Important Questions and Answers for
Employees Impacted by the WTC Tragedy
Revised 10/19/2001
A. The State has established a centralized number for employees to call to learn the latest updates on the status of their offices in lower Manhattan. The toll-free number is 1-866-832-9942.
Q. If my normal work location is in the affected area and I am reassigned where may I be reassigned to?
A. While the State has not announced comprehensive plans in this regard, we do understand that options are being explored and in some cases reassignments have already begun. If or when your agency does reassign affected employees, it has the discretion to reassign you to an alternative work location which may not be in the same borough, or even in NYC, so long as you are working in the same title and for the same appointing authority.
When reassignments occur, the union is prepared to work with your agency on your behalf to minimize any hardship that such reassignments may cause. This might include developing temporary alternate work schedules, compressed work weeks or telecommuting arrangements; identifying other acceptable alternate work locations; or, identifying other means for reducing burdensome travel or other hardship.
Q. If I need to take additional time off what leave may I charge?
A. Entitlement to take additional time off and use accrued time for non-work related injury is generally controlled by the provisions of the Attendance Rules of the State of New York and the provisions of Article 12 of the PEF Agreement. Generally, this means that standard rules and procedures regarding granting of requests for time off continue to apply. In the event that your continued absence is associated with a work-related injury, you may be eligible for workers’ compensation benefits provided by the Workers’ Compensation Law and Article 13 of the PEF Agreement.
Q. Is the PS&T Unit Agreement suspended during the emergency created by the World Trade Center tragedy?
A. No. The terms of the Agreement still apply. However, your department or agency may have special emergency needs and there may be changes in working conditions caused by the destruction of the World Trade Center. These are extraordinary times, and while we encourage all PEF members to be as understanding and flexible as possible, it does not mean that we abandon our rights under the Contract or under the Taylor Law.
You may be required to report to a new work location and/or may experience other changes, such as a change in work schedule. Some of these may be justified and, thus, fall within management’s discretion, while others violate the terms of the Agreement. The specific facts and circumstances will determine whether a contract violation occurred. Please contact your steward or Field Representative immediately, if you think your contract rights have been violated. Remember, even if you believe that management is violating your contract rights, comply with management’s directive, and exercise your Article 34 rights by filing a grievance.
A. Employee Assistance Program services, including grief counseling and referrals are available through local EAP Coordinators or by calling 1-800-822-0244. EAP is working to maximize the number of credentialed counselors available to assist employees. This includes trying to have counselors at the work sites of impacted employees when they return to work. EAP is also working to make group counseling services available. Call 1-800-822-0244 for details on the availability of group counseling services. In addition, employees can call the Ceredian Corporation for telephonic counseling and other resources at 1-800-847-5347.
A. Determination of coverage under Workers' Compensation is made by the Workers' Compensation Board, and it is always based on the facts of the case. That being said, we have been in contact with GOER which has indicated that they would expect that the injuries people directly sustained as a result of the World Trade Center attack and subsequent building collapse would be covered. Injuries sustained in other ways (e.g., offering assistance to victims, stress related injuries) may be covered by Workers' Compensation, but each set of circumstances will have to be separately evaluated. As always, we believe the prudent course is to file the claim. Finally, some questions have been raised about whether Workers’ Compensation Benefits will be paid in the event that the World Trade Center attack is determined to be an Act of War, in which case, other benefits may apply. We will continue to monitor the situation and will share whatever information we obtain.
A. While individual circumstances may vary, if you are physically injured because you were at or near the World Trade Center due to your work, you are likely eligible for workers compensation benefits and leave under the Workers Compensation Law and Article 13 of the PEF Agreement. This may also be the case if, due to work related circumstances, you are experiencing medically documented stress symptoms which prevent you from working. If you are faced with either of these circumstances you should immediately inform your agency that you believe you have experienced a work-related injury and apply for worker’s compensation benefits. You should also contact your field representative for additional information and assistance.
Q. How do employees continue their health insurance coverage while on Workers' Compensation?
A. Employees removed from the payroll because of an accepted work-related injury or occupational condition, can continue health insurance coverage at the employee's share of the premium (10% for individual and 25% for family) for up to 12 months per injury.
Employees removed from the payroll because of a controverted (or contested) work-related injury or occupational condition, can continue health insurance coverage by paying both the employer's and the employee's share of the premium (100%). In certain situations, however, Empire Plan enrollees are entitled to have their health insurance premium contribution waived for up to one year. Typically, the employee's Personnel Office informs the employee of his or her right to apply for the waiver.
Employees or survivors who do not receive this information should be instructed to call their Health Benefits Administrator (HBA). If the local or regional HBA is not available, the employee or survivor should be referred to the agency's main office or headquarters. Employees or survivors may also call the Department of Civil Service/Employee Benefits Division at 1-800-833-4344 or 518-457-5754 for assistance.
While employees are on Workers' Compensation, payment for medical care for their work-related injury or condition is the responsibility of the State Insurance Fund. Other medical services for the employees and their covered dependents continue to be the responsibility of the Empire Plan or their HMO.
Q. Will the employee's dental and vision care coverage continue while s/he is on Workers' Compensation?
A. Dental and vision care coverage continues at no cost to the employee.
Employees enrolled in the Empire Plan, HIP Health Plan of New York and MVP are eligible for the ONECARD Rx Program. This program allows employees to fill prescriptions for work-related injuries or illnesses with the same card they use to obtain prescription drugs under their health plan. There is no copayment, no out-of-pocket cost and no claim form for most work-related prescriptions.
A. Article 11 of the PS&T Unit Agreement provides for a $50,000 accidental death benefit when certain conditions are met. If an employee dies as a result of an accidental on-the-job injury and Workers’ Compensation pays a death benefit, the State must pay a $50,000 death benefit to the surviving spouse and children to whom the Workers’ Compensation Accidental Death Benefit is paid. The benefit is distributed in the same proportion as the Workers’ Compensation Accidental Death Benefit. However, if the Workers’ Compensation Accidental Death Benefit is paid to the deceased employee’s estate, the Article 11 Accidental Death Benefit is paid to the employee’s estate as well.
There is an additional benefit for an employee’s children who receive an Accidental Death Benefit paid pursuant to Article 11. If, after the employee’s death, such a child enrolls in and attends the State University of New York, or an accredited private college or university within New York State, that child shall receive a tuition benefit. The child is entitled to a payment equal to his/her tuition cost up to a maximum of the tuition for the corresponding semester at the State University of New York. This benefit is available for each semester he/she is enrolled and in attendance at such educational institution.
Employees may also be eligible for a death benefit from the retirement system.
A. The headquarters of the State Insurance Fund is located just blocks away from the World Trade Center. At this time, the offices are closed, and it is not known when the offices can be reoccupied.
If you need information about an existing claim, call 1-888-875-5790.
If you have other questions, call 518-437-1879
A. If you are unable to work due to physical injury or medically documented stress symptoms, due to circumstances which were not work related, you may charge accrued sick leave. Management may request medical documentation (including a brief diagnosis, a statement that you are unable to perform the duties of your position, a brief prognosis and an anticipated date of return to work) which it deems satisfactory. In the event that you exhaust accrued sick leave but are still medically unable to return to work, you may charge other accrued leave subject to the same approval procedures and documentation requirements applicable to sick leave.
Injured employees who have exhausted all accruals may be eligible to receive mandatory sick leave at half pay as provided in Article 12.20 of the PEF Agreement. Injured employees may also be eligible to receive discretionary sick leave at half pay of up to one pay period for every complete six months of State service as provided by Section 21.5 of the New York State Attendance Rules. Finally, injured employees may also be eligible to receive donated leave time pursuant to the Leave Donation Program as provided on page 200 of the 1999-2003 PEF Agreement.
Q. I have a family member who has been killed. What types of leave may I charge?
A. Article 12.18 of the PEF Agreement provides that up to 15 days of accrued sick leave per calendar year may be charged for family sick leave and/or bereavement leave due to death in the employee’s immediate family. Therefore, any current entitlement to charge sick leave for death in the immediate family will depend on what sick leave if any you have charged for family sick and/or bereavement leave since January 1, 2001. The definition of family for these purposes includes any relative or relative-in-law regardless of place of residence, or any persons with whom you have been making your home. Accrued personal leave may also be charged, subject to supervisory approval as provided in Article 12.11 of the PEF Agreement. Access to vacation time off will be subject to supervisory approval subject to the provisions of Article 12.6 and 12.7 of the PEF Agreement. Additional time off may only be charged to sick leave if such time off is due to your own medically documented stress (see below).
A. Attendance at funerals for non-family members may not be charged to sick leave. Charge to vacation time or personal leave is appropriate, subject to supervisory approval consistent with Articles 12.6, 12.7 and 12.11 of the PEF Agreement.
A. Article 12.18 of the PEF Agreement provides that up to 15 days of accrued sick leave may be charged for family sick leave and/or bereavement due to death in the employee’s immediate family. Therefore, any current entitlement to charge sick leave to care for an injured family member will depend on what sick leave if any you have charged for family sick or bereavement leave since January 1, 2001. The definition of family for these purposes includes any relative or relative-in-law regardless of place of residence, or any persons with whom the employee has been making his/her home. As is always the case, your agency may request documentation of the family member’s injury and the fact that you are needed to provide direct care to the injured family member. Additional time off may be approved and charged to other accrued leave, subject to normal supervisory approval requirements. Leave donation and sick leave at half pay are not available for absences associated with family illness or injury.
A. If you are experiencing medically documented stress symptoms that prevent you from working you may charge accrued sick leave. As discussed above in response to the questions regarding non-occupational injury, management may request medical documentation that it deems satisfactory to establish that you are unable to work due to such symptoms. In the event that you exhaust accrued sick leave but are still medically unable to return to work, you may charge other accrued leave subject to the same approval procedures and documentation requirements applicable to sick leave.
While you are not eligible to receive donated leave through the Leave Donation Program to care for an injured family member, if you have exhausted your accruals and you are personally experiencing medically documented stress symptoms due to the catastrophic injury of a family member, you may be eligible to receive donated leave time for your own disability through the Leave Donation Program. Finally, you may also be eligible to receive mandatory sick leave at half pay as provided in Article 12.20 of the PEF Agreement and/or discretionary sick leave at half pay of up to one pay period for every complete six months of State service as provided by Section 21.5 of the New York State Attendance Rules.
Q. I have exhausted my accruals and cannot return to work. Are there any other benefits available to me to avoid a disruption in my income?
A. Under the New York State Attendance Rules agencies have the discretionary ability to advance you some additional leave accruals to bridge a short term absence. Specifically, Attendance Rule 21.4 grants agencies authority to advance up to five days of sick leave to employees who have exhausted their accruals. This sick leave must be repaid to the agency as soon as possible after the employee returns to duty. Attendance Rule 21.2(d) also gives agencies the discretionary authority to advance employees with two through seven years of continuous service a portion of their bonus vacations days, pro rated based on the number of pay periods served in their current vacation year. If you have exhausted accruals and require additional short term absence associated with the attack on the World Trade Center you should ask your agency to consider extending you additional accruals pursuant to these Attendance Rules.
Q. I am a volunteer fire fighter or ambulance squad member. Am I allowed any time off without charge to accruals for rescue work associated with the World Trade Center attack?
A. Civil Service Law § 82-a provides that during a declared state of emergency, volunteer firefighters and ambulance squad workers are entitled to leave without charge to accruals for time actually engaged in emergency response activities including travel to and from the site, so long as such absence does not interfere with the proper conduct of governmental functions. The Governor has declared a disaster emergency for all counties in New York City and all counties contiguous thereto as a result of the attack on the World Trade Center.
Article 12.14 of the PS&T Agreement also requires State agencies to excuse reasonable tardiness without charge to accruals for volunteer firefighters and ambulance squad workers caused by participation in voluntary emergency activities. Article 12.14 does not excuse full day absences associated with such activities.
A. The Governor has notified all State agencies that adequate release time without charge to accruals should be granted to employees who request time away from work to donate blood.
Q. I am a Red Cross disaster relief volunteer. Am I entitled to release time for Red Cross relief activities?
A. We understand that the Governor is directing agencies to grant release time without charge to accruals to employees who are Red Cross disaster relief volunteers who are engaged in relief activities associated with the World Trade Center attack.
A. Article 27 provides a maximum benefit of $350 for personal property damaged or destroyed in the actual performance of work, where the employee was not negligent. Any employee who has had personal property destroyed due to the attack on the World Trade Center should submit a claim to his/her agency. The employee must establish the amount of the loss and the department or agency will investigate to substantiate the employee’s claim for reimbursement. The Comptroller has the authority to adjust amounts of reimbursement.
Upon an employee’s request, subject to the availability of funds, the department or agency may pay up to $250 of the maximum $350 dollar benefit out of local funds, pursuant to Comptroller regulations.
A. If you have a change in status that satisfies federal Internal Revenue Service rules for the DCAAccount you can do any one of three things related to your DCAAccount even though the enrollment period for 2001 has passed. You may 1) terminate an existing account; 2) start a new account; or 3) change the contribution rate to your existing account. The permissible changes in status include:
· Marriage ,divorce or separation
· Death (spouse/dependent)
· Birth or adoption of a child
· Beginning or end of employment (employee or spouse)
· Dependent disability
· Change from full-time to part-time employment or vice versa (employee or spouse)
· Beginning of or return from leave of absence (employee or spouse)
· Change in work schedule (employee or spouse)
· Change in custody of dependent
· Change in rate paid
· Change in care provider
· Dependent reaches age 13
This account permits payments of dependant care expenses with pre-tax dollars. If you have a qualifying change in status and enroll in the DCAAccount in 2001 the State will also contribute a sum to your DCAAccount. The State contribution for 2001 is $200, $300, or $400 based on your salary. This sum is not prorated if you are eligible and enroll for the calendar year ending December 31, 2001. If you had a qualifying event, you may enroll for just the amount of the Employer Contribution.
If you have a qualifying change in status, you must enroll within 60 days of the change. You can only be reimbursed for costs incurred from the date of enrollment to the end of the calendar year of enrollment.
Prior to enrolling in DCAA, or changing your dependent care account, confirm that you are eligible to do so and that the dependent care costs for which you want to make contributions are qualifying reimbursable expenses. Call the DCAAccount Team directly at 1-800-358-7202 (then press 2). Let the DCAAccount representatives know that you are calling about the impact of the World Trade Center attack and they will give your inquiry high priority. The Team is aware that the World Trade Center tragedy may create special needs and they have offered to provide extra one-on-one assistance to meet those needs. They are also making preparations to help assist enrollees in rerouting reimbursement checks in cases where banks have suffered damage or enrollees have had to temporarily relocate
A. An enrolled spouse and dependent children will continue to receive Empire Plan or HMO coverage without charge for five biweekly payroll periods beyond the payroll period in which the last health insurance deduction was taken. This is referred to as the extended benefits period.
Survivors should contact the employing agency's Health Benefits Administrator (HBA) for information about eligibility and enrollment during the extended benefits period. If the local or regional HBA is not available, the survivor should be referred to the agency's main office or headquarters (Tax & Finance, 518-457-2793; DOT, 518-485-2234). Survivors may also call the Department of Civil Service/Employee Benefits Division at 1-800-833-4344 or 518-457-5754 for assistance.
During the extended benefits period, survivors should continue to use the cards they already have under the employee's identification number.
Q. How do dependent survivors continue their health insurance coverage after the extended benefits period?
A. Following an employee death due to a work-related injury, the State will pay 100 percent of the cost of NYSHIP coverage for dependents as long as they remain eligible. If the death is not considered the result of a work-related illness or injury, or is controverted, the following conditions apply:
· If at the time of death an employee had 10 years of service and was 10 years or less from retirement, dependents will make the same contribution that active employees make toward the cost of the Empire Plan or HMO premium (10% for individual and 25% for family).
· If at the time of death an employee had 10 years of service but was not within 10 years of retirement, dependents will be required to pay both the employer's and the employee's share of the premium (100%).
· If at the time of death an employee had less than 10 years of service, dependents will be required to pay COBRA rates which include both the employer's and the employee's share of the premium plus a two percent administrative charge (102%).
After a dependent becomes covered as a dependent survivor, benefits will change to retiree benefits. A new card will be issued in the survivor's own name and identification number.
The death of an employee is considered a "qualifying event" that allows a surviving spouse to change from family to individual coverage, assuming no dependent children are enrolled.
Q. Will dental and vision benefits continue for surviving dependents?
A. Dental benefits for survivors ends 28 days after the last day of the last payroll period worked. After that survivors can continue dental benefits through COBRA or by converting to a direct-pay policy. COBRA coverage requires payment of the full premium plus a two percent administrative fee ($23.37 per month/individual or $69.20 per month/family). For information regarding the direct-pay policy, dependent survivors should contact GHI directly.
Vision benefits end 28 days after the last day of the last payroll period worked. After that survivors can continue vision benefits through COBRA, which requires payment of the full premium plus a two percent administrative fee ($3.00 per month/individual or $8.43 per month/family).
Q. If an employee is on sick leave or sick leave at half-pay does it change his/her biweekly premium contribution for health insurance?
A. No, as long as the employee is using accrued sick leave or is on sick leave at half pay there is no impact on his/her premium contribution.
Q. How do employees continue their health insurance coverage while on Family and Medical Leave?
A. Under the Family and Medical Leave Act (FMLA), eligible workers are entitled to up to 12 weeks of unpaid leave in a 12-month period for certain family and medical reasons. During the Family and Medical Leave, employees may continue health insurance and other benefits at the employee share of the premium (10% for individual and 25% for family). But, employees will be required to repay the employer share of the premium (90% for individual and 75% for family) if they terminate their employment following the FMLA leave period.
Q. Will the employee's dental and vision care coverage continue while on Family and Medical Leave?
A. Dental and vision care coverage will continue at no cost to the employee.
Q. How does leave without pay status affect an employee's health insurance coverage?
A. Once an employee has exhausted sick leave accruals, Family and Medical Leave Act provisions, and goes on leave without pay (LWOP), he or she must choose to continue health insurance coverage because it is not automatic. Generally, LWOP status requires the employee to pay both the employee and employer share of premium.
In certain situations, however, Empire Plan enrollees are entitled to have their health insurance premium contribution waived for up to one year. Typically, the employee's Personnel Office informs the employee of his or her right to apply for the waiver.
Employees who do not receive this information should be instructed to call their Health Benefits Administrator (HBA). If the local or regional HBA is not available, the employee should be referred to the agency's main office or headquarters. Employees may also call the Department of Civil Service/Employee Benefits Division at 1-800-833-4344 or 518-457-5754 for assistance.
Dental benefits end 28 days after the last day of the last payroll period worked. After that employees in LWOP status can continue dental benefits by paying the full premium cost ($22.91 per month/individual or $67.84 per month/family).
Vision benefits end 28 days after the last day of the last payroll period worked. After that employees in LWOP status can continue vision benefits by paying the full premium cost ($2.94 per month/individual or $8.26 per month/family).
Q. What do employees and dependent survivors need to do to receive benefits for mental health care services?
A. If enrolled in the Empire Plan, they must call ValueOptions at 1-800-446-3995 before seeking any mental health treatment. The Empire Plan permits up to three visits for crisis intervention with a network provider. There is no copay required for approved crisis intervention visits.
If enrolled in an HMO, they should call the HMO directly for a referral. PEF members may be enrolled in one of the following HMOs that serve NYC, Long Island and New Jersey:
|
Aetna US Healthcare |
1-800-323-9930 |
|
Empire Blue Choice HMO |
1-800-662-5193 |
|
GHI HMO |
1-877-244-4466 |
|
HIP |
1-877-861-0175 |
|
Vytra |
1-800-406-0806 |
If an employee is enrolled in an HMO outside of the NYC area and is uncertain of how to contact that HMO, the employee should check the health benefits section of the PEF Website or contact his or her agency health benefits administrator for assistance.
Q. Can an HMO deny benefits for the treatment of injuries employees sustained as a result of the attack on the WTC because they didn't call their primary care physician before getting care?
A. An HMO cannot require its members to get "prior authorization" (that is, permission from them) to use the emergency room or any emergency services. However, all claims for coverage of emergency services will be reviewed to determine if the services were medically necessary to stabilize or treat an emergency condition. HMOs typically require their members to call as soon as reasonably possible after receiving emergency services.
Q. If an employee serves in the National Guard and is deployed to New York City, how does that affect his/her health benefits?
A. Under New York State Military Law, National Guard members are eligible for paid leave while performing ordered military duty for 30 calendar days or 22 workdays (whichever provides the greater benefit to the employee in any calendar year). During this period, New York State Health Insurance Program (NYSHIP) benefits continue and the employee remains responsible for the employee share of the premium.
In addition, PEF and GOER have reached an agreement to provide salary and health benefit protections to State employees who have been activated by the Governor to assist with the World Trade Center tragedy. National Guard members or reservists who are activated by the Governor or the federal government in response to the September 11, 2001 attack will be entitled to the following salary and benefit protections through September 10, 2002:
Supplemental Military Leave
Following exhaustion of the leave provided under NYS Military Law section 242, employees activated in connection with the attacks on the United States on September 11, 2001 will also be entitled to an additional 30 calendar days or 22 workdays of supplemental full-pay military leave. During this period, employees will continue to receive both their State pay and military pay. State provided health insurance continues and the employee remains responsible for the employee share of the premium.
Leave at Reduced Pay
Employees who have exhausted both military and supplemental military leave will also be entitled to Leave at Reduced Pay. During this period, the State will pay the difference between the military compensation employees receive while on duty and the State salaries they would otherwise have received (assuming the State salary is higher).
While on leave at reduced pay, employees are not eligible to be credited with biweekly leave accruals. They are, however, eligible to be credited with vacation bonus days and personal leave days on their anniversary dates.
Health benefits will also continue for the dependents of activated employees, provided they have been enrolled in NYSHIP with dependent coverage for at least 30 days prior to being activated. Health benefits will be provided to covered dependents at no cost to the employee for a period not to exceed 12 months from the date of activation, less any period the employee remains in full pay status. The employee's health care services will be provided free of charge by the military during this period of activation, and the State has agreed to waive the employee share of the health insurance premium for dependents as well. Benefits will cease to be provided at such time as the employee’s active duty is terminated or the employee returns to State employment, whichever occurs first. Dental and vision benefits will also be continued.
Q. Can an injured employee enrolled in the Health Care Spending Account change the amount of his/her pre-tax deduction?
A. Certain "qualifying events" as defined by the Internal Revenue Service permit employees to change the amount of their deductions. The taking of and/or return from leave without pay is considered a qualifying event. Being absent while charging sick leave accruals is not a qualifying event. Changing the amount of pre-tax deduction must be done within 30 days of the qualifying event.