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HomeMy WebLinkAboutCity Council - 4149 + t RESOLUTION NO. 4149 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH APPROVING AND IMPLEMENTING A MEMORANDUM OF AGREEMENT WITH THE HUNTINGTON BEACH FIREMEN'S ASSOCIATION The City Council of the City of Huntington Beach does hereby resolve as follows : The Memorandum of Agreement between the City of Huntington Beach and the Huntington Beach Firemen' s Association, dated July 1, 1975, a copy of which is attached hereto and by reference made a part hereof, is hereby adopted and ordered implemented in accordance with the terms and conditions thereof. PASSED AND ADOPTED by the City Council of the City of Huntington Beach at an adjourned regular meeting thereof held on the 23rd day of October, 1975 • MAYOR ATTEST: City Clerk APPROVED AS TO CONTENT: APPROVED AS TO FORM: DON P. BONFA, City Attorney City Administrator WILLIAM S.' AMSBARY, Depu City Attorney MHM: er 1f� Res. No. 4149 S'rATE OF CALIFORNIA ) COUNTY OF ORANGE ) ss: CITY OF HUNTINGTON BEACH ) I, ALICIA M. WENTWORTH, the duly elected, qualified City Clerk of the City of Huntington Beach, and ex-officio Clerk of the City Council of said City, do hereby certify that the whole number of members of the City. Council of the City of Huntington Beach is seven; that the foregoing resolution was passed and adopted by the affirmative vote of more than a majority of all the members of said City Council at a regular adjourned meeting thereof held on the 23rd day of October 19 75 by the following vote: AYES: Councilmen: Bartlett, Wieder, Matney, Shipley, Gibbs NOES: Councilmen: None ABSENT: Councilmen: Coen, Duke City Clerk and ex-officio Clerk of the City Council of the City of Huntington Beach, California f. MEMORANDUM OF AGREEMENT Between THE CITY OF HUNTINGTON BEACH, CALIFORNIA (hereinafter called CITY) and THE HUNTINGTON BEACH FIREMEN'S ASSOCIATION (hereinafter called ASSOCIATION PREAMBLE WHEREAS, pursuant to California Law, the CITY, acting by and through its designated representatives, duly appointed by the governing body of said CITY, and the representatives of the ASSOCIATION, a duly recognized employee association, have met and conferred in good faith and have fully communicated and exchanged information concerning wages, hours and other terms and conditions of employment for the fiscal year 1975-1976; and WHEREAS, except as otherwise expressly provided herein, all terms and conditions of this Agreement shall apply to all employees represented by the ASSOCIATION; and WHEREAS, the representatives of the CITY and the ASSOCIATION desire to reduce their agreements to writing, NOW, THEREFORE, this Memorandum of Agreement is made to become effective July 1, 1975, and it is agreed as follows : :cs 1. ARTICLE 1 REPRESENTATIONAL UNIT It is recognized that the Huntington Beach Firemen's Asso- ciation is the employee organization which has the right to meet and confer in good faith with the CITY on behalf of employees of the Huntington Beach Fire Department within the following classification titles : Fire Apprentice Fire Dispatcher Fire Fighter Supervising Fire Dispatcher Fire Engineer Fire Paramedic Fire Protection Specialist Fire Captain Deputy Fire Marshal ARTICLE 2 SALARY SCHEDULES AND PAYCHECKS A. Employees shall be compensated by the CITY at monthly salary rates by classification title and salary range effective July 1, 1975, as follows: MONTHLY SALARY RATES Title Range A B C D E Fire Apprentice 335 721 823 926 Fire Dispatcher 341 874 921 969 1020 1076 Firefighter 347 1029 1085 1146 1210 1279 Supvg Fire Disp 349 1085 1146 1210 1279 1353 Fire Engineer 351 1146 1210 1279 1353 1427 2, Title Range A B C D E Fire Paramedic 351 1146 1210 1279 1353 1427 Fire Protect Spec 353 1210 1279 1353 1427 1506 Fire Captain 356 1315 1389 1466 1550 1637 Deputy Fire Mar 358 1389 1466 1550 1637 1732 B. Salary set forth in Article 2, Section A, shall be paid on a biweekly basis. By mutual consent of CITY and ASSOCIATION, early payment and other modifications can be made. C. Paychecks shall be ready and available for distribution to each employee by 0800 hours on each pay day at the Joint Powers Training Center barring unforeseen circumstances beyond the control of CITY. A monthly paycheck stub or memorandum accompanying the paycheck shall contain an itemization of amounts paid under various categories of pay, including educational incentive pay, holiday pay, and all overtime, and shall also contain an itemization of the nature and the purpose of each deduction withheld from the employee 's gross earnings. ARTICLE 3 OVERTIME, COMPENSATORY TIME, STANDBY AND CALLBACK A. OVERTIME. (1) Non-exempt employees (as herein defined) working a twenty-one (21) day work cycle shall receive pay at one and one-half (1 1/2) times their normal rate for all time worked in excess of 168 hours in the twenty-one (21) day cycle. In determining hours worked under this paragraph A(1) , so long as 3 the work shift is twenty-four and one-fourth (24 1/4) hours, a sleep period of six and one-fourth (6 1/4) hours shall not be counted as hours worked, except as provided in Article 14, Section C. If the work shift reverts to twenty-four (24) hours, the entire period of twenty-four (24) hours, without deduction for a sleep period, shall be counted as hours worked. (2) Non-exempt employees working ten (10) and fourteen (14) hour shifts shall receive pay at one and one-half (1 1/2) times their normal rate for 'all hours worked in excess of an average of forty-two (42) hours in any week, averaged over an eight (8) week cycle. (3) Non-exempt employees on a regular forty (40) hour per week work schedule will be compensated at a rate one and one-half (1 1/2) times their normal rate hours worked in excess of forty (40) hours in any week. . (4) Non-exempt employees are those employees in all classifications except supervising fire dispatchers, fire captains, and deputy fire marshals . (5) Entitlement to overtime pay at the time and one-half rate is calculated on the basis of actual time worked, exclusive of absences with or without pay. (6) The CITY will maintain an overtime callback system as set out in "Huntington Beach Fire Department Organiza- tion Manual, Policy D-3," published June 25, 1975, a copy of which is attached hereto and incorporated herein as Exhibit "A. " 4. B. COMPENSATORY TIME. In lieu of compensation for overtime as provided in Article 4, Section A, employees may, with approval of the fire chief, be compensated by equivalent compensatory time. Compensatory time may be accumulated to a maximum of 120 hours. Any employee shall be entitled to pay in full at his current salary rate for any compensation time accrued by him. C. STANDBY. Any employee who is ordered to be available on a standby basis for possible recall to duty shall receive a minimum of two (2) hours pay at the straight time rate for each work shift the employee is on standby. If the employee is ordered to work and commences to work before two (2) hours standby has elapsed, he shall be paid for actual time on standby up to commencement of duty time, at which time the employee is on regular pay status at the straight time rate, except to the extent that such hours worked may qualify for time and one-half based on overtime provisions . D. CALLBACK. Employees who are ordered to return to duty on other than their regularly scheduled shift shall receive a minimum two (2) hours compensation at straight time pay or pay for actual hours worked whichever is greater. Actual hours worked shall be counted as hours worked for purposes of overtime compensation. E. HOLDOVER. An employee who is held over beyond the 5. end of his regular shift shall be compensated for the actual time he is required to remain on duty, computed to the nearest quarter hour. ARTICLE 4 INSURANCE A. The CITY shall continue to provide group medical in- surance to employees with coverage and other benefits equal to the Blue Cross Group Medical Plan Number 84394A in effect as of July 1, 1975, a copy of which is attached hereto and incorporated herein as Exhibit "B. " B. The CITY will pay the premiums for dependent health insurance equal to the Blue Cross Group Medical Plan delineated in Article 4, Section A, for those employees who have accumulated 480 or more hours of sick leave in accordance with Article 6, Section A. The use of all or part of said sick leave after the accumulation of said 480 or more hours shall not terminate or suspend the employees' right to have such premiums paid by the CITY. C . The CITY shall provide for each employee at CITY's cost $1, 000 of life insurance with coverage equal to the Safeco Group Life Insurance Plan in effect on July 1, 1975, a copy of which is attached hereto and incorporated herein as Exhibit "C. " Said insurance shall contain provisions for optional supplemental coverage at the employees' cost. D. The CITY shall continue to provide and make available 6. for employee benefit at the employees ' option and cost, a long term disability insurance plan equal to the Group Disa- bility Insurance Plan in effect on July 1, 1975, a .copy of which is attached hereto and incorporated herein as Exhibit I'D. " E. Nothing in this Article 4 shall be deemed to restrict the CITY' s right to change insurance carriers should circum- stances warrant . F. Nothing in this Article 4 shall be deemed to obligate the CITY to improve the benefits outlined in this Article 4 . ARTICLE 5 DENTAL PLAN The CITY shall provide a dental. plan for employees and p p dependents as set forth in the agreement between the CITY and James H. Kaufman, D.D.S. , Incorporated, dated November 11, 1973, known as the "AAA" Plan offered by the Dentists ' Group Manage- ment Corporation, a copy of which is attached hereto and incoporated herein as Exhibit "E. " ARTICLE 6 SICK LEAVE Upon termination, employees shall be paid at their current salary rate for twenty-five (25%) percent of unused, earned sick leave from 480 through 720 hours, and for fifty (50%) percent of all unused, earned sick leave for hours in excess of 720 hours. 7 . ARTICLE 7 HOLIDAYS A. Employees shall be compensated by the CITY in lieu of holidays at the rate of .04375 of the employee's monthly salary rate set forth in Article 2, payable each and every pay period, for the following recognized legal holidays : (1) New Year's Day (January 1) (2) Lincoln's Birthday (February 12) (3) Washington's Birthday (third Monday in February) (4) Memorial Day (last Monday in May) (5) Independence Day (July 4) (6) Labor Day (first Monday in September) (7) Columbus Day (second Monday in October) (8) Veterans ' Day (last Monday in October) (9) Thanksgiving Day (fourth Thursday in November) (10) Friday after Thanksgiving (11) Christmas Day (December 25) B. In the event that a holiday, other than the holidays set forth in Article 7, Section A, is officially declared by the President of the United States, the Governor of the State of California, or the CITY to be a national, state or city holiday, employees shall be compensated by CITY at the equiva- lent of eight (8) hours at the monthly salary rate set forth in Article 2. C. Holidays which fall on Sunday shall be observed the following Monday, and those falling on Saturday shall be observed the preceding Friday. h 8. D. Employees designated by the Fire Chief who are required to work regular shifts on the above holidays set forth in Article 7, Section A, shall not be entitled to time off or overtime. They shall, accrue time for holiday pay purposes based on the number of days in the calendar year that general city offices are closed in observance of legal holidays, Saturdays and Sundays excluded. E. Any employee who does not work shift work may take time off in lieu of holiday pay as set forth in Article 7, Section A. ARTICLE 8 VACATIONS A. The purpose of annual vacation is to provide a rest period which will enable each employee to return to work physically and mentally refreshed. All employees shall be entitled to annual vacation with pay in accordance with this Article 8. B. VACATION ALLOWANCE. Permanent, full time employees shall accrue annual vacations with pay as follows : (1) For the first five (5) years of continuous service, vacation time shall be accrued at the rate of ninety- six (96) hours per year. (2) After five (5) years of continuous service to the completion of ten (10) years of continuous service, vacation time shall be accrued at the rate of 112 hours per year. 9. (3) After ten (10) years of continuous service to the completion of fifteen (15) years of continuous service, vacation time shall be accrued at the rate of 128 hours per year. (4) After fifteen (15) years of continuous service, vacation time shall be accrued at the rate of 160 hours per year. C. VACATION: WHEN TAKEN. No vacation may be taken until the completion of six (6) months of employment. No employee shall be permitted to take a vacation in excess of actual time earned and vacation shall not be accrued in excess of 320 hours. Vacations shall be taken only with permission of the fire chief who shall schedule all vacations with due consideration for the request of the employee and particular regard for the need of the department. D. HOLIDAYS OCCURING DURING VACATION. In the event one or more holidays as set forth in Article 7, Sections A and B, falls within a vacation period of an employee, not receiving holiday pay in accordance with Article 7, Section E, said day or days shall not be charged against the vacation allowance as defined in this Article 8, but the vacation may be extended accordingly. E. VACATION PAYCHECK. Each employee shall, at his option, by written notice to the CITY Finance Director given at least two (2) weeks prior to the commencement of said 10. employee's scheduled vacation, be entitled to receive his earned vacation pay less deductions in advance of said vacation. Said right to receive advance payment of earned vacation pay shall be limited to one such advancement during each employee's anniversary year. F. VACATION PAY UPON TERMINATION. No employee shall be paid for unused vacation other than upon termination of employment at which time said terminating employees shall receive compensation at his current salary rate for all unused, earned vacation to which he is entitled up to and including the effective date of his termination. ARTICLE 9 BEREAVEMENT LEAVE Employees shall be entitled to bereavement leave not to exceed two (2) work shifts for those employees on the twenty- four (24) hour work schedule or three (3) work shifts for all other employees per calendar year in each instance of death in the immediate family. Immediate family is defined as father, mother, sister, brother, spouse, children, grandfather, grandmother, stepfather, stepmother, stepgrandfather, step- grandmother, stepsisters, stepbrothers, mother-in-law, father- in-law, brother-in-law, sister-in-law, stepchildren or wards of which the employee is the legal guardian. 11, ARTICLE 10 COURT SERVICE Employees who are subpoenaed to attend court to serve as witnesses, or who are summoned to perform jury service, shall be entitled to their regular compensation while serving provided the fees, except mileage and subsistence allowance, if any, which they receive as jurors or witnesses, are remitted to CITY. ARTICLE 11 EDUCATION INCENTIVE PLAN A. Employees shall be compensated by CITY for an educa- tion incentive as follows : Education HBFD Incentive Completed Year of Monthly Continuing Education Level "Units Tenure Amount Maintenance Units I Cert. in Fire 1 $ 50 6 Science or 30 Units II 60 Units 2 $ 70 3 III 90 Units (or 3 $ 9Q 3 AA Fire Science) IV 120 Units 5 $ 110 3 V BA or BS Degree 6 $ 120 0 B. It is the purpose and intent of the Education Incentive Plan to motivate the employee to participate in and continue with his education so as to improve his knowledge and general proficiency which will, in turn, result in additional benefits to the fire department and to the CITY. When and as certain levels of additional education are satisfactorily completed 12. and attained, the employee will receive additional monetary compensation in recognition of his educational achievement . As used herein, "education" is defined as units in approved college courses or approved special courses, seminars and programs, or a combination thereof. In order to implement the foregoing, the following stipulations shall apply: (1) Participation in the plan shall be available to all employees . (2) An education committee shall be formed and shall be composed of three members. Of said three members, one shall be appointed by the ASSOCIATION, one appointed by the fire chief and the personnel director or his designee. (3) Certification to an education incentive level and to the additional monthly compensation therefor shall commence on the first day of the month after approval by the fire chief and the education committee. (4) Special courses, seminars and programs which have been approved in advance by the education committee and the fire chief shall be considered as educational units on the basis of one unit for each eighteen (18) hours of instruction. Fractional hours in one course, seminar or program shall be cumulative and may be added to fractional hours resulting from another course, seminar or program. Such courses, seminars and programs shall be at CITY expense and the employee shall attend either on-duty or off-duty at the discretion of the 13. fire chief. (5) An employee who has attained education incentive levels I or II shall, so as to maintain himself therein, satis- factorily complete either two college courses which have been approved in advance by the education committee and fire chief, or two special courses, seminars or programs, or any combina- tion thereof, during every two fiscal years, except that one who has attained education incentive level II with an AA degree shall, so as to maintain himself therein, satisfacto- rily complete either one approved college course or one special course, seminar or program, or any combination thereof. (6) An employee who has attained education incentive level III may, so as to maintain himself therein, satisfacto- rily complete either one college course which has been approved in advance by the education committee and fire chief, or one special course, seminar or program, or any combination thereof, during each two fiscal years . Any employee who elects to not fulfill the foregoing biannual requirement shall revert to and thereafter receive the monthly amount set forth for education incentive level II, but he shall thereafter be reinstated to the monthly amount for education incentive level III upon satisfactory completion of the biannual requirements therefor. (7) An employee who has attained education incentive level IV may, so as to maintain himself therein, satisfactorily complete either one college course which has been approved in 14. advance by the education committee and fire chief, or one special course, seminar or program, or any combination thereof, during each two fiscal years. Any employee who elects to not fulfill the foregoing biannual requirement shall revert to and thereafter receive the monthly amount set forth for education incentive level III, but he shall thereafter be reinstated to the monthly amount for education incentive level IV upon satisfactory completion of the biannual requirements therefor. (8) "Satisfactory completion" of college courses, as referred to in the preceding three paragraphs, shall be at- taining a minimum grade of "C." The furnishing of all docu- mentation, including transcripts, to the education committee shall be the sole responsibility of the employee. (9) Degree majors in public administration, fire protection engineering or other closely related fields to be approved in advance by the education committee and the fire chief. (10) Courses to be related to job or general educa- tion requirements for degree objective as approved by educa- tional institution for degree program. (11) Ten of thirty units and twenty of sixty units must be approved fire science or fire administration. However, an approved degree program will fulfill any unit requirement. (12) Special courses shall not constitute more than one-third (1/3) of total unit credits. 15. C. An employee who has participated in the education incentive program in excess of five (5) years, and who has conscientiously complied with all of the requirements of the education incentive plan, shall not thereafter be reduced below the highest level attained by said employee. ARTICLE 12 RETIREMENT A. The CITY shall provide a retirement program for employees as established by the California Public Employees ' Retirement System, Section 21251.1 of the California Government Code in effect as of July 1, 1975, including the one-half continuance option for safety employees and the 1959 survivor option for all employees as established by the California Public Employees' Retirement System, Section 21382 of the California Government Code in effect as of July 1, 1975. B. In accordance with that certain agreement by and between the CITY and the ASSOCIATION dated November 18, 1974, City Resolution No. 3983, a copy of which is attached hereto and incorporated herein as Exhibit "F, " effective July 1, 1976 the CITY shall provide all safety employees with that certain retire- ment program commonly known and described as the 112% at age 50 plan" which is based on the retirement formula as set forth in the California Public Employees' Retirement System, Sections 20952.5 and 21252. 01 of the California Government Code in 16. effect as of July 1, 1975. This program shall not be for the use and/or benefit of employees who retire or die prior to July 1, 1976. C. The obligations of the CITY and the retirement rights of employees as provided in this Article 12 shall survive the term of this Agreement as set forth in Article 24. ARTICLE 13 COMPENSATION FOR SUPERVISORS Supervisors (supervising fire dispatcher, fire captains and deputy fire marshals) shall be compensated by CITY at a higher rate than any of their subordinates . Said supervisor's rate shall be advanced to a step in his salary grade which will provide him with a rate of one salary step higher than any subordinate's pay (exclusive of overtime, or other special compensation) regardless of the supervisor' s length of service. ARTICLE 14 WORK SHIFT A. This Article 14 applies only to those employees working a twenty-four (24) hour fifteen (15) minute shift schedule. All other employees shall receive pay based on the hours per week worked averaged over the cycle established for each employee as set forth in Article 13. B. The work shift shall be twenty-four (24) hours and fifteen (15) minutes in duration. The average work week shall be forty-two (42) hours as averaged over a twenty-one (21) day 17 period. If an employee works more than 126 hours in a twenty- one (21) day period, he shall receive additional pay to the nearest quarter hour for all additional hours worked. C. If an employee cannot obtain five (5) hours sleep or a reasonable opportunity to sleep from 2130 hours to 0730 each shift, he shall receive six (6) hours and fifteen (15) minutes additional pay for that work shift. If an employee works more than three (3) and three-fourth (3/4) hours between 2130 hours and 0730, he shall receive additional pay for that time in excess of three (3) and three-fourth (3/4) hours to the nearest quarter hour. If an employee works more than five (5) hours between 2130 hours and 0730, he shall receive a total of six (6) hours and fifteen (15) minutes additional pay for that shift. D. No employee shall receive additional pay until he has worked more than eighteen (18) hours in a work shift . E. An employee shall be considered to be working if he is called to duty by order initiated by the fire chief or his designee. F. Exchange of shifts shall occur at 0745 until 0800 hour each day for the purpose of unmaking of beds, showers, clean- up, changing of clothing to uniforms, roll call, daily briefings, exchange of information between shifts, check-out of equipment and apparatus, and any other activity that is required to 18. properly relieve crews . G. Meal periods are paid as hours worked. H. This Article 14 may be revoked by either the CITY or ASSOCIATION after March 1, 1976 upon thirty (30) days prior written notice. If this Article 14 is revoked, the work schedule shall return to the schedule in effect as of July 1, 1975, which is seven (7) twenty-four (24) hour shifts in a twenty-one (21) day cycle that averages to fifty-six (56) hours per week. ARTICLE 15 EARLY RELIEF An employee may be relieved by any other employee who is qualified to relieve him, at any time between the hours of 0600 to 0800. It shall be the responsibility of the employee's supervisor to insure that the relief of all employees is accom- plished in a fair and equitable manner. If any employee abuses this early relief Article 15, the employee ' s supervisor may revoke the early relief. It is understood and agreed that the early relief provided by the terms of this Article 15 shall not result in any additional cost to CITY. ARTICLE 16 CLASSIFIED RELIEF Employees who are assigned as classified relief shall be managed by the CITY as follows : A. Assign relief positions equally among shifts to relieve vacancies occurring due to absence for reasons such as 19. vacations, sickness and injuries. B. Three fire engineers and three firefighters working relief shall receive a 5.5% pay differential for the period of such relief assignment . C. Any employee working in a higher classification shall receive a 5. 5% pay differential for those shifts worked, paid in groups of five shifts . After accrual of said five (5) shifts, the employee shall be paid the 5.5% pay differential for the entire pay period following said accrual. ARTICLE 17 MINIMUM MANNING CITY shall man apparatus with sufficient manpower to assure the safety of employees and the control of risk. A. For the purpose of this Article 17, the minimum manning of apparatus shall be as follows ; (1) Each engine company shall be manned with no less than one (1) fire captain, one (1) fire engineer, and one (1) firefighter. (2) When two-piece companies are utilized by the department, the second unit shall be manned by at least one (1) fire captain and one (1) fire engineer. (a) Two-piece companies shall respond to structure fires as one unit and not be considered as separate engines for response purposes. 20.. (b) The second unit shall only respond by itself on single engine alarms, i.e. , trash fires, vehicle fires and medical aids . (3) Each truck company shall be manned with no less than one (1) fire captain, one (1) fire engineer and two (2) firefighters, one of which may be a fire apprentice. One firefighter may be deleted from the truck company when a paramedic unit is assigned to the truck company during its normal shift and responds to alarms with that company provided that in that event, no fire apprentice shall be assigned to the truck. (4) Paramedic units shall be manned with no less than two (2) fire paramedics. (5) Fire companies not considered to be in full service and immediately available shall not be required to have personnel assigned to them for the purpose of this Article 17. (6) There shall be at least two (2) qualified fire dispatchers on duty at all times . (7) (a) The minimum manning as set forth in this Article 17, shall be specifically and exclusively from employees of the Huntington Beach Fire Department for all routine activ- ities and normal shift duties. (b) No employee shall be assigned to more than one company at the same time for all routine activities and normal shift duties . 21. (c ) Routine activities and normal shift duties shall include those emergencies that would normally be handled by the on-duty suppression force. (8) Employees acting in a higher classification, when properly qualified and compensated in accordance with Article 16, shall be considered equivalent to the required classifica- tion. B. For the purpose of this Article 17, all fire engines shall be defined as apparatus with fire pump, fire hose, water tanks, ground ladders and necessary firefighting equipment, excluding specifically aerial ladder or platform capabilities . C. For the purpose of this Article 17, all fire trucks shall be defined as apparatus that have mounted on the chassis, an aerial ladder or aerial platform. D. For the purpose of this Article 17, a paramedic unit is defined as a vehicle, other than a fire engine, fire truck or salvage unit, that has as its sole purpose a capability of providing emergency medical and/or rescue assistance. E. For the purpose of this Article 17, a salvage unit shall be any vehicle other than those delineated in Paragraphs A through D of this Article 17, which carries equipment and manpower for the purpose of salvage, overhaul, fire control, medical supplies, emergency lighting equipment, or other accessory fire combat and damage prevention equipment . F. Any fire department apparatus, vehicles, technological 22. changes, and new innovations will be discussed with the ASSO- CIATION prior to being placed in full service for immediate response. ARTICLE 18 ASSIGNED SHIFT POLICY Employees of equal rank shall have the option to exchange assigned shifts on a man-for-man basis upon written request to and approval of the fire chief. ARTICLE 19 PROMOTIONAL EXAMINATIONS Promotional examinations shall be announced to all employees no less than thirty (30) days prior to the final filing date for the promotional examination. The CITY may establish a fixed annual date for promotional examinations provided, however, that in the event any examination will be scheduled on a date other than the fixed annual date for promotional exam- inations, the CITY shall announce said promotional examination no less than thirty (30) days prior to the final filing date for said promotional examination. A. All applicants shall meet all requirements for the pro- motional examinations as set forth in the Huntington Beach Fire Department Organizational Manual as of the final filing date for the promotional examination. B. Promotional examinations shall be administered to only qualified applicants who are members of the City of Huntington 23. Beach Fire Department, as long as a minimum of two (2) such applicants apply for each promotional examination. C. Promotional examinations shall be weighted on the basis of sixty (60) percent oral or practical, and forty (40) percent written. Seventy (70) percent shall be considered passing on the examination. In the event that there are less than three (3) qualified candidates who pass the examinations, the seventy (70) percent passing score may be waived by CITY provided, however, that the actual score of the individual employee shall be used for scoring purposes. D. Any challenge to any portion of the examination process must be filed within ten (10) days of the date of said examination. In the event any contract between CITY and a testing agency should preclude review of the examination on CITY premises, the CITY shall authorize such review of said examination to determine the validity of such a challenge. A protest board consisting of three (3) members shall hear the employee protest and shall recommend acceptance or rejection of the protest. The protest board shall consist of one member appointed by the Fire chief, one member appointed by the personnel director and one member appointed by the ASSOCIATION. E. Each employee who participates in a promotional examination shall receive his score and final standing in writing from the CITY within ten (10) days after completion of the promotional selection process period. 24. ARTICLE 20 SAFETY CLOTHING AND UNIFORMS The present uniform and clothing policies as delineated in this Article 20, Section L, shall remain in effect until the fire chief or his designee and the ASSOCIATION mutually agree on a new uniform system and on the date of implementation. On said implementation date, all safety clothing and uniforms required by the CITY to be worn by employees during working hours shall: A. Be of the best fire resistive material available, and meet all applicable state and federal regulations relating to said clothing; B. Be provided by CITY with the exception of the physical fitness uniform; C . Any uniforms with the exception of the physical fitness uniform, that are destroyed or which become unacceptable and which were damaged by circumstances involving the firefighters' regular work while on duty, shall be replaced by CITY at no cost to the employee. D. CITY shall provide the following uniforms on a yearly allocation basis : (1) Five (5) sets of daily work uniforms consisting of pants and shirts; (2) One pair of safety shoes. E. All new regular employees will be authorized to. 25. purchase a new dress uniform and hat as required by the fire chief. The employee shall be reimbursed for dress uniform costs by the CITY. F. All accessory identification, adornments, badges, patches, belt and other appurtenances thereto shall be provided by CITY. G. The employee shall be responsible for the preservation and cleaning of all uniforms . H. CITY shall provide each employee Fifty Dollars ($50) per year (July 1, 1975 through June 30, 1976) for the purchase of physical fitness uniforms and physical fitness shoes, payable in the first payroll in December, 1975. I . A uniform advisory committee composed of two members appointed by the ASSOCIATION and two representatives appointed by the fire chief shall make recommendations on the uniforms to be worn, the method said uniforms will be provided and obtained and further recommendations on safety clothing and uniforms as may be required during the term of this Memorandum of Agreement . J. All employees assigned to staff positions shall be provided two (2) complete sets of the type of uniform required by the fire chief for such positions . Staff employees required to wear said uniform shall also be provided with: (1) Three extra shirts for a total of five; (2) One pair of dress shoes; and (3) One blazer. 26. K. The present uniform policies for non-safety employees shall remain in effect until the fire chief or his designee and the ASSOCIATION mutually agree upon any type of change. L. Each employee shall be paid by the CITY the sum of One Hundred Dollars ($100) on the first pay period in December, 1975, as compensation for the uniform allowance for the period January 1, 1975 through December 31, 1975. Additionally, until the date of implementation of the new uniform system, all monies paid to employees shall be on a pro-rata basis of One Hundred Dollars ($100) per year for the period commencing on January 1, 1976, payable on the first full pay period following the implementation of the new uniform system. M. All uniforms and equipment furnished by CITY shall remain the property of CITY and be returned or replaced if the employee terminates . ARTICLE 21 QUARTERS CITY shall continue to provide necessary kitchen, living and sleeping quarters in the several fire stations. ARTICLE 22 PRECEDENCE In .any case in which any provision of this Memorandum of Agreement is inconsistent with any city ordinance, rule, regu- lation, resolution, including provisions of any Fire Department Manual, the provisions of this Agreement shall supersede and t 27. take precedence. ARTICLE 23 SEVERABILITY If any section, subsection, sentence, clause, phrase or portion of this Agreement or any additions or amendments thereof, or the application thereof to any person, is for any reason held to be invalid or unconstitutional by the decision of any court of competent jurisdiction, such decision shall not affect the validity of the remaining portions of this resolution or its application to other persons. The City Council hereby declares that it would have adopted this Agreement and each section, subsection, sentence, clause, phrase or portion, and any additions or amendments thereof, irrespective of the fact that any one or more sections, subsections, sentences, clauses, phrases or portions, or the application thereof to any person, be declared invalid or unconstitutional. ARTICLE 24 TERM This Memorandum of Agreement shall be in effect for a term of one (1) year commencing on July 1, 1975 and ending at midnight on June 30, 1976. ARTICLE 25 CITY COUNCIL APPROVAL It is the understanding of CITY and ASSOCIATION that this Memorandum of Agreement is of no force or effect whatsoever 28. unless and until adopted by resolution of the City. Council of the City of Huntington Beach. DATED: .:�= % -3 Z 1`fi 7 S I CITY OF HUNTINGTON BEACH APPROVED AS TO FORM: DON P. BONFA, City Attorney By . )'� City Administrator By 4� /� 1.. I Deputy City Attorney / By ((( Personnel Director HUNTINGTON BEACH FIREMEN'S ASSOCIATION 4 APPROVED AS TO FORM: By Lt,"- PACE & PURCELL Presi t By Coun el for IATI0.1 29. a . EXHIBIT A ORGANIZATION MANUAL SECTION D PERSONNEL Policy D-3 OVERTIME WORK SYSTEM I. PURPOSE A. To provide an efficient, fair and reliable method for maintaining adequate on-duty personnel for fire control purposes. II. POLICY A. It shall be the policy of this department to maintain fire control manpower requirements by recalling personnel and shift staff personnel to fire control positions. B. Personnel may be called from a rotating sequential file on a voluntary basis to fill manpower shortages. C. When manpower shortages cannot be filled on a voluntary basis, or when an emergency exists,, personnel called may be required to report for duty. III. RESPONSIBILITY A. The primary responsibility and authority shall rest with the Deputy Operations Officer. B. The Suppression Chief shall administer the system on a day to day basis. C. The Fire Operating Center Supervisor shall implement ,and conduct the operation of the system, and shall be responsible for the maintenance and accuracy of the file . IV PROCEDURE DATE: June 25, 1975 PAGE : 1 of 5 APPROVED: HUNTINGTON BEACH FIRE DEPARTMENT r ORGANIZATION MANUAL __-- SECTION D PERSONNEL Policy D-3 A. All persons requesting to work overtime shall submit their request on an Official Report along with their telephone number and area code.' B. All personnel who have requested ,to work overtime shall have their name placed in the card file in the first vacant numerical position. C. For overtime that can be scheduled in advance, the pro- cedure shall only be initiated one day in advance, and in accord with E-3. Cards shall be rotated at the time the overtime employee is scheduled. Cancellation of the overtime will not affect the rotation sequence of the file. D. Personnel, when contacted, who refuse the overtime offered five consecutive times shall have their card removed. Each individual shall then resubmit his request to have his card placed in the active file. E. Under the day to day supervision and authority of the on-duty Suppression Chief, the F.O.C. Dispatchers shall initiate the activation of the Policy. 1.. The dispatchers shall contact the personnel and notify the on-duty Chief and the Captain at the station where the vacancy exists when the vacancy has been filled. 2. In the event problems arise, interfering with the routine operation of the system, the Dispatcher shall contact the on-duty Suppression Chief for a decision on overtime that can be scheduled in advance. 3. The dispatchers shall implement the procedure for overtime that can be scheduled in. advance between 1800 and 2200 of the evening prior to the scheduled vacancy. DATE: June 25, 1975 PAGE: 2 of 5 APPROVED: UNTINGTON BEACH FIRE DEPARTMENT ORGANIZATION MANUAL SECTION D PERSONNEL Policy D-3 F. The Card system shall be segregated by shift and by rank. 1. All files shall have a numerical sequence and be rotated from front to back as each card is called for overtime. A. Personnel once called shall have their card rotated and the sequential numbering shall not be changed once established. b. When the overtime list is used for non-emer- gency call back, no deviation from the sequential rotation shall be allowed. C. Those employees who are not normally assigned to the call back shift shall not be eligible for overtime except on their normally assigned days off. 1) If their card sequentially comes up for overtime, and they are not available for that overtime, their card will be rotated and the next eligible employee shall be called. 2) Non-shift personnel, who are on the over- time list, shall be- eligible when their card number is called for overtime after their normal work day if the following day is a normally scheduled day off. 3) Staff members may be used to fill existin_ vacancies during their normal work day if so directed, but may not use vacation tim or compensation time off in order to accrue overtime. 4) No employee may use vacation, sick or compensation time in order to accrue overtime. DATE: June 25, 1975 PAGE: 3 of 5 APPROVED: HUNTINGTON BEACH FIRE DEPARTMENT ORGANIZATION MANUAL SECTION D PERSONNEL Policy D-3 5) It shall be the employees responsibility to make known when contacted that he is not eligible for overtime as outlined in this policy. G. All overtime shall be offered in order of the first available overtime period, to the first called employee. H. If a member is called for overtime and the overtime' s canceled after the employee has reported for, duty, the employee shall receive two hours overtime credit. I. Holding employees over until relieved shall not cons- titute call back overtime and no card rotation shall be made. J. Emergency call back shall not constitute overtime that can be scheduled in advance and no card rotation shall be made K. Whenever an employee changes shifts, is promoted, demoted , or re-assigned, he shall be given a new number in the master card file and the number shall be the first vacant sequential number in the appropriate file L. The Suppression Chief may institute a selective call for overtime in special circumstances to obtain necessary manning levels. If the overtime is of a non-emergency nature, the overtime lists will be used as soon as practicable thereafter to fill the vacancy. If the overtime is of a duration of less than four hours, the Suppression Chief at his discretion may use the shift going off duty to cover and shall not use the overtime. file. M. Overtime of a special nature such as mapmaking, vehicle maintenance, communications or other specific job func- tions not normally required to be filled, need not be filled from the overtime list. Those employees who possess the specific skills of this special overtime may request to be utilized. DATE J , 1975 PAGE: 4 of 5 APPROVED: HUNTINGTON BEACH FIRE DEPARTMENT w ORGANIZATION MANUAL SECTION D PERSONNEL Policy n-3 N. Employees who live outside the toll free area shall be required to pay the telephone charges. (All toll calls to be collect) P. If an employee believes that an inaccuracy exists in the overtime master card file, he may request that a repre- sentative of the association investigate his claim and process a grievance if necessary. The Deputy Operations Officer shall make the master card file available to an association designated representative when there appears to be a discrepancy in the call back process. Q. The Fire Chief or his designee' shall confer with the Fireman' s Association whenever any changes are contem- plated in the overtime call back system. DATE: June 25, 1975 PAGE : 5 of 5 APPROVED: < HUNTINGTON BEACH FIRE DEPARTMENT q. bISTRiBUT1ON SPECIAL NOTICE: p , FIRE CHIEF El GENERAL ORDER: xQ GO #75-04, 0 sr Y. TO CHIEF El SPECIAL ORDER: ❑ SO # F E MARSHAL DATE July 29. 197 FROM Chief Watters OPERATIONS OFFICER LI SUBJECT POLICY D-3 "Overtime Work System" DEPUTY OPERATIONS OFF, BATTALION CHIEF - A ❑ REVISION OF SPECIAL NOTICE DATED JULY 24, 1975, BATTALION CHIEF - B CHANGED TO A GENERAL ORDER. _ BATTALION CHIEF - C DEPUTY FIRE MARSHAL-FP ❑ The following is supplemental information agreed to by the department and the Huntington DEPUTY FIRE MARSHAL-FP � Beach Fireman's Association . DEPUTY FIRE MARSHAL-ADM 1. It has been agreed that if there is a busy signal upon contact, the next name DEPUTY FIRE MARSHAL-OP will be called. in order. FIRE PREVENTION ❑ 2. The department will allow an immediate member of the family to accept overtime Q on his behalf, but the member is responsi- ble to report for duty as agreed. 3. A separate file will be maintained for the BUSHARD STATION Paramedics by shift as a separate category. Each Paramedic will be included only under GOTHARD STATION F1 this category for overtime consideration. HEIL STATION LAKE STATION 4 JBW:jj MAGNOLIA STATION El MURDY STATION WARNER STATION Q E LJ SHIFT C D DESTRUCTION DATE: . ,& rYa a r� ".,.� £ r, .,.as:..;it>. r,r, r r n ,£:.. •._..' 6s r... r.�±i:. ...,.... 1 1e. -t. ,,,.. j! ,_ 3., r%+ x S.. s 1 ,tiA. x!.. � f s, h. § .4„ .>.: n n% �:.x .• t:;..e ;.:'ry 3.,. t.s .. J � r :.:Z.- } .,. ,.{bF- tx .. x :..,..f8. •..eti. M. :....s. J';'>.. ...v: 4,Y l'..f ,d �t N : } .-*..J r."§M .. sn.. �,.,IFr { ,:k x7,.„ -;..): .:....:F:3 iFF a•i4.:. -�,..,A.rv,. µU. {{,... fl ..::.,. Vt... 1 .}/'. :. ....4..,_ ,,.o a fr,F, � .>s.s,., ^ ....... .. .. .. c rro, ,+. . .. & a`.... 1 •:k`. � .J, L — �.�' .w:.--msw.�.A.�1. .:, `"'3-';,t f 5620 t„ x EXHIBIT B— ` (REVISED 1-1-75) 1 !. .. H CHOICE OF �y F HOSPITAL AND „ �. CONVERSION PRIVILEGE ; £a> CONTRACTING HOSPITAL, }" IF; ,. , d¢a CONTRACTING EXTENDED n. l } £ ' Ott t If the Subscriber ceases to be employed aft ti , PROFESSIONAL SERVICE b the Employer, and after the a DARE FACILITY AND ;� �` J �,� ,d ,rc, Y pay- ment ": ment of at least one installment of x `' ATTENDING PHYSICIAN , CERTIFICATE h subscription charges in the manner , • ? ,.; Nothing contained in this Certificate prescribed for the Employer, this Cer- . =h shall in any manner restrict or inter "` tificate shall terminate automatically fere with the right of any individual y > 3 > rf,. without notice but he shall be entitled, r}y entitled to service and care to select upon notice to the Service within { {{3}� the Contracting Hospital Contracting r "'J� =t try: fifteen days from the date of termina• sytr.l"�t i ' j.��'�' E�� t ",i',�(y t�a"' Y f' i S 'xlt Extended Care Facility or to make a ,� � m `: �" }� tion of employment, to make applica- i, ` free choice of his attending physician tion for a Group Conversion Agreement �. or surgeon who shall be the holder of a �; q on the basis and at such subscription a valid and unrevoked physician's or { " ISSUED BY . p y �{ +; charges as are then in effect for such ww 'i surgeon's certificate and who is a ryry„' t �,t: �,{ 1p category. However, should the Sub- member of, or acceptable to, the " ' BLUE CROSS Fiak '' scriber remain in the employ of the F t "' e2 k } y attending staff and Board of Directors Employer, this Certificate shall termi- nate <' ;. of the facility in which services are to OF t=° automatically without notice on YY _ . ffi be provided and rendered. : the earliest of the following dates: SOUTHERN CALIFORNIA x Payment of benefits herein shall not Y �� A.The date of expiration of the period M`�A ��zF, be construed as regulating the fee which for which the last monthly sub- scription is paid, a physician or surgeon may charge for l'' LOS ANGELES til his services or as attempting to evaluate B. Upon the date of termination of } ' his services. CALIFORNIA the Group Agreement. y.• ,,.��.,`'' °�'• i• > a ;.�. �„'dye S L a, 0 Registered Mark Blue Cross Association :.:...... ..... . . `' �,•fie. .per. f ..,.4'{§^ "+r '^s }te::�; f :..':;..:£= tl§%'•, :. 4..",... ,..,;.,..... '.Y":] t RIM i eis" a }k 'wA^,hte ass, - �7 v t-r " t r a. „ ... ..�-, u+t,�l '*r - .w, i 1 06�,, 65 1`0,, 'k1F -gzip HOSPITAL AND PROFESSIONAL SERVICE CERTIFICATE ISSUED IN CONNECTION WITH THE GROUP HOSPITAL AND PROFESSIONAL SERVICE AGREEMENT GR-I (7-63) BY BLUE CROSS OF SOUTHERN CALIFORNIA LOS ANGELES, CALIFORNIA Blue Cross Blue Cross of Southern California, a non-profit hospital service plan herein called the "Service," agrees to furnish benefits as herein defined to the Subscriber and his eligible family members,subject to the terms and conditions of the Group Agreement issued to the Employer, A PART I. DEFINITIONS PART 11. TERM OF CERTIFICATE 3. Other Hospital Services A. A "Subscriber" is the eligible employee of the This Certificate will remain in effect for the term The following services shall be provided during the Employer whose application for this Certificate has specified in the Group Agreement held by the Employer, furnishing of eligible days of hospital care to the been accepted by the Service. subject to the payment of subscription charges as extent of one hundred percent of the hospital B. An eligible "Family Member" is the Subscriber's required, and subject to the right of the Service to charges therefor: T terminate or modify it, including the right to change a. Use of operating and cystoscopic rooms. spouse or any unmarried child of either or both under ............ nineteen years of age, unless otherwise specified subscription charges, in accordance with the terms of b. Surgical and anesthetic supplies. herein, as listed on the application completed by the such Group Agreement. Such termination or modification c. Ordinary casts, splints and dressings. Subscriber. Upon notice by the Subscriber, family shall be effective on the date fixed in the notice, but d. Oxygen and all drugs and medications listed members may be added under this Certificate as they shall not affect the right to benefits provided hereunder and accepted in the "United States Pharma- become eligible subject to the enrollment regulations in connection with any hospital stay commencing prior copoeia," "National Formulary" or "New and in effect with the Employer. Immediate coverage will to such date, Non-Official Remedies" at the time they are be provided from and after the moment of birth prescribed and used during the furnishing of for each newborn child of a Subscriber covered by a PART 111. CONDITIONS UNDER WHICH hospital care. e. Administration of blood or blood plasma, but "Sub scriber and one or more dependent"type contract CARE WILL BE FURNISHED IN A HOSPITAL not including the cost of blood or blood plasma. without requiring evidence of insurability. Extension OR EXTENDED CARE FACILITY f. Laboratory and X-ray examinations, elect�o of coverage for any condition commencing beyond thirty-one days from the date of birth of a newborn Care, as herein defined, will be furnished in any legally cardiograms, basal metabolism tests, physlo- operated hospital or extended care facility under the foi- therapy and hydrotherapy. child of a Subscriber covered under a"Subscriber and Z.s' "'Y lowing conditions: one dependent" type contract shall be contingent A. Care shall be furnished for illness or accident, but upon application to the Service by the Subscriber in 4. Other Hospital Benefits limited to those items of care furnished and billed by respect to each newborn child provided such applica- a. The Subscriber or family member shall be the hospital or extended care facility which are neces- tion is made within sixty days from date of birth of entitled to an allowance of one hundred percent sary for treatment of the condition requiring such care. the child in accordance with enrollment regulations, of charges listed in 3. above in the outpatient Family members become ineligible for membership B. The attending physician or surgeon must certify that department of a Contracting Hospital for under the following circumstances: bed care is necessary. emergency care treatment of injury within 1. When the Subscriber becomes ineligible, C. Admission must occur on or after the Subscriber's or seventy two hours after an accident. 2. When a child attains the age of nineteen years, or family member's effective date hereunder. b. The Subscriber or family member shall be upon prior marriage,except that: D. The Service shall provide care only in Contracting Hos- entitled to an allowance of one hundred percent a. In respect to an unmarried child attaining the pitals of Contracting Extended Care Facilities except of charges for services listed in 3. above, age of nineteen years,should he continue to be that, should care be required in an institution which is furnished in the outpatient department of a dependent upon his parent(s) to the extent of not contracting with the Service, benefits will be pro- Contracting Hospital in connection with surgical not less than fifty percent for his subsistence vided as follows: treatment requiring use of operating facilities. and support,his eligibility for benefits hereunder 1. Within the service area of the Service,payment to- shall continue while he remains in such status ward the regular charges of a legally operated hos- until he attains age twenty-three; pital for eligible care will be as follows: 5. Extended Care Facility Benefits b. In respect to an unmarried child attaining the a. For illness, payment will be made up to an Extended care facility benefits, as used in this age of nineteen years, or twenty-three years allowance equivalent to seventy-five percent of Certificate,means and is limited to: when qualifying as set forth in Paragraph a. the benefits payable in accordance with the a. Days of Care above, should he at such time be incapable of provisions of PART IV, hereof, When care is provided in an extended care self-sustaining employment by reason of mental b. For accidents requiring emergency confinement, facility, as defined herein, the Subscriber or retardation or physical handicap and continues payment will be made in accordance with the family member will be entitled to benefits for to be dependent upon his parent(s) to the provisions of PART IV. hereof, each period of disability for a period of time extent of not less than fifty percent of his sub- 2. Outside the service area of the Service, in a legally not to exceed the unused days for such period is sistence and support,his eligibility for benefits operated hospital or an extended care facility ac- of disability for care provided herein in a hereunder shall continue regardless of his age credited by the Joint Commission On Accreditation legally operated or Contracting Hospital. while he remains in such status. The Sub- Of Hospitals,benefits will be as follows: b. Room Accommodations Paxcmant N-01 A- c.en­LQ­A u4 0,,tl-,o r " incapacity and dependency within thirty-one b. Under the terms of the Inter-Plan Benefit Bank services of dietitian and general nursing care. 4 days of the dependent's attainment of age (a reciprocal arrangement among certain Blue If private accommodation are used, the Sub nineteen years or twenty-three years whichever Cross Plans), Acceptance of these benefits will scriber or family member shall be entitled to is applicable, and periodically thereafter as may be in lieu of the benefits under 2, a. above, the same allowance as that specified for the be required by the Service, but not more E. The Subscriber's Identification Card must be presented facility's minimum charge for room accom frequently than annually after a two-year period at time of admission or during the confinement stay, modations of two or more beds, following such dependent's attainment of the If such is not done, because of factors beyond the c. Other Services aforementioned age limitation. Determination control of the patient, benefits will be allowed only if '? of eligibility b the Service shall be conclusive. p The following services shall ay provided during � g Y claim is made within ninety days from date of admission the furnishing of eligible days of care to the 3. A spouse upon entry of final decree of divorce or or thirty days. from date of discharge, whichever is extent of one hundred percent of the facility's annulment. later, accompanied by a receipted hospital bill and The child, or spouse upon entry of final decree of such supporting statements as are necessary to estab- charges therefor: (1)Use of special treatment rooms. divorce or annulment may,upon notice to the Service lish the claim. w within fifteen days of the date on which the change in F. Days of care under the above provisions shall be (2)Ordinary casts,splints and dressings,surgical status occurs, apply as a Subscriber for available and anesthesia supplies. counted against total days of care available under this (3)Oxygen and all drugs and medications listed ; Group Conversion Agreements on the basis and at Certificate. and accepted in the "United States Pharma such subscription charges as are then in effect for such categories. copoeia," "National Formulary" or "New �( C. A "Legally Operated Hospital" is an institution PART IV. BENEFITS and Non-Official Remedies"at the time they } ; �,• are prescribed and used during the furnishing operated in accordance with the laws of the jurisdiction A.HOSPITAL CARE ' of care. u in which it is located pertaining to institutions identified Hospital care, as used in this Certificate, means and is (4)Administration of blood or blood plasma as hospitals and which, for compensation from its ?, p p limited to: but not including the cost of blood or blood patients and on an inpatient basis, is primarily plasma. engaged in providing diagnostic and therapeutic facil- 1. Days of Care t tS)Laboratory and X-ray examinations, elec- Yi •: ities for surgical and medical diagnosis, treatment and Hospital care shall be furnished to the Subscriber trocardio rams,basal metabolism tests, h s care of injured and sick persons by or under the or family member up to an aggregate period of g p y iotherapy and hydrotherapy. i supervision of a staff of licensed physicians or one hundred days for each period of disability, d, For the determination of the amount of benefits "7# s surgeons, and which continuously provides twenty- which means a continuous hospital stay or series payable under Paragraphs b, and c, above, anyfour hours a day nursing service by registered graduate of stays where the dates of discharge and readmis- inpatient hospital days or benefits used in a x nurses. It shall specifically exclude care provided by lion are separated by: legally operated or Contracting Hospita3 or any institution or any affiliate or unit of a legally a. Less than four weeks where the Subscriber is extended care facility during the same period of °. e operated hospital which is primarily a place of rest, the patient. disability for hospital inpatient care shall be a place for the aged, a nursing or convalescent home; b. Less than ninety days where the family member €; '= or a facility operated by the Federal Government is the patient. considered as a prior charge against the benefits �! available in the extended care facility during or any agency thereof. However, should readmission to a hospital be such period of disability, f D. A"Contracting Hospital"is a legally operated hospital, required as a result of accidental injury occurring Also,any days or benefits used in the extended which, at time of admission under,the terms of this during the four-week or ninety-day period referred Certificate, has a contract in.effect with the Service to above, such readmission shall constitute a new care facility shall be considered as a prior charge t 'i against any subsequent inpatient hospital days to furnish hospital'care to the Subscriber and his period of disability. available under this Certificate duringthe same family members. A list of Contracting Hospitals is a r g p period of disability. t„ . available on request. No benefits will be payable in an extended care E. A "Contracting Extended Care Facility" is a legally 2. Daily Hospital Service facility located within the service area of the Service r, t operated nursing or convalescent home or extended One hundred percent of charges for use of a which does not have in effect at the time of admis care unit of a legally operated hospital which,at time hospital room of two or more beds or intensive Sion a contract with the Service to furnish care to eli } of admission under the terms of this Certificate has a care accommodations, including meals, services of gible Subscribers and their eligible family members contract in effect with the Service to furnish extended dietitian and general nursing care. If private `x' care to eligible Subscribers and their eligible family accommodations are used,the Subscriber or family °t n` members. It shall specifically exclude any institution member shall be entitled to the same allowance as as which is primarily a place of rest,a place for the aged, that specified for room accommodations of two or a facility operated by the Federal Government or or more beds. any agency thereof. A list of Contracting Extended fi Care Facilities is available on request. F. A "Physician" or "Surgeon" is one who is duly licensed (1) to prescribe and administer drugs, and (2) to perform surgery within the scope of his license. r G. The "Effective Date" is the date on which this Certificate becomes effective. It appears on the , Agri• Subscriber's Identification Card. $;. fi H. A "Calendar Year" is the twelve-month period com- mencing January 1st of each year at 12:01 A.M., standard time of Los Angeles,California. s, 1. The masculine gender includes the feminine in context. Ns t. i ' GRC-1 "t. (Rev. 1-75) rs, 3•.+ .;., ,. ._ .. ',.a .. ., uTy,.. ,. ,s ,a. ,c ,.sr .. ,t •' no-., x. w ,...: ,.A@,.,.... .qs a... .,R ns .:,De. is::.. .it aari.: ,.,4.. hlk .. i., :££, !.ti3s,, s ;;: s-f�.. s., ,.:„•#tx. t.: t.... .: .ri�,as,.,,... ;. ,.,3 ,�yeiaas• u '::Kt. ,t. tt ri, 3ro �iis-• ....., ,..,h#>... kY. :.'....f), ....,.. e:'tl#x . i�f G"tf r. :': ' .. .:.:v,#'. li .L: •. ;: W.. Ya.•::"'.. +jF'. ?� f'': ., J .i3ry iiYN .A ''\'i3/d ;4Yfa f'• • :' ... Sii aF e.. 8 tFS s£f, ! da..... ..uM . .,iN d£ tun.+,. .3 x44 a.Ta !. ii a :W. .:iY.,:.3' 9': fit',m"b Y 5 .. -•q.7r+ ,.a a'::.'. ,.. ... ✓: '-r#'3 wt... t.-„ .....:sa° . .,:. t• .. :. -}r•r :,B»...,5 .,rn a ., yr `;'i ::,f.. .,••i': .,a }. ,#' ',(" � v i � ,l�a ,x ,.,.y;,,. .,en: B. PROFESSIONAL BENEFITS 3. Consultants 1. Surgical Benefits The Service shall pay for consultation services by a licensed physician or surgeon, Surgical service is defined as operative and cutting procedures for treatment except staff consultations required by hospital rules or regulations, but only of diseases and injuries,and reduction of fractures and dislocations. The Service while the Subscriber or family member is a hospitalized bed patient, for a shall pay for expense incurred for surgical services which are rendered by a condition requiring special skill or knowledge, as assistance in diagnosis or licensed physician or surgeon to the Subscriber or family member up to the treatment aiding the physician or surgeon in charge of the case, limited to one sum of money as set forth in the following schedule opposite the name of the such bedside consultation during each period of continuous hospitalization. specific surgical service rendered,subject to the following: a. The value of each Unit will be$8.00. a. Surgical service must be performed on or after the Subscriber's or family b. Each consultation will be valued at not to exceed three Units. member's effective date of coverage hereunder, unless such person is already hospitalized prior to such date, in which event surgical service will not be provided until after such person has been discharged from the hospital. 4. Medical-While-Hospitalized Benefits b. The Service shall pay for expense incurred for surgical services which are If the Subscriber or family member, while confined in a hospital or extended rendered by an assistant surgeon, other than a hospital intern, resident or care facility as a result of illness or injury, receives medical treatment by and in house officer, to the Subscriber or family member an allowance not to the presence of a licensed physician or surgeon, the Service shall pay expense exceed twenty percent of the amount payable for the primary surgeon, or a incurred for such doctor visit, subject to the following: value of seven Units, whichever is the greater, but in no event will assistant a. The value of each Unit will be$8.00. surgeon benefits be payable when primary surgeon benefits are not payable. b. Not to exceed three Units for the first visit and one Unit per visit thereafter c. All surgical benefits are subject to the following: during a period of disability for which the Subscriber or family member is (1) The value of each Unit will be $8.00. entitled to hospitalization or extended care facility benefits hereunder. (2) If more than one surgical service is performed: c. Benefits shall be limited to one visit in any one day. (a) At different times due to entirely unrelated causes, payment is made d. Benefits shall not be payable for any visit preceding or following any surgical for each procedure; service performed during the same confinement or for any condition arising (b) At different times due to same or related causes, but within a from pregnancy. period of three months, the maximum payment with respect to the primary surgeon shall be two hundred times the above stated Unit Value; 5. Ambulance Benefits (c) At the same time in same operative area, payment is made only for The Service shall pay for expense incurred by the,Subscriber or family member the major procedure; for necessary use of a local ambulance for transportation to or from the hospital (d) At the same time in different operative areas, maximum payment or extended care facility,up to a maximum payment of$50.00 for each inpatient is made for the major procedure plus one-half of the allowance admission or outpatient service for which such person is entitled to hospital or for the minor procedure providing for the next greatest allowance extended care facility benefits hereunder, except that benefits shall not be paid but not to exceed with respect to the primary surgeon a total of for any condition arising from pregnancy. two hundred times the above stated Unit Value. (3) To determine the maximum allowance for any service,the Relative Value. Units indicated in the surgical schedule will be multiplied by the value of each Unit as previously designated. For all surgical services not listed C. ADDITIONAL ACCIDENT BENEFITS herein, the Service shall determine payment on the basis of the most If an accidental injury is sustained by the Subscriber or eligible family member nearly comparable service listed. while covered hereunder, the Service shall pay expenses of professional medical d. Benefits for Cesarean section or miscarriage, if included in the following treatment incurred within ninety days from date of accident,subject to limitations fee schedule, or any other surgical procedure for a condition arising out of hereinafter set forth. Payment shall be made only for usual, customary and pregnancy, will be available only to the Subscriber or spouse subject to the reasonable expenses actually incurred in excess of all other benefits provided same eligibility and waiting period requirements set forth herein for"Hospital hereunder(except Extended Benefits if such coverage is included in this Certificate) Obstetrical Care." and shall not exceed $300.00 for any one accident. 1. Professional medical treatment as used herein shall mean only: 2. Professional Anesthetist Benefits When the Subscriber or family member is entitled to hospital care and surgical a. Medical or surgical treatment by a licensed physician or surgeon. Necessary services furnished and billed by a legally operated hospital, benefits hereunder,the Service shall pay for services of a professional anesthetist, b. except for normal childbirth delivery, up to the sum of money as determined excepting blood, blood plasma and personal services such as charges for radio, telephone and the like; from the anesthesia schedule set forth herein opposite the name of the specific c. Services of a registered nurse, providing such nurse is not related to the Sub-' surgical service rendered,subject to the following: scriber by blood or marriage. a. The value of each Unit will be $8.00. d. Laboratory and X-ray examinations. b. The Units appearing in the Anesthesia column represent basic values. To these will be added Time Units representing the actual time spent admin- 2. The foregoing benefits will not be provided for the following: istering the anesthesia. Time Units will be based on one Unit for each a. Any injury arising out of or in the course of employment, quarter hour or major part thereof. b. Ptomaine poisoning,disease or infection(except pyogenic infection occurring through an accidental cut or wound). c. Eye refractions or fitting of eye glasses. d. An intentionally self-inflicted injury. D.EXTENDED BENEFITS (5) Anesthetic supplies and administration of anesthesia by an anesthetist. The term "Extended Benefits" as used herein means only those services and (6) X-ray,radium and radioactive isotope therapy. supplies listed below and only to the extent they are not provided elsewhere herein. (7) Services of a licensed physician or surgeon, or a registered physical To be eligible for Extended Benefits, it will be necessary that such be furnished in therapist, in connection with physical therapy treatments, other than connection with diagnosis or treatment of any illness, disease or accidental bodily one who ordinarily resides in the Subscriber's home or who is related injury, and be authorized by a licensed physician or surgeon and for only as long as to the Subscriber by blood or marriage. such authorization is given. (8) Diagnostic X-ray and laboratory tests for treatment of illness or accident. I. Upon receipt of due notice and proof that the Subscriber or family member shall (9) Services of a licensed ambulance company for local ambulance service have incurred expense for Extended Benefits, benefits will be provided as follows: to or from a hospital or an extended care facility. a. Such expense must be incurred on or after the Subscriber's or family member's (10) Drugs or medicines directly related to treatment of y illness e injury effective date of coverage hereunder, or, in the event such person is already and requiring a written prescription and dispensed by a licensed phar- hospitalized prior to such effective date, such expense must be incurred sub- macfi or licensed physician casts, surgeon. sequent to the date of discharge from the hospital. An expense will be (11) Artificial limbs o eyes, casts, splints, trusses, braces, crutches, rental considered to have been incurred on the date that the individual receives the of wheel chair, hospital-type bed, c iron lung required for treatment up services for which the charge is made, to a maximum charge of not to exceed the purchase price of the equip- b. Payment for such services shall be based upon charges not exceeding the usual by t used. These supplies will be limited , those reasonably required and customary charges for such services in the community. w standard treatment practices for illness, disease or injury occurring c. For conditions other than complications arising out of pregnancy or resulting while the patient is covered hereunder. (12) Blood transfusions,including cost of blood and blood plasma. childbirth, the Subscriber or family member will be responsible for the first $100.00 of expense incurred in each calendar year for Extended Benefits after becoming eligible for benefits hereunder. If, however, as a result of severe medical or surgical complications arising out of pregnancy or resulting childbirth, expense is incurred for Extended Benefits on behalf of the 2. Exclusions and Limitations mother's care, the deductible amount shall be $500.00. However, notwith- Extended Benefits will not be provided in connection with the following: standing the above requirement of a separate deductible for the Subscriber a. Mental, psychoneurotic and personality disorders except while patient is and each family member,no more than three deductibles shall be required for hospitalized in an institution licensed to provide hospital care for such each family unit during any one calendar year. Any expense for Extended conditions, and as set forth herein under Sub-section 1, Paragraph d. above. Benefits incurred in connection with an illness, disease or injury during the b. Any services or supplies not specifically listed herein as covered benefits. last calendar quarter of any year and applied against such deductible amount c. Any services or supplies furnished in connection with any condition arising for that year shall be carried forward to apply against the deductible amount from pregnancy or resulting childbirth, including all complications thereof, for the ensuing year. Also, if the Subscriber and/or one or more family prenatal or postnatal care, or for routine care of a newborn infant,except as members shall suffer a bodily injury as a result of the same accident, the otherwise provided herein. aggregate deductible amount applicable to all said persons,in connection with d. Treatment on or to the teeth,extraction of teeth,treatment of dental abscess total expense for Extended Benefits incurred for such accident, shall be or granuloma, dental examinations, or treatment of gingival tissues (gums) $100.00 for that year in which the accident occurs. Separate deductibles other than for tumors, except as otherwise specifically provided herein; eye will be required for other than the first year unless such accident occurs glasses, eye refractions, or eye examinations for the correction of vision or during the last calendar quarter of the year. In this event, the above stated fitting of glasses;or the furnishing or replacement of hearing aids. provision relating to the carrying forward of expense incurred to the ensuing e. Medical examinations or tests not connected with care and treatment of an year will apply,and moreover, the provision relating to the aggregate deduct- actual illness, disease or injury. ible amount applicable to all said persons will also apply for the ensuing year. f, Services performed for cosmetic purposes,unless performed for correction of d. If expense incurred for Extended Benefits exceeds the deductible amount as functional disorders or as a result of accidental injury occurring while the set forth above, the Service shall provide payment to the extent of eighty individual is covered hereunder. percent of such excess. When payments exceed an amount of $1,600.00 for a Subscriber or family member during a calendar year, payment will be made to the extent of one hundred percent of incurred covered expenses in 3. Terminal Benefits excess of $1,600.00 for such Subscriber or family member for the remainder a. Except as otherwise provided in Paragraph c. below, should a Subscriber or of such calendar year. If treatment in connection with a mental condition is family member be totally disabled at the date of termination of coverage rendered outside of the hospital, payment for such expenses shall be made hereunder and be under treatment by a licensed physician or surgeon, all by the Service to the extent of fifty percent of the doctor's charges, but not benefits under this Section, as heretofore defined, shall be furnished for the to exceed $10.00 per visit up to a maximum of fifty visits during any calendar duration designated below. Such benefits shall be furnished solely in connec- year. Benefits of this Paragraph d. shall not exceed an aggregate amount of tion with the condition causing such total disability and only during the $300,000.00 per Subscriber or per family member during such person's continuation of such total disability. Proof of such disability and the lifetime while eligible hereunder. continuation thereof shall be furnished to the Service within ninety days e. The Subscriber or family member who has received at least $1,000.00 after the date of termination of coverage hereunder, of benefits hereunder may apply for reinstatement of maximum benefits b. Such benefits will be provided for a period equal to the number of months by furnishing evidence of good health satisfactory to the Service. However, the Subscriber or family member was covered under this Section up to a notwithstanding the above, the Subscriber or family member who has maximum of six months, or until the maximum amount of benefits has incurred expense hereunder which has been charged against the aggregate been paid,whichever occurs first. maximum of $300,000.00 shall automatically have reinstated toward c. If the Subscriber is required to pay the whole, or any part, of the required 1-1 -1 — • —•-1 —r­--•- -- r•••••e r•-••o rAK1 V. "r,1NrKAL .L11V111A11V1NJ (a) Personal servic es,�such as charges for radio, telephone and the like. (b) Private room charges exceeding the minimum rate of the hospital for The Service shall not be required to furnish any benefits in connection with: semi-private(two bed)accommodations. A. Admissions primarily for diagnostic study when inpatient bed care would not If Extended Benefits are furnished by a Contracting Hospital, the Service otherwise have been required, unless otherwise specified herein. reserves the right to make payment directly to the hospital for those B, Any condition for which benefits of any nature are recovered or found to be charges,if any,for which the Service is responsible, recoverable, whether by adjudication or settlement, under any Workmen's Compen- (2) Professional services rendered by a licensed physician or surgeon, sation or Occupational Disease Law, even though the Subscriber or family member (3) Professional services rendered by a licensed physician or surgeon or fails to claim his rights to such benefits. doctor of dental surgery for treatment of a fractured jaw or other accidental injury to natural teeth, providing that injury occurs while C. Services or supplies for which the Subscriber or family member is not legally the patient is covered hereunder. Such services will be covered only required to pay. during the six month period immediately following date of injury, D. Services or supplies for which no charge is made. (4) Professional nursing services of a registered graduate nurse, other than E. Care or treatment obtained from, or for which payment is made by, any United one who ordinarily resides in the Subscriber's home or who is related States Federal or foreign government agency. to the Subscriber by blood or marriage, F. Treatment on or to the teeth, extraction of teeth, treatment of dental abscess or granuloma, dental examinations, or treatment of gingival tissues(gums) other than for tumors, except as specifically provided for under Extended Benefits, if such benefits are included in this Certificate. UNITS UNITS UNITS UNITS Surg.Anes. Surg.Anes. Surg.Anes. Surg,Anes. aFhrymal duct stenosis,probing ........ * 3 3 for cancer,including Hemorrhoidectomy,internal and external 30 3 hospital,diagnostic 8 3 ichrymal sac,removal ....................... 50 4 complete gland resection 100 6 Proctectomy, complete, combined with ureteral catheterization......... 15 3 erygium ............................................ 25 4 Hysteropexy........................................ 40 4 abdomino-perineal,one or two stages. 100 6 with biopsy .................................... 10 0 rabismus,one stage,one or both eyes. 60 4 Myomectomy ...................................... 50 4 Proctoplasty or proctopexy,for Cystostomy with drainage ................... 50 5 RACTURES (SIMPLE, Perineoplasty....................................... 15 3 stricture or prolapse,perineal........... 40 3 Cystotomy with fuiguration................. 60 5 Rectocele repair................................... 30 3 abdominal....... 60 5 Epididymectomy,unilateral ................ 30 3 LOSED REDUCTION) Urethral caruncle,removal...............•.,. 7 3 Procto-sigmoidoscopy,diagnostic,initial. 3 3 Hydrocele,excision,unilateral............. 30 3 stragalus............................................ 20 3 Vaginal plastic,including cystocele and with biopsy,initial.. 5 3 Nephrectomy....................................... 80 5 lavicle................................................ 15 3 rectocele,with or without cervical repair 50 3 THYROID Nephropexy......................................... 70 5 smur,shaft........................................ 40 3 Nephrostomy....................................... 80 5 finger,.............................................I...1 7''A 3 Adenoma,excision ,...,......................... 40 5 Orchiectomy,simple,unilateral........... 20 3 orearm: one bone,shaft..................... 20 3 INFECTIONS AND WOUNDS Parathyroidectomy or exploration of bilateral............. 30 3 both bones,shaft.................. 25 3 Abscesses, incision and drainage......... * 2 3 parathyroid..................................... 70 5 radical,unilateral or bilateral, Kg:Tibia,shaft.................................. 25 3 Foreign body removal,incision............ * 2 3 Thy rogtossal duct,cyst or sinus,excision 45 4 with retroperitoneal Tibia and Fibula........................... 30 3 Wound repair,recent wounds:up to 2'N'* 2 3 Thyroidectomy,subtotal or partial...... 60 5 gland dissection................. 100 5 �tacarpal........................................... 10 3 for each additional inch................... * 1 3 total or complete .......1".. 70 5 Prostate,transurethral electroresection, tatarsal............................................ 10 3 for malignancy with neck complete......................................... 80 5 calcis............................................... 20 3 NERVOUS SYSTEM dissection,limited......... 80 5 Prostatectomy,perineal,subtotal......... 80 6 #sal(except astragalus and os calcis).. 10 3 grain cyst,neoplasm or abscess, radical ........ 100 6 perineal,radical........... 100 6 fie...................................................... 5 3 excision supratentorial............... 125 9 TUMORS AND CYSTS retropubic ................... 80 5 �e amounts shown are for simple,closed reduc• suprapubic,one or two suboccipital.................. 150 11 Cauterization or fulguration of local s.lfthefractureiscom oundorre uiresano en stages.................... 80 5 F ation,an additional allowance will be made. EnceChorphalogram, ........................................, ntucti eria 110 8 lesion,single,small,depending upon g Encephalogram,introduction of material 10 5 type of method and lesion .........., *1'h to 3 0 Ureterotomy........................................ 70 5 Frontal lobotomy, Urethrosco dia nostic..................... 5 3 1'NECOLOGY omy by craniotomy,unilateral 40 9 Excision of small neoplastic,cicatricial, pwith removal of calculus or Laminectomy(other than discs).......... 100 7 inflammatory or congenital lesion irtholin's gland,incision.................... 5 3 Splanchnicectomy,unilateral............... 65 5 of skin or subcutaneous tissues, foreign body ..................... 20 3 excision.................... 20 3 bilateral...............,, 80 8 one,by size..................................... 4 to6 3 Varicocele,excision,unilateral ............ 30 3 rvix: Local excision of lesion......,.... * 3 3 Trephination (or burr holes), explor- Parotid tumor,removal,superficial...... 20 3 ;Cauterization of.............................. 3 0 atory, unilateral............................ 30 8 Parotid gland excision,total,with X-RAY OR RADIUM THERAPY Amputation of................................ 20 3 reservation of facial nerve ............. 70 3 p foray l radium therapy in lieu of surgery tl-de-sac,drainage ............................. * 3 3 Pilonidal cyst.or sinus,complete excision 30 3 for malignancies, neoplastic disease or for fstocele repair................................... 35 3 RECTAL Sebaceous cyst(see lesions above) postoperative care for malignancies. Cation and curettage,diagnostic or for Abscess,perianal,incision and drainage 2 3 `,`removal of uterine polyps............... 15 3 Fissurectomy,if done alone.,............,.. 20 3 URINARY SYSTEM UNITS stula,rectovaginal or vesicovaginal, Fistulectomy Or fistulotomy,subcutaneous 10 3 Cystectomy,partial.............................. 70 6 Per Treatment Schedule: closure........................................ 60 5 submuscular 40 3 complete......................... 100 6 Superficial or low voltage ............... 3 rsterectomy(inlluding preliminary Fistulectomy,second stage.................. 10 3 radical............................. 120 7 Orthovoltage................................... 3 D&C), subtotal........................ 55 4 Hemorrhoid,enucleation of external Cystoscopy,office,diagnostic,initial.... 5 0 Supervoltage including cobalt sources 4 total ............................. 60 4 thrombotic ..................................... * 3 3 with ureteral catheterization.....•... 8 0 Insertion of radium,radon or cobalt. 15 i Fee Schedule (RV64)^ SuUNITS rg.An UNITS rg.Aries. Sug.Anes. Surg.Anes To determine the maximum allowance for any service, the Relative Value Units indicated below will be multi- BLOOD VESSELS AND HEART Ganglion,excision of lesion of tendon Patella th ". plied by the value of each Unit as previously designated. Injection of sclerosing solution or sheath,digits only....................... 10 3 Elbow.....................•............................ * 5 3 The Units appearing in the Anesthesia column repre• into vein of leg,one ..................•..... * 1 0 Intervertebral disc,excision,•.......:....... 90 7 Wrist or carpal: one bone..................... * 5 3 sent basic values, To these will be added Time Units two or more injections,same leg .•... * 2 0 with spinal fusion... 120 7 more than one bone.... * 7 3 representing the actual time spent administering the Ligation and division of long saphenous BREAST Ankle.................................................... 10 3 anesthesia. Time Units will be based on one Unit for, Hip or knee•..................I...................... 20 3 each quarter hour or major part thereof vein at saphenofemoral junction, Mastectomy,partial(incl.deep tumor) Where an asterisk(*)appears and when such proce. with or without injection................ 20 3 unilateral.....•..................... 15 3 EAR, NOSE AND THROAT dure tequires inpatient hospitalization, an additional Ligation and division and complete bilateral .............•..........•... 25 3 Adenoidectom primary 10 3 two Units are allowed for the surgery. stripping of long or short saphenous simple,unilateral ..............•.... 30 3 Y.P Y""t toot"""' Antrum,Caldwell-Luc, UNITS veins,unilateral.............................•. 30 3 radical,unilateral................... 70 3 unilateral......... 50 3 Sur$.Anes. bilateral .........................,.•..... 50 3 Mastotom y with ex p loration,or bilateral........... 65 3 * ABDOMINAL Ligation and division of: drainage of deep abscess •............•... 10 3 Antrum puncture unilateral................. 2 0 Appendectomy.................................... 40 4 Short saphenous vein at Ethmoidectomy,unilateral ...........•...... 30 3 Appendiceal abscess,drainage.............. 30 4 saphenopopliteal junction......... 12ah 3 CHEST Fenestration of semicircular canal ....... 100 6 Cholecystectomy.....................•........... 60 5 Minor varicose vein of leg,initial..... 5 0 Bronchoscopy,diagnostic..................•• 15 4 Hemi-laryngectomy ............................. 60 6 Cholec stotom or cholec stostom 50 5 subsequent 3 0 with biopsy..•........... ......... 20 4 Laryngectomy,with neck dissection.... 140 6 Y Y Y Y •• without neck dissection.... 100 6 Colectomy,partial,including Myocardial aneurysm,repair................ 200 15 with foreign body removal. 25 4 colostomy,if necessary.................1. 80 5 Pericardiectomy•................................. 120 15 Decortication ...................,.....• .,...•..... 100 11 Laryngoscopy,direct,diagnostic.......... 10 4 Enterestomy with anastomosis............ 70 4 Pulmonary-aortic anastomosis ............. 150 is Diaphragmatic hernia repair, with biopsy................... 15 4 Enterostomy or colostomy50 4 transthoracic.................... .............. 80 11 with removal of tumor.. 25 4 with bi""" Lobectom 100 11 Mastoidectomy,simple ........................ 50 4 Esophagoscopy,diagnostic,with biopsy 15 4 BONE,JOINT AND TENDON Y""""total""""""•"""""' Nasal-antral window,unilateral....•....... 15 3 Pneumonectomy,total ..........•............. 100 11 without biopsy 15 4 Amputation: Pneumothorax: intraplewal injection of bilateral.............. 25 3 Gastrectomy,subtotal ......................... 80 6 Foot .....,.....•...........................•..•.... 35 3 air, initial * 5 0 Nasal polyp,excision,single ................ 7 3 total................................ 100 6 Hand,wrist or forearm toot""•'"".. ................... 40 3 subsequent.,..,..,... * 2 0 Septectomy,submucous resection ....... 30 3 Gastrorrhaphy: suture of perforated Arthrodesis: Thoracentesis,initial............................ * 3 0 Tonsillectomy and adenoidectomy gastric ulcer,wound or injury ........... 50 6 Elbow •,•..........................._.......•...... 70 3 Thoracoplasty: first stage .•.................. 60 6 under 18 years ................................ 15 3 Gastrostomy................................•....... 40 5 Hip ...................•............................. 100 5 second stage.•.....•........ 30 5 Tracheotomy...............•....................... 20 4 Gastrotomy ......................................... 50 5 Wrist ...............•..........................•.... 60 3 third stage...•.........•..... 30 5 Hernioplasty: Herruorrhaphy: Herniotomy: Arthroplasty: EYE Femoral, unilateral......................... 35 3 Elbow ,..........:. 80 3 Thoracoscopy,diagnostic,with or "'•""""""•'• without biopsy ..... 20 4 Cataract removal,unilateral...............•. 80 8 bilateral............................ 521/r 3 Hip ................................................. 100 5 e Y toot" toot" Chalazion,incision or excision,single... 5 3 Inguinat, unilateral.......................... 35 3 Wrist ..•.,..........,............................... 80 Thoracotomy,exploratory,with or ' ; without biopsy multiple,same lid................... 6 3 bilateral............................ 521h 3 Bunion operation,Silver type.............. 20 3 p y 50 1 1 P YP multiple,different lids........... 7 3 Laparotomy, exploratory: Cartilage,semi-lunar, DISLOCATIONS (SIMPLE, Corneal ulcer,cautery.......................... * 5 0 exploratory celiotomy .................... 40 4 removal of detached .....................,. 50 3 CLOSED REDUCTION) Dacryocystorhinostomy..........1.1....1....1 70 5 Paracentesis,initial .............................. * 4 0 Exostoses,removal of: Finger: one,one or more joints .......... * 3 3 Enucleation of eye .............................• 40 4 Peritoneoscopy.................................... 15 0 small bones •.,.. ............................... 25 3 Toe: one,one or more joints ............... * 2 0 Foreign body,removal from interior-of Splenectomy ....................................... 60 6 large bones...........................•.......... 40 3 multiple joints and/or toes..•........... 7 3 eye,with or without operative incision 50 6 B-1089 1/75 EXHIBIT B-2 Ewa 1 u �b � � NO— No City of Huntington Beach P.O.BOX 190 CALIFORNIA 92648 xuNn«o o�ecnc" OFFICE OF THE CITY ADMINISTRATOR a j t Au ust 24, 1973 TO ALL CITY EMPLOYEES This booklet which is being reprinted by Blue Cross updates the benefits provided for City la employees in hospital services and major medical expenses. It i hoped that this Blue Cross plan will give you and your dependents the needed benefits and protections when injury or illness should occur in your family. Although it is my sincere hope that you, and the members of your families will enjoy good health at all times, all of us realize that un- exp cted illnesses and injuries are always a possi- bihi y and can be extremely expensive if you do not�have the proper protection. The purpose of this group insurance program is to substantially off et expenses caused by these disabilities. In (order that you will become familiar with the many features of the plan as presented in this booklet, I would suggest that you take time out to familiarize yourself with the various provisions. It i certainly the desire of the City of Hunting- ton Beach to have Blue Cross of Southern Calif- orn a provide you with the best possible coverage whi h should be comparable to that offered to oth r employees in both the private and public sec ors. If on have any specific questions which might aris concerning your coverage under this Plan, feel, free to ask the Personnel Department for assistance. Sincerely, Da id D. Rowlands Cit Administrator D RJbjs 1 BASIC BENEFITS 100 DAYS OF CARE OUTPATIENT CARE IN BLUE CROSS FOR EACH PERIOD OF DISABILITY CONTRACTING HOSPITALS When you or your eligible family members receive In the outpatient department of a Blue Cross care as registered bed patients in a Blue Cross contracting hospital, the plan pays 100% of the contracting hospital, benefits described here are hospital's charges for: available for 100 days during each period of disability. Emergency L Emer enc accident care within 72 hours of the accident. 2. Minor surgery. +' WHERE TO GO FOR CARE V r Benefits described here are available in any Blue u Cross contracting hospital or contracting extended care facility in Southern California. In non-contracting Southern California hospitals, 100% of charges for the following HOSPITAL the plan will pay 100%of contract benefits based SERVICES — regardless of cost: on retail charges for admissions resulting from an 1. Semi-private accommodations. accidental injury; and 75% of such benefits for 2. Services in an intensive care unit. admissions resulting from illness. 3. Meals and dietary services. No benefits will be provided in non-contracting extended care facilities in Southern California. 4. General nursing care. S. Operating and cystoscopic rooms. Outside Southern California, these benefits will be provided in any accredited general hospital. Ex- 6. Surgical and anesthetic supplies. tended care benefits are payable in any facility 7. Ordinary casts,splints and dressings. approved by the Joint Commission on Accred- 8. Oxygen and all drugs and medications used itation of Hospitals. during your hospitalization. SURGERY 9. Laboratory and X-ray examinations, and electrocardiograms. Blue Cross helps pay the doctor bill either in or 10. Physical therapy and hydrotherapy. out of the hospital if you need surgery,treatment of broken bones, dislocations or wounds, X-ray or radium therapy in lieu of surgery will be paid for EXTENDED CARE SERVICES malignancies, non-malignant tumors or for post- In addition to services in an acute general or operative care for malignancies. specialized hospital, benefits are provided in Payments are made in accordance with a schedule extended care facilities contracting with Blue of fees based upon the 1964 Relative Value Studies Cross. These may be separate institutions or of the California Medical Association. Payments special sections of hospitals. Prior hospitalization are determined by applying a $8.00 value to the is not required before being eligible for this type units for each procedure. of care. The total number of days available for Your contract contains an extensive list of oper- each period of disability may be used in a contract ations and their unit values. Here are a few ing hospital, a contracting extended care facility — examples: Appendectomy,40 units —$320;Ton- or in combination. Semi private accommodations, sillectomy(children),15 units—$120;Hemorrhoid- as well as all necessary services, will be paid at the ectomy, internal, 30 units — $240;Chordotomy, same percentage as for hospital care. �' 100 units $800; Myocardial Aneurysm, repair, 200 units—$1600. RENEWAL OF BENEFITS For the Subscriber, the benefits just described ASSISTANT SURGEON renew four weeks after discharge from the hospital; If your operation requires the services of an for the family, 90 days after discharge. For assistant surgeon (other than a hospital intern, hospital care as a result of a new accident, these resident or house officer), Blue Cross will pay up benefits renew immediately. to 20% of the fee schedule amount allocated for the primary surgeon. 2 3 BASIC BENEFITS ADMINISTRATION OF ANESTHETICS ACCIDENT BENEFIT Payment will be made for the administration of If you are injured after this benefit becomes effec- anesthetics in a hospital by a professional anes- tive, it will provide up to $300 in excess of all thetist when the member is entitled to Blue Cross other Basic Plan Benefits to pay expenses for: Hospital and Surgical Benefits,except for normal 1. Services of a licensed physician or surgeon, childbirth delivery. This benefit provides $8.00 2. Hospital confinement, for each anesthesia unit listed in your contract, 3. Services of a registered nurse, plus Time Units representing actual time spent administering the anesthetic. 4. Laboratory and X-ray examinations. These expenses are eligible for payment if incurred within 90 days of the accident. CONSULTATION Blue Cross will pay for consultation services by a licensed physician or surgeon(except staff consult- ations required by hospital regulations) if you are a bed patient hospitalized for a condition requiring special skill or knowledge. Up to $24.00 will be allowed for one bedside consultation during each -� hospitalization. DOCTOR VISITS IN THE HOSPITAL BASIC PLAN EXCLUSIONS You may be hospitalized without needing surgery Hospitalization primarily for diagnostic studies; - for pneumonia, diabetes, or heart trouble, for Workmen's Compensation cases;conditions covered example. In such cases, Blue Cross will pay a by any Federal Government agency; rest cures; medical benefit of up to $24 for the first hospital custodial care; routine physical examinations; visit,and$8 for one visit each day thereafter. This dental care; eye examinations; cosmetic surgery; payment will continue as long as you are entitled blood and blood plasma; any conditions of preg- to Blue Cross hospital or extended care facility nancy,unless specifically listed as a contract benefit. benefits.It will apply except in cases of pregnancy. WHO IS ELIGIBLE Subscribers and their wives or husbands and their unmarried dependent children from birth to age 19. If a child reaches age 19 and continues to be unmarried and dependent upon his parents for at least half of his support,he may be included under - ` their contract to age 23. If an unmarried dependent child reaches the L9 - maximum age limitation of the contract and is incapable of self-sustaining employment by reason of mental retardation or physical handicap, his f eligibility for benefits will continue regardless of AMBULANCE BENEFIT his age,while he remains in such status. You will receive up to $50 to help pay ambulance charges. This amount is payable for each eligible NOTICE admission (not including maternity cases) that This plan supplements coverage provided to requires a trip to or from the hospital or extended eligible employees and their dependents through care facility. You will receive your payment by the Medicare program. Both the Medicare and check from Blue Cross after you submit either the Blue Cross identification cards should be pre- billing from the ambulance company or your sented when receiving health care services. receipt for payment of this bill. 4 5 ) s EXTENDED BENEFITS HOW THE PLAN WORKS PREGNANCY The Deductible—Each person covered by this plan If pregnancy produces severe complications, Blue is responsible for the first$100 of"out-of-pocket" Cross will pay 80% of all eligible charges in excess expense incurred during a calendar year for items of$500,up to a maximum of$50,000. listed under Services Covered. (Benefits paid by your Blue Cross"Basic Plan"or by any other group CARE FOR NERVOUS OR health plan do not count toward your deductible.) MENTAL CONDITIONS No more than $300 per family will be required Hospitalization for nervous or mental conditions during a calendar year. and payment to your doctor for hospital visits Eligible expense incurred during the last three are payable under both portions of your P,an. months of a calendar year and applied against the For outpatient psychiatric care,Extended Benefits member's deductible for that year is carried forward Plan provides 50% of charges, but not to exceed and applied toward deductible expense for the $10 a visit to a maximum of 50 visits during a following year. calendar year(after your annual deductible). Extended Benefits Plan Pays: 800/v of the usual, customary and reasonable charges for Services EXTENDED BENEFITS EXCLUSIONS Covered,after the deductible has been met,up to a . Benefits payable by the Basic Plan; items not beginning of each calendar ye ar, up to $1,000 g out-of-pocket" expense;any condi- tions will automatically be restored to the member's of pregnancy,except as noted. • Work-connected injury or sickness. lifetime maximum. • Care in rest, convalescent or nursing homes. SERVICES COVERED • Routine physical examinations — ment — eye examinations dental treat- ment Hospital Services (including intensive care) — • Cosmetic surgery — hearing aids. charges of a legally operated hospital, except g Y — except for conditions private room charges exceeding the minimum resulting from accidental injury or functional d" cho n al p personal expenses such disorder occurring while co i- rivate rate and p contract is semi-private P effective. e. as telephone,television,etc. Hospital.care care being received at the time this 2. Services of a licensed physician or surgeon contract becomes effective. 3. Services of a registered nurse 4. Anesthetic administration tion and supplies COORDINATIO N OF teeth BENEFITS Ural injury to jaw or natural Benefits Treatment form J fits of 5. T J Y both the Basic and Extended Benefits including replacement of natural teeth plans are coordinated with those provided for the • A licensed physician or surgeon, or doctor member by any other group of dental surgery must provide treatment benefit or service plan. hospital or medical • Injury must occur while this contract is effective • Charges incurred within six months follow- TOTAL DISABILITY ing injury are covered If coverage ends while the member is totally dis- 6. X-ray, radium and radioactive isotope Y erapy abled, and under treatment for that disability, 7. Physical therapy treatments provided b a reg- the Extended Benefits Plan will continue to istered physical therapist or licensed physician provide coverage for the disability for as many or surgeon months as the member has been covered by 8. Required X-ray and laboratory examinations Extended Benefits — up to six months, or until 9. Ambulance trips to and from local hospitals maximum benefit has been paid,whichever occurs 10. Drugs or medicines requiring a written pre- first. scription 11. Artificial limbs, eyes, casts, splints, trusses, braces, crutches; rental of wheel chairs, hos— pital-type beds, iron lungs, and similar equip- ment needed for conditions occurring while The City pays the Employee cost. The cost for this contract is effective Dependents is deducted from our 12. Blood transfusions, including the cost of blood Y paycheck. and blood plasma. 6 7 s I I 1 HOW TO USE YOUR BENEFITS AT A BLUE CROSS CONTRACTING HOSPITAL— Present your Blue Cross Identification Card when you enter the hospital. You need not fill out claim forms, or report any hospital charges to Blue Cross. The hospital will send us a complete report, and we will pay all eligible i expenses for you. IF YOU NEED DOCTOR CARE — Show the doc- tor your Blue Cross Identification Card. Ask him to bill us for all of his services to you which are payable under this plan . . . whether at his office, your home, or in the hospital. j AMBULANCE — When you send ambulance bills, include (1)name of patient(2)dates of services and transported"from and to"(3) total charges (4) name of referring physician(5) Blue Cross group and certificate numbers. MEDICATIONS — When your doctor prescribes medicine, get a pharmacy billing, and include I (1)name of patient(2)prescription number and date (3) retail charges (4) name of referring I physician (5) Blue Cross group and certificate numbers. Cash register receipts cannot be accepted. NURSING SERVICES — If you require the serv- ices of a private duty nurse (R.N.), the bill must include (1) name of patient (2) date and hours nurse worked(3)her charges(4)name of referring physician (5) Blue Cross group and certificate numbers. BLOOD AND BLOOD PLASMA — if you receive a blood transfusion and do not replace the blood, be sure the bill submitted to us includes (1) name of patient (2)date of service(3)total charge (4) Blue Cross group and certificate numbers. APPLIANCES (Casts, Braces, etc.) — For either rental or purchase of this type of equipment, send us (1) name of patient (2) description of item furnished (3) date rental or purchase was made (4) name of referring physician (5) total charge,including whether this is a total purchase price or a rental charge (b) Blue Cross group and certificate numbers. Address all claims and correspondence to: ill@ Orlss of Southern California Claims Department 4777 Sunset Boulevard Los Angeles,California 90027 This booklet is for your convenience. It gives you a quick summary of your Blue C7 oss coverage. Be sure to read your contract for full details. 8 WHAT IS FHP? FHP is a Group Practice Prepayment Program organ- ized as a non-profit health plan. This program pro- LLrr--'' vides health care, including doctors, dentists, x-ray and laboratory services, prescription drugs, and eye PFL © care through its own medical centers and full time $=Hp MEDICAL CENTER LOCATIONS LF=iJ professional staff, Hospital services, acute and LOS ANGELES COUNTY ORANGE COUNTY ;y convalescent,are provided and paid for in community m hospitals. 4nane...Sr x „ 9 FAMILY HEALTH PROGRAM The difference between FHP and insurance coverage - is that while insurance pays for diagnosis and treat- _ °°5 ment, FHP does this and more. FHP is responsible 5,"s ti for the availability, accessibility and quality of the health care provided. One monthly payment includes Long Beach Central Fountain Valley 500 Alamitos Avenue 9900 Talbert Ave, doctor and hospital services, preventive care such as Medica"Dental Medcal/Dental_ A COMPREHENSIVE GROUP periodic physical examinations, immunizations, well 5,„ vrie.lr Gwv PRACTICE PRE-PAYMENT baby care,health screening,vision and hearing testing, convalescent services, and health education. Most w h PROGRAM important,there are no unexpected or unknown costs that might provide a barrier to receiving care, between the consumer and the provider of services. Long Beach Plan Anaheim 2925 N.Pala Verde Ave. 2571 La Palma(at Magnolia) Medical Medical/Deotal EXHIQIT Q-3 G.G Fwy Alondra d i e Arlen,BI 91 405 i t � � Compton Santa Ana gig W,Alondra Blvd, 1002 N.Fairview(at loth) Medical/Dental Medical ka: GUAM,U.S.A. n,de cede, eoso Ger/cam,,e� a^aa Ce°1ef�wan ` HIGH OPTION ada� MEDICAL FHP/CatholicniDicalGenter BENEFITS PLAN Tamuning.g.Guam Medical/Dental CHOOSING YOUR DOCTOR FAMILY HEALTH PROGRAM When you enroll in FHP, you may choose one or ADMINISTRATIVE OFFICES 2925 NO.PALO VERDE AVENUE more of its staff physicians for yourself and family, LONG BEACH,CALIFORNIA 90815 He or she will be the doctor you normally go to for (213)429-2473 (714)898.3516 regular medical care. In an emergency or acute illness, NOTE: This folder is for your convenience—it is not a contract. SOUTHERN CA&I F 0 R N IA you may be seen by another FHP doctor, and ther FHP-MH,6n5 return to your family physician for follow-up care. V11111LQLIV110 rry AN rrnr NUJrl I AL HOSPITAL BENEFITS AND CARE In addition to FHP medical centers and staff ph, OF DAYS YOU PAY NOTHING. Room and Board (semi-private room rate, PLAN COVERS IN FULL—NO LIMIT , NUMBER sician services,each benefit period, $3,000 per perso intensive care, coronary care, maternity care) . is available for each of the following: radiatio Other hospital services such as: therapy; nuclear medicine; and all congenital abno General nursing care, operating and cystoscopic malities for children born under the FHP progran rooms, surgical and anesthetic supplies, drugs and $3,000 per person and 80% of the next $7,000 oxygen, lab & x-ray examinations, electrocardio PLAN COVERS IN FULL — YOU PAY NOTHING. available for dialysis. $20,000 each benefit perio grams, services of hospital based specialists in path- is available for cardiac surgery (including all hospit, ology, radiology and anesthesiology. charges). Physical therapy for neuro-muscular reh� CONVALESCENT HOSPITAL CARE PLAN COVERS IN FULL up to 20 days, bilitation is provided only at FHP or designate, medical centers. Oral surgery is provided only fe DOCTOR'S HOSPITAL SERVICES doctor and hospital services relating to condition Including medical care, surgery,fractures and PLAN COVERS IN FULL — YOU PAY NOTHING. such as injuries, fractures and malignant tumors o maternity care. the jawbone. Eye glasses are limited to one pair eacl Whole blood and derivatives PLAN COVERS administration cost. benefit period. YOU PAY for or replace blood. PREVENTIVE DENTAL SERVICES PLAN COVERS IN FULL — YOU PAY NOTHING. Exclusions An annual full mouth x-ray and clinical examination All care caused by and arising from: Intentionalh, PLAN COVERS $500 EACH BONA FIDE EMER- self-inflicted injuries including injury or illness as i GENCY (includes local ambulance up to $50). FHP result of attempted suicide; alcoholism or drul IN-AREA EMERGENCY CARE by non-FHP staff must be notified within 48 hours. Drugs are not physicians — Necessary medical services to members covered unless administered by a hospital or phy- addiction or abuse; cosmetic surgery; treatment o requiring immediate treatment anywhere in Orange sician. Payment to be in accordance with the Calif- chronic orthopedic deformities;organ transplants anc or Los Angeles counties, or on the island of Guam, ornia Industrial Accident Fee Schedule. Out-of-area experimental treatments; Workers' Compensatior where or when FHP services are not available. benefits may be available for an In-Area emergency cases; military service incurred disability; eligiblf when it is medically contraindicated to move the services provided through governmental agencies or member to a Family Health Program facility. institutions; long term infectious diseases; custodian care; dental care except as listed above under limita• OUT-OF-AREA EMERGENCY CARE by non-FHP PLAN COVERS 80% UP TO $10,000 EACH BONA tions; procedures for the restoration of pre-existinc staff physicians — World wide travel benefits — FIDE EMERGENCY (includes local ambulance). FHP loss of sight or hearing; coverage for congenital Necessary medical services to members requiring must be notified within 48 hours. Drugs are not abnormalities for members not born under the FHP immediate treatment while temporarily outside of covered unless administered by a hospital or phy Orange and Los Angeles counties, or off the island sician. Payment to be in accordance with the Calif- program; fertility procedures; hearing aids; special of Guam, where or when FHP services are not ornia Industrial Accident Fee Schedule. appliances and material; allergy kits;other health and available. accident insurance coverage including UCD coverage and third party liability settlements;benefits available LOCAL AMBULANCE when authorized by an FHP under the Federal Medicare program or State Medi- physician, within the Service Area. PLAN COVERS $50 each occurrence. caid programs; medical care or hospital services not rendered or authorized by FHP physicians; charges NO MAXIMUM for FHP medical centers and FHP incurred by a member during a continuous period PLAN MAXIMUM staff physician's services. All other covered services are subject to a $300,000 maximum for each of hospitalization which commenced prior to the unrelated cause. effective date of his enrollment under this plan; and FHP-MH-6/75 services and benefits unless specified as covered. map Definitions The Plan's Benefit Period shall mean a period of months commencing with the effective date of g=wp GROUP MEDICAL BENEFITS Group Contract, or the duration of the ong Group Contract, whichever is shorter. If the Gr, Contract exceeds 12 months, a new Benefit Pei shall commence 12 months from the initial effec IN AN FHP MEDICAL CENTER date of the Group Contract. DOCTOR'S CARE BY STAFF PHYSICIANS PLAN COVERS IN FULL — YOU PAY NOTHING. Extended maternity coverage provides continual Specialist's care PLAN COVERS IN FULL — YOU PAY NOTHING. of physician's (not hospital) maternity care at Consulting specialist —special unusual cases. PLAN COVERS IN FULL — YOU PAY NOTHING. additional charge for employee or dependent a termination of employment. Diagnostic laboratory test&x-ray examinations PLAN COVERS IN FULL — YOU PAY NOTHING. Periodic health examination, including chest x-ray PLAN COVERS IN FULL — YOU PAY NOTHING. & laboratory No waiting period for maternity benefits means are covered even if you are pregnant at time Routine immunizations and injections PLAN COVERS IN FULL — YOU PAY NOTHING. enrollment. Well child care, including routine immunizations PLAN COVERS IN FULL — YOU PAY NOTHING. Physical therapy PLAN COVERS IN FULL — YOU PAY NOTHING. Certain medications in the FHP generic drug Eye examinations PLAN COVERS IN FULL — YOU PAY NOTHING. mulary are intentionally limited in quantity medical and/or potential abuse reasons. A presc EYE GLASSES PLAN COVERS. YOU PAY $5.00 for standard tion drug unit is: the amount normally dispen frames, single or bi-focal lenses. (Sunglasses at on a single prescription in regular medical pract By FHP prescription only reduced charges). a one-to-three month supply for an on-going disE or illness; or a small, safe amount for those drugs t PRESCRIPTION DRUGS PLAN COVERS an unlimited number of can be habit-forming, addictive or otherwise abusal All FHP prescribed drugs on generic formulary at prescriptions. YOU PAY NOTHING. FHP Medical Center pharmacies FHP MATERNITY CARE An FHP Hospital is any hospital within the Seri Including hospital care by physician and care of Area in which FHP doctors are on staff in regt normal newborn babies. attendance. A current Fist of hospitals used Physician's care of mother before, during and six PLAN COVERS IN FULL — YOU PAY NOTHING. available upon request from the Health Plan Off weeks after delivery. No waiting period; extended coverage; covered from enrollment. SPECIAL MATERNITY CARE ALTERNATIVE A Convalescent Hospital is an Extended Care Faci requiring skilled nursing care. FHP offers free choice of any doctor or hospital PLAN COVERS$500 for all hospital and doctor care. (non-FHP) for maternity care and delivery as an FHP Service Area is the County of Orange, t alternate benefit. Extended coverage does not apply. portion of Los Angeles County lying south Firestone Boulevard (Manchester Boulevard),and MENTAL HEALTH SERVICES PLAN COVERS. YOU PAY $3 registration fee per Island of Guam. visit for the first ten visits and $15 each visit for the Provided in designated FHP Medical Centers. next ten visits each benefit period. Eligibility [Elective AMILY PLANNING SERVICES Subscribers and their wives or husbands and tferilization procedures unmarried dependent children from birth to age irth control pills, contraceptive devices and IUD, PLAN COVERS IN FULL — YOU PAY NOTHING. If a child reaches age 19 and continues to be tot. sterilization dependent upon his parents for support as a Lull ti abortions PLAN COVERS. YOU PAY $100 each abortion, student, he may be included under their contract aae 23. HOW TO USE FHP MEDICAL CENTERS For your convenience, office visits should be made " by appointment, whenever possible. In the daytime n� we have a large staff on duty, and more complete i laboratory and x-ray facilities to serve you. The evening and weekend hours should be reserved for , as`� is acute illness, emergencies, and special circumstances, ; You may be seen anytime during office hours without m an appointment if you are ill, but your waiting time "a will undoubtedly be longer, and you may not be able �i to see the doctor of your choice. ' ,v ONE-STOP CARE FHP provides doctor care, x-ray an( and emergency care at each of its i PERIODIC HEALTH EXAMINATIONS maximizing convenience for you. ff�zs y Periodic health examinations are provided. The initial examination is traditionally scheduled near t yob HOSPITALIZATION your birthday. Call your .FHP Medical Center one month prior;to your birthday to schedule your " Your FHP doctor will arrange for you �y� appointment. A, when it is medically necessary. The I admits you (or a designated referra follow your case each day in the ho certain you are receiving the necessary MEMBERSHIP SERVICE PRESCRIPTION DRUGS A Member Service representative or Benefit Advisor is available during your FHP office hours to answer Prescription medicines are covered by your questions and to help you with any situation A pharmacy is located in each FHP that might arise. FHP encourages you to contact We dispense generic prescriptions wh these individuals on your first visit to your medical center to get acquainted with the facility and how to EMERGENCIES best use it, �� Medical emergency is the sudden and unexpected onset of a condition requiring medical or surgical care which the member secures immediately after the �a�i..n onset (or as soon thereafter as the care can be made available but in any case no later than 24 hours after NOTE: Medical services not covered by FHP under the onset). Emergencies are usually defined as severe , this Plan may be provided in certain cases when pain, excessive bleeding, difficulty in breathing, heart w ordered by the FHP attending physician. Non-Member attack, cardiovascular accident, poisoning, loss of fees will be charged for such services. consciousness or respiration, and convulsions. tg4 k t EXHIBIT D PROTECTION SALARY CONTINUANCE INCOME INSURANCE DESIGNED FOR x 5 EMPLOYEES OF THE - CITY OF HUNTINGTON BEACH f , I ; Salary Continuance Program Long Term Disability Income Group Insurance This booklet describes a program of Long Term Disability Income Insurance which is made available to you at group insurance rates. We recommend your careful consideration of this program which is designed to help protect your earning power, either on or off the job. YOUR NEED FOR SALARY PROTECTION Here are typical examples of what your lost income would amount to in dollars and cents if you were disabled and could never work again. Example 1 At age 27, you would lose 38 years of income, and if you earn $100 a week ($5,200 a year) this loss would amount to $197,600. Example 2 If you earn $150 a week ($7,800 a year) and are age 35, between now and retirement you would lose $234,000. These examples are taken at random. The best example is your own. Why not work out what your financial situation would be? Years Left to Present Normal Retirement Present Yearly Age At Age 65 Salary X $ $. Total Income Lost Losses such as cited in the above examples really do occur! 1 ELIGIBILITY The term "Salary" shall mean the monthly wage or Salary (Exclusive of Bonuses, Commissions and overtime earnings) the Insured Em- I All active full time salaried office clerical and Administrative ployee received from the Employer immediately prior to the date of Personnel; all permanent half-time Employees who work a the Accident or commencement of Disability from Sickness. For minimum of 20 hours per week on an annual basis and Class I and Class III Employees,--During the first two years of dis- who have a minimum 90 days service, ability, a totally disabling accident or sickness is defined as one which will "wholly and continuously disable and prevent the insured person II All active full time salaried policemen, firemen, and life- from performing each and every duty pertaining to his occupation." guards. After two years of payments, the disability will continue to be con- III All active full time salaried employees other than those sidered as total provided that the insured is "wholly" and continuously included in Group I or Group II. disabled and prevented as result of said injury or sickness from engaging in each and every occupation or employment for wages or profit for which he is reasonably qualified due to his training, educa- tion or experience." For Class II Employees —A totally disabling accident or sickness is HOW THE PLAN WORKS defined as one which will "wholly and continuously disable and pre- vent the insured person from performing each and every occupation If you became totally disabled and require the regular care and or employment for wage or profit for which he is reasonably qualified attendance of a legally qualified physician or surgeon other than by training, education or experience. yourself, the Plan will supplement any benefits paid or payable to you (or for which your dependents may qualify far) under the dis- During all periods of disability the disabled employee must be under ability provisions of the Social Security Act, any amount paid or the care of a legally qualified physician. payable under any Workmen's Compensation or Occupational Disease Act.or Law, to provide an aggregate disability benefit of up to 50% of salary to a maximum of $900.00 per month. (With respect to Class II insured Employees: Exclusions This policy does not cover loss caused by or resulting from injury The exclusions to the coverage are losses caused by or resulting from s declared or undeclared war or any act thereof, service in the armed sustained by the Insured Employee by reason of an accident arising forces of any country, suicide or any attempt thereat while sane or out of or in the course of any occupation or employment for wage or profit.) self-destruction or any attempt thereat while insane or sickness result- profit.) from pregnancy, childbirth or miscarriage or miscarriage resulting Benefits begin immediately following the 30th day of Disability due- from accident.. to either Sickness or Accident and continue for life provided you are totally disabled due to an accident and for 36 months or up to age 65, whichever first occurs,if totally disabled due to sickness. 2 3 GUARANTEED IMPORTANT FEATURES MINIMUM PAYMENT FOR SPECIFIC LOSSES Is House Confinement Required? No. This program provides for all non-house confining benefits. You are not required to be house or hospital confined to receive benefits under this policy. When injury results in any of the losses indicated below within 100 days after the date of accident, the Insurance Company will pay the regular monthly accident indemnity for the period you are totally Air Travel Coverage disabled, but in no event will such payments be made for less than the number of months set opposite the loss. If more than one loss You are protected against any loss resulting from an injury that you listed below results from one accident, the schedule is applicable to may incur as a passenger or otherwise, in or on, boarding or leaving only one of such losses, that for which the greater period is provided. any vehicle or device for aerial navigation. Loss of both hands. . . . . . . . . . . . . . . . . . . . . . . . . . . .46 months Lass of both feet . . . . . . . . . . . . . . . . . . . . . . . . .46 months Certificates Loss of entire sight of bath eyes . . . . . . . . . . . . . . .. . . . . . . .46 months An individual certificate will be issued to each insured person by the Plan underwriter; Continental Casualty,Company, and will. describe Loss of one hand and one foot . . . . . . . . . .. . . . . . . .46 months in detail the benefits provided. Loss of one hand and the entire sight of one eye . . . . . . . . .46 months Loss of one foot and the entire sight of one eye . . . . . . . . .'46 months Loss of one hand . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 months j Loss of one foot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 months Loss of the entire sight of one eye . . . . . . . . . . . . . . . . . . . . .15 months Loss of thumb and index finger of either hand . . . . . . . . . . .12 months INDIVIDUAL: TERMINATIONS "Loss" as above used with reference to hand or foot means a complete The insurance of any individual terminates when he ceases to,be an severance through or above the wrist or ankle joint; as used with eligible employee, reaches age 65, the premium is not paid or the reference to eye means the irrecoverable loss of the entire sight thereof; Group Policy terminates., and as used with reference to thumb and index finger means complete severance through or above the metacarpophalangeal joints. Termination of the employee's insurance, however, has no effect on any claim incurred prior to the date of termination. 4 5 To Join This Plan QUESTIONS ABOUT YOUR PLAN Simply complete the enclosed enrollment card and return it to your supervisor. Insurance for employees enrolling before they become eligible shall Are Pre-Existing Conditions Covered? take effect on the date they become eligible. Yes, sickness due.to pre-existing conditions are fully covered. Insurance for employees enrolling within 30 days after they became eligible will take effect on the date application is made to the Com- Are My Benefits Subject to Federal Income Tax? pany• At present, general interpretation of the Federal tax laws pertaining Insurance for employees enrolling within 30 days from the date they to loss of time benefits usually indicate that benefits for which the become eligible will take effect on the date the application is accepted employee pays the premium are wholly tax free. by the Company. Employees not enrolling within 30 days after they become eligible may be required to submit evidence of insurability before coverage will become effective. What Happens If Disability Recurs? If you are absent from active work because of an accident or sickness A recurrence of total disability from the same or related cause or on the date your insurance would otherwise take effect, your insur- causes will be deemed a continuation of the prior disability unless ance will-take effect on the date you return to active work. between such periods the insured employee has performed the duties of his occupation on a full-time basis for at least six consecutive months, in which event such total disability shall be deemed a new The Cost of This Plan disability and subject to a new elimination period. By assuming the administrative cost of the Plan, The City of Hunting. Do I Continue To Pay Premium ton Beach is making it possible for you to buy this protection on a If I Am Disabled? group basis at a much lower cost than that of an individual policy. If you are disabled and receiving benefits under this program, the Your cost will be .6602% of your salary and this will be deducted Continental Casualty Company will waive payment of any premium from each pay period. No amount of monthly salary in excess of for Salary Continuation Benefits which becomes due during the period $180,0.00 will be included in the computation of premium. Examples for which such disability benefits are payable. of benefit amounts and cost are as follows: Monthly Earnings Monthly Benefit What Happens If a Disability Commences $300.00 $150,00 $1.98 After My 64th Birthday? $500.00 $250.00 $3.30 If a disability commences after your 64th birthday and before your 65th birthday,indemnity otherwise payable will be paid for the period $700.00 $350.00 $4.62 of such disability not to exceed 1 year. $900.00 $450.00 $5.94 6 7 i s + : Y h x �y 3 4# s a' ja ^a IN E[{ t: A �• E ?g y t xY, . �� n , z � i �. ,a.�._'§.�.,•. .-.,,+ems,, .-� �- .`�.; f s�. �, .. >� ff:1 'A �q '� �' .���. a'- aj--x, aa� .,-�.:_' ' #z r ,:. ,.._. ..... ,, .4.;-. .„ ,.....r ...�.. , ?+. _.. :.m+r ..,,�.•„•r«„r ..,<: x.,z .. $ „'s:.-r.-x.. ,;4�':: ..+:r .x .#"' y� o-" x VMI Mg _: �<t�.. ..n..•.. .. -'1' -,. i; , bs. a. � ,��r~*w �a �,� � "�:�•�, € ,.,._.. ,., .._ _ _, �� ; ,.-� :. _ .. , „ _%� . ,,, Nam. •��..� ���. � +:�� ' :`.�a .x.. y ....r:. :. -N .fk , z, $_ � .� , . �. 4 . t - � .,„�_: _ 4 .r-s`e,� �,., .. .�-•. _K� fit'` ,�•�;.- 1. r4s !r n rx� N '�� n' °sh`" '� ._.. .,;.,..,.-, ,. -:,.- .,... .qF�- �-n fir.. •�F g >,�..� : ,.-.... r, ,:, Y hYYs>• fi. 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"�',- s, - �` - .-,. _ "� , r EXHIBIT F-1 RESOLUTION NO. 3983 _ - A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH APPROVING AND AUTHORIZING EXECUTION OF A SETTLEMENT AGREEMENT WITH THE FIREMEN'S ASSOCIATION WHEREAS, a dispute has existed between the Firemen 's Associa- tion and the City with regard to a provision of the Memorandum of Agreement between subject entities ; and The dispute was submitted to a hearing officer through the city 's grievance procedure; and The proposed grievance is still subject to the litigation process and the parties desire to resolve same without further litigation; and The parties have in good faith negotiated a settlement of the dispute , NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Huntington Beach that it does approve the settlement of the dispute as per the settlement agreement forwarded herewith , and authorizes execution of the agreement . PASSED AND ADOPTED by the City Council of the City of Huntington Beach at a regular meeting thereof held on the 18th day of November, 1974 . Ity �. j4oT TE� Mayor City Clerk APPROVED AS TO FORM: APPROVED AS TO CONTENT: Cit Attorney *i yr City Administrator 1 . MHM:k ll/14/74 Res. No. 3983 n. STATE OF CALIFORNIA ) COUNTY OF ORANGE CITY OF HUNTINGTON BEACH ) I, ALICIA M. WENTWORTH, the .duly elected, qualified City Clerk of the City of Huntington Beach, and ex-officio Clerk of the City Council of said City, do hereby certify that the whole number of members of the City Council of the City of Huntington Beach is seven; that the foregoing resolution was passed and adopted by the affirmative vote of more than a majority of all the members of said City Council at a regular meeting thereof held on the JRth day of November , 19 74 , by the following vote: AYES: Councilmen: Shipley, Bartlett, Gibbs, Matney, Coen NOES: Councilmen: None ABSENT: Councilmen: Wieder, Duke City Clerk and ex-officio Clerk of the City Council of the City of Huntington Beach, California AGREEMENT THIS AGREEMENT is by and between the HUNTINGTON BEACH FIREMEN'S ASSOCIATION, INC. , hereinafter called "ASSO- CIATION," and the CITY OF HUNTINGTON BEACH, a municipal corporation, hereinafter called "CITY." WHEREAS, the parties hereto entered into a Memo- randum of Agreement on the 27th day of June, 1972, which agreement terminates on June 30, 1975; and, WHEREAS, said Memorandum of Agreement was executed pursuant to Government Code §3500 et seq . and Resolution No. 3335 of the City of Huntington Beach; and, WHEREAS, Article X of said Memorandum of Agreement, dealing with fringe benefits, became the subject of a dispute over the interpretation of the terms thereof; and, WHEREAS, this dispute, pursuant to the personnel rules , was heard by and submitted to a Hearing Officer; and, WHEREAS, a proposed decision by the Hearing Officer, dated June 18, 1974, pursuant to the personnel rules of the City of Huntington Beach has been forwarded to the Personnel Board of the City for consideration; and, WHEREAS, the aforesaid proposed decision determined that the fringe benefits payable under Article X should be implemented by 4.47% commencing July 1, 1974, but that no fringe benefits are to be implemented after June 30 , 1975, as a result of salary surveys taken in February, 1975; and, WHEREAS, the parties desire to settle this matter so as to avoid any further disputes , grievances and litigation pertaining to same; and, WHEREAS, the parties hereto have negotiated in good faith to effectuate a settlement; s 1 . M k 1/7/74 NOW, THEREFORE, the CITY and the ASSOCIATION do hereby agree as follows : 1 . In accord with the intent of Article X of the Memorandum of Agreement to provide fringe benefits to the members of ASSOCIATION, the CITY does hereby agree to provide all safety employees in the Fire Department with that certain retirement program which is commonly known and described as the "2% at Age 50" and which is based on the retirement formula as set forth in the Public Employees Retirement Law in the Government Code, and that said retirement program shall be so provided by the CITY sous to be in full force and effect commencing July 1, 1976, and CITY further agrees to take any and all appropriate and necessary steps so as to implement said program as of said date . 2 . In consideration of the foregoing, upon signing of this agreement by the parties hereto, ASSOCIATION dismisses the grievance which is now pending before the Personnel Board of the City of Huntington Beach pertaining to the interpretation of Article X, and hereby stipulates and agrees that by execution of this agreement, Article X of the aforesaid Memorandum of Agreement has been in fact fully implemented by the CITY to and including June 30, 1974, and that from and after July 1, 1974, no further obligations are due thereunder, except as set forth in paragraph 1 above. 3 . Except as herein provided, the aforesaid Memorandum of Agreement, dated June 27, 1972, shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed this 18th day of November , 2 . r. 1974, by their officers thereunto duly authorized. THE HUNTINGTON BEACH FIREMEN'S ASSOCIATION By CITY OF UNTINGTON BEAC a mur4c pal corpo atio TIE$ —ay or City Clerk APPROVED AS TO FORM: APPROVED AS TO CONTENT: Z*42 ` A�V Ci y Attor e City Administrator :1 3. EXHIBIT F-2 3 RETIREMENT PROGRAM BENEFITS FOR LOCAL SAFETY MEMBERS UNDER THE x ONE-HALF PAY AT AGE 55 FORMULA DECEMBER, 1973 STATE OF CALIFORNIA PUBLIC EMPLOYEES' RETIREMENT SYSTEM Pers-Adm-Do-13 (1/74) TABLE OF CONTENTS Page eneral ---------- ----------------------------------------------------------------------------------------- 3 GENERAL Kcal Safety Membership ______________________________________________________________________ 3 This This describes the series of retirement program benefits for )ntributions ----------------------_-----------____---------______________•--__-•_--------------_------------ 3 Local Safety Members under the "One-half pay at age 55 formula" as provided by public agency employers ,under contract with the Public immary of Benefits -------------------------------------_--------------------___------____---------- 4 Employees' Retirement System (PERS) where the employer has not Refund of Contributions and Interest -------------------------------------------- 5 provided a modification for Social Security covered local safety members. Redeposit of Withdrawn Contributions and Interest______________ ________ 5 The information in this booklet is intended to inform you on a broad Service Retirement _____________________ 5 basis of the protection and benefits provided you and your family as a ---------------------------- Local Safety Member. Some of the provisions described herein apply Age 50 Early Retirement ----------________________ ______••_-____ _----__.__-_____-------------- 6 only if specifically included in your agency's contract with PERS. Disability Retirement .__________________------- --- 7 Those provisions which are optional under the Retirement Law are so identified in this booklet and it is suggested you contact your employer Non-Industrial ---------------_-------------------_-------------------------______:_------.-------- 7 if you have any question on specific provisions included in your agency's Industrial on-the-job injury)__ _________ ____ __ ________ _ ________ __ contract. (on-the-job 1 y) 7 By reason of the number of different benefits, their relationship to Death Benefits Before Retirement -----------------------------------------____----------- 7 each other, and other intricacies of the Law, your best source of infor- Basic Death Benefit -----_--------______ ________________-____.____________________- 7 mation on detailed benefit estimates will be through;the System Area ---�-��----'- Offices, or through the System's Benefits Division. Special Death Benefit (Industrial Death) _______________________________________ 8 LOCAL SAFETY MEMBERSHIP 1957 Survivor Benefit -------------_______-----------------------------------_.----------------- 8 Local safety membership commences on the first day of employment 1959 Survivor Benefit _____ ____________________________________ g in a safety class, if employment is one-half time or more. A safety ---------------------- member, very generally, is an employee engaged in active law enforce- Post Retirement Survivor Continuance Benefit ________________________________ 9 ment or fire suppression activities. Optional Settlements -------------------------------------------------------------------------------- 9 CONTRIBUTIONS Cost-of-Living Adjustment -------_-------------------------------:---------------------.__---- 10 PERS is a pre-funded system; in other words, employer contributions Retired Member Death Benefit ----------------_----------------------__ are made as service is rendered to meet obligations for benefits based _________________ 11 on such service when they become due in the future. The funds derive Reinstatement After Retirement .------------------------------------------------------ 11 from three sources--your contributions, your employer contributions, pplying for Benefits -------------------------------------------------------------------------------- 11 and earnings from investments. Member Contributions Refund of Contributions __---------__________________________________________________________ 11 As a Local Safety Member under the "One-half pay at 55 formula", Death Benefits _---------------_----------------------_ _______________________________________________ 11 you contribute a percentage of your salary, exclusive of overtime. Your rate of contribution is determined by your sex and your nearest age at Service Retirement ----_________--------------------------------------------_----------------------- 11 entry to safety service. Table 1, below, shows the contribution rates Disability Retirement _________________________________________________________________________ 12 for male safety members entering safety service between the ages of 20 Allowance Estimatesthrough 55, inclusive, with no breaks in service. (Contribution rates ---------------------------.---- 12 for female safety members are individually computed—check with your )ard of Administration ____________ _____ _______________., 13 employer for the rate applicable to you.) ,,stem Offices -------------------------------------------------------------------------------------------- 13 3 i Table t l Refund of Contributions and Interest ONE-HALF PAY AT AGE 55 FORMULA If you permanently separate from all System covered employment Rates of Contribution for Male Safety Members before reachingretirement age, our contributions may be refunded (For those entering employment after Agency contract date) P g Y Y with earned interest. If you have a total of five years of credited service Male Rate Male Rate with one or more employers covered by PERS, you have the right to Nearest age at Membership (%) Nearest age at Membership (%) leave your contributions on deposit in return for a retirement allowance 20--- ------- ------- 5.64 38------------------ 11.08 when you reach retirement age. 21____________________ 5.87 39------------------ 10.76 r If you have less than five years' PERS service credit, your contribu- 22-------------------- 6.13 40-------_---------- 10.43 tions, with earned interest, must be refunded to you in a lump sum. At 23____________________ 6.39 41------------------ 10.10 refund, interest is credited and paid only through the previous June 24____________________ 6.68 42------------------- 9.78 25-------------------- 6.99 43------------------ 9.47 30th. 26---------------_---- 7.33 44------------------ 9.16 Redeposit of Withdrawn Contributions and Interest 27____________________ 8.08 45------------------ 9.83 Your benefits depend on the service credited to you. If you have 28-------------------- 8.08 46------------------ 9.00 p Y withdrawn contributions and interest on separation from previous em- 29____________________ 8.97 48__________-__---__ 9.11 to ment covered b PERS you may rede osit these amounts plus 30____________________ 8.97 48------------------ 9.31 1? Y Y + Y Y P � 31-___________________ 9.47 49------------------ 9.48 interest for the period of withdrawal and payment, by lump sum or 32____________________ 10.02 50------------------ 9.65 installment payments and restore your service credit. 33-------------------- 10.62 51------- ---------- 9.83 34____________________ 11.29 52------------------ 10.01 Service Retirement 35____________________ 12.02 53------------------ 10.20 You are eligible for service retirement as a Local Safety Member 36____________________ 11.70 54------------------ 10.38 when you reach the minimum age for retirement and have at least 5 37____________________ 11.38 55-------____--_____ 10.58 years of credited service. The minimum retirement age is 55 (or age 50, if your agency's contract with PERS so provides-ask your employer Employer Contributions if you are not sure). The compulsory retirement age is 65. Your employer also contributes each pay period to the System a Basically, the"one-half pay at age 55" formula provides an allowance percent of the total earnings of Local Safety Members. equal to one-half your final compensation when you attain age 55, If you leave before retirement age and do not take a job with another provided you entered such service initially at age 35 and served con- agency that is covered by the Public Employees' Retirement System, tinuously for the intervening 20 years under this formula. If you reach you can have your money refunded, with interest. The contributions of age 55 with less than 20 years of service, you may retire with an allow- your employer, however, will not be refunded. ance that will be less than 50% of final compensation. If you work beyond age 55 and accumulate more than 20 years of such service, you SUMMARY OF BENEFITS may receive an allowance greater than 50% of final compensation. A number of the following benefits are described in terms of "Final However, your age at entry under this formula and breaks in such Compensation". Final compensation is defined by law as the highest service affect the "benefit factor" used in calculating the allowance. average annual compensation earnable by a member during the three The amount of your service retirement allowance if you retire before consecutive years of employment immediately preceding the effective or after you are eligible for a "50%" monthly allowance will depend date of his retirement, or the date of his last separation from employ- on your "benefit factor". Table 2 shows the benefit factors applicable ment, if earlier, or during any other period of three consecutive years for various employment ages. 1f you have any breaks in service, how- of membership specified by the member. ever,.the benefit factor for your entry age may not apply. Contact the Benefits Division,PERS, for information on the factor applicable to you in the event you do have such breaks in service. 4 5 Tabs s For example, assume you entered local safety service at age 30, are now age 52 with 22 years service, and your final compensation is $900 Nearest age at Entry Benefit Factor per month. The discount factor to be applied to your benefit factor,for retirement at 52 is .787 (see above). Your benefit factor of 2.00% (from 21---------------- 1.471% Table 2) would be reduced to 1.574% (.787 X 2.00%) for each year 22---------------- 1.515 of service. Your allowance would be: 23------------.... 1.563 24----- ---------- 1.663 22 Years X 1.574 X $900 — $311;65 er month 25---------------- 1.667 % P 26---------_------ 1.724 Disability Retirement 27---------------- 1.786 28________________ 1.852 Non-Industrial ________________ . 3 30 If, at an age, you become substantial) incapacitated to perform the 30________________ 2 2•00 duties of your position for cause not related to your employment, and 31________________ 2.083 you have five or more years of credited service you may be eligible for 32________________ 2.174 33________________ 2.273 a monthly disability allowance. 34________________ 2.381 The amount payable is computed by using a benefit factor of 1.8%, 35 and over------. 2.500 times years of credited service, times final compensation. There are, however,provisions in the law for using extra years of service, minimum Your monthly allowance is computed from three values under the allowances, and limitations on the percentage of final compensation that "% pay at 55" formula: may be paid for disability retirements. The amount of the monthly 1. Years of service as a Local Safety Member; allowance may be reduced because of compensation earned after retire- 2. Your benefit factor for each year of such service; ment in other employment not subject to PERS membership. 3. Final Compensation. We suggest you make inquiries at one of the System offices as to your The computation formula is: approximate benefit if you are considering disability retirement. Years of Local X Benefit X Final - Unmodified Industrial(on-the-job injury) Safety Service Factor Compensation Monthly Allowance If, at any age, you become physically or mentally incapacitated to perform the duties of your position as a result of on-the-job injuries For example, assume you entered local safety service at age 30, are you may, after medical examination and determination by your em- now age 58 with 28 years service, and your final compensation is $900 ployer that you are so incapacited, be retired for industrial disability. per month. Your allowance would be: If retired for industrial disability you are entitled to one-half of final compensation for your lifetime, or until recovery from your disability. 28 Years X 2.000% X $900 - $504.00 per month Death Benefits Before Retirement Age 50 Early Retirement Basic Death Benefit If your agency's contract with PERS provides for early retirement The basic death benefit is payable, usually in lump sum, to the statu- at age 50 (ask your employer if you are not sure), the benefit factor for tory or named'beneficiaries and consists of your contributions and in- each year of safety service as shown in Table 2 above would be dis- terest, plus an amount paid from employer contributions equal to one counted as follows: month's salary (average during twelve months preceding death) for each full year of credited current service, to a maximum of six months. Discount Unless you name different beneficiaries or in a different order, the Age at Retirement Factor statutory beneficiaries in the Law apply. The statutory beneficiaries and their order are: so- ------------ .676 a. Your spouse (wife or husband); 51---------------- .729 b. Your children, share and share alike (if no spouse); 52---------------- .787 53________________ .851 c. Your parents,share and share alike (if no spouse or children); 54................ 922 d. Your estate (if none of the above). 6 If you wish-different beneficiaries or in a different order, your em- reach age 18, or if full-time students, to age 22, unless married before ployer will provide you a State Form 241 on which you may enter your that age; and dependent parent to age 62 (mother) or age 65 (father). beneficiaries. It applies only to those members who have this coverage (as evidenced If you have designated a beneficiary and thereafter any one of the by a $2.00 monthly or $.93 bi-weekly payroll deduction). Monthly following events occurs, your designation will, by law, be revoked: benefits are: a. You marry; b. Your marriage is dissolved or annulled; c. Your child is born; Monthly d. You adopt a child. Eligible Survivors Benefit The listed statutory beneficiaries would then become your designated you submitted a new beneficiary designation form. until eligible surviving widow (or dependent widower) beneficiaries unless y Y g until remarriage,with two or more dependent children; Special Death Benefit(Industrial Death) or three eligible children alone_____________________ $430 If your death occurs due to an injury or disease incurred in your An eligible surviving widow (or dependent widower) until remarriage,with one eligible child;or two eligible employment, the System will pay a monthly allowance of one-half of children alone_________________________ __________ 360 final compensation to the surviving wife (or dependent husband) for her lifetime, or until she remarries, or to children until the youngest Surviving widow at ape 62 (or dependent widower at reaches age 18. age 65),not remarried;or one eligible child alone_____ 180 In addition to the Special Death Benefit (50% of final compensation), Dependent parents may also be eligible. if your death incurred in performance of your duty is the result of an The 1959 Survivor Benefit is payable in addition to the 1957 Survivor accident or injury caused by external violence or physical force, and p y the surviving spouse has eligible children of the member in her care Benefit or the basic death benefit, as the case may be. If the survivor under age 18, the Special Death Benefit is increased to the following is eligible for the Special Death Benefit and that benefit is more than percentages of final compensation: the 1959 Survivor Benefit, the amount of the higher benefit would be Spouse with 3 or more children.under age 18___________________ 75% payable. Spouse with 2 children under age 18------------------------------------ 70% Post Retirement Survivor Continuance Benefit Spouse with 1 child under age 18-----------------------------------------. 62%2% Another benefit provision which may be provided to local safety The Special Death Benefit is payable instead of the basic death ben- members through contract provision is the "post retirement survivor efit or the 1957 Survivor Benefit (described below). continuance" benefit (ask your employer if you are not sure whether The 7957 Survivor Benefit this applies to you). This special benefit applies upon your death after The 1957 Survivor Benefit is a monthly benefit payable if you had you retire, either for service or disability, if you have a spouse to whom attained the minimum voluntary retirement age (age 50 or 55 depend- you were married for at least one year prior to the date of your ing on your agency's contract with PERS) and had 5 or more years retirement. of credited service. Your surviving spouse will receive one-half of what your unmodified The benefit is one-half of the amount you would have received had (highest) retirement allowance was until the surviving spouse remar- you retired with a service retirement allowance at the date of death. ries or dies. If you leave no surviving spouse, or the surviving spouse Eligible survivors include: remarries or dies, then the allowance will be paid to any unmarried a. The surviving widow married to the member at least one year children under age 18 and will continue until the youngest child attains before his death, or dependent widower, for life, or to remarriage; age 18. If there is no surviving spouse, or children,under age 18 eligible b. Children to age 18, unless married before that age. for the allowance, it will then be paid to qualifying surviving dependent The 1959 Survivor Benefit parents. (Note: This is an optional contract provision—check with your em- I It is important to note that if you do have the "post retirement sur- ployer if you are not sure whether it applies to you.) The 1959 Survivor vivor continuance" benefit coverage, only one-half of your unmodified Benefit is paid monthly to beneficiaries in the following order-the allowance is subject to the optional settlements described below. surviving widow (or dependent widower) married to the member prior Optional Settlements to the injury or onset of the illness causing death; children until they When you retire, either for service, disability, or industrial disability, you may elect the unmodified (highest) monthly allowance or you 8 9 may elect a lower allowance during your lifetime and provide for a The member does not have to apply for these increases. They are benefit for your survivor. calculated and granted automatically, and appear when applicable, in The optional settlements available to you at retirement are described the May 1st allowance payment. below. If, however, you are covered by the "post retirement survivor Retired Member Death Benefit continuance" benefit provision and you have eligible survivors (as At the death of a retired member, a $500 death benefit is paid in a described above), only one-half of your unmodified allowance is subject lump sum to his statutory or designated beneficiary. The lump sum to reduction under Options 2, 3, or 4, and only one-half of your payment is in addition to any benefit under any optional settlement the accumulated contributions are subject to return under Option 1. member may have selected at retirement. The optional settlements are: Option #1—This option guarantees the return of a retired member's Reinstatement after Retirement contributions (the unmodified allowance does not guar- After you have retired and are receiving an allowance from the antee this). System, you may not be employed by the State of California, the Uni- Option #2--This option permits a member to accept a reduced in- versity, a school district or any public agency under contract with the come during his lifetime and after his death have that Public Employees Retirement System unless you are first reinstated same amount continue for the life of his beneficiary from retirement. There are, however, limited exceptions;to this rule. named at retirement. Your employer can advise you regarding these exceptions. You may return to a contracting public agency (or State) employ- Option #3—This option also permits the member to accept a reduced ment if you have been on a voluntary service retirement for at least a lifetime income and after his death the payment to his year. You must first make application to the Retirement System for beneficiary will be one-half the amount of his reduced reinstatement from retirement. If you meet health, age, and other lifetime income. requirements for reinstatement and return to employment, your retire- Option #4—Under this option the retired member may elect, with ment allowance will cease. When you again retire, your allowance will the approval of the Board of Administration and subject include credit for both your earlier service and your service after to certain limitations, such other joint annuity benefits reinstatement. as are the actuarial equivalent of his retirement allowance. APPLYING FOR BENEFITS Cost of Living Adjustment Refund of Contributions Provision for an annual "cost of living" adjustment to monthly A PERS Form 167 filed through your employer is used to accomplish allowances other than 1959 survivor allowances was incorporated into the election you make to have your contributions remain on deposit or the Retirement Law in 1968. to be refunded to you. Approximately one month is required to process On April 1st of each year, each account is adjusted to reflect the a refund upon notice of separation and request for refund. change, if any, in the California Consumer Price Index, which by law Death Benefits is the average of the Los Angeles-Long Beach and San Francisco-Oak- land area cost of living indices, published by the Bureau of Labor Notice of the death of an active member is usually sent to the Retire- Statistics of the United States Department of Labor. Adjustment may ment System by his employer; or if a retired member, by letter from be byway of increase or decrease. relatives, friends, or other.persons concerned. The adjustment is subject to the following.limitations: The Retirement System will send an affidavit to the .beneficiary for signature with a request for a certified copy of the death certificate. In 1. No adjustment will be made in years for which the adjustment to certain cases, birth or marriage certificates may be required to estab- the member's base allowance would be less than 1%. "Base allow- lish eligibility for survivor benefits. ance" is the member's monthly allowance minus accumulated cost of living increases already granted. Service Retirement 2. Allowances may not be reduced below the base allowance. Submit your Application for Retirement to the Public Employees' 3. Adjustment will commence in the second calendar year following Retirement System about 90 days in advance of your intended service the year of retirement and may not exceed 2% per year, corn- retirement. This is done on PERS Form 369 which your employer will pounded from the base year. The "base year" is the year of have. Remember that normally your retirement cannot be effective retirement. earlier than the first of the month in which your application is received by the System and it is your responsibility to send it to the System. 10 11 The address for personal delivery is Public Employees' Retirement Sys- tem, 1416 9th Street, Sacramento, California. The address for mailing is Public Employees' Retirement System, P.O. Box 1953, Sacramento, California 95809. If you want computations of optional settlements 2 and 3, the name, birth date, and sex of your intended beneficiary must be shown on the BOARD OF ADMINISTRATION application. The System will advise you of the allowance payable and PUBLIC EMPLOYEES' RETIREMENT SYSTEM will furnish the necessary forms and instructions for your retirement. Disability Retirement Stanley B. Fowler,President Whether initiated by your employer or by you, your application for Melvin W. (Mal)Aust *William J. Hammond disability retirement must be filed with the Retirement System. Use Robert F.Carlson Verne Orr PERS Form 369 and remember that normally your retirement cannot * W James Dawson, D.D.S. * Neville W.Turner,M.D. be effective earlier than the first of the month in which your application Jesse E.Goodwin Frank M.Woods is received by the System. Bartlett T.Grimes (Vacancy) As provided under the Retirement Law, your employer will determine *Health Benefits Member whether you are incapacitated physically or mentally for the perform- ance of the duties of your position. Your employer will also make the determination as to whether the disability is industrial. In the event of dispute as to whether the disability is industrial or as to the effective j William E.Payne date of the disability retirement, application may be made, either by Executive Oaicer _ ,your employer or by you, to the Workman's Compensation Appeals Edward K. Coombs Carl Blechinger Board for determination of this question. Assistant Executive Officer Assistant Executive Officer Upon determination of your disability, your employer must advise PERS of its decision in order for the System to act on your application. Allowance Estimates As you near retirement you will be interested in specific information HEADQUARTERS so that you may properly plan ahead for that event. At that time the PUBLIC EMPLOYEES' RETIREMENT SYSTEM S,ystem's Benefits Division or Area Office staff will provide you, at your request, allowance and option estimates, and will review the estimates 1416 9th Street with you so that the material provided is understood. Sacramento,California 95814 Members nearing retirement may obtain the described estimates by writing or by telephoning one of the System offices. Periodic field trips Mailing Address P.O. Box 1953 to outlying areas are made from Los Angeles, San Francisco and Sacra- ti mento. Bulletins are sent to every employer announcing the dates and Sacramento,California 95$09 places where interviews will be conducted. LOS ANGELES AREA OFFICE SAN FRANCISCO AREA OFFICE Room 204-B,State Building Room 3033,State Building 217 West First Street 350 McAllister Street Los Angeles, California 90012 Son Francisco,California 94102 Telephone 620.4430 Telephone 557.0582 SACRAMENTO AREA OFFICE 1416 9th Street Sacramento, California 95814 Telephone 445.8717 12 A85806-801 1-74 30M