Director, Payroll Officer, or their designee of amounts to be deducted from the pay of each such person The City shall transmit to the Washington State Council of County and City Employees, PO Box 750, Everett, Washington, 98206- 0750, the aggregate of such deductions, together with an itemized statement, on or before the 20th day of each month following the month for which deductions are made. The Union agrees to defend, indemnify and hold harmless the City for any loss or damage arising from the operation of this Article knowingly caused by the Union It is also agreed that neither any employee nor the Union shall have any claim against the City for any deductions made or not made unless a claim of error is made in writing to the City within forty-five (45) calendar days after the date such deductions were or should have been made. 2.3 Union Insignia: Employees who are members of the Union, and in good standing, shall be permitted, with the mutual agreement of Transit management, to wear while on duty, the standard type of Union pin prescribed by their State or International organization. ARTICLE 3 - COLLECTIVE BARGAINING 3.1 Bargaining Teams: Collective bargaining between the parties shall be carried out by the City Manager or his/her designee, the City Human Resources Manager or his/her designee, the Union Staff Representative, the Union President, and four (4) additional members from each party. No additional representatives for either party shall be allowed without the consent of the other party The Union Staff Representative and the City Manager shall exchange in writing the names of the person or persons representing the respective parties for collective bargaining purposes prior to the first bargaining session. AFSCME Local 1122 —Transit / 2013 - 2015 Page 3 of 44 3.2 Wages Hours and Working Conditions: Where negotiable matters pertaining to wages, hours and working conditions are fixed by various City ordinances, the City Manager shall give notice to the Secretary of the Union with a copy to the Staff Representative of any proposed enactment or repeal of, or any amendments to, any such ordinance applicable to members of the bargaining unit. Such notice shall be given no less than ten (10) days prior to the first meeting of the City Council where such ordinance is considered, and shall be in writing and contain a copy of the ordinance proposed to be enacted or of the proposed amendment, or shall refer by code number to any ordinance proposed to be repealed No ordinance affecting wages, hours or working conditions of members of the bargaining unit shall be enacted by the City Council unless mutually agreed upon between the City Manager (or designee) and the collective bargaining committee of the Union 3.3 Negotiations Timetable: Prior to the termination of this CBA, the Union and the City shall exchange written proposals for any changes in negotiable matters pertaining to wages, hours and working conditions sought for the subsequent year(s) Thereafter, negotiations shall be governed by RCW 41.56. ARTICLE 4 - PUBLIC DISCLOSURE Neither party shall independently issue releases to any news media nor otherwise make public disclosure during Pre -Mediation negotiations as the parties work towards a collective bargaining agreement, unless required by law ARTICLE 5 - CODE PROVISIONS The following sections of the Yakima Municipal Code are hereby incorporated by reference and made a part of this Agreement. All sections listed shall be in accord with the terms of this Agreement and in the event of a conflict the terms of the Agreement shall prevail Section 2.20.010 Section 2.20.020 Section 2.20.040 Section 2.20.050 Section 2.20.060 Section 2.20.070 Section 2.20.085 Section 2.20.088 Section 2.20.100 - Persons Subject to Plan. - Content of Plan. - Policy for Pay Steps. - Policy for Present Employees; Subsection A. - Transfer, Promotion, Reclassification, Demotion, or Reinstatement of Employees. - Reduction of Salary. - Reimbursement for Expenditures; Subsection 5 - Uniform Allowance, Special Assignment Pay; Subsections (3) and (4). - Classification Plan; Subsections A and E. AFSCME Local 1122 —Transit / 2013 - 2015 Page 4 of 44 Section 2.20.110 - Compensation Plan; Subsection 1. Section 2.24.010 - Longevity Plan- Eligibility- Restrictions; Subsections A, C, D. Section 2.40.020 - Vacation Leave; Subsection A (1), and Subsections B (1), (4). Section 2.40.030 - Sick Leave; Sections A (1), B, C, D, E. Section 2.40.110 - Sick Leave Transfer. Section 2.40.060 - Leave Without Pay. Section 2.40.070 - Unauthorized Absences. Section 2.40.080 - Holidays with Pay; Subsections A, B, C, D, E, F, G, H, K. Section 2.40.100 - Overtime Pay; Subsections A (4), B, C, D, E. ARTICLE 6 - UNION CONSTITUTION AND BYLAWS Upon request of the City Manager or his or her designee, the Union shall promptly furnish to the City Manager a current copy of the constitution, bylaws and any other rules or regulations of the Union, including any revisions thereto ARTICLE 7 - BUSINESS LEAVE 7.1 Members representing the Union, not exceeding four (4) in number, shall be paid at the applicable rate of pay for actual time spent for all meetings between the City and the Union for the purpose of negotiating wages, hours and working conditions, terms of this agreement, or for processing grievances When such meetings take place at a time during which any such members are scheduled to be on duty, they shall be granted leave from duty without any loss of pay Actual time spent for meetings shall be limited to the time spent in the meetings. 7.2 Business Leaves: Such officers and members of the Union may be designated by the Union, not to exceed four (4) in number at any one time shall be granted leave from duty with pay for Union business, such as but not limited to attending labor conventions and educational conferences, collective bargaining preparations and civil service, provided that notice of such conventions or conferences shall be requested and approved by the Department Head, and provided further that the total leave for the bargaining unit for the purpose set forth in this section shall not exceed one hundred thirty-five (135) hours in any fiscal year 7.3 Shop Stewards: Shop stewards shall be allowed up to one (1) hour per month with pay to attend shop stewards meeting(s) conducted during the steward's work shift. The number of shop stewards in the bargaining unit shall be determined by a ratio of one (1) steward per AFSCME Local 1122 —Transit / 2013 - 2015 Page 5 of 44 twenty (20) members in the bargaining unit. The Union shall keep the City notified of the current shop stewards and Local Union Officers. ARTICLE 8- EMPLOYEE RIGHTS 8.1 Personnel Files: Employees shall have the right, upon request, to inspect their personnel file. No material referring to an employee's job competence or conduct shall be placed in the file without the employee's knowledge and the opportunity to attach his or her comments. A copy of any entry pertaining to job competence or conduct will be given to the employee 8.2 Performance Evaluations: The initial discussion regarding a probationary, special or annual performance evaluation shall take place solely between an employee and his or her immediate rating supervisor. Thereafter an employee may be accompanied by a Union representative where job conduct or said performance evaluation is reviewed in a conference with management On-the-job discussions between employee(s) and supervisor(s) regarding job duties, assignments, and/or performance shall not be considered disciplinary action and shall not be subject to this provision Appeals of performance evaluations shall be made in accordance with the Charter Civil Service Commission's Rules and Regulations and shall not be subject to the grievance procedure. 8.3 Off -Duty Actions: Except as otherwise provided in state, federal, and local law, the City Charter, or the Charter Civil Service Rules and Regulations, off-duty activities of an employee shall not be cause for disciplinary action unless such activity is detrimental to the employee's performance on the job 8.4 Work Rules: A) Work rules and policy shall be posted for employees and be in writing They shall be uniformly applied When existing work rules, policy or procedure are changed or new rules or procedures established, employees whose work assignment is affected shall be notified in writing (that is circulating a memorandum) and the new rule or procedure shall be posted prominently on appropriate bulletin boards for a period of seven (7) calendar days before becoming effective, except for changes of an emergency nature. B) Employees shall comply with all existing rules that are not in conflict with the express items of this Agreement, provided that rules are uniformly applied and uniformly enforced, and provided that reasonable notice has been given of the existence of the rule. AFSCME Local 1122 —Transit / 2013 - 2015 Page 6 of 44 C) Any unresolved complaint as to the reasonableness of any new or existing rule, or any complaint involving discrimination in the application of new or existing rules shall be resolved through the grievance procedure 8.5 Safety and Health Committee: The City agrees to maintain a Safety and Health Committee in accordance with state law Such committee shall receive and investigate complaints of unsafe or unhealthy working conditions and shall recommend appropriate remedies to the City. Unresolved complaints of violations of Washington Industrial Safety and Health laws may be referred to the Washington State Department of Labor and Industries, Industrial Safety Division, for investigation 8.6 Union Participation: An employee has the right to hold Union office, seek Union assistance, file a grievance or use other benefits of this Agreement according to the terms set forth without reprisal, repression, intimidation, prejudice, or discrimination 8.7 Probationary Period: The probationary period for promotions to all bargaining unit positions shall be six (6) months Effective April 1, 2006, the probationary period for new hires to all bargaining unit positions shall be twelve (12) months, provided that probationary employees may use vacation leave and are eligible for step increases after six (6) months of employment, subject to and in accordance with all other rules, policies, the Yakima Municipal Code, and this CBA ARTICLE 9 -MANAGEMENT RIGHTS 9.1 Except as specifically abridged, granted, delegated or modified by this Agreement, including amendments, the City retains all legal and inherent exclusive rights with respect to matters of legislative and managerial policy Furthermore, the City reserves all customary management prerogatives including, but not limited to, the right to A) Establish, plan for, and direct the work force toward the organizational goals of the municipal government. B) Determine the organization, and the merits, necessity and level of activity or service provided to the public. C) Determine the City budget and financial policies including accounting procedures. D) Establish, regulate and administer a personnel system, in conformity with the City Charter and Civil Service Rules and Regulations, which provides for all AFSCME Local 1122 —Transit / 2013 - 2015 Page 7 of 44 types of personnel transactions including determining the procedures and standards for hiring, promotion, transfer, assignment, lay off, discipline, retention and classification of positions E) Discipline or discharge of employees for cause as provided by the General Rules and Regulations of the City's Charter Civil Service Commission and in conformity with this Agreement. F) Determine the methods, means, equipment, numbers and kinds of personnel, and the job or position content required to accomplish governmental operations and maintain the efficiency thereof. G) Determine and change the number and locations and types of operations, processes and materials to be used in carrying out all City functions II) Assign work to and schedule employees in accordance with Civil Service classifications and position descriptions, and to establish and change work schedules in accordance with Article 33 - Work Week Provisions I) Relieve any employees from duty due to lack of work or insufficient funds. J) Take all actions necessary to carry out the mission of the City in emergencies 9.2 The above-cited management rights are not to be interpreted as being all- inclusive, but merely indicate the type of rights which belong to the City. It is understood that any of the rights, power and authority the City had prior to the signing of this Agreement are retained by the City. 9.3 Any employee within the bargaining unit who may feel aggrieved by the unfair or discriminatory exercise of any of the Management Rights specified herein above, or any other claimed prerogative may seek their remedy by the grievance procedure provided in the Agreement ARTICLE 10 - LABOR MANAGEMENT COMMITTEE 10.1 Intent: The City and the Union shall cooperate to provide the public with efficient and courteous service, encourage good attendance of employees, and promote a climate of labor relations that will aid in achieving a high level of efficiency and productivity in all departments of City government. AFSCME Local 1122 —Transit / 2013 - 2015 Page 8 of 44 10.2 Makeup: In order to accomplish these goals, a Labor -Management Committee shall be established consisting of three (3) Union members chosen by the Union, the Union Staff Representative, the City Manager or his/her designee, and three (3) individuals selected by the City Manager 10.3 Time Frame: The Labor -Management Committee shall schedule meetings at mutually agreeable times, but not later than fifteen (15) working days from the date of a request for a meeting by a party to this Agreement Requests shall be in writing and contain the item(s) or topic(s) at issue 10.4 Agenda: At least ten (10) working days prior to the meeting, a written agenda shall be prepared by the party requesting the meeting and may be supplemented by additions made by the other party A final agenda shall be established and distributed to all parties at least three (3) working days prior to the date of the meeting Items not on the agenda shall not be discussed at the meeting unless mutually agreed by all parties. 10.5 Resolution: Should the Labor/Management process result in a proposed change in wages, hours, and working conditions, the parties may pursue amendment of this Agreement in accordance with Article 37 of this Agreement ARTICLE 11 - CONTRACTING WORK The City agrees that no permanent employee shall be laid off as a direct result of the City contracting work currently done by City Employees. The City however, retains the right to contract work as deemed desirable or necessary by the City and reassign employees who might otherwise be laid off as a result thereof The City further retains the right to lay off employees at the discretion of the City, due to lack of funds. ARTICLE 12 - STRIKES AND LOCKOUTS PROHIBITED 12.1 Strikes: The Union shall neither cause, encourage nor counsel employees within the bargaining unit to strike, nor shall it in any manner cause, encourage nor counsel any such employee or employees to directly or indirectly commit any concerted acts of work stoppage, slow -down or refusal to perform any customarily assigned duties; provided, however, in the event the laws of the State of Washington should be changed so as to allow the right to strike, or to substitute therefore any other right in its place, this AFSCME Local 1122 —Transit / 2013 - 2015 Page 9 of 44 Agreement shall be construed so as to allow the Union to exercise any such right that is hereafter provided by law or change of law, and the parties to this Agreement hereby agree to be bound by the terms of any such law or change of law 12.2 Lockouts: The City agrees that during the term of this Agreement, there will be no lockouts However, a complete or partial reduction of operations for economic or other compelling business reasons shall not be considered a lockout In addition, if an employee is unable to perform his or her duties because equipment or facilities are not available due to a strike, work stoppage or slowdown by any other employees, such inability to provide work shall not be deemed a lockout ARTICLE 13 -REDUCTION IN FORCE Any reduction in force shall be accomplished in accordance with reduction in force procedures set forth in the Charter Civil Service Rules and Regulations. In the event that it becomes necessary to amend the reduction in force procedure in the Civil Service Rules, the City and the Union shall cooperate to develop reduction in force procedures which shall be mutually acceptable for submission to the Civil Service Commission ARTICLE14 - GRIEVANCE PROCEDURE 14.1 Policy: The parties recognize that the most effective accomplishment of the work of the City requires prompt consideration and equitable adjustments of employee grievances. It is the desire of the parties to adjust grievances informally whenever possible, and both supervisors and employees are expected to make every effort to resolve problems as they arise. However, it is recognized that there may be grievances which can be resolved only after a formal review. Accordingly, the following procedure is hereby established in order that grievances of employees covered by this agreement may be resolved as fairly and expeditiously as possible. 14.2 Remedies: The Union may either grieve matters according to this Article or the Union may appeal to the City of Yakima Charter Civil Service Commission according to the Commission's Rules and Regulations. However, the Union may not exercise both approaches but must choose one or other 14.3 Definitions: A) A "grievance" is a dispute concerning the interpretation, application, or alleged violation of any provision of this Agreement. AFSCME Local 1122 —Transit / 2013 - 2015 Page 10 of 44 B) The term "employee" as used in this Article means a permanent or probationary employee who is a member in good standing of the bargaining unit or group of such employees, accompanied by a representative if so desired. C) The term "working day" as used in this Article means Monday through Friday excluding holidays. 14.4 Special Provisions: A) The aggrieved party and his or her chosen representative shall be granted time off without loss of pay for the purpose of processing a grievance in accordance with Article 7 - Business Leave of this Agreement City employees attending hearings as a witness for the aggrieved party shall be granted time off without loss of pay for the purpose of providing testimony, including Civil Service Commission meetings The aggrieved party's representative may, after making advance notification to the relevant Division Manager, visit the work location of employees covered by this Agreement for the purpose of investigating a grievance Said investigation shall be conducted so as not to disturb the work of uninvolved employees B) Grievances on behalf of one or more employees may be initiated or pursued without the employees' consent. C) A grievance may be entertained in or advanced to any step in the grievance procedure if requested by one party in writing and agreed to by the other party in writing. D) The time limits within which action must be taken or a decision made as specified in this procedure may be extended by mutual written consent of the parties involved. A statement of the duration of such extension of time must be signed by both parties involved at the step to be extended Failure of either party to meet the time limit or extended time limit for responses or appeals at any step in the process shall render the decision in favor of the other party. 14.5 Procedure: To be reviewable under this procedure, a Union grievance must be filed in writing within thirty (30) calendar days after the action or decision giving rise to the grievance and must comply with the following: A) Be filed on an AFSCME Form F-29. B) Identify the facts and circumstances relating to the alleged misapplication, misinterpretation, or violation of a specific provision of this labor agreement. C) Specify the relief sought AFSCME Local 1122 —Transit / 2013 - 2015 Page 11 of 44 14.6 Step 1 - Informal Discussion with Immediate Supervisor: Prior to filing a written grievance as described in Step 2 below, the employee shall meet with his or her immediate supervisor to discuss the subject of dispute. If the subject of dispute is discipline greater than a verbal reprimand, the employee shall skip Step 1 and proceed directly to Step 2 If the subject of dispute is the immediate supervisor, the employee shall meet with his/her Division Manager to discuss the subject of dispute. After such a meeting, the immediate supervisor or Division Manager, as the case may be, shall investigate the relevant facts and circumstances of the grievance and provide a written decision within ten (10) working days 14.7 Step 2 - Written Grievance to Division Manager: The affected employee shall pose the question of the grievance in writing to his or her Division Manager within thirty (30) calendar days of the action or decision giving rise to the grievance The Division Manager shall make a separate investigation and notify the employee in writing of his or her decision, and the reasons therefore, within fifteen (15) working days after receipt of the employee's grievance 14.8 Step 3 - Written Grievance to Department Head: If the employee is dissatisfied with the decision of his Division Manager, the employee may submit the grievance in writing to the Department Head within fifteen (15) working days after receipt of the Division Manager's decision The Department Head shall make a separate investigation and notify the employee in writing of his or her decision, and the reasons therefore, within fifteen (15) working days after receipt of the employee's grievance 14.9 Step 4 - Written Grievance to City Manager: If the employee is dissatisfied with the decision of the Department Head, the employee may obtain a review by the City Manager by submitting a written request to the City Manager within fifteen (15) working days after receipt of the Department Head's decision The City Manager or his designee shall make such investigation and shall, within fifteen (15) working days after receipt of the employee's request for review, inform the employee in writing of the City Manager's findings and decision. 14.10 Grievance Filed By the City: Any grievance by the City against the Union shall be reduced to writing and submitted, no later than thirty (30) calendar days after having been made reasonably aware of the issue, to the President of the Union Local with a copy to the Staff Representative. The Union President shall investigate the relevant facts and shall, within fifteen (15) working days, provide a written decision, and the reasons therefore If the matter is not satisfactorily settled, an appeal may be instituted as set forth in 14 11 below. AFSCME Local 1122 —Transit / 2013 - 2015 Page 12 of 44 14.11 Step 5 - Final Resolution of Grievance Disputes: Either party to this Agreement may refer unsettled grievances to Arbitration A) A request for Arbitration shall be in writing and shall be submitted to the other party not more than thirty (30) working days after the reply of the City Manager, or the Union President as applies, or their designee, unless the time shall be extended by written mutual agreement Such request shall identify the previously filed grievance which is the basis for the request for Arbitration and shall set forth the issue which the party making the request seeks to resolve. B) The Arbitrator may be selected by mutual agreement between the City Manager and the Union Alternatively, the parties may mutually request a list of eleven (11) arbitrators from Public Employment Relations Commission (PERC), American Arbitration Association (AAA), or Federal Mediation and Conciliation Services (FMCS) In the event the parties cannot agree on which agency to request a list from within fifteen (15) working days of the request for arbitration, the parties must request a list of eleven (11) arbitrators from PERC. Within a reasonable period of time from the receipt of the list the parties shall alternately strike names from the list until one (1) name remains, who shall serve as arbitrator The party to strike the first name shall be determined by a coin flip. C) The Arbitrator shall be limited to determining whether the City or the Union has violated or failed to apply properly the terms and conditions of this Agreement The Arbitrator shall have no power to destroy, change, delete from or add to the terms of this Agreement. D) PERC rules and procedures shall govern the arbitration hearing E) The parties agree that the decision of the Arbitrator shall be final and binding and implemented within thirty (30) calendar days following the rendering of the decision. F) The Arbitrator's fees and expenses, room rental, if any, and cost of the transcripts shall be shared equally by the parties. Each party shall bear the remaining costs of the preparation and presentation of its own case, including attorneys' fees, regardless of the outcome. ARTICLE 15 - SOCIAL SECURITY The City will continue to provide the employer's share of FICA (Social Security) coverage for the employees covered in the bargaining unit ARTICLE 16 - EQUAL OPPORTUNITY CLAUSE In accordance with Revised Order No 4 implementing U S Executive Order 11246, "Equal Employment Opportunity Act" of 1972 and the "Vocational Rehabilitation Act" of AFSCME Local 1122 —Transit / 2013 - 2015 Page 13 of 44 1973 as amended and implementing regulations, and the "Americans with Disabilities Act" (ADA) of 1991, it is the policy of the City of Yakima and the Union to not discriminate against any employee or applicant for employment because of race, color, religion, age, sex, national origin, marital status or disability ARTICLE 17 - SALARIES AND DEFERRED COMPENSATION 17.1 Wages: No across the board wage adjustments to the salary schedule In lieu of wage increases there will be the following: Each employee in the bargaining unit shall receive a lump sum payment, paid as a separate check from the normal payroll check $2,250.00 payment within two (2) payroll cycles after ratification by both parties, (Union members and City Council) of the proposal, A) 2014: $2,500 00 first pay cycle after January 1, 2014 B) 2015: $2,900 00 first pay cycle after January 1, 2015 17.2 Direct Deposit: The parties recognize that Direct Deposit is the most effective way of banking All employees shall be able to direct deposit at their own financial institution that offers this service 17.3 Deferred Compensation: Each bargaining unit member shall be paid, in accordance to that employee's monthly salary, deferred earned compensation each month in an amount equal to a percentage of said monthly salary as provided below. The deferred compensation contribution is separate pay and is not part of base monthly salary as codified in the Yakima Municipal Code Pay and Compensation Ordinance 2 20 11 0 This provision is subject to the City's deferred compensation rules and regulations and IRS regulations. The computation of retirement contributions and pension benefits shall be governed by application state law. A) The City will contribute three percent (3%) of each employee's base monthly salary to a deferred compensation plan. AFSCME Local 1122 —Transit / 2013 - 2015 Page 14 of 44 ARTICLE 18 - LONGEVITY 18.1 Longevity: Longevity Compensation shall be in accordance with Yakima Municipal Code Section 2.24.O10A as may be subsequently amended. A) All permanent employees shall accrue longevity as follows: Longevity Compensation Years Service Percentage of Base Pay At least 60 months and less than 120 months At least 120 months and less than 180 months At least 180 months and less than 240 months At least 240 months and less than 300 months At least 300 months or more 1 75% 3 5% 5.0% 6.5% 8 0% B) Accruals shall be prorated per month on actual hours in pay status for extra board employees ARTICLE 19 - SHIFT DIFFERENTIAL 19.1 After Hours: For employees who work a regularly scheduled shift where all or part of the shift hours fall between 6 00 p m and 6 00 a m , an additional six percent (6%) per hour over base pay will be paid for all hours worked within the stipulated period to the nearest one- half (1/2) hour. Persons working overtime past their normal shift will not be entitled to payment under this Article unless all of the scheduled hours of the second shift are worked 19.2 Split Shift: A) Transit Employees who work a split shift shall receive six percent (6%) shift differential for fifty percent (50%) of the hours worked on any split work day, up to twenty (20) hours per week. B) Transit Employees who work a five (5) day work week and have one (1) weekday off, shall receive a six percent (6%) shift differential, for twenty (20) hours a week C) Transit Employees who work a four (4) day work week and have two (2) weekdays off, shall receive a six percent (6%) shift differential, for twenty (20) hours a week AFSCME Local 1122 —Transit / 2013 - 2015 Page 15 of 44 D) Shift differential shall be limited to thirty (30) hours per week for employees who meet the requirements of (A & B) or (A & C) 19.3 Extra board transit operator: Extra board transit operators shall receive shift differential pay as follows: A) For hours worked before 6:00 a.m. and after 6:00 p.m. B) For the same hours of whoever's complete regularly scheduled full-time shift they fill C) For partial shifts pieced together, with an unpaid time lapse of thirty (30) minutes or greater shift differential shall be paid for fifty percent (50%) of the total hours worked that day, rounded up to the nearest one-half (1/2) hour. D) For all additional hours worked before or after a straight eight to eight and one-half (8.0 — 8.5) or ten to ten and one-half (10.0 to 10.25) hour shift, provided that there is an unpaid time lapse of thirty (30) minutes or greater E) When working a regularly scheduled split shift, no additional compensation shall be paid for extra hours worked during that day. ARTICLE 20- OVERTIME AND CALL OUT 20.1 Employees who are required to work more than forty (40) hours in any work week shall be paid one and one-half (1-1/2) times the regular rate of pay for credited time in excess of forty (40) hours per week Credited time shall be in fifteen (15) minute increments. However, compensatory time off at the time and one-half rate (1-1/2) in -lieu of overtime pay may be requested by the affected employee In that case, compensatory time may be taken at such time as is agreed upon by the Employer and the employee, but may not be imposed by the Employer upon any employee who has not so requested such compensatory time off 20.2 Compensatory time off may be accrued to a maximum of forty (40) hours unless the City Manager approves additional accrual because of an emergency or other unusual circumstance Provided, however, existing compensatory time in excess of forty (40) hours shall remain until used. 20.3 Employees may accept any shift(s), and or shift piece(s) of available overtime by seniority No shift shall be split more than once 20.4 Time spent by an employee beyond the normal working day for job-related training classes business and/or safety meetings approved by the Division Manager shall be considered time worked for calculation of overtime pay/compensatory time. The employee must attend the training class or safety meeting in its entirety AFSCME Local 1122 —Transit / 2013 - 2015 Page 16 of 44 20.5 Authorized travel time spent in the performance of the job shall be considered time worked for the calculation of overtime pay. 20.6 Due to the nature of work performed by bargaining unit employees, the Union and the City agree that in the event an employee works beyond his or her regular shift quitting time, that employee shall not have any meal period(s) otherwise required by law. 20.7 In the event the employee is unable to provide or obtain the meal(s) due to location or time of day or emergency, the Division Head shall ensure the employee obtains a meal at the Employer's expense 20.8 Call Out Pay: Regular Operators A) A minimum of two (2) hours pay at the time and one-half (1-1 /2) rate will be paid to an employee as follows 1. Who is requested to return to work at the completion of his or her shift while still at the work site/relief point, or, is called to return to work after leaving the work site/relief point at the completion of his or her shift after they have left the worksite, or 2. Is called to report to work prior to the start of his or her shift, or 3. Is called into work on a day off B) Call out time is counted from the time the employee begins work until the employee is released from the workplace. Any time worked in excess of the two (2) hours shall be paid at the time and one half rate (1-1/2) C) Establishing a one hour business meeting on a monthly basis with the employees — it will be an hour of meeting for one hour's pay. Also, this is not a mandatory meeting The agenda will be developed by both sides and if there are not enough discussion items to fill the hour, the meeting will be cancelled This meeting will be held only on the months there is no quarterly meeting. The time and day will be determined at a later date to allow maximum participation 20.9 Dispatcher Overtime: Permanent Dispatchers shall be offered any available overtime on a seniority basis among the permanent Dispatchers If the permanent Dispatchers are not available to work overtime, the work will be offered to other qualified permanent employees on a seniority basis AFSCME Local 1122 —Transit / 2013 - 2015 Page 17 of 44 20.10 Extra board transit operator Overtime: An Extra board transit operator will be eligible to receive overtime payments in accordance with Article 20 — Overtime & Call Out if they work more than forty (40) hours in any work week No overtime compensation will be paid to an employee who exceeds the regularly scheduled work day unless such work causes the employee to work more than forty (40) hours in the work week, including j ob-related training classes, business and/or safety meetings approved by the Division Manager The employee must attend the training class or safety meeting in its entirety. ARTICLE 21 - STANDBY PAY 21.1 The determination of the need for an assignment of standby time is a responsibility of Management. Employees will have the opportunity to volunteer or exchange for standby prior to being made a required assignment. The employee must notify their supervisor in writing by the end of the previous shift of an exchange with another employee for assigned standby. 21.2 Compensation for assigned standby time will be four dollars ($4.00) per hour. 21.3 Employees on assigned standby time are required to maintain the same physical and mental capacity that is required during regular scheduled work hours and are to be reachable if called. ARTICLE 22 - BILINGUAL PAY Employees who have Spanish bilingual capacity shall receive sixty dollars ($60.00) per month for their work in that capacity subject to prior written approval from the Director of Public Works and subject to achieving a passing score on the bilingual skills examination conducted under the Charter Civil Service Rules and Regulations and administered by the Civil Service Chief Examiner. The Chief Examiner may waive this testing requirement if the employee can demonstrate to the satisfaction of the Chief Examiner, through documentation (i e court interpreter certification from the State of Washington) that the employee has sufficient bilingual skills in the Spanish language. ARTICLE 23 - HEALTH CARE 23.1 Availability: Employees shall participate in the City of Yakima Employees' Health Care Plan. Eligible dependents and retirees may also participate in the Plan. Eligibility rules, types and levels of benefits, payment of premiums through a cafeteria plan, co -payments, co- insurance and deductibility requirements and all other terms and conditions for the provision of these health benefits shall be governed by the City of AFSCME Local 1122 —Transit / 2013 - 2015 Page 18 of 44 Yakima Employees' Welfare Benefit Program. Premium base rates shall be determined annually by the applicable broker of record. 23.2 Employee Only Medical/Vision Coverage: The City shall pay one hundred percent (100%) of monthly employee only medical/vision premiums. 23.3 Dependent Medical/Vision Coverage: A) Effective January 1, 2013: For employees who enroll one or more dependents in the healthcare plans, the monthly dependent unit premium costs shall be capped at $175 00 B) Effective January 1, 2014: For employees who enroll one or more dependents in the healthcare plans, the monthly dependent unit premium costs shall be borne as follows: 1. Fifty percent (50%) shall be paid by the participating employee 2. Fifty percent (50%) shall be paid by the City. Any increase or decrease in the total premium cost in 2014 over 2013 levels and in 2015 over 2014 levels to be shared between the employer and employee on a fifty-fifty percent (50/50%) basis for all benefit categories except employee only, which will remain fully covered by the employer. 23.4 Dental Insurance Coverage: The City shall pay the premium for employee and dependent family dental insurance 23.5 Retiree Coverage: A) Upon payment of the full premium as required in 23.5(D), herein, retirees may elect to remain in the group health care plan until they reach age 65 B) Spouses of retirees may remain in the group health care plan until they reach age 65 or, in the case of spouses of deceased retirees, until they reach age 65 or remarry, whichever occurs first. C) Other dependents of retirees may remain in the group health care plan as long as they remain eligible under the provisions of the plan and until coverage for the retiree and spouse, or, the spouse of a deceased retiree terminates, at which time such dependent insurance coverage ceases regardless of the age of the dependents D) Retirees, or spouses of deceased retirees, shall pay the full premium (including dependents if enrolled) which shall be the same as the normal group rate assessed for coverage of active City employees and dependents as AFSCME Local 1122 —Transit / 2013 - 2015 Page 19 of 44 applicable. Premiums shall be paid by deduction from retirement checks paid to retired employees or their beneficiary. 23.6 Wellness Committee: A representative from this bargaining unit will be appointed to the Wellness Committee The Committee will discuss such topics as heart life programs and physical exam coverage 23.7 Employee Welfare Benefit Board: A) The Union will select voting and non-voting members to serve on the City of Yakima Employees' Welfare Benefit Board (hereinafter referred to as the Board) according to Article III of the City of Yakima Employees' Welfare Benefit Program. B) The purpose of the Board shall be to study and become informed regarding health insurance programs including the City's modified self-funded program; to identify perceived and real problems, and make recommendations to the City and the Union on ways to improve and enhance in an economical fashion the health insurance program C) To enable the Board to become knowledgeable and to make reasonable and objective recommendations for change, the City agrees to the following: 1. The City will provide complete and open disclosure of information necessary for the Board to complete its duties within the confines of the law and concerns for medical confidentiality 2. Any member(s) of the Board who for any reason steps down as a Board member, shall be replaced by the selection process outlined in Article III of the City of Yakima Employees' Welfare Benefit Program 23.8 Right of Withdrawal: The Union shall continue to have the right to withdraw from the City of Yakima Employees' Welfare Benefit Program by notifying the City in writing six (6) months in advance ARTICLE 24 - HEALTH HAZARD INOCULATIONS & CERTIFICATIONS 24.1 For employees who are exposed to health hazards by direct contact with raw sewage, industrial waste, human waste, or animal waste, the City will arrange and provide for inoculations or vaccines recommended by the Washington State Department of Health AFSCME Local 1122 —Transit / 2013 - 2015 Page 20 of 44 24.2 The City of Yakima will pay required fees for any license/certificate required by the City as a condition of continued employment, provided however, that reinstatement costs that are the employee's fault shall be paid by that employee. A) Employees may elect to renew their Commercial Drivers License (CDL) medical certification through their regular attending physician at their own expense or at the medical clinic authorized by the City at the City's expense B) The employee will sign a waiver agreeing to hold the City harmless to liability if they purposely misrepresent or do not accurately disclose medical conditions to their physician during the CDL medical certification process The employee and physician waivers are incorporated into this Agreement as Appendix A. 24.3 As part of the City's Wellness Program and the City's encouragement of good health practices, the City will reimburse the employee for the co -payments related to an annual preventative physical exam up to one hundred dollars ($100.00) per employee. 24.4 Bargaining unit members may be reimbursed up to $100 00 per year for work - appropriate footwear purchased through an approved vendor ARTICLE 25 - LIFE INSURANCE 25.1 The City shall provide life insurance for bargaining unit members with a face value of One Hundred Thousand Dollars ($100,000) per member The life insurance premium shall be paid in full by the City • The amount of Life and Accidental Death and Dismemberment Insurance reduces to sixty-five percent (65%) when you reach age 65, to fifty percent (50%) when you reach age 70 and to thirty-five percent (35%) when you reach age 75 25.2 Retiree Life Insurance: Upon retirement, retirees may elect to continue their participation in the life insurance coverage through a conversion policy The conversion coverage policy requires that retired employees pay their own premium for said coverage AFSCME Local 1122 —Transit / 2013 - 2015 Page 21 of 44 ARTICLE 26 - HOLIDAYS 26.1 Annual Holidays: The following shall be recognized and observed as paid holidays: New Year's Day January 1 Martin Luther King, Jr Day 3rd Monday in January Presidents' Day 3rd Monday in February Memorial Day Last Monday in May Independence Day July 4th Labor Day 1st Monday in September Veterans' Day November 1 lth Thanksgiving Day 4th Thursday in November Day after Thanksgiving Day 4th Friday in November Christmas Day December 25th 26.2 Personal Holiday: Permanent employees shall be entitled to eight (8) hours of personal holiday per calendar year Employees who work a 4/10 schedule shall be entitled to ten (1 0) hours of personal holiday per calendar year Both are subject to the following conditions Personal holiday shall be limited to eight (8) hours for employees who work more than eight (8) hours but less than a ten (10) hour shift, subject to the following conditions: A) The employee has been or is scheduled to be continuously employed by the City for more than six (6) months, and B) The employee has given not less than fourteen (14) calendar days of written notice to the Division Manager, provided however, the employee and the Division manager, or their designee, may agree on an earlier day, and C) The Division Manager or their designee, has approved the day, and D) The day selected does not prevent the Transit Division from providing continued public service and does not interfere with the efficient operation of the Transit Division, and E) The personal day must be taken during the calendar year of entitlement or the day will lapse except when an employee has requested a personal holiday and the request has been denied. F) Personal holiday must be used in its entirety in one single use and may not be broken into less than an eight (8) or ten (10) hour complete shift. 26.3 General Holiday: A) Whenever any holiday specified by State Law falls on Saturday, the preceding Friday shall be the holiday Employees who work Friday in such case shall be paid AFSCME Local 1122 —Transit / 2013 - 2015 Page 22 of 44 according to City Code Section 2.40.080, Subsection E. Whenever any holiday specified by State law falls on Sunday, the following Monday shall be the holiday. Employees who work Monday in such case shall be paid according to City Code Section 2 40 080, Subsection E B) Whenever a holiday falls on a Saturday, the holiday shall be observed Saturday or if a holiday falls on Sunday, the holiday shall be observed Sunday for those employees regularly scheduled to work on Saturday or Sunday. C) Full-time employees whose regularly scheduled Friday and/or Saturday shifts are pre-empted due to no holiday service and/or reduced holiday service shall be compensated at pay code 10 for Friday and pay code 77 for Saturday D) If a holiday falls on a normal day off, equivalent hours off will be granted to be scheduled within sixty (60) days of the holiday an employee's in -lieu account. E) Holiday hours will be offered by seniority as defined in Article 31 - Seniority, to permanent employees, prior to offering the open holiday work to temporary employees, and F) Time and one-half (1-1 /2) will be paid for the hours worked on a holiday in addition to the employee's rate of pay. At the employee's option, the premium holiday pay shall be received or the employee may be paid at straight time with the equivalent of one and one-half (1-1/2) days being granted off within sixty (60) days. Hours of holiday compensatory time earned for every hour worked, if, provided that on the day of the holiday the employee's compensatory time does not exceed forty (40) hours, then all hours of holiday compensatory time may be earned as compensatory time If the employee's compensatory time account exceeds forty (40) hours, the holiday hours worked must be taken as overtime pay. If not specified here the general holiday agreement applies. G) Employees working a 4 day/10 hour schedule shall earn ten (10) hours credit per holiday. All other provisions of this Article will continue to apply. ARTICLE 27 - VACATION Employees shall be granted annual vacation pursuant to the following conditions 27.1 All full time employees shall accrue vacation with pay as follows: YEARS OF SERVICE After one (1) full year After two (2) full years After five (5) full years ACCRUAL RATES 7.34 hours per month (88 hours per year; 40 hours may be taken after 6 months) 8.67 hours per month (104 hours per year) 10.67 hours per month (128 hours per year) AFSCME Local 1122 —Transit / 2013 - 2015 Page 23 of 44 After ten (10) full years 13.34 hours per month (160 hours per year) After fifteen (15) full years 15.34 hours per month (184 hours per year) After twenty (20) full years 19.34 hours per month (232 hours per year) Vacation accruals for on board employees will be prorated based on the difference between the total number of actual hours in pay status in the previous month versus the total number of hours available to work in the previous month. Accruals shall be adjusted monthly. 27.2 Employees shall be allowed to accrue a total amount of vacation time equal to the amount which can be earned in two years. 27.3 Employees who become ill while on approved vacation may utilize sick leave for the period of illness subject to the provisions of Article 28 - Sick Leave, Section 28 3 and 28 4 and provided the employee immediately upon becoming ill notifies the Division Manager and, upon return to work, presents the Division Manager with a physician's certificate stating the nature of the illness and the length of the incapacity. 27.4 Vacation leave cannot be used during the month of accrual. A minimum of one point seven five (1 75) hours of vacation time must be requested 27.5 Vacation Sell -Back Program: Employer implemented vacation sell -back program where an employee could sell back to the City up to one-third (1/3) of their accrued vacation leave within a twelve (12) month period (based on a calendar year ) EXAMPLE: A ten year employee accrues 13 67 hours per month at 165 hours per year 165 hours of vacation leave at 1/3 (.333) would equal 55 hours of vacation time payable to the employee at their current hourly rate. ARTICLE 28 - SICK LEAVE 28.1 Accrual: Sick leave with pay is maintained as an insurance program for salary continuation during periods of illness, and particularly extended illness as follows: A) All full-time employees shall accrue sick leave with pay at the rate of eight (8) hours per month for each full calendar month of the eligible employee's continuous service with the City. Said accrual shall be prorated for on board employees AFSCME Local 1122 —Transit / 2013 - 2015 Page 24 of 44 28.2 Vacation leave cannot be used during the month of accrual. A) A minimum of one point seven five (1.75) hours of vacation time must be requested. 28.3 Permissible Use of A Sick Leave: An employee eligible for sick leave with pay shall be granted such leave for the following reasons A) Personal illness or physical incapacity resulting from causes beyond employee's control B) Verifiable visits by the employee and the employee's dependents enrolled in the City of Yakima Employees' Health Care Plan to a physician or dentist for examination and/or treatment C) Quarantine of employee due to exposure to a contagious disease. D) On the Job Injuries: The sick leave buy back program for work related injuries is eliminated and time loss compensation will be paid in accordance with City of Yakima Administrative Policy PER 405 and in compliance with State of Washington Labor and Industries industrial insurance laws A member who is receiving industrial insurance benefits and whose authorized leave of absence for the injury exceeds 12 -weeks covered by the Federal Family and Medical Leave Act shall be required to pay only the employee's portion of the health insurance premium for an additional 12 - week period. At the end of the second 12 -week period and if the employee has not returned to work, the employee shall be required to pay for both the employee and the City's portions of the applicable health insurance premium E) To care for a child of the employee with a health condition that requires treatment, transportation, or supervision; "Child" as used herein means a biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in the place of a parent ("in loco parentis" as legally defined) who is (a) under 18 years of age or (b) 18 or older and incapable of self-care because of a mental or physical disability. F) To care for a spouse, parent, parent -in-law, or grandparent of an employee who has a serious health condition or an emergency condition. "Parent" as used herein includes an individual who stood in the place of a parent ("in loco parentis" as legally defined) to an employee when the employee was a child. AFSCME Local 1122 —Transit / 2013 - 2015 Page 25 of 44 G) For bereavement leave as provided in Article 30 - Bereavement Leave of this Agreement. II) For serious injury or illness to other members of employee's immediate family constituting an emergency or crisis, provided the employee is engaged in care/treatment, transportation, and/or supervision of the affected individual The term "Immediate Family" means 1. Spouse, children, children of spouse, spouse of children, 2. Step or foster family relationship; 3. Mother, father, brother, sister of employee or spouse; 4. Grandparent or grandchild of employee or spouse; 5. Aunt or uncle of employee or spouse. 6. Any person living in the Immediate Household* of the employee 7. In cases where an employee is responsible for funeral arrangements, sick leave will be granted. I) Employees who have exhausted all accumulated sick leave may use accumulated vacation leave, compensatory time, in lieu time, or their personal holiday in lieu of sick leave subject to the requirements of all other provisions of this Agreement (contract) * Members of the Immediate Household means persons who reside in the same home, who have reciprocal and natural and/or moral duties to and do provide support for one another. The term does not include persons sharing the same general house when the living style is primarily that of a dormitory or commune. 28.4 Requirements for All Paid Sick Leave: A) Absence Reported: Employees must report to the representative designated by their Division Manager the reason for their absence as far in advance of the starting of their scheduled work day as possible. This report shall be made no later than five (5) minutes after the scheduled report time B) Incidents Greater Than Three Days: Employees must keep their Division Manager informed of their condition if their absence is of more than three (3) consecutive working days in duration C) Physician's Statement: A statement by an employee's attending physician may be required if an AFSCME Local 1122 —Transit / 2013 - 2015 Page 26 of 44 absence caused by illness or injury extends beyond three (3) consecutive working days, or for each absence, if requested by the Division Manager. If a physician's statement is to be requested by the Division Manager, the employee shall be so notified before his or her return to work D) Home Visits: Employees may choose to permit home visits. E) Medical Examinations: Employees must permit medical examinations as designated by the City, at the expense of the City, and at the mutual convenience of the City and the employee 28.5 Enforcement of Sick Leave Provisions: A) Failure to Comply: Any failure to comply with the provisions of Article 28 - Sick Leave shall be grounds for denial of sick leave with pay or other paid leave taken in lieu of sick leave for the period of absence. B) Disciplinary Action: Misrepresentation of any material fact in connection with paid sick leave or other paid leave taken in lieu of sick leave by an employee shall constitute grounds for disciplinary action. C) Oversight: It shall be the responsibility of the Department Head or his/her designated representative to 1. Review all sick leave or other paid leave taken in lieu of sick leave and approve that which complies with the provisions of this Section and forward approved time cards to the Finance Department. The Payroll Officer shall not certify the payment of sick leave or other paid leave taken in lieu of sick leave until the approved applications have been received, except that employees still absent at the end of a pay period may be certified for payment of sick leave or other paid leave taken in lieu of sick leave by the Payroll Officer upon recommendation of the Department Head as indicated by their signing the time sheet and subject to the receipt of an approved application for sick leave pay or other paid leave taken in lieu of sick leave immediately upon the employee's return to work; 2. Investigate any suspected abuse of sick leave or other paid leave taken in lieu of sick leave; 3. Withhold approval of sick leave pay or pay for other leave taken in AFSCME Local 1122 —Transit / 2013 - 2015 Page 27 of 44 lieu of sick leave in the event of unauthorized use; 4. Initiate disciplinary action if, as a result of investigation, it is determined that an employee has been guilty of willful misrepresentation in a request for sick leave pay or other pay taken in lieu of sick leave pay D) Unscheduled Sick Leave: 1. An unscheduled sick leave incident shall be defined as any continuous period of absence due to illness or injury One absence equals one incident regardless of the length of time of absence Any sick leave incident in which the employee submits a statement from a health care provider verifying the illness or injury of themselves or a family member(s) shall be considered a scheduled absence 2. Permanent employees shall not exceed twelve (12) incidents of unscheduled sick leave in a calendar year. Exceeding twelve (12) incidents may be cause for discipline 28.6 Sick Leave Exchange: Any permanent employee may exchange accrued sick leave for pay or for additional leave time as appropriate, in accordance with the options provided the employee, subject to the following provisions: A) Upon Retirement or Death: Upon retirement or death the employee's accrued sick leave up to and including 840 hours will be exchanged for pay at the rate of 100% of the employee's current base pay The maximum payment shall be $16,500 B) Upon Termination - Up to 719.99 Hours: Upon termination under honorable conditions, as distinct from retirement or death, the employee's accrued sick leave up to and including 719.99 hours or less will be exchanged for pay at the rate of 25% of the employee's current base pay. Honorable termination includes layoff for budget reasons, as well as resignation with at least fourteen (14) calendar days notice The maximum payment shall be $7,500. C) Upon Termination - 720 Hours or More: Upon termination under honorable conditions, as distinct from retirement or death, employees who have accrued sick leave of 720 hours or more will be exchanged for pay at the rate of 50% of the employee's current base pay, up to AFSCME Local 1122 —Transit / 2013 - 2015 Page 28 of 44 a maximum of and including 840 hours. Honorable termination includes layoff for budget reasons, as well as resignation with at least fourteen (14) calendar days notice The maximum payment shall be $7,500 D) Additional Vacation Days: Employees who have accrued 720 hours or more of sick leave may exchange such sick leave for bonus (additional) leave days at the rate of 32 hours of sick leave for each additional eight (8) hours of leave, not to exceed a total of 40 added leave hours annually, utilization of which would be subject to the scheduling and approval by the Department Head. No request to exchange sick leave for vacation will be granted for less than thirty-two (32) hours of sick leave or eight (8) hours of pay. E) Sick Leave Exchange Procedure: Any permanent employee may exchange accrued sick leave as provided above, subject to the following conditions and provisions: 1. A request for such an exchange shall be made to the Finance Director All requests shall be in writing and shall be signed by the employee making the request 2. Requests will be accepted only during the first five (5) working days of each month with exchanged leave to be available within fifteen (15) calendar days of the date the request is received by the office of the Finance Director. Exceptions to the above will be made for termination, layoff or disability retirement 3. No exchange will be granted to an employee who has been terminated for cause. 4. In the event of layoff, exchange requests are the responsibility of the employee ARTICLE 29 - MATERNITY LEAVE Pregnancy will be treated in accordance with the law. ARTICLE 30 - BEREAVEMENT LEAVE 30.1 Employees shall be granted up to and including three (3) days Bereavement Leave in the event of a death in the immediate family of the employee. Employees shall discuss the duration of the leave with the Transit Manager or his/her designee at the onset of the leave AFSCME Local 1122 —Transit / 2013 - 2015 Page 29 of 44 A) The term "immediate family" means: 1. Spouse, children, children of spouse, spouse of children; 2. Step or foster family relationship; 3. Mother, father, brother, sister of employee or spouse; 4. Grandparent or grandchild of employee or spouse; 5. Aunt or uncle of employee or spouse 6. Any person living in the Immediate Household* of the employee. 7. In cases where an employee is responsible for funeral arrangements bereavement leave will be granted B) The employee shall upon returning to work provide written documentation of the death of the immediate family member before bereavement leave shall be paid. This requirement may be waived by the Transit Manager or his designee. * Members of the Immediate Household means persons who reside in the same home, who have reciprocal and natural and/or moral duties to and do provide support for one another. The term does not include persons sharing the same general house when the living style is primarily that of a dormitory or commune. ARTICLE 31 - SENIORITY 31.1 Transit Seniority Defined: Transit Seniority is defined as the length of time accrued in a permanent non- exempt Civil Service Transit Classification position, subject to the provisions contained in this Article. Seniority shall be recorded as follows: years; days; hours; and minutes. 31.2 Transit Seniority Provisions: A) Transit Seniority shall begin on the actual date of hire in a permanent classified Transit status including the probationary period. B) Transit Seniority for on-call and seasonal positions shall only include the actual time accrued in a pay status C) Transit Seniority shall continue from one (1) classified Transit position to another classified Transit position through transfer or promotion D) Any and all time in a leave without pay status which is not both pre -requested and pre -approved shall be excluded from Transit Seniority E) Any and all time in a leave without pay status, which resulted from the employee's failure to maintain the minimum qualifications of the position, shall be excluded from Transit Seniority AFSCME Local 1122 —Transit / 2013 - 2015 Page 30 of 44 F) Any and all time on suspension due to a sustained disciplinary action shall be excluded from Transit Seniority G) Employees who are separated from service due to a reduction in force shall retain the Transit Seniority they held upon separation, however, no additional Transit Seniority shall accrue during the period of separation should rehire occur. 11) All Transit Seniority shall lapse and become void upon the expiration of the re-employment/recall period, resignation, termination for cause, or abandonment of position 31.3 Seniority Application: Transit Seniority shall be applied to all matters of work assignments City of Yakima Civil Service Seniority shall be applied to all matters of reductions in force. 31.4 Seniority Records: A) The Operations Supervisor with the support of the Human Resources Division shall maintain a current record of individual Transit Seniority for each employee in the Transit Bargaining Unit. B) The individual Transit Seniority records shall be adjusted to reflect any periods of exclusion from seniority, with written notification to the negatively affected employees. C) The City shall compile from the individual records a single descending rank order list of employees from the greatest Transit Seniority to the least seniority. The list will be available to the Union upon request. D) The single list of Transit Seniority shall be updated prior to and posted with any and all sign-up bids and markdown bids E) Current copies of the Transit Seniority list shall be maintained by the Transit Division and the Human Resources Division The City of Yakima Charter Civil Service Commission's Seniority list will be available from the Human Resource Manager upon request. 31.5 Separability Of Service Length: This Article sets specific parameters on the length of service for purposes of rank order for the classified employees It is not the intent of this Article to alter the individual length of continuous, uninterrupted service with the City which may include temporary and/or exempt service that the employee's vacation, sick leave, longevity, retirement, and holiday adjustments are based on AFSCME Local 1122 —Transit / 2013 - 2015 Page 31 of 44 ARTICLE 32 -CHANGE OF WORK STATUS 32.1 Transit seniority as defined in Article 31 - Seniority shall govern the bidding for full or part time regular and Extra board transit operators status of quarterly sign ups, run selection, shifts, and workweek selection by permanent full time and permanent part- time regular and extra board transit operators. All permanent regular Transit Operators shall bid on all scheduled runs and/or shifts by seniority 32.2 To facilitate payroll operations, regular and Extra board transit operators will simultaneously bid for their full or part-time status at the same time as they bid their work schedules 32.3 Work schedule bidding shall be completed within a total time period of eighteen (18) working days. ARTICLE 33 -WORK WEEK PROVISIONS Employees shall be scheduled to work regular hours for each work day and each work week in accordance with the provisions established below The City will grant time off work for a minimum of five (5) Operators per weekday, excluding sick leave and operators who are physically unable to perform their work duties. Management shall determine the maximum number of employees off per day. Employees' schedules will conform to the provisions of this Article unless specifically modified by an Addendum to this contract If the current ratio of permanent full-time to permanent part-time regular operators to Extra board transit operators changes due to significant modifications of service, this article may be renegotiated in accordance to Article 37 2 (Entire Agreement). 33.1 Meal and Rest Periods for Transit Operators: A) Time recovery layovers shall not be considered in calculating rest period compensation B) All straight, eight (8.0) hour or more shifts shall include a total of thirty (30) minutes of non -service rest period compensation C) Straight shifts shall be considered as split shifts when filled by more than one (1) employee and Section D below shall apply. D) All split, eight hour (8 0) hour or more shifts shall include fifteen (15) minutes of non -service rest period compensation within each shift pieces. One (1) fifteen (15) minute rest compensation period shall be before and one (1) rest compensation period shall be after the shift split granted for each three and three-quarter (3 75) hours of paid time AFSCME Local 1122 —Transit / 2013 - 2015 Page 32 of 44 E) All open work and special operations work shall include fifteen (15) minutes of non -service rest period compensation within each four (4) hour period of work F) Due to the nature of work performed by bargaining unit employees, the Union and the City agree that employees shall not have any meal period(s) otherwise required by law 33.2 Transit Dispatchers: A) Regular Hours: The Employer shall establish each work schedule which shall provide for regular starting and quitting times for each work day. B) Work Day: Employees will be scheduled to a work day of eight (8 0) consecutive hours within a twenty-four (24) hour period C) Work Week: The work week shall start on Monday and end on Sunday. It shall consist of four (4) or five (5) consecutive days, with two (2) or three (3) days off. D) Shifts: Shifts shall be assigned by mutual agreement of the Dispatchers; however, seniority bid shall prevail where a consensus agreement cannot be reached. E) Working Out Of Classification: Dispatchers may stand in for Transit Operators in limited emergency situations and break periods F) Uniforms: The Employer shall provide uniforms for each Dispatcher commensurate with current Transit Division standard issue. 33.3 Service Workers: A) Regular Hours: The Employer shall establish each work schedule which shall provide for regular starting and quitting times for each work day. AFSCME Local 1122 —Transit / 2013 - 2015 Page 33 of 44 B) Work Day: Employees will be scheduled to a work day of eight (8) or ten (10) consecutive hours with a one-half (1/2) hour unpaid meal period within a twenty-four (24) hour period C) Work Week: The work week shall start on Monday, end on Sunday, and shall consist of four (4) or five (5) consecutive days, with two (2) or three (3) days off D) Uniforms: The Employer shall provide service worker(s) with clean uniforms daily E) Foul Weather Gear: The Employer shall provide foul weather gear such as, but not limited to, coats, boots, and gloves for the Service Worker(s). 33.4 Vehicle Cleaners: A) Regular Hours: The employer shall establish each work schedule which shall provide for regular starting and quitting times for each work day. B) Work Day: Employees will be scheduled to a work day of six (6) or more hours with a one-half (1/2) hour unpaid meal period within a twenty-four (24) hour period C) Work Week: The work week shall start on Monday, end on Sunday, and shall consist of four (4) or five (5) consecutive days, with two (2) or three (3) days off. D) Uniforms: The employer shall provide vehicle cleaners with clean uniforms daily 33.5 Marketing and Program Administrator, Transit Project Planner, and Transit Office Assistant DA II: A) Regular Hours: These employees may or may not have regularly scheduled work hours B) Work Day: Eight (8) or ten (10) consecutive hours with a one (1) hour unpaid meal period within a twenty-four (24) period AFSCME Local 1122 —Transit / 2013 - 2015 Page 34 of 44 C) Work Week: The work week shall start on Monday, end on Sunday, and shall consist of four(4) or five (5) consecutive days, with two (2) or three (3) days off. 33.6 Route Supervisor: A) Regular Hours: These employees may or may not have regularly scheduled work hours. B) Work Day: Eight (8) hours or ten (10) hours within a twenty-four (24) hour period. C). Work Week: The work week shall start on Monday, end on Sunday, and shall consist of four (4) or five (5) consecutive or non-consecutive days, with two (2) or three (3) days off. D) Uniforms: The Employer shall provide uniforms for each Route Supervisor commensurate with current Transit Division standard issue. 33.7 Regular Transit Operators: A) Regular Hours: The Employer shall establish each work schedule which shall provide for regular starting and quitting times for each work day B) Work Day: Employees will be scheduled to a work day of (8.0 to 8.5) or (10.0 to 10.25) hours in a consecutive or non consecutive hours within a twenty-four (24) period C) Work Week: The work week shall start on Monday and end on Sunday; and shall consist of five (5) consecutive or non consecutive (8.0 to 8.5) hour days, with two (2) days off or four (4) consecutive or non consecutive (10 0 to 10 25) hour days with three (3) days off D) Uniforms: The Employer shall provide uniforms for each regular Transit Operator commensurate with current Transit Division standard issue AFSCME Local 1122 —Transit / 2013 - 2015 Page 35 of 44 33.8 Extra Board Transit Operators: A) Extra board transit operators Scheduled Work: It is recognized and expected that an extra board transit operator may be assigned work to fill in while regular transit operators are absent due to vacation, illness, or other cause, which may preclude the assignment of a specific work schedule and therefore they may not be considered to have a regularly scheduled work shift In the event they have a regularly scheduled work shift, the following shall apply: 1. Scheduled Regular Hours: The Employer shall establish each work schedule, which shall provide for regular starting and quitting time for each work day. 2. Scheduled Work Day: Extra board transit operator runs shall consist of a work day of (10 25) hours or less and may be for consecutive or non consecutive hours 3. Scheduled Work Week: The work week shall start on Monday and end on Sunday and shall consist of up to five (5) consecutive or non consecutive work days The scheduled work week shall be scheduled to meet the needs of the Transit Division. Whenever possible, Extra board transit operators shall be assigned to a specific work schedule not requiring split days off in a calendar week B) Extra Board Transit Operators Open Work: 1. Open Regular Hours: The Employer shall establish each work assignment which shall provide for regular starting and quitting times for each work day Open work will be offered daily by seniority 2. Open Work Day: Known Leave Assignment, Previous Day Before 2 OOp m I. Full Shifts: (a) Extra board transit operator may accept by seniority any full shift that is available (b) Once an Extra board transit operator accepts a full shift of eight (8.0) or more hours, no extra hours will be offered that day until all less senior operators have been offered a work assignment. AFSCME Local 1122 —Transit / 2013 - 2015 Page 36 of 44 II. Pieces of Open Work: (a) An Extra board transit operator may by seniority accept to choose a shift piece(s) of available open work. Open pieces of work that do not conflict may be combined to exceed 10 hours each workday A shift piece may be split only when needed to reach 40 hours for the week. (b) No piece of work will be split that does not leave at least two (2) hours available for another operator to work (c) In case of a piece of work getting assigned to two (2) operators in error, the regular operator will take the run and the extra board operator will have one of the two below listed options • Assigned other work to perform equal to the original hours for said day, or, • Perform a two (2) hour assignment and will have the first choice of any other work that becomes available during said day III. Scheduled Assignments Less Than 8.0 Hours: An Extra board transit operator who has a regularly scheduled bid shift of less than 8 0 hours, may accept extra work that does not conflict which may be combined not to exceed ten and one- quarter (10.25) hours for that workday. IV. Extra Hours: When all available Extra board transit operators have been offered a work assignment and there is still open work, the most senior available operator will be offered extra hours that could cause them to work more than 10.25 hours in a workday. V. If an employee fails to contact dispatch (and could have had an assignment) or decides to pass up a full shift, they will rotate to the least senior bidding position for the next day's "same day" assignments 3. Same Day Work Assignment: I. Work becoming available after 2:00 p.m. the previous day and/or piece(s) remaining from the previous night's assignments II. Work is offered by following the same guidelines outlined in 2) above to the most senior available employee who can work the AFSCME Local 1122 —Transit / 2013 - 2015 Page 37 of 44 shift(s) or piece(s) without loss of service. An employee who passes up work shall rotate to the least senior bid position. III. Open work that is offered to a temporary employee shall be split to accommodate an extra board transit operator who may be available to work a portion of that shift. 4. Open Work Week: Any open work will be split as necessary on the day of the week in which the employee's cumulative hours total forty (40) hours (or as near 40 hours as possible) without leaving a remaining open work piece of less than two (2) hours. C) Call To Report: When called to fill open work the following shall apply: 1. Accepted work report time is one (1) hour from acceptance, and regular report rules apply. 2. Arrival within the first one-half (1/2) hour after the shift starts will be paid from the start of the shift. 3. Arrival after the first one-half (1/2) hour from the shift start time will be paid in quarter (1/4) hour increments rounded to the previous quarter (1/4) hour 4. All extra board operators must submit a leave request for the day(s) they wish not to be available (N/A). Standard leave request procedures will be followed D) Working over 40 Hours: An extra board transit operator may be assigned a full shift or complete shift piece that causes their accumulative weekly total to exceed 40 hours for the week Such assignment shall not exceed three-quarters (0 75) hours of overtime Such assignment will be offered only if no other combination of shifts are available to be worked that would give exactly 40 hours for the week. E) Uniforms: The Employer shall provide uniforms for each extra board transit operator commensurate with current Transit Division standard issue. 33.9 On Call Employees: On Call Employees will not be scheduled for a regular set shift, but rather, will be called to work to fill in during the absence of another employee. On call employees AFSCME Local 1122 —Transit / 2013 - 2015 Page 38 of 44 will be entitled to the meal and rest periods provided for in the scheduled shift for which they are filling in. 33.10 Minimum and Maximum Shift: No employee will be scheduled to a regular shift of less than two (2) consecutive hours No employee shall be scheduled to a regular shift of greater than ten point -two - five (10 25) hours 33.11 Work Schedule Changes: Any overall, long term change in work schedules will be discussed between the Employer and the Union prior to implementation. The Employer may change the regular starting and quitting times and the days worked in a week with five (5) work days notice prior to the effective date of the new schedule The five (5) work day notice may be waived upon written mutual agreement between Management and the Union. Although reasonable warning will be given whenever possible, the five (5) work day notice provision will not be required for temporary individual shift assignment changes which may be made only to cover for the absences of another employee due to termination, resignation, vacations, or sick leave Other than the reasons cited above, an employee's work shift shall not be changed to avoid payment of overtime when an employee is called to work outside that employee's regular work shift or called to work before the regular staring time or retained to work beyond the regular quitting time. 33.12 Emergency Situations: The Employer shall determine when an emergency situation exists and an emergency shall be defined as a sudden, unexpected event which creates a situation endangering the public or employees' health and/or safety. In the case of emergencies, management may make schedule changes as required to protect the public or employees without discussion with the Union or notice to the employees. However, management will endeavor to preserve employee work schedules whenever possible 33.13 Addenda Procedures: Recognizing the diversity of the work force in the Bargaining Unit, the Union and the Employer agree that other work week provisions may, from time to time, be required for various groups of employees It is therefore, agreed that alternative work week provisions may be adopted. These alternative provisions will be adopted as written Addenda to this contract and will require approval of the City and the Union and a majority of the employees covered by the Addenda AFSCME Local 1122 —Transit / 2013 - 2015 Page 39 of 44 ARTICLE 34 - EXTRA BOARD TRANSIT OPERATOR 34.1 Telephone: Extra board transit operator may, as a condition of their employment, be required to have a telephone in their personal residence so that they may be notified if they are needed to work on a particular day 34.2 Vacation, Sick Leave, and Holidays: Extra board transit operator will accrue vacation and sick leave and shall be compensated for holidays at the accrual rate prescribed in this Agreement prorated to reflect the actual percentage of time worked In order to facilitate crediting to those accounts, extra board transit operator benefits will be initially assigned to 50%, 75%, or 100%, as determined by the appointing authority, of the accrual rate. Employees' benefit accruals will be adjusted monthly to reflect actual benefit accrual rates. Holiday and personal holiday time will be adjusted annually ARTICLE 35 - TRADING WORK Employees may trade work with other employees in their same classification, within the same work week (Monday through Sunday), as long as the wage cost to the Employer does not exceed the wage cost had the trade not occurred Trading work will be limited to one (1) time per month per requesting driver and a maximum of six (6) trades per year per employee total, whether they are the requesting driver or the driver accepting the trade. Once the trade is approved that now becomes each employee's new workday for scheduling purposes The employees shall give notice, on the official form, to the Dispatcher no later than 1 00 p m on the day prior to the earliest affected shift ARTICLE 36 - "ROADEO" The Employer will encourage the participation of employees in bus and van "ROADEO S." ARTICLE 37 - ENTIRE AGREEMENT 37.1 This Agreement constitutes the complete and entire Agreement between the parties and neither the City nor the Union shall be bound by any requirement not specifically stated in this Agreement or applicable Civil Service rules, provided however that this Agreement shall be subject to such periodic modifications as may be voluntarily agreed upon in writing by the parties during the term hereof. The parties are not bound by the past practices or understandings of the City or the Union unless such past practices or understandings are incorporated in this Agreement or executed in writing. 37.2 The City and the Union acknowledge that each party has had ample opportunity to submit proposals with respect to any subject or matter regarding wages, hours, and AFSCME Local 1122 —Transit / 2013 - 2015 Page 40 of 44 working conditions not removed from the collective bargaining process by law and agree that all said proposals have been negotiated during the negotiations leading to this Agreement The parties further agree that negotiations will not be reopened on any item during the life of this Agreement except by the mutual consent or as provided in R C W 41.56.492. ARTICLE 38 - SAVINGS CLAUSE 38.1 Applicability to and Compliance with Law: It is understood and agreed that all provisions of this Agreement are subject to applicable laws, and if any provision of any Article of this Agreement is held or found to be in conflict therewith, said Article shall be void and shall not bind either of the parties hereto; however, such invalidity shall not affect the remaining Articles of this Agreement. Notwithstanding any other provisions of this Agreement the parties may take all actions reasonable to comply with the Americans with Disability Act and the Family and Medical Leave Act. If the Washington State Health Services Act of 1993 or Federal Health Care legislation mandates changes to the Health/Care Fringe Benefits Article of this Agreement, then the parties agree to negotiate the effects of those mandated changes 38.2 Effects of Charter Civil Service Rule Changes: It is understood that, should modification of the Charter Civil Service Rules and Regulations take place during the contract period, the parties agree the CBA will be reopened, if requested by either party, to address each modification ARTICLE 39 -TERMINATION This Agreement shall be deemed effective from and after the 1st day of January, 2013 and shall terminate on December 31, 2015, provided, however, that this Agreement shall be subject to such periodic changes or modifications as may be voluntarily and mutually agreed upon by the parties hereto during the term hereof. AFSCME Local 1122 —Transit / 2013 - 2015 Page 41 of 44 ARTICLE 40 — EXECUTION EXECUTED THIS DAY OF OCTOBER, 2013. FOR THE UNION FOR THE CITY OF YAKIMA Eddie Allen, Staff Representative WSCCCE Council 2 Mike Nugent Local 1122 President John Berg, Local 1122 Bargaining Team Member Jim Hogenson, Local 1122 Bargaining Team Member ATTEST Sonya Claar Tee City Clerk Tony O'Rourke City Manager AFSCME Local 1122 —Transit / 2013 - 2015 Page 42 of 44 Appendix A Page 1 of 2 City of Yakima Uniformed Transit Operator Commercial Driver License Medical Examination Declaration MEDICAL EXAMINER DECLARATION The City of Yakima provides paid medical examination services to all employees who are required to have a Commercial Drivers License endorsement as an essential function of their job. Your patient has selected to have you, their regular physician, complete this examination, at their own expense. I am a licensed physician in and conducted an examination of , a patient known to me, in order to determine their physical qualification for operating a commercial vehicle in accordance with the requirements of 49 CFR 391.41 -49. By signing below, I declare that I am familiar with the requirements and guidelines developed by the Federal Motor Carrier Safety Regulations in making my determination of qualification, as well as the driver's responsibilities and work environment outlined in the introductory comments under "The Driver's Role" to 49 CFR 391.41. I further declare that I have read and understand the "Instructions to the Medical Examiner" section of 49 CFR 391.41 including both the General Information and Interpretation of Medical Standards paragraphs. Date Signature of Physician Printed Name of Physician AFSCME Local 1122 —Transit / 2013 - 2015 Page 43 of 44 Appendix A Page 2 of 2 City of Yakima Uniformed Transit Operator Commercial Driver License Medical Examination Liability Waiver RELEASE OF ALL CLAIMS, WAIVER OF LIABILITY, AND HOLD HARMLESS AGREEMENT I am a Uniformed Transit Operator for the City of Yakima who must maintain a valid Commercial Driver's License (COL) in order to operate any commercial motor vehicle I understand that I must be physically qualified to do so in accordance with the Physical Qualifications for Drivers standards as set forth in 49 CFR 391 31, and must obtain a medical examiners certificate initially and for subsequent license renewals. The City of Yakima provides paid medical examination services for this purpose As an alternative to the City provided examination, I am electing to utilize my regular physician for the screening and certificate at my own expense acknowledge my obligation to fully represent all medical information to my evaluating physician, and to accurately disclose any medical information or condition to the physician, requested or not, to the best of my ability. I FURTHER AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CITY OF YAKIMA, AND ITS ELECTED OR APPOINTED OFFICIALS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS FROM ANY CLAIM, DAMAGE, COST OR LIABILITY RESULTING FROM, OR RELATED TO, ANY INTENTIONAL MISPRESENTATION OR ANY FAILURE TO ACCURATELY DISCLOSE WHAT I KNOW TO BE RELEVANT MEDICAL INFORMATION TO MY EXAMINING PHYSICIAN I agree to all of these terms on behalf of myself, my child (if applicable), my spouse (if applicable), my family, my heirs, my executors and personal representatives of my estate, and this Release of All Claims, Waiver of Liability, and Hold Harmless Agreement is binding on them I have read and understand the information in this Release of All Claims, Waiver of Liability, and Hold Harmless Agreement Date Signature of Operator Printed Name of Operator AFSCME Local 1122 —Transit / 2013 - 2015 Page 44 of 44 COLLECTIVE BARGAINING AGREEMENT by and between CITY OF YAKIMA and YAKIMA POLICE PATROLMANS ASSOCIATION Effective January 1, 2014 through December 31, 2015 TABLE OF CONTENTS ARTICLE 1 - RECOGNITION OF ASSOCIATIONBARGAINING UNIT 3 ARTICLE 2 - COLLECTIVE BARGAINING REPRESENTATIVES 3 ARTICLE 3 - ASSOCIATION MEMBERSHIP/PAYROLL DEDUCTIONS 4 ARTICLE 4 - ASSOCIATION SECURITY 4 ARTICLE 5 - NON-DISCRIMINATION 5 ARTICLE 6 - COLLECTIVE BARGAINING 5 ARTICLE 7 - GRIEVANCE PROCEDURE 6 ARTICLE 8 - UNION LEAVE 8 ARTICLE 9 - ASSOCIATION REPRESENTATIVE ASSIGNED DAY SHIFT 9 ARTICLE 10 - MANAGEMENT RIGHTS 10 ARTICLE 11 - EMPLOYEES' RIGHTS 11 ARTICLE 12 - WAGES 14 ARTICLE 13 - SHIFT HOURS 17 ARTICLE 14 - VACATIONS 18 ARTICLE 15 - SENIORITY SYSTEM 19 ARTICLE 16 - HOLIDAY ASSIGNMENT 20 ARTICLE 17 - HOLIDAYS WITH PAY 20 ARTICLE 18 - UNIFORM CLEANING AND ISSUE 21 ARTICLE 19 - PLAINCLOTHES CLOTHING ALLOWANCE 22 ARTICLE 20 - LIFE INSURANCE 22 ARTICLE 21 - HEALTH INSURANCE 22 ARTICLE 22 - LIABILITY AND PHYSICAL DAMAGE INSURANCE 23 ARTICLE 23 - DIFFERENTIAL PAY 24 ARTICLE 24 - SICK LEAVE 25 ARTICLE 25 - TRANSPORTATION 29 ARTICLE 26 - TRAVEL AND TRAINING TIME 29 ARTICLE 27 - GENERAL, SPECIAL AND PERSONNEL ORDERS 30 ARTICLE 28 - ADVANCE NOTICE OF SHIFT CHANGE 30 ARTICLE 29 - IMPROVED PERFORMANCE AND EFFICIENCY 30 ARTICLE 30 - SAVINGS CLAUSE 31 ARTICLE 31 - WITNESS -CIVIL SERVICE BOARD 31 ARTICLE 32 - PHYSICAL FITNESS 31 ARTICLE 33 - DEFERRED COMPENSATION 31 ARTICLE 34 - MILITARY & CIVIL LEAVE 32 ARTICLE 35 - OFF-DUTY EMPLOYMENT 32 ARTICLE 36 - LAYOFFS 33 ARTICLE 37 - DURATION 34 -2- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 COLLECTIVE BARGAINING AGREEMENT BETWEEN THE CITY OF YAKIMA AND YAKIMA POLICE PATROLMANS ASSOCIATION THIS AGREEMENT, is made and entered into by and between the City of Yakima, Washington, hereinafter called the City, and the Yakima Police Patrolmans Association, hereinafter called the Association WITNESSETH: WHEREAS, Chapter 41 56 of the Revised Code of Washington (hereinafter RCW 41 56) contemplates the execution of collective bargaining agreements between cities and collective bargaining representatives of government employees, the intent and purpose of such chapter being the promotion of the continued improvement of the relationship between the public employers and their employees by providing a uniform basis for implementing the right of employees to join labor organizations of their own choosing and to be represented by such organizations in matters concerning their employment relations with public employers, and WHEREAS, the parties to this agreement recognize that benefits accrue to employees of the City by virtue of their Association membership, and that the best interests of the government and people of the City of Yakima are served by the City's official recognition of the Association, NOW, THEREFORE, pursuant to RCW 41 56, and in accordance with the intent and purpose thereof, and for the purpose of promoting the morale, well-being and security of the employees of the Yakima Police Department represented by the Association, and for the purpose of promoting the general efficiency of the government of the City of Yakima, the parties hereto agree as follows ARTICLE 1 - RECOGNITION OF ASSOCIATION/BARGAINING UNIT The City hereby recognizes the Association as the exclusive bargaining representative of employees within the bargaining unit, which consists of all full-time regular police officers, including probationary police officers, of the Yakima Police Department except those persons appointed to positions above the rank of Sergeant ARTICLE 2 - COLLECTIVE BARGAINING REPRESENTATIVES Collective bargaining between the parties shall be carried out by the City Manager, or his designates, on behalf of the City Council, and a person or persons representing the Association. The Secretary of the Association shall notify the City Manager in writing of the names of the person or persons representing the Association for collective bargaining purposes and the City Manager shall notify the Association of his designates in a similar manner. -3- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 ARTICLE 3 - ASSOCIATION MEMBERSHIP/PAYROLL DEDUCTIONS Section 1 - Association Membership. Each employee within the bargaining unit is eligible to become and remain an Association member However, active Association membership shall not be open to those employees of the Yakima Police Department permanently appointed to the positions excepted from the bargaining unit by Article 1 of this Agreement. In the event an Association member is permanently appointed to any position excepted from the bargaining unit, active Association membership shall thereupon be closed to him and he shall immediately discontinue active Association membership Section 2 - Payroll Deductions. The City agrees to deduct Association membership fees, dues and other assessments by the Association against its members within the bargaining unit from the pay of those members who authorize the City to do so in writing The Secretary of the Association shall forward signed authorization cards to the Finance Officer of the City setting forth the amounts to be deducted from the pay of each such person. The City shall transmit to the Treasurer of the Association the aggregate of such deductions during each calendar month, together with an itemized statement, on or before the 20th day of each month following the month for which such deductions are made In the event the City receives a written notice, signed by any person from whose pay such deductions are being made, that no further deductions are to be made, the City shall make no such deductions from any pay earned by that person after receipt by the City of such notice The City shall notify the Secretary of the Association of all such notices received by the City, which notification to the Association shall be given in writing no later than the next working day after the receipt of such notice by the City and shall include the name of the person involved. The Association agrees to defend, at the expense of the Association, any claim, allegation, cause of action, or lawsuit against the City arising from the above cited deductions or the transmittal of such deductions to the Association, except one brought by the Association for failure of the City to comply with the terms of the Agreement. ARTICLE 4 - ASSOCIATION SECURITY It shall be a condition of employment that all employees covered by this Agreement who are members of the Association in good standing on the effective date of this Agreement shall remain members in good standing It shall also be a condition of employment that all employees covered by this Agreement and hired on or after its effective date shall, on or before the thirty-first (31st) day following the beginning of such employment, become and remain members in good standing of the Association. All employees covered by this Agreement, except new employees during the first thirty-one (31) days of their employment, shall be required to be and remain members in good standing of the Association The City shall discharge any employees as to whom the Association, through its authorized representative, delivers to the City a written notice that such employee is not in good standing in conformity with this Article Upon receipt of a notice requesting termination of an employee who has not become or remained a member in good standing of the Association, the City shall immediately notify such employee that if he has not complied with the Association membership requirements of this Agreement within fifteen (15) days, his employment shall automatically be terminated The Association agrees to withdraw any letter of termination if the employee, in respect to whom such -4- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 letter has been served, shall complete his membership requirements within the time limit specified heretofore. Any employee having objections to Association membership, based on bona fide religious tenets or teachings of a church or religious body of which he is a member, shall pay an amount of money equivalent to regular Association dues and initiation fees to a non -religious charity or to another charitable organization mutually agreed upon by the objecting employee and the Association Written proof of payment shall be given to the authorized representative of the Association. If an employee for any reason does not wish to be a member of the Association, that employee shall proportionately and fairly share in the cost of the collective bargaining process Therefore, the cost for such bargaining unit member shall be fixed proportionately at the amount of dues uniformly required of each member of the bargaining unit to defray the cost of services rendered in negotiating and administering this Agreement. Payment of a maintenance fee in this amount shall be in lieu of another obligation under this Article Indemnification The Association shall indemnify, defend, and hold the Employer harmless from all suits, actions, proceedings and claims against the City or persons acting on behalf of the Employer, whether for damages, compensation, reinstatement or any combination thereof arising from the sole application of this Article of this Agreement In the event that any part of Article III shall be declared invalid or that all or any portion of the monthly service fee must be refunded to any non-member, the Association and its members shall be solely responsible for such reimbursement. ARTICLE 5 - NON-DISCRIMINATION It is the policy of the City of Yakima and the Association not to discriminate against any employees or applicants for employment because of race, color, religion, age, sex, physical, mental, or emotional handicap or national origin It is not the intent of management to lower employment standards or hire individuals incapable of performing the required tasks of the job classification. Nothing in this section shall prohibit the City from establishing bona fide occupational qualifications ARTICLE 6 - COLLECTIVE BARGAINING Section 1 All matters pertaining to wages, hours and working conditions, except as otherwise provided in this Agreement, shall be established through the negotiation procedure. Section 2 The Association shall submit to the City Manager and the City Manager shall submit to the Association a written proposal for any changes in matter pertaining to wages, hours, or working conditions desired for the successor contract. The written proposals of the Association shall be submitted no later than the first business day of July of the last year of the agreement and the City's proposal shall be submitted within ten (10) business days of receipt of the Association's proposal The Association's receipt of the City's proposal shall be considered the formal commencement of negotiations. The Association and the City shall follow the collective bargaining procedure set forth in RCW 41 56, unless they mutually agree to waive said procedure in whole or in part -5- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 Commencement of mediation or arbitration as therein provided shall not prevent the parties from entering into negotiations seeking to resolve any differences during the pendency of mediation or arbitration. Any agreements reached during such negotiations shall be reported to the appropriate panel, and thereafter shall not be considered by said panel. All agreements reached not otherwise included in this Collective Bargaining Agreement shall be reduced to writing in a separate Memorandum of Agreement which shall be signed by the City Manager or his designee and the Association's representative. Section 3 One copy of the preliminary City Budget for each year shall be delivered to the Association or the Association shall be given written notice where it may obtain same, as soon as said preliminary budget is printed. One copy of the adopted annual budget shall be delivered to the Association or the Association shall be given written notice where it may obtain same as soon as the adopted annual budget is printed ARTICLE 7 - GRIEVANCE PROCEDURE Section 1 - Policy The parties recognize that the most effective accomplishment of the work of the City requires prompt consideration and equitable adjustments of employee grievances. It is the desire of the parties to adjust grievances informally whenever possible, and both supervisors and employees are expected to make every effort to resolve problems as they arise However, it is recognized that there may be grievances which can be resolved only after a formal review Accordingly, the following procedure is hereby established in order that grievances of employees covered by this agreement may be resolved as fairly and expeditiously as possible. Section 2 - Grievance Defined A grievance is a dispute involving the interpretation, application or alleged violation of any specific provisions of this Collective Bargaining Agreement Section 3 - Special Provisions (a) To be reviewable under this procedure, a grievance must be filed in writing within thirty (30) calendar days after the action or decision giving rise to the grievance. (b) The term "employee" as used in this Article shall mean the Association, individual employee, or group of employees, accompanied by a representative if so desired. (c) An Association officer and/or aggrieved party shall be granted time off without loss of pay for the purpose of processing a grievance (d) The Association may initiate or process grievances with or without the consent of an individual employee (e) A grievance may be entertained in or advanced to any step in the grievance procedure if the parties so jointly agree In the event the grievance relates to discipline greater than a verbal reprimand, the parties agree to forego the initial steps and file the grievance directly with the Chief of Police. -6- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 (f) The time limits within which action must be taken or a decision made as specified in this procedure may be extended by mutual written consent of the parties involved. A statement of the duration of such extension of time must be signed by both parties involved at the step to be extended. Failure of either party to meet the time limit or extended time limit for responses or appeals shall render the decision in favor of the other party (g) Any grievance shall be considered settled at the completion of any steps if all parties are satisfied or if neither party presents the matter to a higher authority within the prescribed period of time If the grievance is not appealed as prescribed the issues shall be deemed withdrawn. (h) If an employee seeks a Civil Service Remedy then said employee waives all rights to use the grievance procedure If an employee uses the grievance procedure then said employee waives all rights to use the Civil Service Procedures. No later than the thirtieth (30th) calendar day after the action or decision giving rise to the grievance, the employee must make an election of remedies as set forth in this section Section 4 - Procedure. (a) Written Grievance to Division Commander Within thirty (30) calendar days after an employee has been made reasonably aware of a wrongful act charged, an employee shall first reduce his grievance to writing and discuss it with his Division Commander. Said Commander or Designee shall make an investigation of the relevant facts and circumstances of the complaint and provide a written decision, and the reasons therefore, within thirty (30) calendar days If the grievance is delegated to a designee, such designation shall be acknowledged in the written response. (b) Grievance Appealed to Police Chief An employee who is dissatisfied with the decision of the Division Commander may submit the grievance in writing within ten (10) calendar days to the Police Chief. In the event the grievance begins with the Police Chief, the employee must file the grievance in writing within thirty (30) calendar days after the action or decision giving rise to the grievance The Police Chief or Designee shall make a separate investigation and notify the employee in writing of his decision, and the reasons therefore, within thirty (30) calendar days after receipt of the employee's grievance. If the grievance is delegated to a designee, such designation shall be acknowledged in the written response (c) Grievance Appealed to City Manager. An employee who is dissatisfied with the decision of the Chief of Police may request a review by the City Manager by submitting a written request to him Such request shall be submitted within ten (10) calendar days after receipt of the decision from the Chief of the Police The City Manager or Designee shall make a separate investigation and notify the Employee in writing of his decision, and the reasons therefore, within forty-five (45) calendar days If the grievance is delegated to a designee, such designation shall be acknowledged in the written response. -7- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 (d) Arbitration The Association shall notify the City Manager within fourty-five (45) calendar days of the date the City Manager issues his decision in Section 7(4)(c) of this Collective Bargaining Agreement if the Association desires to submit the grievance to arbitration as the final step in the grievance procedure. In the event the parties are unable to mutually agree upon an arbitrator, either party may request a list for thirteen (13) qualified arbitrators according to the following procedure the parties shall attempt to agree as to whether the Public Employment Relations Commission, the Federal Mediation and Conciliation Service, or the American Arbitration Association will supply the list If no agreement is reached, the list shall be requested from the Public Employment Relations Commission The parties shall select an arbitrator from the applicable list by mutually agreeing to an arbitrator or by alternately striking names. The parties shall flip a coin to decide who starts the striking process. The final name left on this list shall be the arbitrator The arbitrator's decision shall be final and binding but the arbitrator shall have no power to alter, modify, add to or subtract from the terms of this agreement. The cost of the arbitrator shall be borne equally between the City and the Association. The City and the Association will pay their own remaining costs of arbitration, including attorneys' fees, regardless of the outcome ARTICLE 8 — UNION LEAVE Section 1 — Business Leave (a) Members representing the Association, not exceeding three (3) in number, shall be granted leave from duty without any loss of pay during the pre -impasse period as provided in RCW 41 56, for all meetings between the City and the Association for the purpose of negotiating the terms of a contract and/or attendance at mediation, when such meetings take place at a time during which any such members are scheduled to be on duty. (b) Members representing the Association, not exceeding three (3) in number, shall be granted leave from duty without any loss of pay during the post -impasse period as provided in RCW 41.56, for meetings between the City and the Association for purposes of interest arbitration hearings when such activities take place at a time during which any such members are scheduled to be on duty (c) Such officers and members of the Association as may be designated by the Association, not to exceed two (2) in number at any one time, shall be granted leave from duty with pay for Association business, such as attending labor conventions and educational conferences regarding collective bargaining, provided that notice of such conventions or conferences shall be given at least three (3) weeks prior thereto to Chief of the Police Department, and provided further that the total leave for the entire bargaining unit for the purposes set forth in this section shall not exceed fifteen (15) days in any fiscal year (d) Officers and members of the Association on business leave, either paid or unpaid, will list the date, place and nature or reason for leave on forms required by the Chief of Police, to enable the Chief to verify the legitimacy of such absence Section 2 — City owned Equipment and Supplies -8- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 An Executive Board Member may utilize city owned/operated equipment to communicate with the Association and/or Management for the exclusive purpose of administration of this Agreement. Such use will: 1. Comply with the City of Yakima, Computer Use Policy — ADM 620 2 Result in little or no cost to the City, 3 Not interfere with the performance of their official duties, 4. Not distract from the conduct of City business; 5. Not disrupt other City employees and will not obligate other employees to make a personal use of City resources, 6 Not compromise the security or integrity of city information or software, and 7. Not include the making of long distance telephone calls, except by the use of a personal calling card during a break. 8 Limited use of printer and copiers The Association, its members and its Executive Board Members will not use City equipment for Association organizing or advocating for or against the Association in an election. Section 3 —Meetings Executive Board Members may be released during normal working hours to attend meetings scheduled for the following a Grievance meetings, including attempts at informal resolution, b. Investigatory interviews in according with Article 11, Employee Rights; c. Pre -disciplinary and disciplinary meetings; d Other hearings and meetings related to contract administration Section 4 - Authorized Work Time Executive Board Members shall be allowed release time while on duty to discuss grievances and/or disciplinary matters with Association members, provided that such discussion does not unreasonably interfere with the work and duties of the employees involved and provided the Board Member will notify his/her supervisor and receive prior approval, which shall not be unreasonably denied. Section 5 - Identification of Executive Board Members The Union will provide the Chief and the Human Resources Office with a written list of current Executive Board Members The Union will notify the Chief and Human Resources of any and all changes of Executive Board Members within ten (10) calendar days of the change The Employer will not recognize an employee if his/her name does not appear on the list. ARTICLE 9 - ASSOCIATION REPRESENTATIVE ASSIGNED DAY SHIFT To assist the City during the term of contract negotiations, the Association Chairman, if a member of the negotiating committee, shall be assigned to an appropriate day shift During the balance of the term of the contract the Association shall submit to the Chief of Police a list of not less than three (3) names of members (which may include the Chairman), authorized to handle a grievance, and the Chief shall schedule at least one (1) of these on an appropriate day shift -9- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 ARTICLE 10 - MANAGEMENT RIGHTS The City recognizes that the exercise of management rights shall not conflict with specific provisions of this agreement The Association recognizes the exclusive right and prerogative of the City to make and implement decisions with respect to the operation and management of the Police Department. Such rights and prerogatives include, but are not limited to, the following: (1) Establish, plan for, and direct the work force toward the goals of the City with regard to police services. (2) Determine the organization, and the merits, necessity and level of activity or service provided to the public (3) Determine the City budget and financial policies including accounting procedures. (4) Determine the procedures and standards for hiring and promotion consistent with Civil Service rules and regulations and the City Charter. However, if the Employer seeks to change Civil Service rules, then the parties will bargain about those changes. (5) Determine and direct transfers and assignments of personnel to and from different duties, responsibilities and/or Departments. (6) Decision to lay off personnel due to lack of work, lack of funds or reorganization (7) Discipline personnel for just cause. (8) Determine and direct the retention or discontinuance of positions and classifications (9) Determine job descriptions, duties of personnel and job classifications. (10) Determine the methods, means, equipment, numbers and kinds of personnel necessary to effectively and efficiently provide police and related services to the public (11) Determine and change the number and locations and types of operations, processes and materials to be used in carrying out all City functions (12) Assign work to and schedule employees in accordance with classifications and position descriptions, and to establish and change work schedules in accordance with Article 13. (13) Take necessary actions to carry out the mission of the City in emergencies An emergency is defined as a sudden, unforeseen event which threatens the public health or safety (14) Assign incidental duties reasonably connected with but not necessarily enumerated in job descriptions which shall nevertheless be performed when requested to do so by the Employer -10- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 The exercise of management rights shall not interfere with the Association's statutory right and duty to be the exclusive representative for bargaining unit employees. ARTICLE 11 - EMPLOYEES' RIGHTS No employee shall, by reason of his employment, be deprived of any rights or freedoms which are afforded to other citizens of the United States by the United States Constitution The employee will be required to answer any questions involving non -criminal matters under investigation. Prior to any questioning, the employee will be notified in writing and acknowledge receipt of the following: "You are about to be questioned as part of an internal investigation being conducted by the Police Department. You are hereby ordered to answer the questions which are put to you which relate to your conduct and/or job performance and to cooperate with this investigation. Your failure to cooperate with this investigation can be the subject of disciplinary action in and of itself, including dismissal The statements you make or evidence gained as a result of this required cooperation may be used for administrative purposes but will not be used or introduced into evidence in a criminal proceeding." Section 1 - Discipline and Discharge. All discipline must be based upon just cause. Any discipline shall be imposed in a manner least likely to embarrass the employee before the public or other employees Any disciplinary action imposed upon an employee may be the basis for a grievance through the regular grievance procedure Disciplinary actions or measures shall include the following: verbal reprimands; written reprimand; transfer for disciplinary reasons, suspension, demotion, or discharge Discipline shall be progressive in nature where appropriate Where discipline consists of a verbal reprimand alone the employee is limited to the grievance procedure outlined in subsections (a) of Article 7, Section 4 of this Agreement Such verbal reprimands are not subject to investigation and review by the Police Chief and the City Manager pursuant to subsections (b) and (c) and are not subject to arbitration pursuant to subsection (d) of Article 7, Section 4 of this Agreement. Section 2 - Bill of Rights All employees within the bargaining unit shall be entitled to the protection of what shall hereafter be termed as the "Police Officers Bill of Rights." The wide ranging powers and duties given to the Department and its members involve them in all manner of contacts and relationships with the public Of these contacts come many questions concerning the actions of members of the force These questions often require an immediate investigation by superior officers designated by the Chief of Police. In an effort to ensure that these investigations are conducted in a manner which is conducive to good order and discipline, the following guidelines are promulgated. (a) Notification of formal internal investigation Investigations should be commenced within (30) calendar days of notification of the violation. Within (3) calendar days after the Department assigns an internal investigation number to an administrative investigation, any employee who is the subject of the complaint shall be informed in -11- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 writing of the nature of the investigation, and advised of the rights of the employee unless notification may prejudice the integrity of the investigation. The YPPA will be provided a copy of the notice. If the employee is on days off or leave when the internal investigation number is drawn, the Department will notify the employee within (3) calendar days of their return to duty Any employee who is the subject of the complaint shall be informed in writing of the nature of the investigation and advised of the rights of the employee at least twenty-four (24) hours before any interview of the employee begins. The affected employee may waive the requirement to wait twenty-four (24) hours Written notice shall include sufficient information necessary to reasonably apprise the employee of the allegations of such complaint No employee will be interviewed over a subject that the employer knows or should know will result in an economic sanction without providing the notice required by this subsection. (b) Recording Interviews The Association stipulates that the interview of an employee during an investigation shall be audio recorded and a copy provided to each party Upon mutual agreement between the City and the Association representative, including agreement on the placement of the audio-visual equipment, the interview of an employee may be audio -visually recorded. The City will provide a copy of the audio- visual recording to the Association representative immediately or within twelve (12) hours following the completion of the interview (c) Any interview of an employee shall be at a reasonable hour, preferably when the employee is on duty, unless the exigencies of the investigation dictate otherwise. The interview, which shall not violate the employee's constitutional rights, shall take place at the Yakima Police Station facility, except where impractical. The employee shall be afforded the opportunity and facilities to contact and consult privately with an attorney of the employee's own choosing and/or a representative of the Association Said employee's attorney and/or Association representative and/or Association attorney may be present during the interview but shall not participate in the interrogation except to counsel the employee, provided that the Association representative, employee attorney or Association attorney may participate to the extent permitted by the law (d) The questioning shall not be overly long and the employee shall be entitled reasonable intermissions as the employee shall request for personal necessities, meals, telephone calls and rest periods (e) Prior to the disclosure of investigation made in subsection (g) of this section, the employee shall not be subjected to any offensive language, nor shall the employee be threatened with dismissal, transfer, or other disciplinary punishment as a guise to obtain the resignation of the employee nor shall the employee be intimidated in any manner No promises or reward shall be made as an inducement to answer questions. This provision does not apply to probationary employees (f) It shall be unlawful for the City to require any employee covered by this agreement to take or be subjected to any polygraph or any polygraph type of examination as the -12- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 (g) condition of continued or continuous employment or to avoid any threatened disciplinary action. Disclosure of Investigation. Except in the event good cause, investigations shall be completed within seventy-five (75) days. An employee who is the subject of an investigation shall be provided written notice if the investigation is not concluded within seventy five (75) calendar days of the notification given per Article 11, Section 2 (a). The notice shall include a projected completion date and a brief description of the good cause basis for the delay. After the first notice, the employee shall be provided further notice of extensions at thirty day intervals The proceeding requirement does not apply to criminal investigations No later than seven (7) calendar days prior to a pre -disciplinary hearing, the employee shall be advised of the results of the investigation and the recommended disposition and shall be furnished a complete copy of the investigation report, provided that the Employer is not required to release statements made by persons requesting confidentiality where the request was initiated by such persons, and provided further, such confidential statements may not be relied upon to form the basis of discipline The employee and his/her representative shall be allowed up to thirty (30) calendar days to perform an independent investigation prior to the pre -disciplinary hearing, with additional time for good cause. The employee and any representative of the employee are prohibited from contacting any witnesses or complainants in the investigation until such time as the disclosure of investigation described in this subsection occurs A copy of the final outcome documentation of the investigation will be sent to the YPPA union office upon completion. (h) Use of Deadly Force Situations When an employee, whether on or off duty, uses deadly force which results in the injury or death of a person, or discharges a firearm in which no injury occurs, the employee shall not be required to make a written or recorded statement for forty-eight (48) hours after the incident except that immediately following the incident the employee shall verbally report to a superior a brief summary of the incident and any information necessary to secure evidence, identify witnesses, or apprehend suspects in accordance with the form attached as Appendix D. The affected employee may waive the requirement to wait forty-eight (48) hours (i) Psychological or Medical Evaluations. When there is probable cause to believe that an employee is psychologically or medically unfit to perform his/her duties, the employer may require the employee to undergo a psychological or medical examination in accordance with current standards established by the Washington Association of Sheriffs and Police Chiefs, the International Association Chiefs of Police, the American with Disabilities Act, and other applicable State or Federal Laws. Consultations with the City's Employee Assistance Program are not considered psychological or medical examinations (j) Personnel Records The Police Department shall maintain only one working personnel file for each employee The City Human Resources Division will retain the permanent personnel file. This does not preclude a supervisor from maintaining notes regarding an employee's performance, or the Department from maintaining computerized records relating to training, promotion, assignment, or similar data -13- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 Annual employee evaluations and records of disciplinary action resulting in demotion or the loss of time or pay in the amount of forty (40) hours or more may be retained permanently. All other records of disciplinary action may be retained in an employee's Department personnel file for a period of not more than three (3) years, provided that if an employee's personnel record indicates a pattern of similar types of discipline, all such records may be retained until a period of three (3) years has elapsed during which there has been no further disciplinary action for the same or similar behavior. Records retained in an employee's Department personnel file longer than provided in this section shall be inadmissible in any proceedings concerning disciplinary action of that employee Upon receiving a request for all or part of a personnel file, the affected employee shall be notified of the request, and the information shall not be released for a period of three business days from the time of said notification, except upon service of a court order or subpoena properly recorded and signed by a judge or magistrate demanding immediate release. The City Attorney will advise the Department in all matters pertaining to the release of information contained in a personnel file (k) Drug Testing. See attached Appendix B, the City of Yakima Police Department Drug and Alcohol Testing Policy. (1) In the event of a layoff as provided for in Article 38, or a resignation or involuntary separation from service due a documented disability under RCW 49.60, the Americans with Disabilities Act, or other applicable disability law, resulting in the employee's inability to retain maintain fitness for duty, said employee shall be placed on a re- employment register for two (2) years from the date of separation In the event of a fitness for duty termination, upon verification that the employee is fit for duty the employee shall be subject to recall in the same manner provided for in the Police Civil Service Rules as are other employees on the re-employment register The Employer retains the right to conduct its own medical examinations consistent with this agreement and the ADA, for the purpose of ascertaining the officer's fitness for duty. For the purposes of seniority and years of service calculations, employees re-employed through this process, who were terminated as the result of a lay off or fitness for determination shall be credited for applicable service time with a tolling for the period of discharge. Within 90 days of the effective date of this agreement the Parties shall present to the Police Civil Service Commission, a mutual agreeable rule change implementing this Article. ARTICLE 12 - WAGES Section 1 - Base Monthly Salary Schedule There are to be no changes to monthly compensation during the duration of this agreement. -14- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 The top step Sergeant monthly wage will be established and maintained at 15% above the top step Police Officer monthly wage. Section 2. — Policy for Pay Steps. The following shall be the general policy with respect to the use of the pay steps within salary ranges a. The minimum rate of pay for a class shall be paid to any person on his original appointment, except appointments at a salary rate above the minimum may be authorized by the appointing authority when necessary to fill positions in "shortage" occupations or when necessary to recruit applicants with exceptional qualifications Lateral hires with 2 years of more of experience (after the academy) within the last 3 years shall be appointed at step C. b The basic salary range shall consist of five steps to be known as Steps -A, B, C, D, and E. An employee, shall normally be advanced to the next higher step six months after the date of hiring or promotion and to the succeeding steps at one-year intervals, providing that employee's work has been satisfactory and the employee is making normal progress on the job For purposes of computing the length of time for eligibility for within -range increases, the period of all leaves of absence without pay shall not be included except to the extent required by law. In order to simplify the preparation of payrolls, eligibility for within -range salary increases shall be computed in the manner heretofore set forth, provided, however, that upon an eligibility date falling on or before the fifteenth day of the month, such increase shall become effective as of the first day of the month; and provided further, that upon an eligibility date falling on or after the sixteenth day of the month, such increase shall become effective as of the first day of the following month c. Contemporaneous with this agreement a letter of interpretation will drafted related to Article 12, Section 2 b. above. Section 3 — Promotion and Demotion Wage Adjustments When an employee is promoted, demoted or reinstated, the employee's rate of pay for the new position shall be determined as follows: a Promotion An employee promoted to a position in a class having a higher pay range shall receive a salary increase as follows (1.) If the employee's rate of pay in the lower class is below the minimum salary of the higher class, the employee's rate of pay shall be increased to the minimum rate of the higher class (2.) If the employee's rate of pay in the lower class falls within the range of pay for the higher class, the employee shall be advanced to the pay step in the higher range which is next higher in amount above the employee's pay before promotion. (3) In the case of promotion, within -range increases shall be granted in accordance with subsection 2(b) of Article 12. b. Demotion. An employee demoted from a position in one class to another class having a lower pay range shall receive a salary decrease -15- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 If the rate of pay of the employee in the higher class is above the maximum salary for the lower class, the employee's rate of pay will be decreased to the maximum rate of the lower class. (2.) If the rate of pay of the employee in the higher class is within the pay range of the lower class, the employee's rate of pay shall be reduced to the next lower pay step in the range. Section 4 - Longevity Commissioned Police Officers and Sergeants of the City of Yakima who are regularly and continuously employed full time, and who have completed periods of service as hereinafter set forth, shall receive compensation, called longevity pay, in addition to their regular salary, according to the following schedule, to be paid on the first applicable pay day following the 31st day of December and the 30th day of June of each year Years Of Service At least four (4) years and less than nine (9) years At least nine (9) years and less than fourteen (14) years At least fourteen (14) years and less than nineteen (19) years Longevity Compensation 1 5% of base monthly salary 3.0% of base monthly salary 5.5% of base monthly salary At least nineteen (19) years and 7 0% of base monthly salary less than twenty-four (24) years Twenty-four (24) years or more 10.0% of base monthly salary Section 5 - Longevity Payment at Termination a. Upon termination of employment of anyone entitled to longevity pay, such person shall receive a longevity payment, according to the above schedule, for the number of months of eligibility served by such employee from the date on which the immediately previous longevity payment was made. Such payment shall not be made for fractions of a month, and if termination of employment occurs on or before the fifteenth day of any month, that month shall not be counted as one for which longevity pay is to be made, and if termination of employment occurs after the fifteenth day of any month, that month shall be counted as one full month for which longevity pay is to be made. b No longevity pay shall be paid to any employee who is discharged from employment for disciplinary reasons. -16- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 c Employees covered by the Washington State Law Enforcement Officers' and Firefighters' Retirement System who terminate their employment after disability leave and are placed on disability retirement shall receive longevity pay for the period of disability leave as provided in Chapter 41.26 of the Revised Code of Washington. Section 6 — Direct Deposit Direct deposit shall be allowed to a banking institution of the employee's choice. ARTICLE 13 - SHIFT HOURS (a) The Police Department and the Association jointly agree to a ten (10) hour and forty (40) minute shift plan for officers assigned to work the normal patrol shifts (not a specialty assignment) pursuant to Appendix "A" Shift schedule starting and ending times may vary by no more than 15 minutes. Shift hours shall be assigned by seniority bidding for all bargaining unit members and shall be for a period of one calendar year Seniority shall be as defined in Article 15 Bidding shall occur during the month of October or November of each year. Employees may bid for both shift and team, provided that the City may assign an employee to the opposite team on a shift at the time of the bidding process for a legitimate reason In the event that reassignment during the course of the year is required, officer assigned to patrol shall fill existing vacant slots The City retains the right to move an officer to a different team for good cause, with advance notice to the affected officer(s). Unless it is not possible, the good cause reassignment should be to the same shift If for any reason the City or the Association has a concern about the shift hours described above, the City and the Association agree to attempt to resolve the issue in a cooperative fashion For all other bargaining unit employees, the Employer reserves the right to implement, from time to time, eight (8), nine (9), and/or ten (10) hour shift plans, per past practices. If the Employer decides to modify these plans, from time to time, the Employer will provide notice of such change in accordance with Article 29 to the affected employee(s) except in the event of an emergency. In the event of an emergency, the Employer will provide as much notice as practicable. For all other bargaining unit employees, and in the event the Employer intends to implement changes in shift plans for duty assignments of more than three (3) months in duration, the Employer agrees to review the impacts of such long term shift changes with the Association prior to their implementation (b) Work performed in excess of the regularly scheduled work day or work week shall be considered overtime and such time shall be compensated at the rate of time and one half (1 1/2), provided that Community Service Officers and Narcotics Investigators shall be compensated at the overtime rate only when hours are worked in excess of the regularly scheduled work week -17- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 For any bargaining unit member working a 10 hour and 40 minute shift, the regular work period for that member shall be 28 days and the regular hours of work during that 28 -day period shall not exceed 171 hours. For any bargaining unit member working a 9 hour shift, the regular work period for that member shall be 14 days and the regular hours of work during that 14 -day period shall not exceed 86 hours. For any bargaining unit members working a 10 hour shift, the regular work period for that member shall be 21 days and the regular hours of work during that 21 -day period shall not exceed 128 hours. (c) Fractions of an hour served in overtime duty shall be rounded to the next quarter hour for the purpose of computing the amount of overtime (d) Court time and Callout. Officers called to duty outside the regularly scheduled shift or required to attend court outside their regularly scheduled shift shall be compensated with a minimum of three (3) hours at the overtime rate Hours worked beyond this minimum shall be compensated at the overtime rate, subject to the provisions of sections (b) and (c) above. Officers called to work within twenty minutes of their scheduled shift start time are not entitled to call out time, and will be compensated by overtime only for the actual amount of time they worked prior to shift start Hours worked beyond, but concurrent with, an employee's scheduled shift shall not be considered callout time. Off duty self initiated police activity is not considered call out time, but will be compensated at a time and one half rate. (e) Officers shall be allowed to accumulate up to a maximum of sixty (60) hours of compensatory time. Compensatory time is defined as time off in lieu of overtime, including but not limited to, time off in lieu of paid overtime for court or callout time. Any time accrued in excess of sixty (60) hours shall be cashed out on a quarterly basis (f) Daylight Savings Time. In the event a members shift is shortened by one hour due to daylight savings time, that member will be required to submit a leave request for that hour. In the event a members shift is lengthened by one hour due to daylight saving time the member is entitled to compensation for that hour ARTICLE 14 - VACATIONS Police Officers and Sergeants shall be granted annual vacation as follows: After one (1) full year of employment Eighty-five (85) hours (forty hours may be taken after six months of employment) After two (2) full years of employment One hundred and one (101) hours After five (5) full years of employment One hundred and twenty-five (125) hours -18- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 After ten (10) full years of employment After fifteen (15) full years of employment After twenty (20) full years of employment After twenty-five (25) full years of employment One hundred and sixty-five (165) hours One hundred and eighty-nine (189) hours One hundred and ninety-seven (197) hours Two hundred and five (205) hours Section 2 - Maximum Vacation Accrual Said employees may accumulate vacation leave time in an amount equal to the vacation time the employee earns during two (2) years' of service, according to the above schedule. Section 3 - Compensation for or Transfer of Vacation Leave Accrual in Excess of Maximum Amount Vacation leave accumulated in excess of the limits specified in Section 2 of this Article shall be paid to the respective employee at the rate of 100% of the employee's base wage in effect as of December 31 of that year; provided, however, that the employee must use at least 75% of his/her vacation leave accrued during the year in order to qualify for the payment unless some or all of the employee's scheduled vacation for that year is canceled and cannot be rescheduled that year, and such prevents the employee from complying with the 75% vacation leave use requirement. At the end of each year, all vacation leave accrued in excess of the limits specified in Section 2 of this Article, but for which the employee does not qualify for payment, shall be forfeited provided that employees who are denied a reasonable opportunity to take their leave for operational or other legitimate reasons shall be allowed to carry the excess forward into the next calendar year. Section 4 - Permissible Use of Vacation Accruals with Pay (1) Vacation leave accumulated at the end of six months of service may be taken in the seventh month and each month thereafter as accumulated. (2) Vacation leave must be taken at such time as the employee can be spared, but an employee will be allowed to take his leave when he desires if it is possible to schedule it at that time. (3) All vacation leave must be requested in advance and approved by the employee's department head. Section 5 - Terminal Leave a. A permanent employee, when leaving the service of the city and who has given at least two weeks' notice of his intention to leave, shall be compensated for vacation leave earned and accumulated to the date of separation b. No compensation for vacation leave shall be payable to any employee who terminates his employment or is terminated before he has completed six months of service -19- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 c. Terminal leave shall be computed by multiplying the hourly rate in effect at the time of termination by the number of hours accumulated. ARTICLE 15 - SENIORITY SYSTEM A seniority roster will be maintained by the Chief of the Police Department, or his/her designate, and shall be used to schedule vacation leaves and days off. Scheduling vacation leave and days off shall be executed by the Chief, or his designate, as an administrative function Seniority among officers shall govern priorities for vacation leave and days off, subject to the following conditions Two (2) officers from each work unit shall be allowed vacation leave within any three week period for the entire three week period, provided that initial vacation scheduling will be for a maximum of two consecutive weeks, and any remaining vacation leave will then be scheduled by seniority For the purpose of this section, the term "work unit" means the Division to which an officer is assigned The Chief of Police may apply this provision to smaller work units at his discretion. For purposes of this Article, and for purposes of scheduling vacation leave and days off, seniority means a status of employee gained by continuous length of service and by rank, with an employee of higher rank having greater seniority than an employee of lower rank, and, as between employees of equal ranks, the employee with the longest continuous service in that commissioned rank having seniority, provided that between employees of equal rank where one of the employees has been demoted, the demoted employee's seniority shall equal his or her length of continuous service served in the rank demoted to plus any service in higher ranks. Determination Of Seniority Between Employees of Equal Rank with the Same Length of Continuous Service Seniority is established by the length of continuous service, starting with the date of hire. If two (2) or more persons are hired on the same day, the score appearing on the entrance examination used for the appointment shall determine seniority, with the person obtaining the highest score to have the greatest seniority. If two (2) or more persons have identical scores on the entrance examination, seniority shall be determined by the drawing of lots per Police Civil Service Rules and Regulations An employee within the bargaining unit who may feel aggrieved by the administration of such a seniority system shall seek his remedy by the grievance procedure provided in Article 7 of this Agreement ARTICLE 16 - HOLIDAY ASSIGNMENT Where shift strength is reduced or increased on holidays, consistent with the needs of the City, assignments shall be offered to the most senior qualified officer within a work unit (e g squad) of the appropriate division Except for an emergency, the City shall provide a minimum of forty-eight (48) hours notice of any deviation from normal shift strength so that officers may plan the use of their time. -20- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 ARTICLE 17 - HOLIDAYS WITH PAY (a) Chapter 2.40.080 of the City of Yakima Municipal Code shall govern holidays with pay for bargaining unit employees. (b) Members of this bargaining unit shall receive a bank of ninety-six (96) hours on January 1, of each calendar year. (Twelve holidays) (c) Officers assigned to shifts longer than eight (8) hours shall receive additional hours to correspond to the length of their assigned shift For example, officers assigned to nine (9) hour shifts shall receive 108 hours, officers assigned to 10 hour shifts shall receive 120 hours, and officers assigned to the 10 hour 40 minute shift shall receive 128.17 hours. ARTICLE 18 - UNIFORM CLEANING AND ISSUE The City shall pay for all necessary cleaning of uniforms for members of the bargaining unit. The City may determine, from time to time, where said uniforms shall be cleaned Reasonable regulations concerning such cleaning may be adopted by the Police Department Uniform items listed below and other apparel and collateral equipment will be supplied to each patrol officer with the commencement of employment and, consistent with current practice, replaced on an "as needed" basis Uniform Item Minimum Issue Initial disbursement: Item Quantity Trousers 3 pair Winter Shirt 3 Winter Jumpsuit 1 Mock Turtleneck 2 Summer Shirt 3 Winter Jacket 1 Hat 1 Emblems 1 pair Badge Holder 1 Buttons 1 dozen Body Armor 1 Body Armor Covers 2 Gunbelt 1 Holster 1 -21- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 Cuff Case 1 Batteries and bulbs (for Streamlight) Replaced as needed Chemical Irritant 1 container Chemical Irritant Holder 1 Ammo Pouch (Detective) 1 Detective Holster 1 Name Tag per Shirt 1 Summer Pants 2 The City will provide a three hundred ($300) dollar allowance every two years for the purchase or repair of approved footwear for officers assigned to units not eligible for a clothing allowance The City and the YPPA will execute a Memo of Understanding (MOU) contemporaneous with this agreement for the phased acquisition of AR -15 rifles for employees electing to purchase such rifles up to twenty-five percent (25%) of the bargaining unit each year The cost of the purchases shall be repaid by officers at a 0% interest rate over a two (2) year period in equal deductions from the employee's paycheck. Employees who terminate employment shall have the remaining unpaid balance removed from their final paycheck. ARTICLE 19 — PLAINCLOTHES CLOTHING ALLOWANCE Police officers and police sergeants assigned to the Detective Division of the Police Department, and police officers and police sergeants assigned to the Administration and Services Divisions, when not required to wear a uniform in the performance of their assigned duties, shall be paid a monthly clothing allowance of seventy dollars ($70.00) in lieu of an issued uniform. Additionally, the Chief of Police in his discretion may extend and/or discontinue, from time to time, the clothing allowance for police officers and police sergeants assigned to the SRO or any other police unit ARTICLE 20 - LIFE INSURANCE The City shall provide one hundred fifty thousand dollars ($150,000.00) group life insurance for each employee in the bargaining unit. ARTICLE 21 - HEALTH INSURANCE 21 1 Medical, Vision and Dental Care Coverage — As identified in this agreement, Medical, vision, and dental coverage shall be maintained for the duration of this agreement for covered bargaining unit employees, retirees and their dependents, provided that the parties may mutually agree to re -open the contract to address any issues regarding coverage The Association may have up to two non-voting representatives on the Health Plan Board as observers. 21 2 Health Care and Dental Coverage Premium Contributions -22- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 (a) Employee Health Care Coverage - LEOFF I and LEOFF II employee only health care coverage premiums shall be paid for by the City. (b) Dependent Health Care Coverage - The City will share the monthly premium for dependent medical insurance with bargaining unit members Members shall contribute on a monthly basis according to the following schedule: For employees with one dependent For employees with two dependents For employees with three or more dependents: 0 5% of wages 1 0% of wages 1.5% of wages For purposes of this subsection, "wages" means the top step patrol officer wage during the month of contribution and "dependent" means a spouse, child, or other individual eligible for medical coverage under the City of Yakima's Health Care Plan. Effective July 1, 2012, the parties shall revise the health insurance program On that date the YPPA plan design will be outlined as in the 2011 Healthcare Plan Report as Option C (c) Dental Care Coverage - The City shall pay the premium for active LEOFF I and LEOFF II employees and their dependents for dental care (d) Retiree Coverage - Retirees and dependents of retirees may remain in the group plan until they reach age 65 or, in the case of spouses of deceased retirees until they reach age 65 or remarry whichever occurs first Retirees and unremarried spouses of deceased retirees shall pay the premium (including dependents if enrolled) which shall be the same as the normal group rate assess for coverage of active City employees and dependents covered by this agreement. Premiums shall be paid by deduction from retirement checks paid to retired employees or their beneficiary 21.3 Long Term Disability Coverage - The City will allow employees to use payroll deduction for their entire long term disability coverage premium. ARTICLE 22 - LIABILITY AND PHYSICAL DAMAGE INSURANCE Section 1 - Liability Insurance The City shall provide liability insurance, including false arrest insurance, for Association members covered by this Agreement while in the performance of their duties, with a minimum limit of Three Hundred Thousand Dollars ($300,000.00) per occurrence; provided, however, nothing in this section shall prohibit the City from self-insuring that liability or false arrest insurance The City shall defend and indemnify police officers in accordance with City of Yakima Resolution D-5820, dated September 18, 1990, a copy of which is attached hereto (Appendix C) and incorporated herein by this reference. The incorporation of the Resolution referenced above does not preclude the City from modifying the Resolution in accordance with the provisions of the first sentence of this section Section 2 - Defense Against Criminal Charges. The City shall, at the City's expense, defend any officer against any criminal charges brought against such officer for action occurring while acting in -23- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 the official capacity as a Police Officer The City's obligation to provide for such defense and/or defense costs shall terminate upon a conviction of a criminal law violation in Court. It shall be the obligation of the officer to pay for attorney's fees and costs associated with an appeal unless the appeal reverses a conviction in which case the City will reimburse the officer for attorney's fees and costs associated with the appeal If such officer is found guilty and there is an entry of final, non -appealable judgment or conviction, it shall then be the responsibility of such officer to reimburse the City for all fees, expenses and costs related to the defense. If the officer is retried, the provisions of this article shall apply anew. If an outside attorney is hired to provide such defense, the City shall be notified of the identity of such attorney and an agreement with the City shall be reached concerning the fees to be charged by such outside attorney prior to the time that attorney is retained Section 3 - Physical Damage Insurance. The City shall provide full physical damage insurance on police vehicles, which insurance shall include police officers as insureds, or the City shall, in the alternative, become self-insured for such physical damage insurance In either case the City waives any claim it may have against any police officer for physical damage to City property, but the City retains its right to discipline any employee for just cause. ARTICLE 23 - DIFFERENTIAL PAY Section 1 - CRU members shall receive 2% of their current base pay in addition to their regular salary for each full month assigned to the CRU. Section 2 - Field Training Officers Police Officers assigned to orient and train newly hired uniformed officers, and actually engaged in same, shall receive a payment, per month, of five percent (5%) of their current base pay for that month, over and above their normal rate of pay. Officers assigned such duty for periods of less than one (1) week during the pay period shall not be eligible for such differential The City retains the exclusive right to select said Field Training Officers and determine the duration of assignment. Section 3 - Investigative Assignment Only Police Officers, and Police Sergeants assigned in writing, by the Chief or Designee, to the Detective Division, as Traffic Investigators, Narcotics Investigations, and any Interagency Task Force, shall receive a payment, per month, of three percent (3%) of their current base pay for that month, over and above their normal rate of pay. The City retains the exclusive right to, from time to time, select said Investigators, Detectives, Narcotics Unit and any Interagency Task Force members, and to determine the duration of assignment, provided, however, if the transfer is for disciplinary reasons, then nothing in this section prevents the employee from grieving the disciplinary transfer in accordance with Article 7. Operational transfers are not grievable. Police Officers and/or Sergeants desiring a transfer out of an Investigative Assignment shall submit a memorandum requesting reassignment, through the chain of command, to the Chief of Police Section 4 - Education Incentive Police Officers and Sergeants shall be paid a monthly education incentive payment based on the following schedule AA Degree or 90 college credits 1 5% of their current base pay for that month -24- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 BA Degree MA Degree: 3 0% of their current base pay for that month 4.0% of their current base pay for that month Education incentive pay shall be paid to employees only after the City has received an official transcript from the educational institution verifying the degree or credits received Section 5 - Bilingual Pay. Employees who have a bilingual capacity for the Spanish language or American Sign Language (ASL) shall receive an additional 3% of their current base pay, per month, special assignment pay for their work in that capacity subject to achieving a passing score on the bilingual/biliterate skills examination conducted under the Police Civil Service Rules and Regulations and administered by the Civil Service Chief Examiner. The Police Chief may waive this testing requirement if the employee can demonstrate to the satisfaction of the Police Chief, through documentation or otherwise (i e , court interpreter certification from the State of Washington), that the employee has sufficient bilingual/biliterate skills in the Spanish language or ASL A determination for bilingual capacity shall be made by the City within six (6) months of graduation from the law enforcement academy. Upon certification, compensation shall be retroactive to the date of academy graduation Should a language other than English, Spanish, or ASL be necessary for the conduct of official business of the Department by an officer who is bilingual in that language, the officer may be compensated bilingual pay for the month in which the service was needed. Section 6 — Motorcycle Duty When any employee of the police department is assigned by the chief of the department to a position which requires operation of a motorcycle, such member shall be paid 2% of their current base pay in addition to their regular salary. Section 7 - Acting Pay During routine operations when an officer is assigned to fulfill the duties and responsibilities of a classification higher than his own for a period of four (4) hours or more he shall be paid the lowest rate of the higher classification which provides any salary increase for the officer. Section 8 — Shift Differential Pay All general squad patrol division officers (those not assigned a specialty) who work 10 hour and 40 minute shifts shall receive shift differential pay as set out in the following schedule. Only those people assigned as a general squad patrol officer on the division shift roster are eligible for this differential pay. Shifts starting between 0500 and 0859 Shifts starting between 0900 and 1459: Shifts starting between 1500 and 1859: Shifts starting between 1900 and 0459 No differential pay 1% of current base pay 1.75% of current base pay 2 25% of current base pay Any Patrol officer involuntarily reassigned from a bid -for shift, for other than disciplinary transfers, shall be entitled to whichever shift premium is greater between the bid -for shift and the reassigned shift Section 9 — Gang Unit Pay. All patrol division and special operations officers assigned to the Gang Unit shall be paid 1 75% of their current base pay in addition to their regular salary for each full month assigned to the Gang Unit Section 10 — Notice of Specialty Openings. Notice of all openings for specialty positions will be posted -25- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 Section 11 — K-9 Officers. Employees assigned to K-9 duty shall receive a premium equal to 2% of their current base pay. ARTICLE 24 - SICK LEAVE Section 1 - Accrual. LEOFF II employees shall accrue ten (10) hours of sick leave for each full calendar month of service with the City. Unused sick leave may be accumulated for an unlimited period, provided, however, that LEOFF II employees shall be permitted to accumulate up to a maximum of 1200 hours of sick leave For the purposes of this Article only, a day shall be equivalent to ten (10) hours. On the first day of employment each newly hired permanent employee of the bargaining shall receive 120 hours twelve sick leave, subject to following restrictions (a) No additional sick leave will be accrued during the employee's first year of employment (b) Should the employee either voluntarily or involuntarily terminate employment during the first year and used sick leave hours equivalent to more than the number of months employed, the excess hours shall be deducted from the employee's accrued paid leave balance (i e vacation, compensatory, etc ) LEOFF I employees shall not be entitled to sick leave benefits conferred by this chapter; provided, such employees shall be accorded leaves of absence as provided by Article 24, Section 3 (d) and (e) below Section 2 - Sick Leave Pool. A sick leave pool shall supplement approved sick leave for LEOFF II employees The pool shall have no additional contributions made by the City and the allocation of hours from the pool shall be at the discretion of the Association The Association may elect to require repayment from recipients of leave loaned from the pool in order to maintain the pool. The parties agree to adopt an MOU during the course of this agreement to alter this section. Section 3 - Permissible Use of Sick Leave An employee eligible for sick leave with pay shall be granted such leave for the following reasons: (1) Personal illness or physical incapacity resulting from causes beyond employee's control, (2) Quarantine of employee due to exposure to a contagious disease; (3) On-the-job injuries - In the event an LEOFF II employee is unable to work due to an on-the-job injury, said employee will be compensated by being kept on salary (KOS) and will continue to earn their regular wages and benefits, provided the employee complies with all the provisions of the City policy (Directive PER 405) Kept on salary status will extend for a period not to exceed six (6) months, or until the officer has been released by a physician to full duty, whichever is sooner. If, after six (6) months in a kept on salary status, the employee is unable to return to full duty, he or she will revert to the traditional Worker's Compensation time loss payment system in accordance with -26- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 RCW 51 32 090 The employee will be allowed to make an election regarding their time loss according to City policy. (4) In the event of a death in the employee's immediate family and upon approval from a supervisor, the employee may use up to three days of paid bereavement leave per calendar year `Immediate family" for purposes of this subparagraph means any husband, wife, parent, grandparent, child, grandchild, brother, sister, or registered domestic partner. Any request for use of sick leave beyond the 3 days must be pre - approved by the Chief or designee, (5) Serious injury or illness to members of employee's immediate family living with and dependent upon the employee, constituting an emergency or crisis; any sick leave granted for this purpose must be recommended by the Department head and approved by the appointing authority, Illness and disability caused or contributed to by pregnancy, miscarriage, abortion or childbirth, Sick leave shall not be allowed for any period of time that the employee is gainfully employed by another employer; An employee will be entitled to use the employee's accrued sick leave to care for a child of the employee under the age of eighteen with a health condition that requires treatment or supervision or for a serious health condition or an emergency condition of a spouse, registered domestic partner, parent, parent -in-law, or grandparent. Section 4 - Requirements for All Paid Sick Leave (1) Employees must report to the representative designated by the Department head the reason for the absence as far in advance of the starting of their scheduled work days as possible, but in no event shall this report be made later than the first day of absence (2) Employees must keep their Department head informed of their condition if absence is of more than three (3) working days in duration (3) For each absence an employee must submit upon the approved form an explanation of the reason for such absence consistent with federal and state law. A statement by the attending physician may be required if an absence by illness or injury extends beyond three (3) working days, or for each absence, if requested by the Department head (4) Employees must permit home visits or medical examinations at the expense and convenience of the City consistent with federal and state law Section 5 - Enforcement of Sick Leave Provisions. (1) Any failure to comply with the provisions of Section 4 shall be grounds for denial of sick leave with pay for the period of absence. -27- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 (2) Misrepresentation of any material facts in connection with paid sick leave by any employee shall constitute grounds for suspension or discharge. (3) It shall be the responsibility of the Department head or designated representative to: (a) Review all applications for sick leave and approve those which are bona fide and comply with the provisions of this section and forward same to the Personnel Division. The Personnel Officer shall not certify the payment of sick leave until the approved applications have been received, except that employees still absent at the end of a pay period may be certified for payment of sick leave by the Personnel Officer upon recommendation of the Department head as indicated by his signing the time sheet and subject to the receipt of an approved application for sick leave pay immediately upon the employee's return to work, (b) Investigate any suspected abuse of sick leave; (c) Withhold approval of sick leave pay in the event of unauthorized use, (d) Initiate disciplinary action if, as a result of investigation, it is determined that an employee has been guilty of willful misrepresentation in a request for sick leave pay. Section 6 - Sick Leave Exchange Eligible employees may exchange accrued sick leave for pay or for additional leave time as appropriate, in accordance with the options provided the employee, subject to the following provisions: (1) No exchange of accrued sick leave for additional leave days or for cash will be granted for those employees with seven hundred and twenty (720) hours or less of accrued sick leave except: (a) Upon retirement or death the employee's accrued sick leave up to seven hundred and twenty (720) hours or less will be exchanged for pay at the rate of fifty percent (50%) of the employee's current base pay. (b) Upon termination under honorable conditions, as distinct from retirement or death, the employee's accrued sick leave up to seven hundred and twenty (720) hours or less will be exchanged for pay at the rate of twenty-five percent (25%) of the employee's current base pay Honorable termination includes layoff for budget reasons, as well as resignation with proper notice (c) Payments authorized herein shall be the lesser of the amounts allowed in 1(a) or 1(b), or the percentage ratio of the employee's accrual versus 720 hours, applied to $22,000 but in no case shall such payment exceed $22,000 (2) Exchange of accrued sick leave for additional leave days or for cash will be granted to employees who have accrued seven hundred and twenty (720) hours or more subject to the following provisions: -28- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 (3) (a) Upon retirement or death, the employee's accrued sick leave up through a maximum of seven hundred and twenty (720) hours will be exchanged for pay at the rate of one hundred percent (100%) of the employee's current base pay. (b) Upon termination under honorable conditions, as distinct from death or retirement, the employee's accrued sick leave up to a maximum of seven hundred and twenty (720) hours will be exchanged for pay at the rate of fifty percent (50%) of the employee's current base pay. (c) The maximum amount allowable for payout is $$22,000 (d) Employees who have accrued more than seven hundred and twenty (720) hours of sick leave may exchange such sick leave for bonus (additional) leave days at the rate of three (3) days of sick leave for each additional leave day, not to exceed a total of three (3) added leave days annually. Employees may receive compensation in lieu of taking leave days, utilization of which would be subject to the scheduling and approval by the Department head Sick Leave Exchange Procedure. Eligible employees may exchange accrued sick leave as provided above at the option of the employee, subject to the following conditions and provisions (a) A request for such an exchange shall be made to the Director of Finance and Budget via the Department Timekeeper. All requests shall be in writing and shall be signed by the employee making the request (b) Requests will be accepted only during the first five (5) working days of each month with exchanged leave to be available within fifteen (15) calendar days of the date the request is received by the office of the Director of Finance and Budget Exceptions to the above will be made for termination, layoff or disability retirement. (c) No request will be granted for less than eight (8) hours' pay or eight (8) hours additional leave (d) No exchange will be granted to an employee who has been terminated for cause, as defined by civil service (e) In the event of layoff, exchange requests are the responsibility of the employee. Section 7 — VEBA Employees shall participate in the VEBA program the Association has established ARTICLE 25 - TRANSPORTATION Section 1 - Mileage Reimbursement. The City shall pay each officer for his use, at the request of the City, of his personal auto. The mileage reimbursement rate will be tied to the mileage rate permissible under IRS regulations -29- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 Section 2 - Reserved Parking. In the event the current City parking lot is no longer available, then a minimum of ten (10) parking spaces shall be reserved in proximity to the Police Station/ Legal Center for Association members whose shifts begin after noon. Use of said spaces shall be controlled by permit issued by the Chief of Police or designee ARTICLE 26 - TRAVEL AND TRAINING TIME Section 1 - Training Time Time spent in training that is required by the City is considered compensable hours of work; provided, however, time spent by employees is not compensable if all of the following four (4) conditions are present: (a) attendance is outside the employee's regular working hours, (b) attendance is voluntary; (c) the training program, lecture, meeting or other similar activity is not directly related to the officer's job; and (d) the officer(s) do not perform any productive work during such attendance. Also, time spent in training which is mandated by state or federal government as a condition of practice in the profession is not considered compensable where the training is not tailored to meet the particular needs of the City. If time spent in training is beyond the regularly scheduled shift, then time spent in training will be compensated at the overtime rate Section 2 - Travel Time. Travel time during regular working hours shall be considered compensable. Travel time outside regular work hours on City business shall not be compensable unless the officer is actually driving Travel time as a passenger on an airplane, train, boat, bus or automobile outside of regular working hours is not considered compensable Where all the employees traveling together are doing so outside of their regular working hours, the selection of the driver is by the choice of the ranking employee. Section 3 — Meal Reimbursement Employees will be provided an allowance of $40 per day for meals for travel more than 50 miles outside the limits of the City of Yakima. Effective January 1, 2015 this rate will be increased to $45 per day. ARTICLE 27 - GENERAL, SPECIAL AND PERSONNEL ORDERS The City will furnish the Association with copies of all written general rules and special orders from within the Police Department pertaining to wages, hours, conditions of employment and assignments of members. ARTICLE 28 - ADVANCE NOTICE OF SHIFT CHANGE An officer will normally be given adequate advance notice of any change in his regular hours of work, except where an emergency exists [an emergency is defined as an event unforeseen by the Department, -30- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 affecting the Department's ability to perform its mission] Posting shall constitute adequate notice Notice given less than forty-eight (48) hours before he is to begin work under the changed schedule entitles the officer to compensation at the overtime rate for those hours not exceeding eight (8) hours that are earlier, later or different from the hours he last worked in a work day. An officer is not entitled to compensation at the overtime rate if he is otherwise entitled to compensation under the same hours of work ARTICLE 29 - IMPROVED PERFORMANCE AND EFFICIENCY The parties recognize the desirability of improving performance and increasing efficiency of the Yakima Police Department in order to provide maximum services at reduced costs. It is therefore agreed that the Association will actively cooperate and participate in studies and efforts to discover and employ new methods and practices which result in improved performance and increased efficiency in the Yakima Police Department ARTICLE 30 - SAVINGS CLAUSE It is understood and agreed that all provisions of this Agreement are subject to applicable laws, and if any provision of any Article of this Agreement is held or found to be in conflict therewith, said Article shall be void and shall not bind either of the parties hereto. However, such invalidity shall not affect the remaining Articles of this Agreement Notwithstanding any other provision of this Agreement, the Employer may take all actions reasonable to comply with the Americans with Disability Act and the Family Medical Leave Act. If the Washington Health Services Act (Health Care Reform) of 1993 or federal health care legislation mandates changes to the Health Insurance Article during the term of the Agreement, then the parties agree to negotiate about those mandated changes subject to the dollar amounts and contribution formula remaining the same as provided for in Article 21 In the event that any provision shall be held unlawful and unenforceable by any court of competent jurisdiction, the parties agree to meet forthwith for the purpose of re -negotiating such provision in an attempt to reach a valid agreement ARTICLE 31 - WITNESS -CIVIL SERVICE BOARD An officer shall be compensated for all off-duty time that he spends as a witness before the Civil Service Board or arbitration hearing at the same rate and in the same manner as he is compensated for Court Time; provided that the Association or the employee (when proceeding on an individual basis) will only call witnesses who are reasonably necessary for a reasonably necessary duration Time spent as a witness at such proceedings outside of regular working hours shall be compensated at time and one-half (1.5) on an hour for hour basis with no call back minimum. ARTICLE 32- PHYSICAL FITNESS The City requires that members of the Police Department be physically fit for the optimum performance of their duties and the Association agrees to cooperate with the City in developing appropriate standards and testing of fitness. -31- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 ARTICLE 33 - DEFERRED COMPENSATION Each bargaining unit member shall be paid, in addition to that employee's monthly salary, deferred earned compensation each month in an amount equal to 5.5% of said monthly salary. The deferred compensation contribution is separate pay and is not part of the base monthly salary schedule codified in Yakima Municipal Code Pay and Compensation Ordinance, subsection 2.20.110. This provision is subject to the City's deferred compensation rules and regulations adopted by the City Council and IRS regulations, and the computation of retirement contributions and pension benefits shall be governed by applicable state law. ARTICLE 34 - MILITARY AND CIVIL LEAVE Section 1. — Military Leave. Leave not to exceed twenty-one working days during each calendar year, over and above annual vacation or sick leave, may be allowed any employee who is a member of the National Guard or of any organized reserve or armed forces of the United States. The employee will be paid his normal pay during such military leave period when taking part in active training duty. Section 2 — Civil Leave Necessary leave will be provided to permit an employee to serve as a member of a jury or to exercise other civic duties Employees will remain in full employment status and will receive their full salary during periods of civil leave, however, any compensation received for performing civil duties must be remitted to the Finance Department. ARTICLE 35 - OFF-DUTY EMPLOYMENT Section 1 - Duty to Inform Chief. Any employee who desires to take any additional employment not relating to the use of commission authority during off-duty hours shall inform the Chief of Police in writing at least seven (7) calendar days prior to the date of anticipated off-duty employment The employee will fully describe the location and nature of the work to be performed, the proposed work hours, all items, if any, of Department equipment proposed to be used, and the anticipated duration of the employment The Chief or his designee shall respond to the request within 72 hours excluding weekends and any holidays This section does not apply to off-duty employment which has been specifically pre -approved by memo or Special Order from the Chief of Police. Section 2 - Authorization for Off -Duty Employment Prior to accepting off-duty employment not relating to the use of commission authority, an employee must obtain specific written authorization from the Chief of Police. The Chief of Police may suspend, modify, deny or terminate off-duty employment at any time for reasons including, but not necessarily limited to, the following: a Incompatibility with the employee's city work schedule or interference with the employee's ability to perform his or her regular Police Department duties. b Conflict with Department goals, objectives, policies or procedures -32- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 c Nature of work is inconsistent with the professional image of the Department or creates an appearance of impropriety. d. Unusual illness or absence record prior to or following hours of off-duty employment. e Work associated with premises where intoxicants are served for consumption, at the discretion of the Chief of Police. f Work associated with a political party, candidate, or issue, or may give the appearance of an endorsement of a particular business, product or service g. Work would result in an unreasonable competition with a private business. Section 3 - Use of Department Uniforms and Equipment It is at the sole discretion of the Chief of Police to authorize or deny the use of any and all items of Department -owned and/or issued equipment in the course of off-duty employment. No item of Department owned and/or issued equipment will be used for off-duty employment without the specific prior written approval of the Chief of Police Section 4 - Scheduling Off -Duty Employment. Off duty work involving the use of commission authority shall be scheduled and paid by the City. However, the Yakima Police Patrolmans Association must provide a list every six months of personnel to the Chief or designee for appropriate assignment depending upon availability It is understood that this off-duty work for other organizations is to be paid at the rate of first class officer, straight time. The City's actions to coordinate and schedule this work and administer payment is not intended to make this "time worked" for overtime purposes. Section 5 - Indemnification and Defense The Chief of Police or designee, on behalf of the City, would attempt to obtain from a prospective off-duty employer an indemnification and defense agreement and/or proof of adequate liability insurance coverage prior to approving off-duty employment, including a requirement that the City be named as an additional insured on the insurance policy Section 6 - Off -Duty Employment Prohibited for Certain Employees. Employees who are on suspension or sick/disability leave or administrative leave or who are on entry-level probationary status are generally prohibited from off-duty employment, unless specifically exempted from this provision by the Chief of Police. Section 7 - Obligation to Department The primary obligation and responsibility of all employees is to the Police Department Employees who are directed or required to perform overtime or other Department -related work will do so regardless of conflict with their off-duty employment. Section 8 - Industrial Insurance The parties agree that for the purpose of coverage under the laws and regulations of LEOFF, the Washington State Department of Labor and Industries, and all other federal and state employment laws and regulations, YPPA members performing off-duty work not involving the use of commissioned authority shall not be considered employees of the City but shall be considered employees for these purposes, for off-duty work administered by the City ARTICLE 36 — LAYOFFS -33- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 Whenever it becomes necessary through lack of finances or other cause to reduce the force, persons to be laid off shall be given at least four weeks notice and the order of layoff shall be accomplished in the following manner: a. Persons serving in a temporary capacity within a classification to be reduced shall be first laid off in order of seniority, least senior first, b. Those still serving their probationary period within a classification to be reduced in order of seniority, least senior first, c. Those whose appointments are complete within a classification to be reduced in order of seniority, least senior first d Seniority for the purpose of this article shall mean accumulated time in employment within a particular classification within a department excluding leaves of absences in excess of 90 days and time off due to suspensions without pay. In the event of identical accumulated time within the affected classification, the order of hire or promotion shall determine seniority e In the event any permanently appointed person employed in a classification above entry level is laid off, that person shall have the right to voluntarily reduce in rank to the next lower classification previously held within the department regardless of whether a vacancy exists within that classification. Any person, other than persons serving temporary appointments in higher classifications, choosing voluntary reduction in rank under this section shall be regarded as the most senior person in that classification to which they are reduced for the purpose of any further layoffs. Temporary appointees electing voluntary reduction in rank shall assume the seniority in the previously held classification. The least senior permanently appointed person within any classification shall be laid off in the event all the positions within the classification are filled and a voluntary reduction in rank from a higher classification occurs. Likewise, if a person is laid off as a result of a voluntary reduction in rank that person may voluntarily reduce in rank to the next lower classification previously held f. All persons except temporary appointees who choose to voluntarily reduce in rank shall be placed on a reinstatement register for each classification from which they were reduced ARTICLE 37 - DURATION This agreement shall be effective on January 1, 2014 and shall continue through December 31, 2015 Executed by the parties hereto this day of ,2013. Yakima Police Patrolmans Association City of Yakima By By Chairman of YPPA City Manager -34- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 By: By: Secretary of YPPA Chief of Police ATTEST: City Clerk -35- YPPA Collective Bargaining Agreement January 1, 2014 — December 31, 2015 COLLECTIVE BARGAINING AGREEMENT By and Between The City of Yakima And International Association of Firefighters Local #469 Yakima Battalion Chiefs Effective: January 1, 2012 through December 31, 2013 ITEM TITLE: SUBMITTED BY: CONTACT PERSON/TELEPHONE: SUMMARY EXPLANATION: BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT Item No. —T For Meeting of: April 3, 2012 Ordinance amending Chapter 2.04 entitled "Group Insurance" of the City of Yakima Municipal Code, specifically by adding a new section 2.04.030 C on authority to exempt certain positions from the health care plan, and deleting 2.04.060 entitled "Physical Examination". City Manager's Office and Legal Department Michael A. Morales, Interim City Manager, 575-6040 The proposed amendment adds a new section relating to health care insurance which is for the purpose of recruitment only for the specific positions of city manager, chief of police, fire chief, city attorney, director of public works, director of community and economic development, and director of finance, when a person to whom an offer of employment is made has an existing health care plan from their former employment that they desire to maintain upon employment with the City. The amendment provides authority to agree to compensate that person for the cost to that person to maintain their present health care plan, up to but not to exceed the amount the City's health care plan would otherwise have contributed to their health care costs for similar coverage under the City's health care plan. The City's contribution for the health care allowance would never be more than the City would have contributed if the employee had similar coverage under the City health care plan. The second amendment is a housekeeping measure to delete YMC 2.04.060 entitled "Physical Examination", which has not been used for several years. Physical examinations are currently covered through the City health care plan. Resolution Contract: Contract Term: Insurance Required? No Funding Source: Ordinance X Mail to: Amount: Other (specify) Expiration Date: Phone: APPROVED FOR SUBMITTAL: City Manager STAFF RECOMMENDATION: Staff respectfully requests the City Council to pass the amendments to the Ordinance involving group insurance for the City's health care plan. BOARD/COMMISSION RECOMMENDATION: ATTACHMENTS: Click to download An Ordinance relating to Group Insurance for employees of the City of Yakima; amending Chapter 2.04 entitled "Group Insurance" of the City of Yakima Municipal Code, specifically by adding a new section 2.04.030 C on authority to exempt certain positions f fl An Ordinance relating to Group Insurance for employees of the City of Yakima; amending Chapter 2.04 entitled "Group Insurance" of the City of Yakima Municipal Code, specifically by adding a new section 2.04.030 C on authority to exempt certain positions f • TABLE OF CONTENTS ARTICLE 1— UNION RECOGNITION AND BARGAINING UNIT 3 ARTICLE 2 — WAGES 3 ARTICLE 3 — HEALTH CARE INSURANCE 4 ARTICLE 4 — LIFE INSURANCE ... 5 ARTICLE 5 — MEDICAL EXPENSE REIMBURSEMENT PLAN (MERP) 5 ARTICLE 6 — SPECIAL PAY (Bi -lingual) 5 ARTICLE 7 — WORKWEEK AND SCHEDULE 5 ARTICLE 8 — LONGEVITY PAY 6 ARTICLE 9 — DEFERRED COMPENSATION 6 ARTICLE 10 — PROMOTIONAL STANDARDS ..6 ARTICLE 11— VACATION LEAVE 6 ARTICLE 12 — HOLIDAY TIME 7 ARTICLE 13 — KELLY TIME 7 ARTICLE 14 — MEDICAL EXAMS 7 ARTICLE 15 — OVERTIME PAY 7 ARTICLE 16 — EMERGENCY CALLBACK 8 ARTICLE 17 — OVERTIME HIRING 8 ARTICLE 18 — VACATION AND SICK LEAVE CASH OUT 8 ARTICLE 19 —UNION BUSINESS LEAVE 9 ARTICLE 20 — NATIONAL FIRE ACADEMY 9 ARTICLE 21— STATE MOBILIZATION 9 ARTICLE 22 — COMMUNICATIONS PROGRAM 9 ARTICLE 23 — JOB SECURITY 9 ARTICLE 24 — DISABILITY INSURANCE 10 ARTICLE 25 — DRUG TESTING POLICY 11 ARTICLE 26 — DISCIPLINE POLICY 12 ARTICLE 27 — TERM OF AGREEMENT 12 International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 2 COLLECTIVE BARGAINING AGREEMENT (CBA) By and Between THE CITY OF YAKIMA, WASHINGTON And LOCAL 469, INTERNTIONAL ASSOCIATION OF FIREFIGHTERS, AFL-CIO GENERAL PROVISIONS ARTICLE 1— UNION RECOGNITION AND BARGAINING UNIT This CBA acknowledges and confirms the agreement by and between the City of Yakima and the Battalion Chiefs of Yakima Firefighters Local #469 regarding compensation and specific employment matters for the Battalion Chiefs. The parties agree to the following points having been addressed and clarified regarding issues, which may or may not be addressed in the Management Compensation Plan or supplement said Plan. Except as provided for herein, the Battalion Chiefs shall be a part of but not limited to the Management Compensation Plan adopted in Ordinance No. 94-83 effective April 16, 1995. ARTICLE 2 — WAGES Effective 1/1/2012: base wage salary increase of 2% Effective 7/1/2012: base wage salary increase of 2% Effective 1/1/2013: base wage salary increase of 1% International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 3 ARTICLE 3 — HEALTH CARE INSURANCE The City shall maintain current Health Insurance Premiums as outlined in Management Compensation Plan. Medical, Vision and Dental Care Coverage: (a) Covered bargaining unit employees, retirees and their dependents shall participate in the "City of Yakima Employees' Health & Welfare Benefit Plans". Eligibility rules, types and or levels of benefits, payment of premiums through a cafeteria plan, co -payment, coinsurance and deductibility requirements and all other terms and conditions for the provision of these health benefits shall be governed by the "City of Yakima Employees' Welfare Benefit Program". Health and Dental Care Premium Contributions: (a) Dental Care Premium Contributions. The City shall pay the premium for employee and dependent dental care coverage. (b) Employee contributions under this Article will be accomplished through normal payroll deductions. Retiree Coverage: The City of Yakima Employees' Health and Welfare Benefit Plan shall provide retirees and dependents of retirees the right to remain in the group plan, except in the case cited below. (a) Retirees may elect to remain in the group medical plan until they reach age 65, upon payment of the required premium. (b) Spouses of retirees may remain in the group medical plan until they reach age 65 or in the case of spouses of deceased retirees, until they reach age 65 or remarry, whichever occurs first. (c) Other dependents of retirees may remain in the group health care plan as long as they remain eligible under the provisions of the plan or when coverage for the retiree and spouse, or, the spouse of deceased retiree terminates, at which time such dependent insurance coverage would cease regardless of the age of the dependents. . (d) Retirees, or spouses of deceased retirees, shall pay the premium and other shared dependent coverage costs (including dependents if enrolled), which shall be based on the same formula as active employees and dependents within the bargaining unit. Premiums shall be paid by deduction from retirement checks paid to retired employees or their beneficiary. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 4 ARTICLE 4 — LIFE INSURANCE Effective July 1, 2012, the City will provide, without cost to the employee, $100,000 in face amount of life insurance. ARTICLE 5 — MEDICAL EXPENSE REIMBURSEMENT PLAN (MERP) The City will allow members of this bargaining unit, who are eligible, to continue to make contributions into and participate in the Washington Sate Council of Fire Fighters Employee Benefit Trust (the "Trust Agreement") and the Premium Reimbursement Plan of the Washington Sate Council of Fire Fighters Employee Benefit Trust (the "plan") at their own expense. All employees who have participated in the Medical Expense Reimbursement Plan (MERP) for not less than one month prior to being promoted into this bargaining unit may continue to be plan participants. Internal Revenue Service (IRS) codes require all eligible employees participate and there is no individual election to continue contributions. Excess sick leave conversion rights are to the Medical Savings Account/Voluntary Employees Beneficiary Association (MSA/VEBA) Plan for management employees. The Union and the Employees agree to hold the Employer harmless and indemnify the Employer from any and all liability, claims, demands, law suits, and/or losses, damage or injury to persons or property, of whatsoever kind, arising from and in any way related to the implementation and administration of the Trust Fund. The Union and Employees shall be one hundred percent (100%) liable for any and all liabilities that arise out of the Trust Fund. The Union and Employees shall be liable for any and all tax penalties, as well as any other liabilities arising out of the implementation and administration of the Trust Fund. ARTICLE 6 — SPECIAL PAY Bi -lingual Pay: A Spanish bilingual oral slcills premium pay is established at $75.00 per month subject to the employee achieving a passing score on the bilingual skills examination conducted under the Fire Civil Services Rules and Regulations and administered by the Civil Service Chief Examiner. The Fire Chief may waive this testing requirement if the employee can demonstrate to the satisfaction of the Fire Chief, through documentation or otherwise (i.e. court interpreter certification from the State of Washington) that the employee has sufficient bilingual skills in the Spanish language to benefit the Department. ARTICLE 7 — WORKWEEK AND SCHEDULE The workweek for "Shift" Battalion Chiefs shall be 50.46 hours. 24-hour shift employees shall be assigned to the "48-96" shift. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 5 ARTICLE 8 — LONGEVITY PAY Longevity shall reflect the current Longevity pay scale as outlined in the Management Compensation Plan, City of Yakima Municipal Code, Chapter 2.24, Longevity Plan 2.24.010(B).. Years of Service Percent of Base Pay 5 2.5 10 4.0 15 5.5 20 7.0 24 10.0 ARTICLE 9 — DEFERRED COMPENSATION The City shall maintain current deferred compensation as outlined in Management Compensation Plan. Said deferred compensation is separate pay and is not part of the base monthly salary schedule codified in Yakima Municipal Code Pay and Compensation Ordinance, subsection 2.20.110. This provision is subject to the City's deferred compensation rules and regulations adopted by the City Council and IRS regulations, and the computation of retirement contributions and pension benefits shall be governed by applicable state law. ARTICLE 10 — PROMOTIONAL STANDARDS In order to test for the position of Battalion Chief, candidates will have a minimum of five (5) years suppression experience as Company Officer in the Yakima Fire Department. The candidate will have also successfully completed the Battalion Chief Task Book issued by the Yakima Fire Department. ARTICLE 11— VACATION LEAVE Effective January 1, 2013, Battalion Chiefs assigned to Operations will be awarded vacation time in the following manner. Service in Years Accrual Hrs/Mo. Accrual Hrs/Yr. Maximum Accrued 0-5 14 168 348 5-10 16 192 396 10-15 18 216 444 15-20 20 240 492 20+ 22 264 540 International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 6 ARTICLE 12 — HOLIDAY TIME At the first of each year, Battalion Chiefs will receive a credit of 120 hours to their holiday leave account. New employees hired after that date will receive holiday credits at the rate of 10 hours per month for all months remaining in the calendar year. New employees must be scheduled to work for more than one-half (1/2) of the month's shifts in order to receive holiday credit for the month in which they were hired. Employees transferring from days to shifts will receive holiday credits at the rate of ten (10) holiday hours per month for the calendar months remaining in the year. Employees transferring from shifts to days will have ten (10) hours per month for each calendar month remaining in the year deducted from their 120 hours of holiday credits which shall not be reduced to less than zero credits. The employee's schedule which encompasses more than one-half (1/2) of a month shall determine whether or not credits are added or reduced for that month. Holiday time must be used in the calendar year in which it was credited and may not carry-over into successive calendar years. Unused holiday time will be paid at 100% of the base wage as of December 31 of each year up to a maximum of ninety-six (96) hours per employee. An employee who uses up their 120 hours of holidays and leaves the Department before December 31 shall have 10 hours removed from their earned leave account for each month remaining in the year that the employee has not worked at least one (1) shift. ARTICLE 13 — KELLY TIME Battalion Chiefs working the 48/96 schedule shall receive twelve (12) 24 hour shifts per year as Kelly Days pro -rated over the course of the year. ARTICLE 14 — MEDICAL EXAMS Complete medical physical exams will be provided at the City's expense at the age of 40 and every two years thereafter. After the age of 50 annual medical exams will be provided at the City's expense on the recommendation of a physician otherwise they will be provided every two years. The City shall send notification at least 60 days prior to his/her birthday that examination is. due. The employee shall sign a letter stating whether he/she wishes to have the examination. ARTICLE 15 -- OVERTIME PAY Battalion Chief overtime pay shall be paid at a rate of one and one half times (11/2) the straight -time hourly rate for each hour that is worked outside the normal weekly work schedule to provide coverage of the Shift Commander position in the absence of the regularly scheduled shift Battalion Chief. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 7 ARTICLE 16 — EMERGENCY CALLBACK Pay for emergency call back shall be computed at the rate of 1'/ times the normal rate based on a 40 hour workweek. State Mobilization time will be computed at the rate of 1 %2 times the normal rate based on a 50.46 hour workweek. ARTICLE 17 — OVERTIME HIRING In the event of a vacancy created by the shift Battalion Chief due to the use of Kelly days, vacation time, holiday time, union leave, administrative leave or sick/disability leave and Department manpower meets the minimum levels to fill all required positions, a qualified Captain from that shift will be allowed to fill the position. The roster will be set by 2100 hours of the shift before the affected shift. If no qualified Captains are available on the shift, the Battalion Chiefs will be offered the overtime. If the Battalion Chiefs decline and Department manpower does not meet the minimum levels to fill all required positions and there is a qualified Captain available on that shift, then that Captain will be assigned Acting Battalion Chief and an off duty Captain will be hired to backfill. ARTICLE 18 — VACATION AND SICK LEAVE CASH OUT Except as provided above regarding holiday accrual, and only for the purpose of cash outs of earned leave time (vacation) and/or sick leave time, at the time of retirement or termination of service to the Department, Battalion Chiefs shall receive compensation at an hourly rate based on their applicable monthly salary divided by 173.33 hours. Total cash out shall comply with limits set froth in the City of Yakima Management Compensation Plan, except for the following: 18.1— Sick Leave Cash -out Upon retirement, the employee's accrued sick leave up through a maximum of one hundred twenty-five days (one thousand hours) will be submitted to the employee's Voluntary Employee Beneficiary Association (VEBA) account at the rate of one hundred percent of the employee's current base pay to a maximum of thirty-eight thousand five hundred ($38,500.00). 18.2 — Sick Leave Exchange In accordance with YMC 2.40.030 E. 2. c. (except at a rate of three (3) days to one (1) instead of four (4) days to one (1)), employees who have more than ninety days (seven hundred twenty hours) of sick leave may exchange such sick leave for bonus (additional) leave days at the rate of three (3) days of sick leave to one (1) leave day, not to exceed a total of five added leave days annually, utilization of which would be subject to the • -scheduling and approval by the department head. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 8 18.3 — Vacation Leave Cash -Out Any vacation accumulated over the stated limits shall be paid at one hundred percent (100%) of base wage as of December 31 of each year; provided, however, at least seventy-five percent (75%) of the annual accrual rate for vacation must have been used during the year in order to qualify for the payment; provided, however, if the Employer cancels an employee's scheduled vacation and this canceling results in vacation accumulation over the stated limits as of December 31 of any particular year then the Employer will pay for said vacation at the normal hourly rate. Payment for any vacation accumulated over the stated limits is subject to the Employers' inability to reschedule the vacation time off. Neither party shall unreasonably withhold approval of rescheduling of vacation previously canceled. ARTICLE 19 — UNION BUSINESS LEAVE Members of the Battalion Chief bargaining unit shall be granted up to a total of seventy- two (72) hours of leave time to attend to Union business such as negotiations, labor seminars, and conventions in accordance with all applicable laws and ordinances of the State of Washington. ARTICLE 20 — NATIONAL FIRE ACADEMY The City agrees to allow Battalion Chiefs to attend classes at the National Fire Academy for the Executive Fire Officer program and/or other classes that may be valuable in performing the duties of Battalion Chief/Incident Commander. The Fire Chief may limit participation due to unforeseen circumstances adversely affecting shift manning. ARTICLE 21— STATE MOBILIZATION The City agrees to allow Battalion Chiefs to participate in mobilizations as part of state or national Incident Management teams that may be needed to assist in state or national emergencies. The Fire Chief may limit participation due to unforeseen circumstances affecting the Department. ARTICLE 22 — COMMUNICATIONS PROGRAM The Battalion Chiefs shall be included in the Fire Department communications program. The Fire Department and the Battalion Chiefs agree to create the best communications system possible within the City's economic resources available for Command Staff. ARTICLE 23 — JOB SECURITY In the event any permanently appointed person employed in a classification above entry level is laid off, that person shall have the right to voluntarily reduce in rank to the next lower classification previously held within the department regardless of whether a vacancy exists within that classification. Any person, other than persons serving International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 9 temporary appointments in higher classifications, choosing voluntary reduction in rank under this section shall be regarded as the most senior person in that classification to which they are reduced for the purpose of any further layoffs. Temporary appointees electing voluntary reduction in rank shall assume the seniority in the previously held classification. The least senior permanently appointed person within any classification shall be laid off in the event all the positions with the classification are filled and a voluntary reduction in rank from a higher classification occurs. Likewise, if a person is laid off as a result of a voluntary reduction in rank they may voluntarily reduce in rank to the next lower classification previously held. All persons except temporary appointees who choose to voluntarily reduce in rank under the terms of this agreement shall be placed on a reinstatement register for each classification from which they were reduced. The orders of reductions in rank shall follow the seniority rules laid out in Civil Service Rule XX in the General Rules and Regulations of the Civil Service Commission for Fire Management Employees of the City of Yakima. ARTICLE 24 — DISABILITY INSURANCE The City agrees to provide the Battalion Chiefs disability insurance as outline in the Management benefits program. The City also agrees to allow the Battalion Chiefs to purchase private disability insurance at their own cost. The City will allow the union to execute a disability life insurance policy with Standard Insurance Company that provides both short-term and long-term disability life insurance for its members. Upon execution of such a policy a covered employee is generally provided with up to fifty percent (50%) of his/her base pay in the event that the person incurs an off-duty injury, illness and/or disability and is unable to work. In order to qualify for said benefits under the policy for a particular month, the employee can receive a minimum of fifty percent (50%) of his/her base pay from the City through the utilization of accrued sick leave, compensatory time and annual leave in a month and must be in leave without pay status for the remainder of the month (a) In the event that an insured employee covered by the Local 469 Standard Insurance Company Disability Plan applies for and receives benefits from said plan the City shall permit the employee to receive a minimum of fifty percent (50%) of his/her base pay from the City through the utilization of accrued sick leave, compensatory time and annually leave in a month and allow them to be in a leave without pay status for up to fifty percent (50%) of their scheduled hours for the affected pay period. (b) Base pay for the purpose of receiving Standard Insurance Company benefits shall be the base pay per Master Ordinance plus the Deferred Compensation contribution. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 10 (c) It shall be the responsibility of the employee to inform the fire department timekeeper on or before the date in which he or she starts the leave without pay status. It shall be the responsibility of the employee to inform the fire department timekeeper on or before the date which he or she ends the leave without pay status. (d) If the insured employee's scheduled hours spent for a pay period is anticipated to be lower than the minimum number of hours required by the Washington State Department of Retirements (DRS) for receipt of full service credit for that month, then the employee may use a sufficient number of hours of his/her accrued leave for that pay period to satisfy the minimum numbers required by DRS to receive full service credit for that month. (e) It shall be the employee's responsibility to reconcile his/her monthly pay from the City with payments from the disability insurance carrier (Standard Insurance) to ensure that he/she does not violate and /or breach .any of the terms and conditions of the disability insurance policy, including but not limited to the 100% payout ceiling. Local 469 recognizes that the City does not have any liability with or to the disability insurance carrier or Local 469 whatsoever with regard to insurance disputes between the carrier and employees represented by Local 469, including by not limited to the reconciliation of pay and the 100% payout ceiling. Further, Local 469 agrees to indemnify, defend and hold harmless the City of Yakima, it officers, elected officials, employees and agents from any and all claims, demands, losses, liens, liabilities, penalties, fines, lawsuits, and other proceedings and all judgments, awards. Costs and expenses (including attorneys' fees and disbursements) caused by or occurring as a result of any dispute between an employee represented by Local 469 and the disability insurance carrier. (f) Both Local 469 and the City have participated in the drafting of this language and as such, it is agreed by the parties that the general contract rule of law that ambiguities in the contact language shall be construed against the drafter of a contract shall have no application to any legal proceeding, arbitration and/or action in which this section of the contract and its terms and conditions are being interpreted and/or enforced. ARTICLE 25 — DRUG TESTING POLICY The Battalion Chiefs shall participate in the Department Drug Testing Policy as it applies to all LEOFF management personnel. Intemational Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 11 ARTICLE 26 — DISCIPLINE POLICY The Disciplinary Policy is incorporated into this Agreement and is attached hereto as Appendix A. In accordance with relevant PERC decisions and by agreement of the Parties should a conflict occur between the provisions of collectively bargained Appendix A and the provisions of Rule XIX - Disciplinary Actions, contained in the General Rules and Regulations of the Civil Service Commission For Fire Management Employees of the City of Yakima then such conflict shall be resolved in favor of the provisions in Appendix A which shall supersede. Where there is no conflict between Appendix A and Rule XIX the provisions of each shall equally apply to employee discipline. ARTICLE 27 — TERM OF AGREEMENT This agreement shall remain in effect from January 1, 2012 to December 31, 2013. By mutual consent of the parties to the agreement, any part or the entire agreement may be opened for cause during the term of the memorandum. Agreed to this J ' day of , 2012 City o Yakima % / 7 ] F LOCAL #469 Tonr'Ro e, City Manager Dave Willson, Fire Chief Rodriguez, President By: Sonya Claar-Tee City Clerk City Contract No. D-01 Resolution No. R. -,›01,.)J-1 International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 12 Abel Castillej a, Representative APPENDIX A Yakima Fire Department DISCIPLINARY POLICY Purpose: To increase professionalism, improve morale, improve manager/employee relations, foster long-term positive change, and deter future performance deficiencies. The City of Yakima Fire Department and Yakima Public Safety Communications Center hereby adopts the following disciplinary guidelines, relating to the administration a process of corrective disciplinary actions. This policy is in addition to any applicable policies, SOPs, and guidelines regarding disciplinary action applicable to bargaining unit members, including the Fire Civil Service Rules and Regulations. Procedure A. Progressive Discipline The process of progressive discipline is intended to assist the employee in overcoming performance problems and to meet job expectations. Progressive discipline is most successful when it assists an individual in becoming an effective and productive member of the organization. Failing that, progressive discipline enables the organization to address misconduct or sub- standard performance of employees who demonstrate an unwillingness or inability to improve. Generally, there are four main types of corrective disciplinary action; oral reprimand, written reprimand, suspension, and discharge. Demotions, deductions of pay within the pay range, and other forms of discipline may also be used depending on the circumstances. The four main types of corrective discipline are defined as follows: 1. Oral Reprimand — Any instance in which an employee is issued an oral reprimand for an infraction or performance deficiency by any supervisor. An oral reprimand shall include all of the following: • A meeting with the employee and his/her immediate supervisor. • The employee informed that this is an oral reprimand • Oral reprimands will be memorialized by memo to include the date and time of the infraction, the department policy, SOP or guideline that has been violated, International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 13 an action plan to correct the behavior and action necessary to avoid further discipline. • A memo documenting receipt of the oral discipline shall be signed by the individual and the immediate supervisor. This memo is to be filed with the Deputy Chief or Assistant communications Manager and a copy is to be provided to the employee. Memo is not placed in employee's personnel file. 2. Written Reprimand — Any instance in which an employee is formally issued a written reprimand document for an infraction or performance deficiency by any supervisor. Written reprimand shall include all of the following: • A meeting with employee, immediate supervisor, • The employee informed that this is a formal written reprimand. • Written reprimands will be memorialized by a letter which shall document date and time of the infraction, the department policy, SOP, or guideline that has been violated, the previous related discipline, an action plan to correct the behavior and action necessary to avoid further discipline. • A copy shall be maintained in employee's personnel file and given to the employee. 3. Suspension — Any instance in which any employee is released from duty without pay from city service. If subsequent to a satisfactory investigation, suspension of an employee is the contemplated level of discipline the process shall include all of the following: • Provide the employee with a pre -disciplinary letter that schedules the "Loudermill" meeting with the employee. • The pre -disciplinary letter shall inform the employee of the alleged policy, SOP or guideline violation, including time and date. Also include any previous related discipline, violations and the anticipated level of discipline • A discipline letter will be issued informing the employee of the length of the suspension, containing an action plan designed to correct the behavior. The letter will also contain action necessary to avoid further discipline and detail the employee's return to work. • The original disciplinary letter will be provided to the employee and a copy of the pre -disciplinary and disciplinary letters will be maintained in the employee's personnel file. 4. Discharge — Any instance in which an employee is involuntarily terminated from city service. If subsequent to a thorough investigation, discharge of an employee is the contemplated level of discipline the process shall include all of the following: • Provide the employee with a pre -disciplinary letter that schedules the Intemational Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 14 "Loudermill" meeting with the employee. • The pre -disciplinary letter shall inform the employee of the alleged policy, SOP or guideline violation, including time and date. Include previous related discipline and violations and anticipated level of discipline. • A discipline letter will be issued that informs the employee of the effective date of the discharge and appeal process. • The employee will be given the original disciplinary letter and a written copy of the pre -disciplinary and disciplinary letters will be maintained in the employee's personnel file. B. Progressive Disciplinary Process When a sub -standard performance persists despite informal counseling, coaching or remedial training, an increase in the level of disciplinary action will be initiated and directed toward correcting the behavior. Continuing offenses, which alone may justify nothing more severe than a written reprimand, may be cause for more serious discipline up to and including discharge should the employee not make the corrections required. The Progressive Disciplinary process will utilize only the level of discipline and corrective action necessary to achieve the improved performance and deter future rule violations. All oral reprimands shall be placed on file in the Deputy Chief or Assistant Communications Managers office. Oral reprimands are not to be placed into the employee's personnel file and shall be removed from the Deputy Chief or Communications Supervisors file upon request of the employee after two years. Written and suspension documentation shall be placed in the employee's personnel file. Time begins the day the documents are filed into the employee's personnel file. The documentation shall be removed upon request of the employee after two years. Consistent with the Fire Civil Service Rules and Regulations, an employee disciplined under this policy may file with the Civil Service Commission a written request for a hearing, within 15 days from the time of receipt of written notice of such discipline, whereupon, consistent with the Rules, the Commission shall conduct such hearing. Failure to file such written request within the time specified shall be deemed a waiver of any right of review. C. Definitions of levels of infraction: rvlinor Infraction — Any violation that does not compromise safety, efficiency, or the ability to properly respond to or process an emergency call. Violations of this type may rise to the level of an oral or written reprimand. Multiple violations may rise to the level of termination. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 15 Examples but not limited to: • Tardiness • Inefficiency or inattention to duties • Failure to maintain satisfactory and harmonious working relationships (depending on the extent, this may be considered a more serious infraction). More Serious Infraction — Any violation that compromises the integrity of the department or the city or which the consequences cause only minor disruption of work. Violations of this type may rise to the level of a reduction in pay, suspension or demotion. Multiple violations may rise to the level of termination. Examples but not limited to: • Careless, negligent or improper use of City property • Releasing confidential information without proper authority • Unauthorized absence or improper use of any type of leave • Public defamation of character or the organization Intolerable Infraction —Any action that endangers the safety, health, or well-being of another person. The act is of sufficient magnitude that the consequences cause disruption of work or gross discredit to the Department or City of Yakima. Violations of this type may rise to the level of immediate termination. Examples but not limited to: • Fighting with the intent to do bodily harm • Insubordination, open and willfully defying of an order • Consumption or distribution of alcohol or illegal drugs on duty • Falsification, fraud, or willful omission of information related to the job • Endangering of coworkers and/or civilians due to reckless behavior • Pattern of performance deficiencies D. Probationary Employees These guidelines are designed to promote corrective discipline and do not apply to probationary employees. E. Training In order to assist supervisors in enforcing this policy and applying discipline uniformly, labor and management will cooperatively present training to all supervisors. International Association of Firefighters Battalion Chiefs January 1, 2012 to December 31, 2013 16