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MEA - Municipal Employees Association - 2002-12-16
, ✓�� �-tau-c-, ��_� �,�,� Council/Agency Meeting Held: p Deferred/Continued to: Approved ❑ Conditionally Approved ❑ Denied Cit lerk' Sign re Council Meeting Date: 9/20/2004 Department ID Number: AS-04-036 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTIONS SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS - SUBMITTED BY: PENELOPE CULBRE H-GRAPT, CITY ADM NI'SAXTOR PREPARED BY: CLAY MARTIN, DIRECTOR OF ADMINISTRATIVE SERVICL� _ SUBJECT: SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION REGARDING UNIFORMS, INCREASE TO LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE COVERAGE, AND AN INCREASE TO THE GENERAL LEAVE ACCRUAL CAP AND CASH OUT PROVISION .,6�e S. Alo. �q)5: 8',,)_ Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The City and the Huntington Beach Municipal Employees' Association (MEA) have reached a side letter agreement regarding uniforms, an increase to the coverage level for life and accidental death & dismemberment insurance (AD&D), and an increase to the general leave accrual cap and cash out provision. Funding Source: As required by state law in accordance with the California Public Employees' Retirement System (PERS), the city will begin reporting for all eligible employees the value of city provided uniforms as compensation for retirement calculation purposes. There is a one-time cost of $14,000 and an ongoing annual cost of $7,000 related to reporting uniforms to PERS. The coverage level increase for life and accidental death & dismemberment insurance represents an increase of $2,800 annually to the budget. The increase to the General Leave accrual cap from 600 hours to 640 hours represents a maximum liability of $530,000. At this time no adjustment is needed to the fiscal year 2003/2004 budget or proposed fiscal year 2004/2005 budget. Recommended Action: Adopt Resolution No. o yL_ Via, a resolution of the City Council of Huntington Beach amending the Memorandum of Understanding (MOU) between the City and the Huntington Beach Municipal Employees' Association by adopting the side letter of agreement. REQUEST FOR ACTION MEETING DATE: 9/20/2004 DEPARTMENT ID NUMBER:AS-04-036 Alternative Action(s): Reject the resolution and maintain current wages, hours, and other terms and conditions of employment in the MOU. Analysis: Representatives of the City and the MEA have completed the meet and confer process on a side letter agreement for MOU provision changes to uniforms, life and AD&D insurance coverage, and general leave. Uniform Value Reportable as Compensation In July 2003 the city underwent a random audit conducted by PERS. This audit was to review the city's compliance with all reporting procedures as required by state law. A finding was that the city was not reporting the value of city -provided uniforms as compensation for the purposes of calculating retirement. The city began the meet -and -confer process with MEA to update the current uniform policy and to identify all eligible employee classifications and uniform components for the purpose of deriving a value by uniform category. This side letter agreement incorporates the revised uniform policy. In addition to reporting to PERS the value of uniforms prospectively (at a cost of approximately $7,000 annually), the city will retroactively report the value of uniforms for fiscal years 2002/2003 and 2003/2004. The cost of this adjustment is estimated at $14,000, which is the employer pick-up of the 7% employee contribution to PERS . Life and AD&D Insurance Coverage Currently, there is a difference in the coverage level for employees represented by the MEA and employees represented by the Management Employees' Organization (MEO) and those in the non -associated group. This change will increase the coverage for life insurance from $25,000 to $45,000 and coverage for AD&D insurance from $10,000 to $45,000 resulting in the same insurance coverage level for all non -safety employees. General Leave Accrual Caps The annual cap on general leave accrual for MEA is currently at 600 hours. This will be increased to 640 hours to match the cap for non -associated employees. Additionally, as provided for non -associated employees, MEA employees' ability to cash out general leave will increase from once a fiscal year to twice a fiscal year. The annual maximum cash out of 120 hours remains in effect. The additional 40 hours of general leave accrual may increase the city's leave accrual liability by $530,000 annually. Attachment(s): M.lOn AIRACA . :s..,., -:. - 1—"-. A. n n147111MA A.AG MR ATTACHMENT #1 RESOLUTION NO. 2 o 0 4_ g z A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH AMENDING THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION, BY ADOPTING A SIDE LETTER OF AGREEMENT (UNIFORMS, INSURANCE COVERAGE, GENERAL LEAVE ACCRUALS) WHEREAS, on December 16, 2002, the City Council of Huntington Beach adopted Resolution No. 2002-133 for the purpose of adopting the 2003 Memorandum of Understanding (MOU) between the City and the Municipal Employees' Association (MEA); and Subsequent to the adoption of the MOU, the City of Huntington Beach and the MEA agreed to changes, corrections, and clarifications to the MOU that are reflected in a Side Letter of Agreement between the City of Huntington Beach and the MEA ("Side Letter of Agreement") attached hereto as Exhibit A and incorporated herein by this reference, NOW THEREFORE, the City Council of the City of Huntington Beach does hereby resolve as follows: 1. The. Side Letter of Agreement attached hereto as Exhibit A is approved and adopted. 2. ` The Side Letter of Agreement amends the MOU betweenthe City and the MEA. PASSED AND ADOPTED by the City Council of the City of Huntington Beach at a regular meeting thereof held on the 9 0 t b day of „tarnhor , 2004. APP VED AS TO FORM: Ci y Attorne INITIATE ND PROVED: Director of ministra Tve ervices G: Resolutions: 2004: MEA Side Letter Sep 2004 EX,Y/,5/7- 4 6IF-SOZ-LL-nO--J AOO'/ - ff;k Side Letter Agreement Between the City of Huntington Beach and the Huntington Beach Municipal Employees Association Effective:. September 21, 2004 This is to memorialize an agreement between the City of Huntington Beach (City) and the Huntington Beach Municipal Employees Association (MEA) to reflect agreed upon changes, corrections or clarifications to the existing Memorandum -of -Understanding (adopted December 16, 2002, Resolution 2002-133). All other terms` and conditions of the existing side letters and the Memorandum -of -Understanding remain in full force and effect. Both parties, agree to continue the meet and confer process in good faith as required. by the Meyers-Milias-Brown Act. The goal of the continued meet and confer process is a new Memorandum -Of -Understanding between the City and MEA. The subject.,: of the continued meet and confer process shall be all issues between the parties concerning wages, hours, and other terms and conditions of employment. This agreement is to be incorporated into any future Memorandum -of - Understanding between the City and MEA. Article Vill — Uniforms, Clothing, Tools and Equipment; Section A; Article X -- Health and Other Insurance Benefits, Sections D;.Article.. XII Leave Benefits, Section A.1.d; and Exhibit B shall now read: 1 ARTICLE Vill — UNIFORMS, SAFETY SHOES, TOOLS AND VEHICLE USE A. Uniforms and Safety Shoes The City's Uniform and Safety Shoe Policy shall be set forth in Exhibit B a copy of which is attached hereto and incorporated herein by this reference, provided however, that employees represented by MEA working in the Police: Department shall be issued property in accordance with the equipment issue form for the particular position to which they are assigned. ARTICLE X — HEALTH AND OTHER INSURANCE A. Health C. Life and Accidental Death and Dismemberment Insurance Effective October 1, 2004 each permanent employee shall be provided with $45,000 of life insurance and $45,000 of accidental death and dismemberment insurance paid, for by the city. Each employee shall have the option, at his/her own expense, to purchase additional amounts of life insurance and accidental death and dismemberment insurance to the extent provided by the city's current: providers. ARTICLE XII — LEAVE BENEFITS A. Leave With Pay 1. General Leave d) Conversion to Cash Effective the beginning of fiscal year 2004/2005,'' two times during each fiscal year, each permanent employee shall have the option to convert into a cash payment or deferred compensation up to a total of one hundred -twenty (120) hours of accrued general leave benefits per fiscal year. The value of each hour of conversion is the employee's current base hourly rate, as reflected in Exhibit A. The employee shall give payroll two (2) weeks advance notice of their decision to exercise such option. 2 EXHIBIT B — UNIFORM POLICY A. General The City, in accordance with agreements now established, shall furnish uniforms to those personnel designated by. the various department heads as. required to wear a standard uniform for appearance, uniformity and public recognition purposes, in the procedures and guidelines set forth hereinafter. B. Affected Personnel All employees categorized shall wear a standard City adopted uniform. Each department head shall determine which employees must wear a uniform. Uniform Listing by Category/Classification (Exhibit B-1). C. Personal Protective Equipment All personal protective equipment as related to employee job duties and responsibilities shall be provided based on supervisor -designated need. Examples of personal protective equipment include, but may not be limited to the following: hardhats, foul weather gear, steel -toed rubber boots, steel -toed caps, wood heat resistant soles, special hazard gloves, safety glasses, face shields, ear. protectors, arm and shin guards. R-1 safety` vests shall be furnished to all employees having occasion to work within travel ways. D. Safety Shoes 1. Black safety toe shoes or boots as each assignment dictates. a. Two pair per year. b. Boots will be black, heavy duty and laced. c. Damaged shoes shall be turned into operating supervisor who shall authorize replacement or repair. 2. The maximum. amount to.be.reimbursed for a pair of safety shoes will. , not exceed one.. hundred. and eighty-five dollars ($185) per pair every six months or sooner, if necessary. 3. Shoes or boots shall be purchased through designated standard outlets. 3 E. Employee Responsibilities 1. To wear a clean and complete uniform as required. 2. Uniform appearance shall include.: a Patch to be worn above left shirt or jacket pocket. b. Pants to have no cuffs. c. Worn with pride in appearance to public, i.e., shirt buttoned, shirttail tucked in, etc. 3. To wash and provide minimum repair; i.e., buttons, small tears, etc. 4. To provide any alterations necessary including sewing on of City patches. 5. To notwear the uniform for other than City duties or work. 6. To notify supervisor of need to replace due to disrepair or severe 1 staining producing an undesirable appearance. 7. To turn in all uniform components, including patches upon termination. 8. To turn in all personal protective equipment upon termination. 9. To wear all personal protective equipment prescribed by the City safety officer and supervisor of the division. F. City Responsibilities 1. To furnish funding for the agreed uniform allowances. 2. To report to the California Public Employees' Retirement System (CaIPERS) the cost of uniforms provided as set forth in, Uniform Listing by Category/Classification, Exhibit B-1, for each classification as special compensation in accordance with Title 2, California Code of Regulations, Section 571(a)(5). For employees that are not required to wear uniforms on a daily basis or who are not actively employed for an entire payroll calendar year, a prorated cost of uniforms may apply. 3. To provide and maintain one or more retail clothing outlets for the various allotments. City reserves the right to name vendor. 4. To maintain records of purchases. 4 C. Department Head or Designee Responsibilities 1. To ensure employee compliance with the Uniform Policy. 2. To approve replacement. of deteriorated uniform component(s) and personnel protective .equipment as required and to maintain: a listing for each eligible employee, by name and classification, of all uniform' component(s) and personal protective equipment purchased. 3. To confirm receipt of uniforms, patches and personal protective equipment from an employee upon termination. A Termination Checklist Form is to be completed, signed by the employee, and submitted to the Human Resources Office. 4. To report to the Human Resources Manager any changes to the Uniform Listing by Category/Classification (Exhibit B-1). The City reserves the right to add, delete, change or modify the Uniform Listing as required. 5 Exhibit B-1 Category of Uniform Group 1: 5 Shirts, T-Shirts and Pants, Patches, 1 Jacket PW/CS Field Issue Group 2: 1. Blue Suit, 2 Pants/ Polo Shirts, 1 Sweater, 1 Pair Shoes Fire Group 3: 2 Blue Shirts, 3 Pants/Skirts, 1 choice Jacket/Sweater/Sweatshirt PD Group 4: 2 Polo Shirts, 2 Pants or 2 Shorts, 1 Hat CS Group 5: 5 Polo Shirts, 1 Jacket, 1 Windbreaker not annually), 1 Hat (Inspection) Group 6: 2 T-Shirts CS Group 8: 4 Battle Dress Uniform, 4 Polo Shirts, 1 Jacket, 1 Rainsuit PD Group 9: 4 Blue Pants, 2 Shorts, 4 Polos or Blue Shirts,1 Jacket, 1 Rainsuit PD Group 10: 5 Shirts, 5 Pants, Shoes PPE/Safetey not PERS reportable Group 11: 3 Shirts, 3 Pants, Boots PPE/Safetey not PERS reportable Group 12: 5 Polo Shirts, 3 Pants, 1 Sweatshirt or Windbreaker IS . Uniform Listing by Category/Classification* Bldg & Safety 0210 ' Building Inspector 1 5 Bldg & Safety 0211 Inspector II 5 Bldg & Safety _Building 0208 Building Inspector HII 5 Comm Svcs 0358 Beach E ui Operator 1 Comm Svcs 0149 Beach Maint Crewleader 1 Comm Svcs 1 0452 Beach Maint Service Worker 1 Comm Svcs 0252 Community Srvcs Rec Coord 6 Daily wear not required. Used for special events and/or sports leagues. Frequency of use varies - seasonal from weekly to month) Comm Svcs 0258 Community Srvcs Rec Su v 6 Daily wear not required. Used for special events and/or sports leagues. Frequency of use varies - seasonal from weekly to month) Comm Svcs 0448 Marine Equipment Mechanic 1 Comm Svcs 0264 . Park Naturalist .. 4 Comm Svcs 0177 Parkin` Meter Repair Tech Comm Svcs 0395 Parking Meter Repair Worker 1 Comm Svcs 0459 Parking/Camping Crewleader 4 Comm Svcs 0401 Parkin /Cam ping Leadworker 4 Comm Svcs 0363 Senior Marine Equip Mechanic 1 Comm Svcs 0265 Senior Services Assistant 6 Bus Driver only Comm Svcs Library Police 0400 Custodian 1 Comm Svcs Police Fire 0262 0232 Parking/Traffic Control Officr Emer ency Medical Srvcs Coord 3 2 Fire 0198 Services Coordinator 2 Daily wear not required Fire _Emergency 0260 Fire Safety Program Specialist 2 jDaily wear not required R De artment , p J°b Class�flcat�on 'Type 4 s Cat o r of Un�foem Notes�� Fire 0173 Fire TrainingMaintenance Tech 11 Fire 0190 ;Haz Mat Program Specialist 10 Police 0337 !Helicopter Maintenance Tech 1 Information Services 0492 ,Info Systems Technician IV t2 4 of 5 ees issued uniform; 2 in the field & 2 in radio re air sho Planning 0186 ;.Code Enforcement Officer 1 5 Planning 0182 ;Code Enforcement Officer II 5 Planning 0434 I'5enior Code Enforcement Ofcr 5 Police 0263 ;Community Relations Specialist 3 Daily wear not required Police 0255 ;Crime Scene Investigator 8 Police 0462!Crossing Guard Coordinator 9 Police 0455 !Parking/Traffic Control Coord 9 Police 0307 Police Records Specialist 3 In Records Division only Police 0283 Police Records Supervisor 3 Police 0282 ;Police Records Technician 3 Police 0308 'Police Services Specialist 3 In Records Division only Police 0215 Police Systems Coordinator 3 Police 0259 Property Officer 9 Police 0334 Senior Helicopter Maint Tech 1 Public Works 0340 Carpenter 1 Public Works 0345 ;Concrete Finisher 1 Public Works 0172 ,Construction Ins ction Trainee 5 Public Works 0463 :Construction Inspector _ 5 . . Public Works. 0192 ;Cross Connection Control. ,Spec . 5 Public Works 0375 'Electrical Leadworker 1 Public Works 0339 Electrician 1 Public Works 0472 :Equip Auto Maint Leadworker 1 Public Works 0382 �Equip Services Crewleader 1 Public Works 0142 [Equip/Auto Maint Crewleader 1 Public Works 0383 jEquipment Support Assistant 1 Public Works 0407 Facilities Maint Leadworker 1 Public Works 0391 ;Facilities Maintenance Tech 1 Public Works 0398 Field Service Representative 1 In Public Works only Public Works 0352 ;Grader Equip Operator 1 Public Works 0390 Groundsworker 1 Public Works 0155 !Irrigation Crewleader 1 Public Works 0357.. Irri ation S ecialist 1 Public Works 0359 Landscape Equip Operator 1 Public Works 0145 Landscape Maint Crewleader 1 Public Works 0402 !Landscape Maint Leadworker 1 Public Works 0344 Masonry Worker 1 Public Works 0384 !Mechanic I 1 Public Works 0348 Mechanic II 1 Public Works 0347 Mechanic III 1 Public Works 0341 Painter 1 Public Works 0378 'Painter Leadworker 1 7 \ r f ✓" ^max Depazrtments J W XiY"• y.ki%. laSSrticat4Qn 'k rF _ ~ Off 5 Public Works 0153 Park Maintenance Crewleader 1 Public Works 0154 Pest Contrl Advisor Crewleader 1 Public Works 0367 Pest Control Specialist 1 Public Works 0342 Plumber 1 Public Works 0171 Senior Contruction Inspector 5 Public Works 0343 Senior Facilities Maint Tech 1 Public Works 0188 Senior Inspector Water Constr 5 Public Works 0350 Senior Vehicle Body Technician 1 Public Works 0349 Senior Wastewtr Pump Mechanic 1 Public Works 0396 Senior Water Meter Reader 1 Public Works 0148 Signs & Markings Crewleader 1 Public Works 0338 Signs Leadworker 1 Public Works 0354 Signs/Markings Equip Operator 1 Public Works 0361 Street Equip Operator 1 Public Works 0150 Street Maint Crewleader 1 Public Works 0406 Street Maint Leadworker 1 Public Works 0478 Street Services Leadworker 1 Public Works 0346 Telemetry Instrument Tech 1 Public Works 0388 ; ire Service Worker T 1 Public Works 0140 Traff Signal/Light Crewleader 1 Public Works 0389 Traffic Maint Service Worker 1 Public Works- ': 0410 Traffic Markings Leadworker 1 . Public Works 0336 Traffic Signals Electrician 1 Public Works 0374 Traffic/Signal/Light Leadworkr 1 Public Works 0365 Tree Equipment Operator 1 Public Works 0460 Trees Maint Leadworker 1 Public Works 0144 Trees Maintenance Crewleader 1 Public Works 0372 Vehicle Body Repair Crewleader 1 Public Works 0351 Vehicle Body Technician 1 Public Works 0385 Warehousekee er 1 Public Works 0362 Wastewater Equip Operator 1 Public Works 0454 Wastewater Maint Service Workr 1 Public Works 0146 Wastewater O s Crewleader 1 Public Works 0404 Wastewater O s Leadworker 1 .Public Works 0387 Wastewater Pump Mechanic 1 Public Works 0189 Water Construction Inspector. 5 Public Works 0151 Water Dist Maint Crewleader 1 Public Works 0379 Water Dist Maint Leadworker 1 Public Works 0147 Water Dist Meters Crewleader 1 Public Works 0377 Water Dist Meters Leadworker 1 Public Works 0364 Water Equip Operator 1 Public Works 0397 Water Meter Reader 1 Public Works 0356 Water Meter Repair Technician 1 Public Works 0152 Water Operations Crewleader 1 Public Works 0371 Water Operations Leadworker 1 Public Works 0461 Water Service Worker 1 F. 0368 +va�,�.���r� f$`a _21 Public Works Water Systems Technician I 1 Public Works 0369 Water Systems Technician II 1 Public Works 0370 Water Sy stems Technician III . 1 Public Works 0449 Wafer Utilit Locator 1 *Note: unless otherwise indicted, uniforms are required for daily wear. It is the understanding of the City of Huntington Beach and the Huntington Beach Municipal Employees Association that this side letter to the existing Memorandum -of -Understanding (adopted December 16, 2002, Resolution 2002-133) is of no force or effect whatsoever unless and until adopted by resolution of the City Council of the City of Huntington Beach. IN WITNESS WHEREOF, the parties hereto have executed this side letter to the Memorandum -of -Understanding this / eday of September, 2004!, HUNTINGTON BEACH CITY OF HUNTINGTON BEACH MUNICIPAL EMPLOYEES] Clay a John Von Holle Director of Administrative Services Pjsident Irma Yousse f Wh U Robert Hidusky Human Resources Manager Vice -President William W. Davis Legal Counsel APPROVED AS TO FORM: �- Jennifer McGrath City Attorney ;SOCIATION Res. No. 2004-82 STATE OF CALIFORNIA COUNTY OF ORANGE ) ss: CITY OF HUNTINGTON BEACH ) I, JOAN L. FLYNN the duly appointed, 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 at least a majority of all the members of said City Council at an regular meeting thereof held on the 20th day of September, 2004 by the following vote: AYES: Sullivan, Coerper, Hardy, Green, Boardman NOES: None ABSENT: Cook, (Vacant Position Unfilled) ABSTAIN: None Uy Clerk and ex -offs Clerk of the City Council of the City of Huntington Beach, California IL E INITIATING DEPARTMENT: ADMINISTRATIVE SERVICES SUBJECT: SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND MEA COUNCIL MEETING DATE: September 20, 2004 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable ❑ Resolution (w/exhibits & legislative draft if applicable) Attached Not Applicable ❑ Tract Map, Location Map and/or other Exhibits Attached ❑ Not Applicable ❑ Contract/Agreement (w/exhibits if applicable) Attached Not Applicable El ❑ Signed in full b the CityAttome Subleases, Third Party Agreements, etc. Attached Not Applicable ❑ ❑ Approved as to form by City Attome ) Certificates of Insurance (Approved b the CityAttorne pp y Y� Attached Not A plicable ❑ ❑ Fiscal Impact Statement Unbud et, over $5,000 p ( g ) Attached Not Applicable ❑ ❑ Bonds (If applicable) Attached Applicable ❑Not ❑ Staff Report (If applicable) Attached Applicable ElNot ❑ Commission, Board or Committee applicable) Report If a p ( pp ) Attached Not Applicable ❑ ❑ Findings/Conditions for Approval and/or Denial Attached Not Applicable ❑ ❑ "EXPLANATION FOR'IVUSSING ATTACHMENTS EXPLANATION FOR RETURN'OF ITEM: KL A Author: Sharon Hennegen F� CITY OF HUNTINGTON BEA H MEETING DATE: July 6, 2004 DEPARTMENT ID /7A) �9�nai.1 fvG , NUMBER: AS-04-025 Council/Agency Meeting Held: 7,71hZdP0q. Deferred/Continued to: Approved ❑ Conditionally Approved ❑ Denied C y ClPrk'Voignage Council Meeting Date: July 6, 2004 Department Number: AS-04=025 CITY OF HUNTINGTON BEACH = REQUEST FOR ACTION ' SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL , SUBMITTED BY: PENELOPE CULBRETH-GRAFT! CI ADMINISTRA O' PREPARED BY: WILLIAM P. WORKMAN, ASSISTANT CITY ADMINISTRATOR CLAY MARTIN, DIRECTOR OF ADMINISTRATIVE SERVICES �� SUBJECT: ADOPT RESOLUTION APPROVING A SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION REGARDING AN AGENCY SHOP AGREEMENTpS.Nb• Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The city and the Huntington Beach Municipal Employees' Association (MEA) have negotiated a side letter agreement permitting agency shop for employees in the MEA bargaining unit. Funding Source: There is no cost associated with the side letter. Recommended Action: Adopt Resolution No. )o01-r- bO , a resolution of the City Council of Huntington Beach amending the Memorandum of Understanding between the City and the Huntington Beach Municipal Employees' Association by adopting the side letter of agreement. Alternative Action(s): Reject the resolution and maintain the current wages, hours, and other terms and conditions of employment. Under State law, the MEA may impose agency shop on the city by a majority vote of employees in the bargaining unit. ►! • P:\RCA\Agency Shop Agreement.doc 6/21/2004 5:52 PM REQUEST FOR ACTION MEETING DATE: July 6, 2004 DEPARTMENT ID NUMBER: AS-04-025 Analysis: Representatives of the city and the Huntington Beach Municipal Employees' Association (MEA) have completed negotiations on a side letter agreement regarding agency shop. Recent amendments to the Meyers-Milias-Brown Act under California Government Code 3502.5 authorizes an agency shop arrangement without a negotiated agreement upon a signed petition by thirty percent (30%) of the employees in the applicable bargaining unit requesting an agency shop agreement and majority approval of the employees voting in a secret ballot election on the issue. During the current negotiating sessions with MEA, the association requested that the city implement an agency shop agreement with all employees of the MEA bargaining unit. MEA indicated that it had majority support for an agency shop arrangement and provided petition signatures representing approximately sixty percent (60%) of employees. State law provides that if the city and MEA did not reach an agreement after thirty (30) days of negotiating, MEA would be able to impose an agency shop arrangement upon the City by a majority vote. The city agreed to implement an agency shop to negotiate the details of administrating the agreement. With City Council approval of the side letter and resolution, the agency shop agreement will be effective July 1, 2004. Deductions from employee salaries will begin July 31, 2004. Attachment(s): RCA Author: William McReynolds D:\Documents and Settings\jonesd\Local Settings\Temporary Internet Files\OLK74\Agency Shop Agreement.doc 6/24/2004 8:09 AM RESOLUTION NO. 2004-50 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH AMENDING THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION, BY ADOPTING THE SIDE LETTER OF AGREEMENT WHEREAS, on December 16, 2002, the City Council of Huntington Beach adopted Resolution No. 2002-133 for the purpose of adopting the 2000/03 Memorandum of Understanding (MOU) between the City and the Municipal Employees' Association (MEA); Subsequent to the adoption of the MOU, the City of Huntington Beach and the MEA agreed to changes, corrections, and clarifications to the MOU that are reflected in a Side Letter of Agreement between the City of Huntington Beach and the MEA ("Side Letter of Agreement") attached hereto as Exhibit A and incorporated herein by this reference. NOW THEREFORE, IT IS HEREBY RESOLVED by the City Council of the City of Huntington Beach as follows: Section 1. The Side Letter of Agreement attached hereto as Exhibit A is approved and adopted. Section 2. The Side Letter of Agreement amends the MOU between the City of Huntington Beach and the MEA. PASSED AND ADOPTED by the City Council of the City of Huntington Beach at a regular meeting thereof held on the 6th day of July , 2004. ATTEST: City Cler 16T�'f REVIEWED AND APPROVED: APPROVED AS TO FORM: PA ity Administrator 7Xt4yAtztAoA-y �- MAN INITIATE D PPROVED: (::�� u7l�)— Director rdministra-li'v`FServices 04reso/MEA side/6/14/04 Resolution 2004-50 .E iCf}-1 C3 / T Side Letter Agreement — Agency Shop Agreement Between the City of Huntington Beach and the Huntington Beach Municipal Employees Association Effective: July 1, 2004 This is to memorialize an agreement between the City of Huntington Beach (City) and the Huntington Beach Municipal Employees Association (MEA) to reflect agreed upon changes, corrections or clarifications to the existing Memorandum -of -Understanding (adopted December 16, 2002, Resolution 2002-133). All other terms and conditions of the existing side letters and the Memorandum -of -Understanding remain in full force and effect. Both parties agree to continue the meet and confer process in good faith as required by the Meyers-Milias-Brown Act. The goal of the continued meet and confer process is a new Memorandum -of -Understanding between the City and MEA. The subject of the continued meet and confer process shall be all issues between the parties concerning wages, hours, and other terms and conditions of employment. This agreement is to be incorporated into any future Memorandum -of - Understanding between the City and MEA. 1 Resolution 2004-50 AGENCY SHOP AGREEMENT LEGISLATIVE AUTHORITY The City of Huntington Beach (City) and the Huntington Beach Municipal Employees Association (Association) mutually understand and agree that in accordance with State of California law, per adoption of SB 739 (specifically, Government Code Section 3502.5), the Association will be covered by an Agency Shop. As a result of this Agency Shop Agreement between the City and the Association, and as a condition of continued employment, this Agency Shop Agreement hereby requires that all bargaining unit employees represented by the Association: 1. Elect to join the Association and pay association dues; 2. Pay an agency fee for representation; 3. Or with a religious exemption, pay a fee equal to the agency fee to be donated to selected charities. The following agency shop agreement will be implemented in conformity with California Government Code Section 3502.5 and applicable law and will be incorporated into any successor Memorandum of Understanding entered into between City and Association, unless rescinded pursuant to the terms of this agreement. ASSOCIATION DUES/AGENCY FEE COLLECTION Effective with the pay period beginning July 31, 2004, the City shall deduct Association dues, agency fee and religious exemption fees from all employees who have signed a written authorization and a copy of that authorization has been provided to the Human Resources Manager at least three weeks before that date. The authorization shall indicate whether association dues, agency fee or religious exemption fees shall be deducted and shall be jointly developed by the City and the Association. Employees who do not sign the written authorization, or whose written authorization is not provided to the Human Resources Manager at least three weeks before the beginning of the pay period when deductions under this Agency Shop Agreement. are to begin, shall be subject to the agency fee deduction. Employees on leave without pay or employees who earn a salary less than the Association deduction shall not have association dues, agency fee, or religious exemption fees deducted for that pay period. The agency fee is a fee equal to direct representation costs as determined by the Association's certified financial report. The Association shall notify the Human Resources Manager of the amount of the association dues and the agency fee to be deducted from the unit members' paychecks three weeks prior to the date of the first deduction and then once per year thereafter by September 1st, for implementation in the first full pay period beginning in October of each year. 2 Resolution 2004-50 NEW HIRE NOTIFICATION Effective July 31, 2004, all new hires in the Bargaining Unit shall be informed by the Human Resources Manager or designee, at the time of hire, that an Agency Shop Agreement is in effect for their classification, by providing a copy of this agreement, the Memorandum of Understanding and a form, mutually developed between the City and the Association that outlines the employee's choices under the Agency Shop Agreement. The employee shall be provided thirty (30) calendar days from the date of hire to elect their choice and provide a signed copy of that choice to the Human Resources Manager. Deductions under this Agency Shop Agreement for new hires will start with the first full payroll period beginning 30 days after the new hire submits his/her selection to the Human Resources Manager. The Association may request to meet with new hires at a time and place mutually agreed upon between the City and the Association. FAILURE TO PAY DUES/FEES All unit employees who choose not to become members of the Association or resign from Association membership shall be required to pay to the Association a representation service fee (the agency fee referenced in this Agency Shop Agreement) that represents such employee's proportionate share of the Association's cost of legally authorized representation services on behalf of unit employees in their relations with the City. Such agency fee shall in no event exceed the regular, periodic membership dues paid by unit employees who are members of the Association. Unit employees who change their status (from Association member to agency fee payer or to religious exemption, or vice -versa) after the effective date of this Agency Shop Agreement shall be subject to the terms of the changed status with the first full pay period beginning thirty (30) days or more after the employee informs the Human Resources Manager of the change in writing on a form to be jointly developed by the City and the Association. RELIGIOUS EXEMPTION Any employee who is a member of a religious body whose traditional tenets or teachings include objections to joining or financially supporting employee organizations shall not be required to pay an agency fee, but shall pay by means of mandatory payroll deduction an amount equal to the agency fee to a non- religious, non -labor charitable organization exempt from taxation under Section 501(c)(3) of the Internal Revenue Code. Those fees shall be remitted by the Association to any of the non -labor, non -religious charitable organizations offered by the Association for this purpose, at the choice of the employee. To qualify for the religious exemption the employee must provide to the Association a written statement of objection, along with verifiable evidence of membership in a religious body as described above. The City will implement the KI Resolution No. 2004-50 change in status, with the first full pay period beginning thirty (30) days or more after the employee submits the appropriate form to the City to change his/her status, unless notified by the Association in writing that the requested exemption is not valid. The City shall not be made a party to any dispute arising relative to the determination of religious exemptions. The Association shall keep an adequate itemized record of its financial transactions and shall make a written financial report thereof, in the form of a balance sheet certified as to accuracy by its president and treasurer or corresponding principal officer, or by a certified public accountant, available annually, to the City, to Agency Fee payers and to unit members who elect the religious exemption relating to this Agency Shop Agreement, within 60 days following the end of its fiscal year. All forms submitted by an employee to the City, or by the Association on behalf of an employee, shall be retained by the City in the employee's personnel file. The Human Resources Manager or designee shall provide the Association a list of all unit members with dues paying status with each association dues check remitted to the Association. This list and the association dues shall be submitted by the City to the Association within three weeks of each pay period. RESCISSION OF AGREEMENT The Agency Shop Agreement may be rescinded at any time during the period of time that the Association remains the exclusive bargaining agent for the unit employees, by a majority vote of all the employees in the bargaining unit. A request for such vote must be supported by a petition containing the signatures of at least thirty (30) percent of the employees in the unit. The election shall be by secret ballot and conducted by California State Mediation and Conciliation and in accordance with state law. INDEMNIFICATION The Association shall indemnify, defend and hold the City harmless from and against all claims and liabilities as a result of implementing and maintaining this Agency Shop Agreement. The City and the Association recognize the right of the employees to form, join and participate in lawful activities of employee organizations and the equal alternative right of employees to refuse to join or participate in employee organization activities. During the life of this agreement all unit members who choose to become members of the Association shall be required to maintain their membership in the 4 Resolution No. 2004-50 Association in good standing, subject however, to the right to resign from membership no sooner than April 15, or later than May 15, of any year this agreement remains in effect. Any unit member may exercise the right to resign by submitting a written notice to the Association and to the City during the resignation period on the Deduction Authorization/Change in Status form. The change in deductions from the employee's payroll will be effective with the frst.full pay period beginning 30 days or more after the Human Resources Manager receives the employee's written notice. The City and the Association agree that neither shall discriminate nor retaliate against any employee for the employee's participation or non -participation in any Association activity. PAYROLL DEDUCTION Effective with the pay period beginning July 31, 2004, the City will deduct from each paycheck of unit employees, and remit to the Association, the normal and regular Association dues and agency fees, in the timelines described as voluntarily authorized in writing by the employee, subject to the following conditions: (1) Such deductions shall be made only upon submission of a Deduction Authorization/Change in Status form to the Human Resources Manager. Said form shall be duly completed and signed by the employee. If no form is completed by the employee, the employee shall be subject to the agency fee. (2) The City shall not be obligated to put into effect any new, changed or discontinued deduction until the first full pay period commencing thirty (30) days or longer after such submission. Every effort will be made by the City to remit dues to the Association within three weeks of receipt. The Association agrees to indemnify and hold the City harmless against any and all suits, claims, demands and liabilities that may arise out of, or by reason of, any action that shall be taken by the City for the purpose of complying with this Section. 5 Resolution No. 2004-50 It is the understanding of the City of Huntington Beach and the Huntington Beach Municipal Employees Association that this side letter to the existing Memorandum -of -Understanding (adopted December 16, 2002, Resolution 2002-133) is of no force or effect whatsoever unless and until adopted by resolution of the City Council of the City of Huntington Beach. IN WITNESS WHEREOF, the parties hereto have executed this side letter to the Memorandum -of -Understanding this I Y��day of June, 2004. HUNTINGTON BEACH CITY OF HUNTINGTON BEACH MUNICIPAL EMPLOYEES ASSOCIATION W&6VY7 P�j William P. Workman Assistant Citv Administrator Clay Ma�t"n Director of Administrative Services Steven M. Berliner Chief Negotiator APPROVED AS TO FORM: n nnifer McGrath '()(0/« City Attorney n Von Holle sident Robert d Vice-President W. Davis Legal Counsel Res. No. 2004-50 STATE OF CALIFORNIA COUNTY OF ORANGE ) ss: CITY OF HUNTINGTON BEACH ) I, JOAN L. FLYNN the duly appointed, 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 at least a majority of all the members of said City Council at an regular meeting thereof held on the 6th day of July, 2004 by the following vote: AYES: Sullivan, Coerper Hardy, Green, Boardman, Cook NOES: None ABSENT: Houchen ABSTAIN: None CJU Clerk and ex-offici Jerk of the City Council of the City of Huntington Beach, California ATTACHMENT #2 Senate Bill No. 739 CHAPTER 901 An act to amend Sections 3500, 3501, 3502.5, and 3508.5 of, to amend, renumber, and add Section 3509 of, to amend and renumber Section 3510 of, to add Section 3511 to, and to repeal and add Section 3507.1 of, the Government Code, relating to public employment. [Approved by Govemor September 28, 2000. Filed with Secretary of State September 29, 2000] LEGISLATIVE COUNSEL'S DIGEST SB 739, Solis. Local public employees: agency shop arrangement and the Public Employment Relations Board. (1) Under the Meyers-Milias-Brown Act, an agency shop agreement may be negotiated between a public agency and a recognized public employee organization. This bill would additionally authorize an agency shop arrangement without a negotiated agreement upon a signed petition by 30% of the employees in the applicable bargaining unit requesting an agency shop agreement and majority approval of the employees voting in a secret ballot election on the issue. The bill would provide that the petition may be filed only after good faith negotiations, not to exceed 30 days, have taken place between the parties in an effort to reach an agreement. The bill would require the Division of Conciliation of the Department of Industrial Relations to conduct an election that may not be held more frequently than once a year, if the parties cannot agree within a prescribed time period on the selection of a neutral person or entity to conduct the election. (2) Existing law establishes the Public Employment Relations Board in state government as a means of resolving disputes and enforcing the statutory duties and rights of employers and employees under the Educational Employment Relations Act, the Higher Education Employer -Employee Relations Act, and the Ralph C. bills Act. This bill would expand the jurisdiction of the Public Employment Relations Board to include resolving disputes and enforcing the statutory duties and rights of employers and employees under the Meyers-Milias-Brown Act and would specifically include resolving disputes alleging violation of rules and regulations adopted by a public agency, other than the County of Los Angeles and the City of Los Angeles, pursuant to the Meyers-Milias-Brown Act that are consistent with the act concerning unit determinations, representations, recognition, and elections. The bill would provide that implementation of this provision is subject to the appropriation 88 Ch. 901 — 2 of funds for this purpose in the annual Budget Act and that the provision becomes operative on July 1, 2001. (3) Existing law provides that in the absence of local procedures for resolving disputes on the appropriateness of a unit of representation, upon the request of any of the parties, the dispute is to be submitted to the Division of Conciliation of the Department of Industrial Relations. This bill would require any dispute under rules adopted by a public agency on the appropriateness of a unit, exclusive or majority representation, and election procedures, upon request of a party, to be submitted to the board for resolution. The board would make its determinations based on the rules adopted by the public agency. (4) The act specifies that nothing in its provisions affects the rights of a public employee to authorize a dues deduction from his or her salary or wages pursuant to specified provisions of law. This bill would additionally require a public employer to deduct the payment of dues or service fees to a recognized employee organization as required by an agency shop arrangement between the recognized employee organization and the public employer_ It would also provide that agency fee obligations shall continue in effect as long as the employee organization is the recognized bargaining representative, notwithstanding the expiration of any agreement between the public employer and the recognized employee organization. (5) The provisions of this bill would not apply to any recognized employee organization representing peace officers, as defined in a specified provision of existing law. The people of the State of California do enact as follows: SECTION 1. Section 3500 of the Government Code is amended to read: 3500. (a) It is the purpose of this chapter to promote full communication between public employers and their employees by providing a reasonable method of resolving disputes regarding wages, hours, and other terms and conditions of employment between public employers and public employee organizations. It is also the purpose of this chapter to promote the improvement of personnel management and employer -employee relations within the various public agencies in the State of California by providing a uniform basis for recognizing the right of public employees to join organizations of their own choice and be represented by those organizations in their employment relationships with public agencies. Nothing contained herein shall be deemed to supersede the provisions of existing state law and the charters, ordinances, and rules of local public agencies that establish and regulate a merit or civil service system or which provide for other methods of administering 88 3 — Ch. 901 employer -employee relations nor is it intended that this chapter be binding upon those public agencies that provide procedures for the administration of employer -employee relations in accordance with the provisions of this chapter. This chapter is intended, instead, to strengthen merit, civil service and other methods of administering employer -employee relations through the establishment of uniform and orderly methods of communication between employees and the public agencies by which they are employed. (b) The Legislature finds and declares that the duties and responsibilities of local agency employer representatives under this chapter are substantially similar to the duties and responsibilities required under existing collective bargaining enforcement procedures and therefore the costs incurred by the local agency employer representatives in performing those duties and responsibilities under this chapter are not reimbursable as state -mandated costs. SEC. 2. Section 3501 of the Government Code is amended to read: 3501. As used in this chapter: (a) "Employee organization" means any organization which includes employees of a public agency and which has as one of its primary purposes representing those employees in their relations with that public agency. (b) "Recognized employee organization" means an employee organization which has been formally acknowledged by the public agency as an employee organization that represents employees of the public agency. (c) Except as otherwise provided in this subdivision, "public agency" means every governmental subdivision, every district, every public and quasi -public corporation, every public agency and public service corporation and every town, city, county, city and county and municipal corporation, whether incorporated or not and whether chartered or not. As used in this chapter, "public agency" does not mean a school district or a county board of education or a county superintendent of schools or a personnel commission in a school district having a merit system as provided in Chapter 5 (commencing with Section 45100) of Part 25 and Chapter 4 (commencing with Section 88000) of Part 51 of the Education Code or the State of California. (d) "Public employee" means any person employed by any public agency, including employees of the fire departments and fire services of counties- cities, cities and counties, districts, and other political subdivisions of the state, excepting those persons elected by popular vote or appointed to office by the Governor of this state. (e) "Mediation" means effort by an impartial third party to assist in reconciling a dispute regarding wages, hours and other terms and conditions of employment between representatives of the public 88 Ch. 901 — 4 — agency and the recognized employee organization or recognized employee organizations through interpretation, suggestion and advice. ('f) "Board" means the Public Employment Relations Board established pursuant to Section 3541. SEC. 3. Section 3502.5 of the Government Code is amended to read: 3502.5. (a) Notwithstanding Section 3502 or 3502.6, or any other provision of this chapter, or any other law, rule, or regulation, an agency shop agreement may be negotiated between a public agency and a recognized public employee organization which has been recognized as the exclusive or majority bargaining agent pursuant to reasonable rules and regulations, ordinances, and enactments, in accordance with this chapter. As used in this chapter, "agency shop" means an arrangement that requires an employee, as a condition of continued employment, either to join the recognized employee organization, or to pay the organization a service fee in an amount not to exceed the standard initiation fee, periodic dues, and general assessments of the organization. (b) In addition to the procedure prescribed in subdivision (a), an agency shop arrangement between the public agency and a recognized employee organization that has been recognized as the exclusive or majority bargaining agent shall be placed in effect, without a negotiated agreement, upon (1) a signed petition of 30 percent of the employees in the applicable bargaining unit requesting an agency shop agreement and an election to implement an agency fee arrangement, and (2) the approval of a majority of employees who cast ballots and vote in a secret ballot election in favor of the agency shop agreement. The petition may only be filed after good faith negotiations, not to exceed 30 days, have taken place between the parties in an effort to reach agreement. An election that may not be held more frequently than once a year shall be conducted by the Division of Conciliation of the Department of Industrial Relations in the event that the public agency and the recognized employee organization cannot agree within 10 days from the filing of the petition to select jointly a neutral person or entity to conduct the election. In the event of an agency fee arrangement outside of an agreement that is in effect, the recognized employee organization shall indemnify and hold the public agency harmless against any liability arising from any claims, demands, or other action relating to the public agency's compliance with the agency fee obligation. (c) Any employee who is a member of a bona fide religion, body, or sect that has historically held conscientious objections to joining or financially supporting public employee organizations shall not be required to join or financially support any public employee organization as a condition of employment. The employee may be required, in lieu of periodic dues, initiation fees, or agency shop fees, 88 5 — Ch. 901 to pay sums equal to the dues, initiation fees, or agency shop fees to a nonreligious, nonlabor charitable fund exempt from taxation under Section 501(c)(3) of the Internal Revenue Code, chosen by the employee from a list of at least three of these funds, designated in a memorandum of understanding between the public agency and the public employee organization, or if the memorandum of understanding fails to designate the funds, then to any such fund chosen by the employee. Proof of the payments shall be made on a monthly basis to the public agency as a condition of continued exemption from the requirement of financial support to the public employee organization. (d) An agency shop provision in a memorandum of understanding that is in effect may be rescinded by a majority vote of all the employees in the unit covered by the memorandum of understanding, provided that: (1) a request for such a vote is supported by a petition containing the signatures of at least 30 percent of the employees in the unit; (2) the vote is by secret ballot; (3) the vote may be taken at any time during the term of the memorandum of understanding, but in no event shall there be more than one vote taken during that term. Notwithstanding the above, the public agency and the recognized employee organization may negotiate, and by mutual agreement provide for, an alternative procedure or procedures regarding a vote on an agency shop agreement. The procedures in this subdivision are also applicable to an agency shop agreement placed in effect pursuant to subdivision (b). (e) An agency shop arrangement shall not apply to management, confidential, or supervisory employees. (f) Every recognized employee organization that has agreed to an agency shop provision or is a party to an agency shop arrangement shall keep an adequate itemized record of its financial transactions and shall make available annually, to the public agency with which the agency shop provision was negotiated, and to the employees who are members of the organization, within 60 days after the end of its fiscal year, a detailed written financial report thereof in the form of a balance sheet and an operating statement, certified as to accuracy by its president and treasurer or corresponding principal officer, or by a certified public accountant. An employee organization required to file financial reports under the Labor -Management Disclosure Act of 1959 covering employees governed by this chapter, or required to file financial reports under Section 3546.5, may satisfy the financial reporting requirement of this section by providing the public agency with a copy of the financial reports. SEC. 4. Section 3507.1 of the Government Code is repealed. SEC. 5. Section 3507.1 is added to the Government Code, to read: 3507.1. (a) Unit determinations and representation elections shall be determined and processed in accordance with rules adopted 88 Ch. 901 by a public agency in accordance with this chapter. In a representation election, a majority of the votes cast by the employees in the appropriate bargaining unit shall be required. (b) Notwithstanding subdivision (a) and rules adopted by a public agency pursuant to Section 3507, a bargaining unit in effect as of the effective date of this section shall continue in effect unless changed under the rules adopted by a public agency pursuant to Section 3507. SEC. 6. Section 3508.5 of the Government Code is amended to read: 3508.5. (a) Nothing in this chapter shall affect the right of a public employee to authorize a dues or service fees deduction from his or her salary or wages pursuant to Section 1157.1, 1157.2, 1157.3, 1157.4, 1157.5, or 1157.7. (b) A public employer shall deduct the payment of dues or service fees to a recognized employee organization as required by an agency shop arrangement between the recognized employee organization and the public employer. (c) Agency fee obligations, including, but not limited to, dues or agency fee deductions on behalf of a recognized employee organization, shall continue in effect as long as the employee organization is the recognized bargaining representative, notwithstanding the expiration of any agreement between the public employer and the recognized employee organization. SEC. 7. Section 3509 of the Government Code is amended and renumbered to read: 3510. (a) The provisions of this chapter shall be interpreted and applied by the board in a manner consistent with and in accordance with judicial interpretations of this chapter. (b) The enactment of this chapter shall not be construed as making the provisions of Section 923 of the Labor Code applicable to public employees. SEC. 8. Section 3509 is added to the Government Code, to read: 3509. (a) The powers and duties of the board described in Section 3541.3 shall also apply, as appropriate, to this chapter and shall include the authority as set forth in subdivisions (b) and (c). (b) A complaint alleging any violation of this chapter or of any rules and regulations adopted by a public agency pursuant to Section 3507 shall be processed as an unfair practice charge by the board. The initial determination as to whether the charge of unfair practice is justified and, if so, the appropriate remedy necessary to effectuate the purposes of this chapter, shall be a matter within the exclusive jurisdiction of the board. The board shall apply and interpret unfair labor practices consistent with existing judicial interpretations of this chapter. (c) The board shall enforce and apply rules adopted by a public agency concerning unit determinations, representation, recognition, and elections. 88 Ch. 901 (d) Notwithstanding subdivisions (a) to (c), inclusive, the employee relations commissions established by, and in effect for, the County of Los Angeles and the City of Los Angeles pursuant to Section 3507 shall have the power and responsibility to take actions on recognition, unit determinations, elections, and unfair practices, and to issue determinations and orders as the employee relations commissions deem necessary, consistent with and pursuant to the policies of this chapter. (e) This section shall not apply to employees designated as management employees under Section 3507.5. (f) Implementation of this section is subject to the appropriation of funds for this purpose in the annual Budget Act. (g) This section shall become operative on July 1, 2001. SEC. 9. Section 3510 of the Government Code is amended and renumbered to read: 3500.5. This chapter shall be known and may be cited as the "Meyers-Milias-Brown Act." SEC. 10. Section 3511 is added to the Government Code, to read: 3511. The changes made to Sections 3501, 3507.1, and 3509 of the Government Code by legislation enacted during the 1999-2000 Regular Session of the Legislature shall not apply to persons who are peace officers as defined in Section 830.1 of the Penal Code. I 88 i INITIATING DEPARTMENT: ADMINISTRATIVE SERVICES SUBJECT: ADOPT RESOLUTION APPROVING A SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION REGARDING AN AGENCY SHOP AGREEMENT COUNCIL MEETING DATE: July 6, 2004 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached) Tract Map, Location Map and/or other Exhibits Not Applicable Contract/ Agreement (w/exhibits if applicable) (Signed in full by the City Attorney Not Applicable Subleases, Third Party Agreements, etc. (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Not Applicable Financial Impact Statement (Unbudget, over $5,000) Not Applicable Bonds (If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial Not Applicable EXPLANATION FORMISSING ATTACHMENTS::. ■�1:��J'4s�►'I_®.1[�1;► ®i®l:a��'�i isJ� s [®]Ii i � ►!i KUA Hutnor: William McReynolds CITY OF HUNTINGTON BEAGH MEETING DATE: May 17, 2004 a DEPARTMENT ID NUMBER: AS-04-014 Council/Agency Meeting Held:/ Deferred/Continued to: Approved ❑ Conditionally Approved ❑ Denied Ci I k's gnat re Council Meeting Date: May 17, 2004 Departm nJlNurnber- 7* Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The City and Huntington Beach Municipal Employees' Association have come to a side letter agreement regarding language changes to the 9/80 Work Schedule as defined. Funding Source: Non -Applicable. Recommended Action: Adopt Resolution No. �a004-30 , a resolution of the City Council of Huntington Beach amending the Memorandum of Understanding between the City and the Huntington Beach Municipal Employees' Association by adopting the side letter of agreement regarding Work Schedules. Alternative Action(s): Reject the resolution and maintain the current language for the 9/80 Work Schedule. Analysis: Representatives of the City and the Huntington Beach Municipal Employees' Association (MEA) have completed the meet and confer process on a side letter agreement for changes to the 9/80 Work Schedule language. H:\RCA's\MEA Work Schedule Side Letter.doc 4/29/200410:06 AM REQUEST FOR ACTION MEETING DATE: May 17, 2004 DEPARTMENT ID NUMBER: AS-04-014 The proposed 9/80 Work Schedule language modifications change two sections of the MEA Memorandum of Understanding (MOU). The first change to the work schedule language pertains to Article IX — Hours of Work/Overtime (A.2.b). The change allows employees not assigned to the Civic Center the ability to be assigned a 9/80 work schedule with another flex day besides Friday, with department head approval. The second change pertains to Exhibit J — 9/80 Work Schedule Defined. This change serves to clarify the current practice of non- exempt employees taking their lunch hour four hours into their work schedule on their designated flex day on or other designated flex days or as provided for in the first change above. The 9/80 Work Schedule language is designed to be in compliance with the Federal Labor Standards Act (FLSA). The changes as agreed to in the MOU are necessary to continue to meet this requirement. The new language gives departments the necessary flexibility to apply the 9/80 work schedule to non Civic Center employees to meet operational needs within the FLSA. Attachment(s): RCA Author: William McReynolds H:\RCA's\MEA Work Schedule Side Letter.doc 13 4/29/2004 10:06 AM ATTACHMENT #1 RESOLUTION NO. 2004-30 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH AMENDING THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND - THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION, BY ADOPTING THE SIDE LETTER OF AGREEMENT REGARDING WORK SCHEDULES WHEREAS, on December 16, 2002, the City Council of Huntington Beach adopted Resolution No. 2002-133 for the purpose of adopting the 2003 Memorandum of Understanding (MOU) between the City and the Municipal Employees' Association (MEA); Subsequent to the adoption of the MOU, the City of Huntington Beach and the MEA agreed to changes, corrections, and clarifications to the MOU that are reflected in a Side Letter of Agreement between the City of Huntington Beach and the MEA ("Side Letter of Agreement") attached hereto as Exhibit A and incorporated herein by this reference. NOW THEREFORE, IT IS HEREBY RESOLVED by the City Council of the City of Huntington Beach as follows: Section 1. The Side Letter of Agreement attached hereto as Exhibit A is approved and adopted. 'Section 2. ` The Side Letter of Agreement amends the MOU between the City of Huntington Beach and the MEA. PASSED AND ADOPTED by the City Council of the City of Huntington Beach at a regular meeting thereof held on the 17th day of May , 2004. ATTEST: At a .yiI.AmOTCity Clerlr REVIEWED AND APPRO ED: APPROVED AS TO FORM: ` ter. U � �V City Administrator (J--y rn Att ey INITIATE ND PPROVED: Director ;fY`ministrative Services G:NRES0LUT1N\2004VMEA side 5-4-04.doc Side Letter Agreement — Hours Of Work/Overtime Between the City of Huntington Beach and the Huntington Beach Municipal Employees Association Effective: May 4, 2004 This is to memorialize an agreement between the City of Huntington Beach (City) and the Huntington Beach Municipal Employees Association (MEA) to reflect agreed upon changes, corrections or clarifications to Article IX — Hours Of Work/Overtime Section 2.b and Exhibit J - 9/80 Work Schedule of the existing Memorandum -of -Understanding. All other terms and conditions of the existing side letters and the Memorandum -of -Understanding remain in full force and effect. Both parties agree to continue the meet and confer process in good faith as required by the Meyers-Milias-Brown Act. The goal of the continued meet and confer process is a new Memorandum -of -Understanding between the City and the MEA. The subject of the continued meet and confer process shall be all issues between the parties concerning wages, hours, and other terms and conditions of employment. This agreement is to be incorporated into any future Memorandum -of - Understanding between the City and the MEA. Article IX — Hours Of Work/Overtime Section 2.b and Exhibit J - 9/80 Work Schedule shall now read: ARTICLE IX — HOURS OF WORK/OVERTIME A. Work Schedule 2. Flex Schedule and Alternative Work Schedule b. 9/80 Work Schedule Civic Center Employees The 9/80 work schedule, as outlined in Exhibit J, shall be defined for all MEA employees assigned to the Civic Center as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours (Friday), plus a one -hour lunch during each work shift, totaling forty (40) hours in each FLSA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. Non- Civic Center Employees The 9/80 work schedule, as outlined in Exhibit J, shall be defined for all MEA employees not assigned to the Civic Center as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours, plus their scheduled lunch break during each work shift, totaling forty (40) hours in each FLSA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. 4.7- EXHIBIT J - 9/80 WORK SCHEDULE This work schedule is known as the "9/80'. The 9/80 work schedule is designed to be in compliance with the requirements of the Fair Labor Standards Act (FLSA). In the event that there is a conflict with the current rules,. practices and/or procedures regarding work schedules and leave plans, then the rules listed below shall govern. 9/80 WORK SCHEDULE DEFINED The 9/80 work schedule shall be defined as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours, with a scheduled lunch break during each work shift, totaling forty (40) hours in each FLSA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. A. The FLSA work week for each MEA employee on a 9/80 schedule shall begin and end four hours into that employee's regularly scheduled shift on the day of the week that the employee alternatively works an 8 hour shift and takes off. For example, MEA employees on a 9/80 schedule who are assigned to the Civic Center shall have an FLSA work week that starts .and ends four hours into the employee's regularly scheduled shift each Friday, as these employees may only have 9/80 schedules that provide for alternating Fridays off with working 8 hour days on Fridays. Employees may only take their lunch break on their 8 hour day after first having worked 4 hours in that shift, unless the employee receives prior approval of their supervisor, as overtime may occur in such situations. B. Two Week Pay Period - The pay period for employees starts Friday mid - shift (p.m.) and continues for fourteen (14) days until Friday mid -shift (a.m.). During this period, each week is made up of four (4) nine (9) hour work days (thirty-six (36) hours) and one (1) four (4) hour Friday and those hours equal forty (40) work hours in each work week (e.g. the Friday is split into four (4) hours for the a.m. shift, which is charged to work week one and four (4) hours for the p.m. shift, which is charged to workweek two). C. A/B Schedules - To continue to provide service to the public every Friday, MEA employees on a 9/80 schedule assigned to the Civic Center, are to be divided between two schedules, known as the "A" schedule and the "B" schedule, based upon the departmental needs. For identification purposes, the "A" schedule shall be known as the schedule with a day off on the Friday in the middle of the pay period, or, "off on payday', the "B" schedule shall have the first Friday (p.m.) and the last Friday (a.m.) off, or "working on payday". An example is listed below: I=M=MMMM00MnnnnnnMMnU�aa D. Schedule Changes — FLSA non-exempt employees cannot change. #heir assigned schedules, without prior approval of their supervisor, Department Head, and the Human Resources Manager or designee. The purpose of this authorization is to review the impact on overtime. FLSA exempt employees may change their schedules at the beginning of any pay period with supervisor and Department Head approval. E. Emergencies — All employees on the 9/80 work schedule are subject to be called to work any time to meet any and all emergencies or unusual conditions which, in the opinion of the City Administrator, Department Head or designee may require such service from any of said employees. OVERTIME DEFINED FLSA Non -Exempt Employees — All non-exempt employees under the 9/80 work schedule shall earn overtime for all hours worked after the first forty (40) hours in their designated FLSA work week as required under FLSA. Employees are required to obtain supervisor authorization prior to working any overtime. 1. Overtime Compensation - As stated in Memorandum -of -Understanding g 2. Compensatory Time — As stated in Memorandum -of -Understanding LEAVE BENEFITS When an employee is off on a scheduled workday under the 9/80 work schedule, then nine (9) hours of eligible leave per workday shall be charged against the employee's leave balance or eight (8) hours shall be charged if the day off is a Friday. All leaves shall continue under the current accrual, eligibility, request and approval requirements. 1. General Leave — As stated in Memorandum -of -Understanding 2. Sick Leave - As stated in Memorandum -of -Understanding 3. Bereavement Leave — As stated in Memorandum -of -Understanding 4. Holidays - a. For a recognized city holiday, eight (8) hours, as stated in Article XII.2, are earned for each holiday. For the charging of hours on a scheduled holiday, the employee must use eight (8) hours of holiday time off and one (1) hour from the employee's General Leave or Compensatory Time banks for a nine (9) hour workday charge or eight (8) hours holiday time off for a flex day off. b. If a holiday falls on an FLSA non-exempt employee's flex day off, the employee must then take the work shift before. or. after, the holiday off with supervisor and Department Head approval. If.the employee cannot take the work shift before or after the holiday off the employee will be granted eight (8) hours of general leave. c. If a holiday falls on an FLSA exempt employee's flex day off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. FLSA exempt employees shall not be granted any administrative/general leave or any added compensation for not taking a work shift off on a scheduled holiday. 5. Jury Duty — The provisions of the Personnel Rules shall continue to apply, however, if an FLSA exempt employee is called to serve on jury duty during a the employee's flex day off, Saturday, or Sunday, or on a city holiday, then the jury duty shall be considered the same as having occurred during the employees day off work, therefore, the employee will receive no added compensation. It is the understanding of the City of Huntington Beach and the Huntington Beach Municipal Employees Association that this side letter to the existing Memorandum -of -Understanding is of no force or effect whatsoever unless and. until adopted by resolution of the City Council of the City of Huntington Beach IN WITNESS WHEREOF, the parties hereto have executed this side letter to the Memorandum -of -Understanding this Q3 day of April, 2004. CITY OF HUNTINGTON BEACH t William P. Workman Assistant City Administr ,or HUNTINGTON BEACH MUNICIPAL EMPLOYEES ASSOCIATION n Von Holle sident Clay Ma Robert Hidusky Director of Administrative Services Vice -President oe Steven M. gerliner William W. Davis Chief Negotiator Legal Counsel Res. No. 2004-30 STATE OF CALIFORNIA ..COUNTY OF ORANGE ) ss: CITY OF HUNTINGTON BEACH ) I, CONNIE BROCKWAY, 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 at least a majority of all the members of said City Council at an adjourned regular meeting thereof held on the 17th day of May 2004 by the following vote: AYES: Sullivan, Coerper, Hardy, Green, Boardman, Cook, Houchen NOES: None ABSENT: None ABSTAIN: None s 4w srna,jr-City Clerk nd ex-officio Gfferk of the City Council of the City of Huntington, Beach, California - INITIATING DEPARTMENT: ADMINISTRATIVE SERVICES SUBJECT: ADOPT RESOLUTION APPROVING SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE MUNICIPAL EMPLOYEES' ASSOCIATION REGARDING THE 9/80 WORK SCHEDULE COUNCIL MEETING DATE: May 17, 2004 RCA ATTACHMENTS - STATUS Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached Tract Map, Location Map and/or other Exhibits Not Applicable Contract/Agreement (w/exhibits if applicable) (Signed in full by the City Attorney) Not Applicable Subleases, Third Party Agreements, etc. (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Not Applicable Financial Impact Statement (Unbudget, over $5,000) Not Applicable Bonds (If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial Not Applicable EXPLANATION W P 1. ®,, ® R WRW RCA Author: William McReynolds ,, �X- CITY OF HUNTINGTON BE MEETING DATE: February 2, 2004 DEPARTMENT ID NUMBER: AS-04-001 Council/Agency Meeting Held: A._ --ooc Deferred/Continued to: Approved ❑ Conditionally Approved ❑ Denied I City C e, s Sin ure Council Meeting Date: February 2, 2004 Department ID Number: AS-04-001 CITY OF HUNTINGTON BEACH REQUEST FOR ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL 00 SUBMITTED BY: RAY SILVER, CITY ADMINISTRATORS PREPARED BY: WILLIAM P. WORKMAN, ASSISTANT CITY ADMINISTRTOR CLAY MARTIN, DIRECTOR OF ADMINISTRATIVE SERV}tCE9 SUBJECT: ADOPT RESOLUTION APPROVING A SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION ���^ /Uri . d 00 - Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The city and Huntington Beach Municipal Employees' Association have come to a side letter agreement regarding health insurance for calendar year 2004. Funding Source: Funding was adopted by the City Council with the adoption of Councilmember Coerper's December 15, 2003 H-Item titled, "H" Item for December 15, 2003, City Council Meeting Approval of Funds to Pay Part of Employees Health Insurance Costs. The increase in total annual cost to implement the side letter agreement with the Huntington Beach Municipal Employees' Association is approximately $204,000. The remainder of the funding is included in the Fiscal Year 2003/2004 budget. Recommended Action: Adopt Resolution No. 2,io a resolution of the City Council of Huntington Beach amending the Memorandum of Understanding between the City and the Huntington Beach Municipal Employees' Association by adopting the side letter of agreement. Alternative Action(s): Reject the resolution and maintain the current health insurance plans and employer, contributions. �,/ H:\RCA's\MEA Health Side Letter 2004.doc - 1/28/200410:50 AM I MEETING DATE: February 2, 2004 DEPARTMENT ID NUMBER: AS-04-001 Analysis: Representatives of the city and the Huntington Beach Municipal Employees' Association (MEA) have completed the meet and confer process on a side letter agreement for health insurance benefits for the 2004 calendar year. Health Insurance Effective April 1, 2004 the City Plan POS and Health Net HMO will no longer be available to MEA represented employees. Starting April 1, 2004 all MEA represented employees will begin utilizing either a Blue Shield PPO or HMO or a Kaiser Permanente HMO for medical insurance. The current dental and vision insurance plans remain in place. To assist employees in bridging the period between January 1, 2004 and March 31, 2004 (until the new medical plans are in place April 1, 2004) the city will increase the current medical insurance employer contributions by $93.88 per month in each category of coverage. Effective April 1, 2004 the city will return the medical insurance employer contribution to the 2003 rates and then add $37.72 per month to the 2003 health insurance employer contribution rates in each category of coverage. The current dental and vision insurance plans employer contributions remain in place. The side letter agreement does contain a clause, which may require the city to increase the maximum employer contribution to the same levels provided to another represented employee association in the city. The clause does expire on July 2, 2004. Depending on the category of coverage selected by each employee in the medical, dental, and vision insurance plans, employees will be up to $2,907.79 in calendar year 2004 for health insurance. Monthly Premiums January 1, 2004 through March 31, 2004. Monthl Y City Health Delta Delta VSP Premium Plan Net Dental Dental Vision POS HMO (PPO) (HMO) EE $481.40 $312.76 $51.18 $24.38 $18.07 EE + 1 951.96 685.31 97.86 41.46 18.07 EE + 2 or more " 1,165.54 903.25 138.83 63.40 18.07 H:\RCA's\MEA Health Side Letter 2004.doc -8- 1/28/2004 10:50 AM o�- REQUEST FOR ACTION MEETING DATE: February 2, 2004 DEPARTMENT ID NUMBER: AS-04-001 April 1, 2004 through December 31, 2004. Blue Shield Blue Shield Kaiser Monthly Blue Shield Premium High Option Low Option:Permanente HMO 90/1.0 PPO 80/20 PPO HMO I;EE $366.21 $322.32 $253.46 $270.75 EE + 1 802.01 705.88 555.06 592.94 EE + 2 or more 1,047.37 921.84 724.87 779.76 Monthly Delta Delta' VSP. Premium Dental Dental Vision (PPO) (HMO) EE.$51.18 $24.38 $18.07 EE + 1 97.86 41.46 18.07 EE + 2 or more 138.83 63.40 18.07 Employer Contribution January 1, 2004 through March 31, 2004. Monthly '` City Health Delta Delta VSP Employer Plan Net Dental Dental Contribution POS HMO (PPO) (HMO) Vision EE $429.93 $330.19 $42.88 $23.00 $17.58 EE + 1 758.41 611.67 81.82 39.11 17.58 EE + 2 or more 907.50 776.34 116.36 59.81 17.58 April 1, 2004 through December 31, 2004. Monthly Blue Shield Blue Shield Kaiser Employer High Option Low Option Blue Shield Permanente . Contribution 90/10 PPO 80/20 PPO HMO HMO EE '- $373.77 $373.77 $274.03 $274.03 `EE + 1 702.25 702.25 555.51 555.51 EE + 2or more 851.34 851.34 720.18 720.18 H:\RCA's\MEA Health Side Letter 2004.doc 4- 1/28/2004 10:50 AM 13 REQUEST FOR ACTION MEETING DATE: February 2, 2004 DEPARTMENT ID NUMBER: AS-04-001 Monthly Delta Delta VSP Employer Dental Dental Contribution (PPO) (HMO) Vision EE $42.88 $23.00 $17.58 EE + 1_ __ 81.82 39.11 17.58 EE + 2 or more 116.36 59.81 17.58 Employee Contributions January 1, 2004 through March 31, 2004: Monthly City Health Delta Delta VSP Employee Plan Net Dental Dental Contribution POS HMO (PPO) (HMO) Vision EE $51.47 $0.00 $8.30 $1.38 $0.49 EE + 1- 193.55 73.64 16.04 2.35 0.49 EE + 2 or more 258.04 126.91 22.47 3.59 0.49 April 1, 2004 through December 31, 2004: Monthly Blue Shield Blue Shield Blue Shield -Kaiser - Employee High Low Option Permanente Contribution g0/1'0 PPO 80I20 PPO HMO HMO EE' $0.00 $0.00 $0.00 $0.00 EE + 1 99.76 3.63 0.00 37.43 EE + 2 or more 196.03 70.50 4.69 59.58 Monthly Delta Delta VSP Employee Dental Dental Contribution (PPO) (HMO) Vision EE $8.30 $1.38 $0.49 EE + 1 16.04 2.35 0.49 EE + 2 or more 22.47 3.59 0.49 H:\RCNs\MEA Health Side Letter 2004.doc 11281200410:50 AM REQUEST FOR ACTION MEETING DATE: February 2, 2004 DEPARTMENT ID NUMBER: AS-04-001 Post -Retirement Health Insurance The side letter agreement contains language modifying the city's current practice regarding employee's who retiree with less than ten years of service with the city and their participation in city sponsored medical insurance. The current practice is not to allow employees who retiree with less than ten years of service to the city to participate in city sponsored medical insurance. The new practice will allow these employees to participate with the retiree paying the full cost of the medical insurance coverage. The current Retiree Subsidy Medical Plan will continue without any changes for employees with more than ten years of service to the city. Starting April 1, 2004 the city will allow retirees over age sixty-five to participate in city sponsored medical insurance plans that are supplemental to Medicare. The retiree shall pay the full premium to participate in city sponsored medical insurance plans that are supplemental to Medicare for themselves or qualified dependents without any city subsidy. Retirees or qualified dependents, upon turning age 65, who choose not to participate in city sponsored medical insurance plans that are supplemental to Medicare permanently lose eligibility for this insurance. Health Insurance Contracts The contracts for Blue Shield and Kaiser Permanente to provide health insurance coverage should be before the City Council in March 2004. Attachment(s): RCA Author: William McReynolds HARCA's\MEA Health Side Letter 2004.doc 16- 1/28/2004 5:18 PM ATTACHMENT #1 RESOLUTION NO. aO' _ C� A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH AMENDING THE MEMORANDUM OF UNDERSTANDING BET«'EEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION, BY ADOPTING THE SIDE LETTER OF AGREEMENT WHEREAS, on December 16, 2002, the City Council of Huntington Beach adopted Resolution No: 209-2--1 for the purpose of adopting the 2000/03 Memorandum of Understanding (MOU) between the City and the Municipal Employees' Association (MEA); Subsequent to the adoption of the MOU, the City of Huntington Beach and the MEA agreed to changes, corrections, and clarifications to the MOU that are reflected in a Side Letter of Agreement between the City of Huntington Beach and the MEA ("Side Letter of Agreement") attached hereto as Exhibit A and incorporated herein by this reference. NOW THEREFORE, IT IS HEREBY RESOLVED by the City Council of the City of Huntington Beach as follows: Section 1. The Side Letter of Agreement attached hereto as Exhibit A is approved and adopted. Section 2. The, Side Letter of Agreement amends the MOU between the City of.Huntington. Beach and the MEA. PASSED AND ADOPTED by the City Council of the City of Huntington Beach at a regular meeting thereof held on the 2nd day of February , 2004. ATTEST: REVIEWED AND APPROVED: City Adm' strator A� Ma r APPROVED AS TO FORM: �$ City Attorney �1�j�0�( INITIA PRO Director oicesv 04reso/MEA side/l/28/04 Res. No. 2004-6' STATE OF CALIFORNIA COUNTY OF. ORANGE ) ss: CITY OF HUNTINGTON BEACH I, CONNIE BROCKWAY, 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 at least a majority of all the members of said City Council at an regular meeting thereof held on the 2nd day of February, 2004 by the following vote: AYES: Coerper, Hardy, Green, Boardman, Cook NOES: Sullivan ABSENT: Houchen ABSTAIN: None City Clerk and ex-officio erk of the City Council of the City of. Huntington Beach, California Side Letter Agreement — Health and Other Insurance Benefits Between the City of Huntington Beach and the Huntington Beach Municipal Employees Association Effective: January.1, 2004 This is to memorialize an agreement between the City of Huntington Beach (City) and the Huntington Beach Municipal Employees Association (MEA) to reflect agreed upon changes, corrections or clarifications to Article X — Health and Other Insurance Benefits of the existing Memorandum -of -Understanding. All other terms and conditions of the existing side letters and the Memorandum -of - Understanding remain in full force and effect. Both parties agree to continue the meet and confer process in good faith as required by the Meyers-Milias-Brown Act. The goal of the continued meet and confer process is a new Memorandum -of -Understanding between the City and the MEA. The subject of the continued meet and .confer process shall be all issues between the parties concerning wages, hours, and other terms and conditions of employment. This agreement is to be incorporated into any future Memorandum -of - Understanding between the City and the MEA. Article X — Health and Other Insurance Benefits, Sections B.2, I and J shall now read: 1 ARTICLE X - HEALTH AND OTHER INSURANCE BENEFITS B. Eligibility Criteria and. Cost 2. Year 2004 Health and Other Insurance Benefit Premiums, Employer Contribution, and Employee Contribution a. Monthly Premiums January 1, 2004 through March 31, 2004. Monthly City Health Delta Delta VSP Premium Plan Net Dental Dental Vision POS HMO (PPO) (HMO) EE $481.40 $312.76 $51.18 $24.38 $18.07 EE + 1 951.96 685.31 97.86 41.46 18.07 EE + 2 or more 1,165.54 903.25 138.83 63.40 18.07 Effective April 1, 2004 the City Plan POS and Health Net HMO will not be available to MEA represented employees. April 1, 2004 through December 31, 2004. Monthly Blue Shield Blue Shield Blue Shield Kaiser Premium High Option Low Option HMO Permanente 90/10 PPO 80/20 PPO HMO EE $366.21 $322.32 $253.46 $270.75 EE + 1 802.01 705.88 555.06 592.94 EE + 2 or more 1,047.37 921.84 724.87 779.76 Monthly Delta Delta VSP Premium Dental Dental Vision (PPO) (HMO) EE $51.18 $24.38 $18.07 EE + 1 97.86 41.46 18.07 EE + 2 or more 138.83 63.40 18.07 2 b. Employer Contribution The City's maximum monthly employer contribution for health and other insurance premiums are set forth in the charts below. With a written request from the association, the City Administrator is authorized to modify the City's maximum monthly employer contribution (e.g. the "employer contribution" described below in .the chart for April 1, 2004 through December 31, 2004), `to reflect: changes necessary to make the City's maximum monthly employer contribution the same as the "employer contribution" or "cap" provided to another represented employee association in the City. The change to the City's maximum monthly employer contribution for MEA will become effective the beginning of the pay period after the association's written proposal is received by the City Administrator's Office. The City Administrator's authorization to modify the City's maximum monthly employer contribution for MEA (described above) shall expire at 12:00 p.m. on Friday, July 2, 2004. January 1, 2004 through March 31, 2004. Monthly City Health Delta Delta VSP Employer Plan Net Dental Dental Contribution POS HMO (PPO) (HMO) Vision EE $429.93 $330.19 $42.88 $23.00 $17.58 EE + 1 758.41 611.67 81.82 39.11 17.58 EE + 2 or more 907.50 776.34 116.36 59.81 17.58 April 1, 2004 through December 31, 2004. Monthly Blue Shield Blue Shield Blue Shield Kaiser Employer High Option Low Option Permanente Contribution 90/10 PPO 80/20 PPO HMO HMO EE $373.77 S373.77 $274.03 $274.03 EE + 1 702.25 702.25 555.51 555.51 EE + 2 or more 851.34 851.34 720.18 720.18 3 Monthly Delta Delta VSP Employer Dental Dental Contribution (PPO) (HMO) Vision EE $42.88 $23.00 $17.58 EE + 1 81.82 39.11 17.58 EE + 2 or more 116.36 59.81 17.58 In no event shall the employee be entitled to the difference between the employer contribution and the premiums for insurance plan(s) selected by the employee. c. Employee Contributions The employee paid contributions translate to the following on a monthly basis: January 1, 2004 through March 31, 2004: Monthly City Health Delta Delta VSP Em to ee p Y.. Plan Net Dental Dental Contribution POS . HMO (PPO) (HMO) Vision EE $51.47 $0.00 $8.30 $1.38 $0.49 EE + 1 193.55 73.64 L16.04 2.35 0.49 EE + 2 or more 258.04 126.91 1 22.47 3.59 0.49 April 1, 2004 through December 31, 2004: Monthly Blue Shield Blue Shield Blue Shield Kaiser Employee High Option Low Option Permanente Contribution 90/10 PPO 80/20 PPO HMO HMO EE $0.00 $0.00 $0.00 $0.00 EE + 1 99.76 3.63 0.00 37.43 EE + 2 or more 196.03 70.50 4.69 59.58 4 Monthly Delta Delta VSP Employee Dental Dental Contribution (PPO) (HMO) Vision EE $8.30 $1.38 . $0.49 EE + 1 16.04 2.35 0.49 EE + 2 or more 22.47 3.59 0.49 The employee paid contributions translate to the following on a bi-weekly (per paycheck) basis: January 1, 2004 through March 31, 2004: Bi-Weekly City Health Delta Delta VSP, Employee Plan Net Dental Dental Contribution POS HMO (PPO) (HMO) Vision EE $23.76 $0.00 $3.83 $0.64 $0.23 EE + 1 89.33 33.99 7.40 1.08 0.23 EE + 2 or more 119.10 58.57 ` 10.37 1.66 0.23 April 1, 2004 through December 31, 2004: Bi-Weekly Blue Shield Blue Shield Blue Shield Kaiser Employee High Option Low Option Permanente Contribution 90/10 PPO 80/20 PPO HMO HMO EE $0.00 $0.00 $0.00 $0.00 EE + 1 46.04 1.68 0.00 17.28 EE + 2 or more 90.48 32.54 2.16 27.50 Bi-Weekly Delta Delta VSP Employee Dental Dental Contribution (PPO) (HMO) Vision EE $3.83 $0.64 $0.23 EE + 1 7.40 1.08 0.23 EE + 2 or more 10.37 1.66 0.23 9 I. Retiree Medical Coverage for Retirees Not Eligible for the City Medical Retiree Subsidy Plan Employees who retire from the City after January 1, 2004 and are granted a retirement allowance by the California Public Employees' Retirement System and are not eligible for. the City's Retiree Subsidy Medical Plan may choose to participate in City sponsored medical insurance plans until the first of the month in which they turn age sixty-five (65). The retiree shall pay the full premium for City sponsored medical insurance for themselves and/or qualified dependents without any City subsidy. Employees who retire from the City and receive a retirement allowance from the California Public Employees' Retirement System and are not eligible for the City's Retiree Subsidy Medical Plan and choose not to participate in City sponsored medical insurance upon retirement permanently lose eligibility for this insurance. However, if a retiree who is not eligible for the City's Retiree Subsidy Medical Plan chooses not to participate in city sponsored medical insurance plans because the retiree has access to other group medical insurance, and subsequently loses eligibility for that group medical insurance, the retiree and their qualified dependents will have access to city sponsored medical insurance plans reinstated. Eligibility for Retiree Medical Coverage terminates the first of the month in which the retiree or qualified dependent turns age sixty-five (65). J. Post-65 Supplemental Medicare Coverage Retirees who are participating in the Retiree Subsidy Medical Plan as of January 1, 2004 and all future retirees who meet the criteria to participate in City sponsored medical insurance, with or without the Retiree Medical Subsidy Plan, may participate in City sponsored medical insurance plans that are supplemental to Medicare, after a contract is in place between the City and a health insurance provider. A retiree or qualified dependent must choose to participate in City sponsored medical insurance plans that are supplemental to Medicare beginning the first of the month in which the retiree or qualified dependent turns age sixty-five (65). The retiree shall pay the full premium to participate in City sponsored medical insurance plans that are supplemental to Medicare for themselves or qualified dependents without any City subsidy. Al Retirees or qualified dependents, upon turning age 65, who choose not to participate in City sponsored medical insurance plans that are supplemental to Medicare permanently lose eligibility for this insurance. In order to completely implement the terms and conditions of this agreement pertaining to the Article X Health and Other Insurance Benefits, Sections I and J the City and MEA agree to meet and confer regarding changes to Exhibit I of the current Memorandum -of -Understanding. The City and MEA agree that the goal of the changes to Exhibit I of the current Memorandum -of -Understanding is to make Exhibit I consistent with the language presented in this side letter. It is the understanding of the City of Huntington Beach and the Huntington Beach Municipal Employees Association that this side letter to the existing Memorandum -of -Understanding is of no force or effect whatsoever unless and until adopted by resolution of the City Council of the City of Huntington. Beach. IN WITNESS WHEREOF, the parties hereto have executed this side letter to the Memorandum -of -Understanding this 7-7Yday of January, 2004. HUNTINGTON BEACH CITY OF HUNTINGTON XBECH MUNICIPAL EMPLOYEES ASSOCIATION P, x_ R William P. Workman hn Von Holle Assistant City Administrator P esident 1' Steven M. Berliner Robert Hidusky Chief Negotiator Vice -President William W. Davis APPROVED AS TO FORM: Legal Counsel JIle J nifer Mc rath City Attorney 7 ATTACHMENT #2 PPS CP ,High January 1 2004 Questions? Call 1-800-200-3242 Highlights: DEDUCTIBLES (all providers combined) Benefits marked with an asterisk (*) are NOT subject to the calendar -year medical deductible. • Individual Calendar -Year Copayment Maximum e Individual e Family LIFETIME MAXIMUMS THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE CONSULTED FOR A DETAILED DESCRIPTION OF COVERAGE BENEFITS AND LIMITATIONS. Preferred Non -Preferred Providers' Providers' $500 $1,000 $2,000 $10,000 $4,000 $20,000 unlimited Co,vered'S'ervices Member Copayment, • • Physician services • Office visits and consultations $20/visit* 40%* • Specialist visits and consultations $20/visit* 40%* • Laboratory and X-rays $20/visit 40% • Mammogram and pap test or other FDA -approved cervical cancer screening tests $20/visit* 40% • Allergy testing or treatment 10% 40% • Diagnostic testing 10% 40% Preventive care , • Annual routine physical exam Includes: eye/ear screening, immunizations, vaccinations No charge* 40% • Mammogram and pap test screening No charge* 40% or other FDA -approved cervical cancer screening tests • Laboratory No charge* 40% Well -baby care • Office visits and consultations Includes: eye/ear screening, immunizations, vaccinations $20/visit* Not covered • Laboratory $20/visit Not covered OUTPATIENT SERVICES • Outpatient surgery in hospital/facility 10% 40%2 • Outpatient treatment, renal dialysis and necessary supplies 10% 40%2# HOSPITALIZATION SERVICES • Inpatient visits and consultations 10% 40% • Surgeons and assistants, anesthesiologists, pathologists, radiologists 10% 40% • Semi -private room and board, medically necessary services 10% 40%2 (including subacute care) and supplies EMERGENCY HEALTH COVERAGE • Facility services (waived if admitted directly to the hospital as an inpatient) $50*# + 10%* • Emergency room physician services 10% 10% AMBULANCE SERVICES 20% 20% PRESCRIPTION DRUG COVERAGE A description of your outpatient prescription drug cover?ge is provided separately. If you do not have the separate drug sheet that goes with this matrix, please contact your bene l s administrator. Preferred Non -Preferred DURABLE MEDICAL EQUIPMENT Providers' Providers' • Home medical equipment, prosthetics/orthotics 10% (Orthoses Only -Up to 40% (Orthoses Only -Up $2,000 per person per to $2,000 per person per year) year) ® MHSA Participating MHSA Non - Providers' Participating MENTAL HEALTH SERVICES (PSYCHIATRIC)3 Providers' • Inpatient services 10% 40%2 • Outpatient visits for severe mental health conditions $20/visit* 40%* • Outpatient visits for non -severe mental health conditions $20/visit # 40% (up to 30 visits per calendar year combined with outpatient chemical dependency visits)" CHEMICAL DEPENDENCY SERVICES (SUBSTANCE ABUSE) • Inpatient services for medical acute detoxification 10% 40% • Outpatient visits (up to 30 visits per calendar year combined with outpatient non -severe mental $20/visit# 40% health visits)" HOME HEALTH SERVICES (combined maximum of 100 preauthorized visits per calendar year) Preferred Non -Preferred Providers' Providers' • Home health and home infusion care (see "Outpatient Prescription Drug Coverage' for home 10% 10%4 self-administered injectables) HOSPICE • Routine home care and inpatient respite care No charge No Charge w/prior auth • 24 hour continuous home care and general inpatient care 10% 10% w/prior auth OTHER Alternative care6 • Chiropractic and acupuncture services (up to 20 visits, combined, per calendar year) 10% 40% Physical medicine • Office visits and related services (such as physical therapy and occupational therapy) - 10% 40% Pregnancy and maternity • Prenatal and postnatal care 10% 40% • All necessary inpatient hospital services See "Hospitalization Services" See "Hospitalization Services" Family planning • Family planning counseling $20/visit* Not covered • Elective abortion, tubal ligation, vasectomy 10% Not covered • Contraceptive devices and fitting $20/visit* 40%* Skilled nursing facility (SNF) services (up to 180 days per calendar year) • Semi -private accommodations —freestanding SNF 10% 40% • Semi -private accommodations — hospital SNF unit 10% 40%2 Covered out-of-state benefits Benefits provided through BlueCard Program, for out-of-state 10% or $20 copay 40% emergency and non -emergency care, are provided at the preferred level of the local Blue Plan allowable amount when you use a Blue Cross/Blue Shield provider. Diabetes care • Equipment, devices and non -testing supplies (for testing supplies, please see "Outpatient 10% 40% Prescription Drug Coverage") • Self -management training and education $20/visit i 40% Hearing aid services • Audiological evaluations $20/visit* 40%# • Hearing aid instrument and ancillary equipment 10% 40% (up to two hearing aids) ($1,000 maximum ($1,000 maximum every 24 months) every 24 months) Optional Benefits Optional dental, vision, inpatient substance abuse treatment, or infertility benefits are available. If your employer purchased any of these benefits, a description of the benefit is provided separately. * Benefits are not subject to the calendar -year medical deductible. # Copayments and charges for services not included in the calculation of the member's calendar -year copayment maximum continue to be the member's responsibility after the calendar -year copayment maximum is reached. Deductible does not apply toward the calendar -year maximum. Please refer to the Evidence of Coverage, the Disclosure Form and the Group Health Service Contract for exact terms and conditions of coverage. 1 Member is responsible for copayment in addition to any charges above allowable amounts. The copayment percentage indicated is a percentage of allowable amounts. Preferred providers accept Blue Shield's allowable amount as full payment for covered services. Non -preferred providers can charge more than these amounts. When members use non -preferred providers, they must pay the applicable copayment plus any amount that exceeds Blue Shield's allowable amount. Charges above the allowable amount do not count toward the calendar -year deductible or copayment maximum. 2 The maximum allowed charges for non -emergency hospital services received from a non -preferred hospital is $600 per day. Members are responsible for 40 percent of this $600 per day, plus all charges in excess of $600. For physician services, members pay 40 percent of allowable amounts, plus all charges in excess of allowable amounts. 3 Mental health and chemical dependency services, other than medical acute detoxification, are accessed through the MHSA. Services for medical acute detoxification are accessed through Blue Shield using Blue Shield's preferred providers or non -preferred providers. For a listing of severe mental illnesses, including serious emotional disturbances of a child, and other benefit details, please refer to the Evidence of Coverage or plan contract. 4 Out -of -network home health care and home infusion services are not covered unless they are pre -authorized by Blue Shield. When these services are preauthorized, members pay 10 percent, the preferred provider level. 5 Covered hospice services received from any hospice agency must be pre -authorized by Blue Shield. If Blue Shield preauthorizes hospice services from a non -participating hospice agency, those hospice services will be reimbursed at participating hospice agency level. 6 All outpatient non -severe mental health, outpatient substance abuse, acupuncture and chiropractic visits accrue to the calendar -year visit maximum regardless of whether the plan deductible has been met. Benefits are subject to modification for subsequently enacted state or federal legislation. PPO CP High (8/03) li THIS MAImIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE, DISCLOSURE FORM AND PLAN CONTRACT SHOULD BE CONSULTED FOR A DETAILED DESCRIPTION OF COVERAGE BENEFITS AND LIMITATIONS. DEDUCTIBLES` (All providers combined) Preferred Non -Preferred Providers' Providers' Calendar -year medical deductible $500 individual/ $1,000 family Calendar -year copayment maximum" • Individual $3,000 $10,000 • Family $6,000 $20,000 LIFETIME MAXIMUMS unlimited PROFESSIONAL SERVICES Physician services • Physician and specialist office visits $20/visit* 40%* • Laboratory and X-rays $20/visit 40% • Allergy testing or treatment 20% 40% • Diagnostic testing 20% 40% Preventive care • Annual physical exam, eye/ear screenings and immunizations according to age No charge* 40% schedule • Laboratory, including mammogram and Pap test screening No charge* 40% or other FDA -approved cervical cancer screening tests Well -baby care • Office visits and consultations Includes: eye/ear screenings, immunizations, vaccinations $20/visit* Not covered • Laboratory $20/visit Not covered OUTPATIENT SERVICES • Outpatient surgery in hospital/facility 20% 40%2 • Outpatient treatment, renal dialysis and necessary supplies 20% 40%021 HOSPITALIZATION SERVICES • Inpatient physician services (including pregnancy and maternity care) 20% 40%2 • Semi -private room and board, medically necessary services 20% 40%2 and supplies Skilled nursing facility (SNF) serviCeS3 (Up to 100 combined days per calendar year; semi -private accommodations) • Freestanding SNF 20% 40% • Hospital SNF unit 20% 40%2 EMERGENCY HEALTH COVERAGE • Facility services (The $50 copayment per emergency room visit is waived if the member is directly $50*# + 20%f admitted to the hospital for inpatient services) • Emergency room physician services 20% 20% AMBULANCE SERVICES 20% 20% PRESCRIPTION DRUG COVERAGE A description of your outpatient prescription drug coverage is provided separately. If you do not have the separate drug sheet that goes with this matrix, please contact your benefits administrator or call Customer Services at 800-200-3242. Preferred Non -Preferred DURABLE MEDICAL EQUIPMENT Providers' Providers' • Home medical equipment, prosthetics/orthotics 20% of allowable amount 40% of allowable amount (up to $2,000 maximum per (up to $2,000 maximum per calendar year) calendar year) MHSA Participating MHSA Non - MENTAL HEALTH SERVICES(PSYCHIATRIC)4 Providers' Participating Providers' • Inpatient hospital facility services 200/6 40%2 • Outpatient visits for severe mental health conditions $20/visit* 40%* • Outpatient visits for non -severe mental health conditions 20/visit# 40% (Up to 30 visits per calendar year combined with outpatient chemical dependency visits)' CHEMICAL DEPENDENCY SERVICES (SUBSTANCE ABUSE) • Inpatient services for medical acute detoxification 20% 40% • Outpatient visits (Up to 30 visits per calendar year combined with outpatient non -severe mental $20/visit# 40% health visits)' HOME HEALTH SERVICES (Combined maximum of 100 prior authorized visits per calendar year) Preferred Non -Preferred Providers' Providers' • Home health and home infusion care (See "Prescription Drug Coverage" for home self- 20% 20% with prior administered injectables) authorization HOSPICE • Routine home care and inpatient respite care No charge No charge with prior authorization • 24 hour continuous home care and general inpatient care 20% 20% with prior authorization OTHER Alternative cares • Chiropractic and acupuncture services (up to 15 visits, combined, per calendar year) 20% 40% Physical medicine • Office visits and related services (such as physical therapy and occupational therapy) 20% 40% Family planning • Family planning counseling $20/visit* Not covered • Elective abortion, tubal ligation, vasectomy 20% Not covered • Contraceptive devices and fitting $20/visit* 40%* Covered out-of-state benefits Benefits provided through Bluecard Program, for out-of-state 20% or $20-copay 40% emergency and non -emergency care, are provided at the preferred level of the local Blue Plan allowable amount when you use a Blue Cross/Blue Shield provider. Diabetes care • Equipment, devices and non -testing supplies (for testing supplies, please see "Prescription 20% 40% Drug Coverage') • Self -management training and education $20/visit 40% Hearing aid services • Audiological evaluations $20/visit* 40%# • Hearing aid instrument and ancillary equipment 20% 40% (up to two hearing aids) ($1,000 maximum every 24 months) (eve0ry24 months) Optional Benefits Optional dental, vision, inpatient substance abuse treatment, or infertility benefits are available. If your employer purchased any of these benefits, a description of the benefit is provided separately. Footnotes * Benefits are not subject to the calendar -year medical deductible. # Copayments and charges for services not included in the calculation of the member's calendar -year copayment maximum continue to be the member's responsibility after the calendar -year copayment maximum is reached. Deductible does not apply toward the calendar -year maximum. Please refer to the Evidence of Coverage, the Disclosure Form and the Group Health Service Contract for exact terms and conditions of coverage. 1 Member is responsible for copayment in addition to any charges above allowable amounts. The copayment percentage indicated is a percentage of allowable amounts. Preferred providers accept Blue Shield's allowable amount as full payment for covered services. Non -preferred providers can charge more than these amounts. When members use non -preferred providers, they must pay the applicable copayment plus any amount that exceeds Blue Shield's allowable amount. Charges above the allowable amount do not count toward the calendar -year deductible or copayment maximum. 2 The maximum allowed charges for non -emergency hospital services received from a non -preferred hospital is $600 per day. Members are responsible for 40% of this $600 per day, plus all charges in excess of $600. 3 Services may require prior authorization by Blue Shield. When these services are prior authorized, members pay the preferred or participating provider amount. 4 Mental health and chemical dependency services, other than medical acute detoxification, are accessed through the mental health services administrator (MHSA) - US Behavioral Health Plan, California (USBHPC) - using MHSA participating and non -participating providers. Services for medical acute detoxification are accessed through Blue Shield using Blue Shield's preferred providers or non -preferred providers. For a listing of severe mental illnesses, including serious emotional disturbances of a child, and other benefit details, please refer to the Evidence of Coverage or plan contract. 5 All outpatient non -severe mental health, outpatient substance abuse, acupuncture and chiropractic visits accrue to the calendar -year visit maximum regardless of whether the plan deductible has been met. Benefits are subject to modification for subsequently enacted state or federal legislation. PPO CP Low (8/03) Blue Shield of California An Independent Member of the Blue Shield Association Shield Spectrum PPO & PPO Outpatient Prescription Drug (For groups of 51 and above) Highlight: 3-Tier/Incentive Formulary THIS L. _.jG SUMMARY IS INTENDED TO BE Plus Plans USED WITH THE SHIELD SPECTRUM PPO OR PPO PLUS PLANS UNIFORM HEALTH PLAN Coverage BENEFITS AND COVERAGE MATRIX. g THE EVIDENCE OF COVERAGE, DISCLOSURE FORMAND PLAN CONTRACT SHOULD BE CONSULTED FOR A DETAILED DESCRIPTION OF COVERAGE BENEFITS AND LIMITATIONS. No Calendar -Year Brand -Name Drug Deductible $5 Generic/$15 Formulary Brand-Name/$30 Non -Formulary Brand -Name Drugs — Retail Pharmacy $10 Generic/$25 Formulary Brand-Name/$45 Non -Formulary Brand -Name Drugs — Mail Service Covered Services Member Copayment DEDUCTIBLES (Prescription drug coverage benefits are not subject to the medical plan deductible.) Calendar -year brand -name drug deductible PRESCRIPTION DRUG COVERAGE' (Including oral contraceptives, diaphragms, and covered diabetic drugs and testing supplies). — Retail prescriptions (For up to a 30-day supply) — Mail service prescriptions (For up to a 90-day supply) — Home self-administered injectable drugs (May require preauthorization from Blue Shield Pharmacy Services) None Participating Pharmacy $5 Generic $15 Formulary Brand $30 Non -Formulary Brand $10 Generic $25 Formulary Brand $45 Non -Formulary Brand 30% Non -Participating Pharmacy Member pays 25% of allowable amount plus a copayment of: $5 Generic $15 Formulary Brand $30 Non -Formulary Brand Not covered Not Covered * If the physician or member requests a brand -name drug and a generic drug equivalent is available, the member is responsible for paying the difference between the cost to Blue Shield of California of the brand -name drug and its generic drug equivalent, as well as the applicable formulary generic drug copayment. # Copayments and charges for services not included in the calculation of the member's calendar -year copayment maximum continue to be the member's responsibility after the calendar -year copayment maximum is reached. Please refer to the Evidence of Coverage, the Disclosure Form and the Group Health Service Contract for exact terms and conditions of coverage. This benefit chart is just the beginning to making the most of your coverage. To help you get your money's worth, we have created many opportunities for you to save on costs wherever possible. Read on and learn about the unique resources we have to support you. f r - Ch(!1 gen-d instead of brand name dru s � ' s We're driving the use of generics to help you get safe, affordable drugs at a time when prescription costs continue to grow. Increasing drug costs is one of the main reasons that overall healthcare coverage has become more expensive. But the use of generics can have a direct and indirect impact on keeping rates down. By choosing a proven generic over a brand -name drug, you can quickly lower your costs. Generics cost less than brand -name drugs so we can pass the savings on to you through affordable generic drug coverage. When you ask for a drug that is available as a generic you have a copayment that is significantly less than the copayment for the brand, and no deductible. G Dose generic instead of brand nam drugs, contfndid ,, a _ �"..,� You can trust generics to be equivalent to their brand -name counterpart. They must contain the same active ingredient and have approval from the U.S. Food and Drug Administration for meeting the same safety standards. About half the drugs on the market today are available in generic form. Your doctor can help you decide if a specific drug is right for you. At your next visit, let your doctor know you prefer generics and remember to bring a copy of your formulary. For a printed copy, call the customer service number on your Blue Shield ID card or download one from the "pharmacy" section of www.mylifepath.com. Use online harm c tools at,m, lifepath coin ,x �� a We created the "pharmacy" section of our Web site to give you access to resources to help you be informed and make cost -saving decisions. • ask the pharmacist — If you have clinical questions about prescription or over-the-counter drugs, you can use this feature to connect with the drug information pharmacists at the University of California, San Francisco. Simply submit your question using easy electronic forms. Within one to two business days, a clinical pharmacist will reply by e-mail with a link to a confidential response posted on the mylifepath site. Then, you have the option of saving the answer to a personal archive for later reference. • drug database & formulary — Use this feature to get information on our most current formulary list, generic alternatives that help you lower out-of-pocket costs and details about specific coverage restrictions. You can search by drug name, try browsing by first letter, or searching by medical condition or drug class. Plus, watch for the most recent changes to our formulary highlighted in our "Announcements" box. • participating pharmacies — Using this feature, you can locate participating pharmacies for maximum coverage. Just enter a zip code or city and our new tool aggregates a list, across retail chains and independents, and serves it up on our site. S�gnupy4oe`our prescriptwli marl service ' URdeF the aGies s�nf eu s+te; -ysu caw also takes antage of the€ e -SCr' make eveR more of your benefits. Through this prog�am, you ran eRjoy the ef having Your pFeSGFiptions delivered Fight to your home along with significant savings. You may get a larger quantity and save OR YGUF GOpayment. And- there is.AeVeF a Gharge f9F standard shipping. All you have to do is order a 90 days supply of the mainteRanG9 prescriptions you tabi4zed aw: If you take a particular drug for a chronic condition such as diabetes or high blood pressure on an ongoing basis, going to the "pharmacy" at www.mylifepath.com can save you a trip - or several trips - to your local network pharmacy. Our plans offer coverage of a mail service benefit, available through Express Scripts. Members who take stabilized doses of long-term maintenance medications can order a mail service refill of up to a 90-day supply. After sending your initial maintenance drug prescription to Express Scripts, you can order refills via the "pharmacy" section of www.mylifepath.com. If you prefer to renew your prescription by phone, you can call Express Scripts at (800) 44-6962, or TTY (800) 972-4348 if you are hearing impaired. Allow up to 94 days for delivery, from the day you mail your initial prescription order or order a refill. If you don't have Internet access, call Customer Service at the number on your Blue Shield ID card to find out more about your drug benefits and get a mail service order form. Please note that injectable drugs other than insulin and drugs used for short-term conditions, such as migraine medications and antibiotics, are not covered by this mail service benefit. ((A)) (1 /04) Blue Shield of'Californii An Codependent Member of the 91oe Shield AssoclaC4 t THIS MA i RIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE CONSULTED FOR A DETAILED DESCRIPTION OF COVERAGE BENEFITS AND LIMITATIONS. Highlights DEDUCTIBLES Calendar -year medical deductible None Calendar -year copayment maximum# (for many covered services) $1,000*per Individual $2,000" per Family LIFETIME MAXIMUMS None PROFESSIONAL SERVICES Physician services — outpatient • Personal Physician office visits and consultations $10/visit • Specialist visits and consultations (with an authorized referral) $10/visit • Obstetrical/Gynecological (OB/GYN) physician services $10/visit (A woman may self -refer to an OB/GYN or family practice physician in her Personal Physician's medical group or IPA for OB/GYN services.) • Allergy testing or treatments $10/visit • Injectable medications administered during office visit (other than injectables for allergy) No charge Access+ Specialis M (self -referred office visits or consultations only)2 $30/visit Laboratory, X-ray and diagnostic tests No charge Preventive care • Scheduled routine physical exams $10/visit — Well -baby, child and adult exams according to age schedule — Annual gynecological exams (A woman may self -refer to an OB/GYN or family practice physician in her Personal Physician's medical group or IPA.) • Immunizations $10/visit • Vision eye refraction and hearing screenings up to age 1$ $10/visit OUTPATIENT SERVICES Non -emergency • Outpatient surgery No charge • Outpatient treatment, renal dialysis and necessary supplies No charge HOSPITALIZATION SERVICES • Inpatient physician visits and consultations No charge • Surgeons and assistants, anesthesiologists, pathologists, radiologists No charge • Semi -private room and board, medically necessary services No charge and supplies, including subacute care EMERGENCY HEALTH COVERAGE (waived if admitted directly to the hospital as an inpatient) $25/visit AMBULANCE SERVICES No charge PRESCRIPTION DRUG COVERAGE A description of your outpatient prescription drug coverage is provided separately. If you do not have the separate drug sheet that goes with this matrix, please contact your benefits administrator. DURABLE MEDICAL EQUIPMENT • Home medical equipment, prosthetics/orthotics, MENTAL HEALTH SERVICES (PSYCHIATRIC)' Inpatient physician services Outpatient visits for severe mental health conditions Outpatient visits for non -severe mental health conditions (up to 30 visits per calendar year combined with outpatient chemical dependency visits) No charge No charge $10/visit $10/visit CHEMICAL DEPENDENCY -SERVICES (SUBSTANCE ABUSE)3 • FJnpatient services for medical acute`detoxification No charge • Outpatient YISI#S (up to 30 visits per cajendar year combined with outpatient non -severe mental health $10/visit visits) HOME HEALTH SERVICES • Agency visits (up to 100 visits per calendar year) No charge • Medical supplies/IV solutions/home self-injectables from home infusion agency' No charge • Home self-injectables obtained from Blue Shield of California participating pharmacy $30 per prescription, up to a 30-day supply HOSPICES • Routine home care and inpatient respite care No charge • 24 hour continuous home care and general inpatient care No charge OTHER Pregnancy and maternity care • Prenatal and postnatal physician office visits No charge • All necessary inpatient hospital services No charge Family planning and infertility services • Family planning counseling $10/visit • Diagnosis and treatment of causes of infertility 50% of allowed charges • Tubal ligation 5, 6 and elective abortions $100 • Vasectomy $75 • Contraceptive devices and fitting $10/visit Rehabilitative therapy services — physical, speech, occupational and respiratory therapy • Outpatient visits $10/visit • In rehab unit of hospital No charge • In skilled nursing facility (SNF) rehab units No charge Skilled nursing facility (SNF) services (up to too days per calendar year9) No charge Urgent care outside service area (BlueCard Program) $50/visit Diabetes care • Equipment, devices and non -testing supplies 50% of allowed charges (For testing supplies, please see "Outpatient Prescription Drug Coverage.") • Self -management training and education $10/visit Hearing Aid Services • Audiological evaluations No charge • Hearing aid instrument and ancillary equipment $1,000 maximum every 36 months (up to two hearing aids) Optional benefits Optional dental, vision, chiropractic, chiropractic and acupuncture, inpatient substance abuse treatment or infertility benefits are available. If your employer purchased any of these benefits, a description of the benefit is provided separately. # Copayments and charges for services not included in the calculation of the member's calendar -year copayment maximum continue to be the member's responsibility after the calendar -year copayment maximum is reached. Copayments for many covered services accrue to the calendar -year copayment maximum. 1 Serum administered during the office visit is included. For serum purchased separately from the office visit, the member copayment is 50 percent of allowed charges. 2 To use this option, members must select a Personal Physician who is affiliated with a medical group or IPA that is an Access+ provider group, which offers the Access+ Specialist feature. Members should then select a specialist within that medical group or IPA. Access+ Specialist visits for mental health or substance abuse services must be provided by a mental health services administrator's (MHSA) network participating provider. Access+ Specialist visits for mental health services for non -severe mental illness, or non -serious emotional disturbances of a child, or substance abuse will accrue toward the 20-visit per calendar -year maximum. In addition, all Access+ Specialist visits require a $30.00 member copayment per visit. 3 Mental health and chemical dependency services, other than medical acute detoxification, are accessed through the MHSA using MHSA participating providers. Services for medical acute detoxification are accessed through Blue Shield using Blue Shield HMO providers. For a listing of severe mental illnesses, including serious emotional disturbances of a child, and other benefit details, please refer to the Evidence of Coverage or plan contract. 4 In vitro fertilization, injectables for infertility, artificial insemination and GIFT are excluded. 5 Copayment does not apply when performed in conjunction with delivery or abdominal surgery. 6 Physician services copayment in the office or outpatient hospital facility only. If procedure is performed in an inpatient hospital facility setting, additional hospital services copayment will apply. 7 Home self -injectable medications may require preauthorization by Blue Shield and must be obtained from home infusion agencies or Blue Shield participating pharmacies. 8 Covered hospice services received from any hospice agency must be pre -authorized by Blue Shield. If Blue Shield preauthorizes hospice services from a non -participating hospice agency, those hospice services will be reimbursed at participating hospice agency level. 9 Skilled nursing services are limited to 100 days during any calendar -year except when received through a hospice program provided by a participating hospice agency. This 100-day maximum on skilled nursing services is a combined maximum between hospital and skilled nursing facilities. Benefits are subject to modification for subsequently enacted state or federal legislation. Access+HMO CP10 (8/03) Y W flue Shield of CahforWa Arrindep nd& U n �k 0 the BI— Shield Assn<nat N' Access+ HMOsM Outpatient Prescription Drug Coverage (For groups of 51 and above) Highlight: 3-Tier/Incentive Formulary THIS L. _JG SUMMARY IS INTENDED TO BE USED WITH THE ACCESS+ HMO OR ADDED ADVANTAGE POS PLANS UNIFORM HEALTH PLAN BENEFITS AND COVERAGE MATRIX. THE EVIDENCE OF COVERAGE, DISCLOSURE FORM AND PLAN CONTRACT SHOULD BE CONSULTED FOR A DETAILED DESCRIPTION OF COVERAGE BENEFITS AND LIMITATIONS. No Calendar -Year Brand -Name Drug Deductible $5 Generic/$15 Formulary Brand-Name/$30 Non -Formulary Brand -Name Drugs — Retail Pharmacy $10 Generic/$25 Formulary Brand-Name/$45 Non -Formulary Brand -Name Drugs — Mail Service Covered Services, Member Copayment° DEDUCTIBLES (Prescription drug coverage benefits are not subject to the medical plan deductible.) Calendar -year brand -name drug deductible None PRESCRIPTION DRUG COVERAGE+ Participating Mail Service (Includes oral contraceptives, diaphragms, and covered diabetic drugs and testing supplies) Pharmacy Prescriptions (For up to a 30-day supply)# (For up to a 90-day supply)" — Generic drugs $5/prescription $10/prescription — Formulary brand -name drugs $15/prescription $25/prescription — Non -formulary brand -name drugs $30/prescription $45/prescription — Home self-administered injectable drugs (may require prior authorization from Blue Shield 20% Not covered Pharmacy Services) (Up to $100 copayment maximum I per prescription) If the physician or member requests a brand -name drug and a generic drug equivalent is available, the member is responsible for paying the difference between the cost to Blue Shield of California of the brand -name drug and its generic drug equivalent, as well as the applicable formulary generic drug copayment. Drugs from non -participating pharmacies are not covered except in emergency and urgent situations. # Copayments and charges for services not included in the calculation of the member's calendar -year copayment maximum continue to be the member's responsibility after the calendar -year copayment maximum is reached. Please refer to the Evidence of Coverage, the Disclosure Form and the Group Health Service Contract for exact terms and conditions of coverage. Stretch Your Prescription Drug Dollar Even; Furfher This benefit chart is just the beginning to making the most of your coverage. To help you get your money's worth, we have created many opportunities for you to save on costs wherever possible. Read on and learn about the unique resources we have to support you. ; Choosey=gener"stead.of brand name drugs 111P We're driving the use of generics to help you get safe, affordable drugs at a time when prescription costs continue to grow. Increasing drug costs is one of the main reasons that overall healthcare coverage has become more expensive. But the use of generics can have a direct and indirect impact on keeping rates down. By choosing a proven generic over a brand -name drug, you can quickly lower your costs. Generics cost less than brand -name drugs so we can pass the savings on to you through affordable generic drug coverage. When you ask for a drug that is available as a generic you have a copayment that is significantly less than the copayment for the brand, and no deductible. You can trust generics to provide a therapeutic equivalent to their brand -name counterpart. They must contain the same active ingredient and have approval from the U.S. Food and Drug Administration for meeting the same safety standards. About half the drugs on the market today are available in generic form. Your doctor can help you decide if a specific drug is right for you. At your next visit, let your doctor know you prefer generics and remember to bring a copy of your formulary. For a printed copy, call the customer service number on your Blue Shield ID card or download one from the "pharmacy" section of www.mylifepath.com. Use,onUne ,pharmacy to©is at Niylifepath c©>n ,,. We created the "pharmacy" section of our Web site to give you access to resources to help you be informed and make cost -saving decisions. ask the pharmacist — If you have clinical questions about prescription or over-the-counter drugs, you can use this feature to connect with the drug information pharmacists at the University of California, San Francisco. Simply submit your question using easy electronic forms. Within one to two business days, a clinical pharmacist will reply by e-mail with a link to a confidential response posted on the mylifepath site. Then, you have the option of saving the answer to a personal archive for later reference. • drug database & formulary — Use this feature to get information on our most current formulary list, generic alternatives that help you lower out-of-pocket costs and details about specific coverage restrictions. You can search by drug name, try browsing by first letter, or searching by medical condition or drug class. Plus, watch for the most recent changes to our formulary highlighted in our "Announcements" box. • participating pharmacies — Using this feature, you can locate participating pharmacies for maximum coverage. Just enter a zip code or city and our new tool aggregates a list, across retail chains and independents, and serves it up on our site. firAND.- ,. .� n u f©r our: rescri tion mail seruice .: P_ �?, W" s mow: If you take a particular drug for a chronic condition such as diabetes or high blood pressure on an ongoing basis, going to the "pharmacy' at www.mylifepath.com can save you a trip - or several trips - to your local network pharmacy. Our plans offer coverage of a mail service benefit, available through Express Scripts. Members who take stabilized doses of long-term maintenance medications can order a mail service refill of up to a 90-day supply. After sending your initial maintenance drug prescription to Express Scripts, you can order refills via the "pharmacy" section of www.mylifepath.com. If you prefer to renew your prescription by phone, you can call Express Scripts at (800) 544-6962, or TTY (800) 972-4348 if you are hearing impaired. Allow up to 14 days for delivery, from the day you mail your initial prescription order or order a refill. If you don't have Internet access, call Member Service at the number on your Blue Shield ID card to find out more about your drug benefits and get a mail service order form. Please note that injectable drugs other than insulin and drugs used for short-term conditions, such as migraine medications and antibiotics, are not covered by this mail service benefit. «A» (1/04) Blue Shield of California An independent Member of the 61ue Shield Association CITY OF HUNTINGTON BEACH Effective Date: 1/01/2004-12/31/2004 Kaiser Permanente Southern California MEMBER SERVICES TELEPHONE 1-800-464-4000 WEB SITE WWWRaiserpermanente.org ANNUAL DEDUCTIBLE None MAXIMUM OUT-OF-POCKET $1,500 per member $3,000 per family unit (two or more people MAXIMUM LIFETIME BENEFIT None HOSPITAL CARE Room and Board, Surgeon, Physician visit $0 Copay per admission and Anesthesiologist All Inpatient services are included in 1001 Copay when authorized by a Plan physician OFFICE CARE Physician Visit, Routine Physical $10 Copay per visit Specialist Care $10 Copay per visit Outpatient Surgery $10 Copay per procedure Allergy Tests and Injections No charge Immunizations, Lab and X-ray 100 % Covered Mammography 100% Covered Vision Exams/Hearing Exams $10 Copay per exam, as needed Physical, Speech & Occupational Therapy Visit $10 Copay per visit. Benefits are limited to short-term therapy that can be expected to result in significant improvement of a members condition within a period of two months from the first date of treatment. EMERGENCY CARE In Area $50 Copay (waived if admitted) Out -of -Area -- - $50 Copay (waived if admitted). Worldwide coverage for emergency services due to unforeseen illness. Limited to emergency services required before the members condition permits transfer of travel to the nearest Kaiser facility. Non -participating facility must notify health plan within 24 hours of hospitalization or as soon as reasonably possible. Follow-up care is not covered. Ambulance Service No charge per trip, when determined to meet the criteria that define an emergency MATERNITY Delivery/Nursery Care for Newborns $0 Copay per admission Pre -natal and Post -natal Visits No charge after confirmation of pregnancy and initial post-partum visit Well -Baby Care No charge (23 months or younger) PRESCRIPTION DRUGS Generic/Brand $5 copay for generic/$15 copay for brand per prescription for up to a 100-day supply in accordance with Health Plan formulary guidelines and when obtained at Plan pharmacies. Drugs for the treatment of sexual dysfunction are covered at 50 of charges with a maximum dosage limit of 27 doses for 100-day supply. Drugs for the treatment of infertility are covered at 50 % of charges as part of an approved treatment. MENTAL HEALTH Inpatient $0 Copay; Up to 30 days per calendar year. No days limit - AB88 Diagnosis* Outpatient $10 Copay per visit, Up to 20 visits per calendar year. No visit limit - AB88 Diagnosis* SUBSTANCE ABUSE Inpatient Detox: $0 Copay per admission Transitional Residential Recovery Service (TRRS) in a non -medical sefting:$100 Copay per admission, up to 60 days per calendar year, but no more than 120 days in any 5 consecutive calendar year period. Outpatient Individual: $10 Copay per visit, Group: $5 Copay per visit; No outpatient visit limit. INFERTILITY SERVICES — Inpatient 50 % of member rate per admission for approved treatment Outpatient 50 % of member rate per visit for approved treatment DURABLE MEDICAL EQUIPMENT No charge PROSTHETICS & ORTHOTICS DIABETIC BENEFITS Insulin: $5 Copay for up to 100-daysupply; Testing Supplies: 80 % Covered up to 100-day supply. HOME HEALTH 100 % Covered when prescribed by a plan physician (within Service Area) SKILLED NURSING FACILITY (SNF) No COp2y for up to 100 days per benefit period HOSPICE CARE 100 % Covered when selected as an alternative to traditional services and authorized by a Plan physician (within Service Area) for Traditional Plan member who are diagnosed with a terminal illness and who have a life expectancy of twelve months or less. OPTICAL Not Covered CHIROPRACTIC $10/visit; Up to 20 visits per calendar year HEARING AIDS $1000 Allowance; 1 device/ear; 2 device(s)/36 months Students to age 25 Covered Services and supplies described above are covered only if prescribed and authorized by a plan physician and received at a Plan facility inside the service area. *AB88 (Mental Health Parity) Diagnosis: Schizophrenia, Schizoaffective disorder, Bipolar disorder (manic-depressive illness), Major depressive disorders, Panic disorder. Obsessive -compulsive disorder, Pervasive developmental disorder or autism, Anorexia nervosa, Bulimia nervosa, and Serious Emotional Disturbances (SED) when specific criteria are met. **Services covered are medically necessary diagnostic planning sevices for inferldy problems - Provider visit, diagnosis, and treatment (Inpatient and Outpatient fertility procedures, Infertility Treatment). Artificial insemination is covered except for donor semen and donor eggs and services related to their procurement and storage. All other services related to conception by artificial means are not covered. Such non -covered services include but are not limited to In Vitro Fertilization Ovum Transplants, Gamete Intrafalopian Transfer (GIFT) and Zygote Intrafallopian Transfer (ZIFT). CONFIDENTIAL COMMUNICATION This transmission may contain confidential information which is legally privileged or otherwide protected. This information is intended only for the use of the individual or entity named above. If you are not the Intended recipient, or the person responsible for receiving andlor delivering it to the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of any information contained in this transmittal is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone and return the original transmission to the sender. Thank you. Grace Hong, Senior Sales Executive, license #-0007504 * Marlene Pocinich, Sales Associate, license #OB74585 City of Huntington Beach F lloll !Kill: - •' _- INITIATING DEPARTMENT: ADMINISTRATIVE SERVICES SUBJECT: ADOPT RESOLUTION APPROVING SIDE LETTER TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE MUNICIPAL EMPLOYEES' ASSOCIATION COUNCIL MEETING DATE: February 2, 2004 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached Tract Map, Location Map and/or other Exhibits Not Applicable Contract/Agreement (w/exhibits if applicable) Signed in full by the City Attorney) Not Applicable Subleases, Third Party Agreements, etc. (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Not Applicable Financial Impact Statement Unbudget, over $5,000 Not Applicable Bonds (If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial I Not Applicable EXPLANATION FOR MISSING ATTACHMENTS EXPLANATION FOR RETURN0F ITEM:. RGA Author: William McReynolds CITY OF HUNTINGTON BEACH MEETING DATE: October 6, 2003 DEPARTMENT ID NUMBER: AS-03-41 Council/Agency Meeting Held: / n la Deferred/Continued to: pproved ® Conditionally Approved ® Denied City Clerk's Signatuile Council Meeting Date: October 6, 2003 Department ID Number: AS-03-41 CITY OF HUNTINGTON BEACH REQUEST FOR ACTION C o.� SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL C- SUBMITTED BY: RAY SILVER, City Administratora?- c `== �ry C PREPARED BY: CLAY MARTIN, Director of Administrative Services SUBJECT: ADOPT RESOLUTION APPROVING SIDE LETTEn 970 MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE MUNICIPAL EMPLOYEES' ASSOCIATION REGARDING H O L I DAY PAY Q Q C N) -- b d-Z _,,-I U Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The City's retirement program through the Public Employees' Retirement System (PERS) requires that certain portions of an employee's earnings be reported for benefit calculation purposes. These earnings are generally referred to as being "PERS-able." Aside from regular earnings, excluding overtime, additional pay for employees who are required to work on scheduled holidays as a part of their regular work schedule is "PERS-able." This side letter identifies those classifications represented by the Municipal Employees' Association (MEA) that meet the PERS criteria for holiday pay. Funding Source: This action does not increase the compensation paid to the employee, but identifies the classifications that must have holiday pay reported to PERS. Therefore, the fiscal impact is the City's PERS contribution, which is 7% of the holiday pay earned, for an annual cost of approximately $1,000 to $5,000 dollars. Funding is included in the FY 03-04 budget. Recommended Action: Adopt Resolution No. a 003=q �o , a resolution of the City Council of Huntington Beach amending the Memorandum of Understanding between the City of Huntington Beach and Municipal Employees' Association regarding holiday pay. PARCA\MEA side letter Holiday Pay.doc -2- F-- — LJ 9/22/2003 5:07 PM REQUEST FOR ACTION MEETING DATE: October 6, 2003 DEPARTMENT ID NUMBER: AS-03-41 Alternative Action(s): None. PERS law requires the reporting of holiday pay. Analysis: The MEA MOU provides that permanent employees who are required to work on holidays are to be compensated at the rate of time and one-half the hourly rate exclusive of any other premiums for all hours worked on said holiday. Section 571 of the PERS Regulations defines "holiday pay" as "additional compensation for employees who are normally required to work on an approved holiday because they work in positions that require scheduled staffing without regard to holidays. If these employees are paid over and above their normal monthly rate of pay for approved holidays, the additional compensation is holiday pay and reportable to PERS." This side letter identifies which classifications in the MEA meet the criteria defined by PERS for reporting holiday pay. Attachment(s): RCA Author: Sharon Hennegen P:\RCA\MEA side letter Holiday Pay.doc -3- 9/22/2003 5:07 PM ATTACHMENT #1 RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH AMENDING THE MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY OF HUNTINGTON BEACH AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION REGARDING HOLIDAY PAY WHEREAS, the City Council of the City of Huntington Beach desires to modify benefits for employees represented by the Huntington Beach Municipal Employees' Association, regarding holiday pay, NOW, THEREFORE, the City Council of the City of Huntington Beach resolves as follows: 1. The Side Letter of Agreement, with effective date of O CI • G , 2003, to Memorandum of Understanding (M.O.U.) Between the City of Huntington Beach and the Huntington Beach Municipal Employees' Association, a copy of which is attached hereto and by reference made a part hereof, is hereby approved and ordered implemented in accordance with the terms and conditions thereof. 2. The City Administrator is authorized to execute this Side Letter on behalf of the City. 3. The Side Letter shall be effective for the term of the current M.O.U. adopted by Resolution No. 2apa-/83 and such additional term, if any, as referenced in the Side Letter. PASSED AND ADOPTED by the City Council of the City of Huntington Beach at a regular meeting thereof held on the 470 day of ®C.7-0,8&R , 2003. Mayor ATTEST: APPROVED AS TO FORM: zgw� 10W,411 &&4-- City Clerk °S/31- ity Attorney REVIEWED AND APPROVED: City A strator INITIATE D APPROVED: Director of dministrative Services 03reso/side letter -holiday pay 1 EXHIBIT A Side Letter of Agreement — Holiday Pay Between the City of Huntington Beach and the Huntington Beach Municipal Employees' Association Effective Date: October 6, 2003 This is to memorialize an agreement between the City of Huntington Beach and the Huntington Beach Municipal Employees' Association (MEA) to reflect agreed upon changes,, corrections or clarifications to Article IX — Hours of Work/Overtime of the existing 2003 Memorandum -of -Understanding. This agreement is to be incorporated into any future Memorandum -of - Understanding between the City of Huntington Beach and the Huntington Beach Municipal Employees' Association. ARTICLE IX — HOURS OF WORK/OVERTIME C. - Overtime/Compensato[y Time 3. Holiday ^ e#4ne Premium Permanent employees who aFe Feq iFe work on a legal holiday as designated in Article XII.A.2 shall be compensated at the rate of time and one-half the hourly rate exclusive of any other premiums for all hours worked on said holiday. Holiday pay ssMPe er#efiied--ei the as+, l holidays as de6ignated-in Artiste It is the understanding of the City of Huntington Beach and the Huntington Beach Municipal Employees' Association that this side letter to the existing Memorandum -of -Understanding is of no force or effect whatsoever unless and until adopted by resolution of the City Council of the City of Huntington Beach. . IN WITNESS WHEREOF, the parties hereto have executed this side letter to the Memorandum -of -Understanding this day of October, 2003. CITY OF HUNTINGTON BEACH William P. Workman I Assistant City Administrator Clay Ma Direct of Administrative Services APPROVED AS TO FORM: Jennifer McGrath City Attorney HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION n Von Holle, MEA President Res. No. 2003-76 STATE OF CALIFORNIA COUNTY OF ORANGE ) ss: CITY OF HUNTINGTON BEACH ) I, CONNIE BROCKWAY, 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 at least a majority of all the members of said City Council at an regular meeting thereof held on the 6th day of October, 2003 by the following vote: AYES: Coerper, Green, Boardman, Cook, Houchen, Hardy NOES: None ABSENT: Sullivan ABSTAIN: None �� ity Clerk and ex-officio Clerk of the City Council of the City of Huntington Beach, California I I q RMIT111111[ff(�q INITIATING DEPARTMENT: ADMINISTRATIVE SERVICES SUBJECT: ADOPT RESOLUTION APPROVING SIDE'LETTER TO .M-EMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE MUNICIPAL EMPLOYEES'. ASSOCIATION.. COUNCIL MEETING DATE: October 6, 2003 RCA ATTAINMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached Tract Map, Location Map and/or other Exhibits Not Applicable Contract/Agreement (w/exhibits if applicable) (Signed in full by the City Attorney) Not Applicable Subleases, Third Party Agreements, etc. (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Not Applicable Financial Impact Statement (Unbudget, over $5,000) Not Applicable Bonds,(If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial Not Applicable EXPLANATION FOR MISSING ATTACHMENTS RCA Author: Sharon Hennegen (7) October 6, 2003 - Council/Agency Agenda - Page 7 E-5.(City Council) Adopt Resolution No. 2003-77 Approving Application for State Funding Under the 2002 Resources Bond Act, Robert-Z'Berg-Harris Urban Open Space and Recreation Block Grant Program — Anticipated to be Used for Edison Park Sports Youth Complex ( ) Adopt Resolution No. 2003-77 "A Resolution of the City Council of the City of Huntington Beach Approving the Application for Grant Funds for the Roberti- Z'Berg-Harris Block Grant Program under the California Clean Water, Clean Air, Safe Neighborhood Parks, and Coastal Protection Act of 2002." Submitted by the Community Services Director. Funding Source: State of California, 2002 Resources Bond Act, Robert_i- Z'Berg-Harris Urban Block Grant Program. (Funds in the amount of $526,949 have been allocated to the City under the California Clean Water, Clean Air, Sate Neighborhood Parks, and Coastal Protection Act of 2002.) Adopted 6-0-1 (Sullivan absent) E-6. (City Council) Adopt Resolution No: 2003-76 ADorovina-Side Letter -to Memorandum of, Understanding (MOU) Between the City -and the Municipal -Employees'- Association k (MEA) Regarding Holiday Pay ( ) —Adopt Resolution No. 2003-76 — "A Resolution of the City Council of the City of Huntington Beach Amending the Memorandum of Understanding Between the City of Huntington Beach and the Huntington Beach Municipal Employees'Association Regarding Holiday Pay." Submitted by the City Administrator. Funding Source: This action does not increase the compensation paid to the employee, but identifies the classifications that must have holiday pay reported to PERS (Public Employee's Retirement System). The fiscal impact is. the City's PERS contribution (7% of holiday pay earned) for an annual cost of approximately $1 1000 to $5, 000. Funding is included_ in the Fiscal Year 2003-2004 budget: Adopted 6-0-1 (Sullivan absent) E-7. (City Council) Adopt Resolution Nos. 2003-73. 2003-74.�and 2003-75 Approving Side Letters to Memoranda of Understanding (MOU) between the City and the Police Officers' -Association (POA), the Fire Association (HBFA),-and fhe'Marine Safety Officer's Association (MSOA) ( . ) —1. Adopt Resolution. No.,2003--73 - "A Resolution of the City Council of the City of Huntington Beach Amending the Memorandum of Understanding between the City of Huntington Beach and Huntington Beach Police Officers' Association Regarding Compensatory Time,"and 2. Adopt Resolution No. 2003-74 - "A Resolution of the City Council of the City of Huntington Beach Amending the Memorandum of Understanding between the City of Huntington Beach and Huntington Beach Firefighter's Association Regarding Compensatory Time," and 3. Adopt Resolution No. 2003-75 - "A Resolution of the City Council of the City of Huntington Beach Amending the Memorandum of Understanding between the City of Huntington Beach and Huntington Beach Marine Safety Officers'Association Regarding Compensatory Time." Submitted by the City Administrator. Funding Source: The ability to provide compensatory time results in the reduction of paid overtime. Adopted 6-0-1 (Sullivan absent) 7 CITY OF HUNTINGTON BEACH MEETING -'DATE: December 16, 2002 DEPARTMENT ID NUMBER: 02-056 Council/Agency Meeting Held: 2 /� 02_ �Def rred/Continued to: City Clerk's Sign re Approved ❑ Conditionally Approved ® Denied Council Meeting Date: December 16, 2002 Department ID Number: Q27056 CITY OF HUNTINGTON BEACH REQUEST FOR COUNCIL ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS SUBMITTED BY: RAY SILVER, CITY ADMINISTRATORS ' '„= PREPARED BY: WILLIAM P. WORKMAN, ASSISTANT CITY ADMINISTRATO CLAY MARTIN, DIRECTOR OF ADMINISTRATIVE SERVICES SUBJECT: APPROVAL OF MEMORANDUM OF UNDERSTANDING BETWE N THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES ASSOCIATION ,4 . Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: Should the city and the Huntington Beach Municipal Employees' Association enter into a new Memorandum -of -Understanding covering the period of December 21, 2002 through December 20, 2003? Funding Source: Funding is included in the Fiscal Year 2002/2003 budget. The total annual cost to implement the Memorandum -of -Understanding with the Huntington Beach Municipal Employees' Association is $1,200,000. Recommended Action: Adopt Resolution a resolution of the City Council of Huntington Beach approving and implementing the Memorandum -of -Understanding between the Huntington Beach Municipal Employees' Association (MEA) and the City of Huntington Beach for 12/21/02 through 12/20/03. Alternative Action(s): Reject the resolution and maintain the current salary and benefits of the Huntington Beach Municipal Employees' Association. 2003 MEA MOU.doc -1- 12/5/2002 11:32 AM REQUEST FOR COUNCIL ACTION MEETING DATE: December 16, 2002 DEPARTMENT ID NUMBER: 02-056 Analysis: Representatives of the City and the Huntington Beach Municipal Employees' Association (MEA) have completed the meet and confer process with agreement on a new Memorandum -of -Understanding (MOU) for the period of December 21, 2002 through December 19, 2003. Proposed modified salary and benefit changes include the following: Salary Three percent (3%) salary increase effective December 21, 2002. As a point of reference the current Consumer Price Index for Urban Wage Earners and Clerical Workers averages 2.5% for the Los Angeles -Riverside -Orange County region. This is based on the period October 1, 2001 through September 30, 2002. Health Insurance Effective January 4, 2002 employees will share in the cost for 2003 medical, dental, and vision increases. Depending on the category of coverage selected by each employee in the medical, dental, and vision plans, employees will be contributing through a pre-tax payroll deduction between approximately $160.00 and $890.00 per year to offset the cost of 2003 health insurance increases. Pre -Retirement Death Benefits for Survivors Upon approval of the City Council, two amendments will be submitted to CalPERS having to do with survivors. The Pre -retirement Optional Settlement 2 Death Benefit provides the surviving spouse of a member eligible for retirement who dies before retiring the benefits that they would be eligible for if the member were to have already been retired. The Fourth Level of 1959 Survivors Benefit provides a monthly allowance to eligible survivors of members who died before retirement. This will bring the 1959 Survivor Benefit to just below the equivalent Social Security benefit. The Fourth Level of 1959 Survivors Benefit is separately funded with the CalPERS system and requires an employee contribution. A summary of these and other changes are included as Attachment #1. 2003 MEA MOU.doc -2. 12/5/2002 11:32 AM REQUEST FOR COUNCIL ACTION MEETING DATE: December 16, 2002 DEPARTMENT ID NUMBER: 02-056 Attachment(s): X-49, -133 RCA Author: William McReynolds 2003 MEA MOU.doc -3- 12/5/2002 11:32 AM SUMMARY OF SALARY AND BENEFIT CHANGES FOR THE MUNICIPAL EMPLOYEES' ASSOCIATION ®g. Terre A one-year term from December 21, 2002 through December 19, 2003 og. Salary 3% increase effective December 21, 2002, (the first day of the pay period under the resolution). Health and Employee Cost Sharing of Benefits Year 2003 Effective January 4, 2002 employees will share in the cost for 2003 medical, dental, and vision increases. Depending on the category of coverage selected by each employee in the medical, dental, and vision plans, employees will be contributing through a pre-tax payroll deduction between approximately $160.00 and $890.00 per year to offset the cost of 2003 health insurance increases. ®;o Hours of Work Effective February 1, 2003, with supervisor and Department Head approval, MEA employees may flex regular scheduled start times between the hours of 7:00 a.m. to 9:00 a.m. Flex schedules shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. Effective February 1, 2003, MEA employees will have the option of working a 5/40 or 9/80 work schedule with supervisor and Department Head approval. MEA employees assigned to the Police Department shall have the option of working the 4/10 work schedule with supervisor and Department Head approval. In order to maintain service to the public, departmental effectiveness, productivity and/or efficiency a Department Head may assign an employee a different work schedule that is in compliance with the requirements of the Fair Labor Standards Act (FLSA) with City Administrator approval. Page 1 SUMMARY OF SALARY AND BENEFIT CHANGES FOR THE MUNICIPAL EMPLOYEES' ASSOCIATION ° Retirement ° The city proposes amending its contract with California Public Employees Retirement System (CaIPERS) to provide the following pre -retirement death benefits, which are described by CalPERS as follows: Pre -retirement Optional Settlement 2 Death Benefit The spouse of a deceased member, who was eligible to retire for service at the time of death, may elect to receive the Pre -Retirement Optional Settlement 2 Death Benefit in lieu of the lump sum Basic Death Benefit. The benefit is a monthly allowance equal to the amount the member would have received if the member had retired from service on the date of death and selected Option 2, the highest monthly allowance a member can leave a spouse. Fourth Level of 1959 Survivor Benefit The 1959 Survivor Benefit provides a monthly allowance to eligible survivors of members who were covered by this benefit program and died before retirement. This benefit coverage is available by contract amendment for those members who are not covered by federal Social Security with their employer. Covered members are required to pay a $2 monthly fee that is deducted from their salary specifically to fund the 1959 Survivor Benefit Program. •% Management Issues • Family Sick Leave — In Compliance with Law and Standardized • Increased Education Reimbursement • Roll Over lawsuits settled, delete language • End Vacation Checks Page 2 RESOLUTION NO. 2002-133 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF HUNTINGTON BEACH MODIFYING SALARY AND BENEFITS. FOR FISCAL YEARS 2002/2003 AND 2003/2004 FOR MUNICIPAL. EMPLOYEES ASSOCIATION WHEREAS, the City Council of the City of Huntington Beach desires to modify salary and benefits for Municipal Employees Association for fiscal years 2002/2003 and 2003/2004, NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Huntington Beach as follows: SECTION 1. Benefits and salary for Municipal Employees Association shall be modified as reflected in EXHIBIT "A," effective as indicated. SECTION 2. Except as modified, existing benefits shall remain in effect. SECTION 3. Any resolution in conflict herewith, whether by minute action or resolution of the City Council heretofore approved, is hereby repealed. PASSED AND ADOPTED by the. City Council of the City of Huntington Beach at a regular meeting thereof held on the 16th day of December 2002 ATTEST: APPROVED AS TO FORM: „a ey CityAer L jity Attome REVIEWED AND APPROVED: City Ad mistrator� INITIATED AND APPROVED: Director of ministrative Services 01 reso/mea-emp/ 12/5/02 Res. No. 2002-133 STATE OF CALIFORNIA COUNTY OF ORANGE ) ss: CITY OF HUNTINGTON BEACH } I, CONNIE BROCKWAY, 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 at least a majority of all the members of said City Council at an regular meeting thereof held on the 16tn day of December, 2002 by the following vote: AYES: Coerper, Green, Cook, Houchen, Hardy NOES: Sullivan, Boardman ABSENT: None ABSTAIN: None City Clerk and ex-officio CI rk of the City Council of the City of Huntington Beach, California i Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page PREAMBLE...................................................................................................................................1 ARTICLE I— TERM OF MOU.................................................................................................... I ARTICLE II REPRESENTATIONAL UNITICLASS.................................:........................1 ARTICLE III — MANAGEMENT RIGHTS................................................................................. 2 ARTICLE IV — EXISTING CONDITIONS................................................................................. 2 ARTICLEV - SEVERABILITY....................................................... ....... ......................... 2 ARTICLE VI—SALARYSCHEDULE......................................................................................... 2 A. Classification and Salary Rates 2 ARTICLE VII — SPECIAL PAY................................................................................................... 3 A. Education 3 1. Tuition Reimbursement............................................................................................................................. 3 B. Actina Assienment 3 C. Assienment Pav 3 1. Leadworker Differential............................................................................................................................ 3 2. Shift Differential........................................................................................................................................ 3 a. Afternoon Shift .... ................::... ....................................:.....::::................................................. 3 b. Night Shift ..........::........: ....... .......... 4 C. Shifts Defined ........................................................................... ......................... 4. 3. Court Standby Time .....................:...:.......:...:............................................................................................. 4 4. Court Appearance Time............................................................................................................................. 4 D. �ecial Certification/Skill Pay 4 1. Bilingual Skill............................................................................................................................................ 4 2. Shorthand Skill.................................................................................................:........................................ 5 3. Plan Checker. Building.............................................................................................................................. 5 a. Plans Exam, ner ICBO Certification...................................................................................................... 5 b. EIT/AA Decree in Engineering............................................................................................................ 5 ARTICLE VIII — UNIFORMS, CLOTHING, TOOLS AND EQUIPMENT .............................. S A. Uniforms and Safety Shoes 5 1. Safety Shoes — Cost.......................................................................................................... .................. 5 B. Tool Allowance 6 C. Vehicle Use 6 D. Process Owner Assimment Pay 6 ARTICLE IX — HOURS OF WORKIO VER TIME ....................................................................... 6 A. Work Schedule 6 1. Work Periods under Fair Labor Standards Act ..................................... ............................................... ...... 6 2. Flex Schedule and Alternative Work Schedule - Civic Center Employees ............................................... 7 B. Hours of Work Defined 8 C. Overtime/Compensatory Time 8 1. Callback............................................................................................ .........................8 2003 MEA MOU Final.doc i 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page 2. Mandatory Standby.................................................................................................................................... 9 3. Holiday Overtime...................................................................................................................................... 9 ARTICLE X - HEALTHAND OTHER INSURANCE BENEFITS .......................................... 9 A. Health 9 B. Eligibility Criteria and Cost 9 1. City Paid Medical Insurance — Employees and Dependents............................:......................................... 9 2. Year 2003 Premiums............................................................................................................................... 10 3. Future Premiums...................................................................................................................................... 10 C. COBRA 10 D. Life and Accidental Death and Dismemberment 10 E. Long Term Disability Insurance 11 F. Medical Cash -Out 11 G. Section 125 Plan 11 H. Miscellaneous 11 ARTICLEXI — RETIREMENT.................................................................................................. 12 A. Benefits 12 1. Self -Funded Supplemental Retirement Benefit ................................................. :.................................... .. 12 2. Deferred Compensation (Retiree Medical Funding).. 3. Medical Insurance for Retirees ............:........ ...:....: .:...:.....: .:..:... ..:...:................:::: ..........::...... 13 B. Public Employees' Retirement System 14 1. Employee's Contribution 14 2. Two Percent at Age 55 Formula 14 3. Pre -Retirement Optional Settlement 2 Death Benefit 14 4. Fourth Level of 1959 Survivor Benefits 14 ARTICLE XII — LEAVE BENEFITS......................................................................................... 15 A. Leave With Pay 15 1. General Leave.......................................................................................................................................... 15 a) Accrual................................................................................................................................................15 b) Eligibility and Approval .......................... ..::.....::..:......................................... .......................... 15 c) Family Sick Leave..........:.....:......:................................................:..............:...................................... 15 d) Conversion to Cash............................................................................................................................. 15 e) One Week Minimum Vacation Requirement...................................................................................... 16 2. Holidays...................................................................................................................................................16 3. Sick Leave............................................................................................................................................... 16 a) Accrual............:.........:.............:...............:.................:.............................:........:..................................16 b) Credit............................:......:.:.....:.........................................................:.......................:... ..............16 c) Usage ....... :........................ ...... ............................................................................................................. 17 d) Family Sick Leave.............................................................................................................................. 17 e) Payoff at Termination...................................................................:.............:....................................... 17 d) Extended Absences............................................................................................................................. 17 4. Bereavement Leave................................................................................................................................. 17 5. Association Business............................................................................................................................... 17 2003 MEA MOU Final.doc ii 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page 6. JM Duty................................................................................................................................................. 17 7. Patemi Leave........................................................................................................................................ 17 ARTICLE XIII - CITY RULES ................ ...... ....... ........................ . ....... 18 A. Personnel Rules 18 1. Rule 5 — Recruitment and Examination Procedure.................................................................................. 18 a) 5-4 — Order of Certification................................................................................................................ 18 b) 5-14 — Promotional Exams................................................................................................................... 18 c) 5-20 — Duration of Employment Lists................................................................................................ 18 2. Rule 7 — Discipline........:.................................................................:....................................................... 19 . a) 7-2 — Causes for Discipline.................................................................................................................. 19 3. Rule 8 — Termination............................................................................................................................... 19 a) 8-1 — Medical Examination. Evaluation of Employee's Work Capacity. Demotion, Transfer or Terminationof Appointment........................................................................................................................ 19 b) 8-3 — Layoff in Accordance with Length of Service........................................................................... 20 c) 8-11 — Re-Employment....................................................................................................................... 20 4. Rule 9 — Probation................................................................................................................................... 20 a) 9-4 — Rejection of Probationa1y Employee......................................................................................... 20 5. Rule 12 — Classification Plan................................................................................................................... 20 a) 12-10 — Temporary Employees........................................................................................................... 20 6. Rule 14 — Additional Pay and Pay Adjustments...................................................................................... 21 a) 14-6 — Salary Advancements to Meet Recruiting Problems or to Give Credit for Prior Service. Application for Other Advancements........................................................................................................... 21 7. Rule 18 —Attendance and Leaves.:..:...:.........................:......................................::.............:................. 21 a). 18-8 — Sick Leave . ..................... :........ ......... ..................... ......... ......... ......... .............. 21 b) 18-16 — Industrial Accident Leave ......... ......... ..............._...................................... ............. 21, c) 18-19 — hlatemity Leave..... ................ d) 18-20 — Leave of Absence without Pay.............................................................................................. 23 8. Rule 19 — Grievance Procedure Non -Disciplinary Matters..................................................................... 23 a) 19-5 Grievance Procedure................................................................................................................... 23 1) Step 4 — City Administrator ..................... :............... ....................................................................... 23 2) Step 5 — Personnel Board Hearing................................................................................................. 24 9. Rule 20 —Disciplinary Procedure and Appeal.......................................................................................... 24 a) 20-1 — Purpose.................................................................................................................................... 24 b) 20-2 — Disciplinary Procedures........................................................................................................... 24 1) Notice of Proposed Adverse Action............................................................................................... 24 2) Employee's Right to Respond........................................................................................................ 24 3) Time Off......................................................................................................................................... 24 4) Final Notice of Decision................................................................................................................ 25 c) 20-3 — Appeal to Personnel Commission............................................................................................ 25 1) Request for Appeal......................................................................................................................... 25 2) Hearing ...........................................................................................................................................25 3) Final Decision................................................................................................................................ 25 d) 20-4 — Supplemental Hearing by Personnel Board............................................................................. 25 e) 20-5 — Employe Status on Pending Appeal....................................................:.................................. 26 10. Rule 21 — Grievance Procedures - General...........................................:.:........................................... 26 a) 21-7 Hearing Officers............:....::........:....:.:.......................................:....:......................................... 26 b) 21-11 Time. Computation of............................................................:................................................. 26 c) 21-12 Time. Extension of .................................................................................................................. 26 C. Rules Governing_ Layoff, Reduction in Lieu of Layoff and Re -Employment 26 1. Part 1 — Lavoff Procedure........................................................................................................................ 26 2. Order of Layoff........................................................................................................................................ 28 2003 MEA MOU Final.doc iii 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page 3. Notification of Employees...................................................................................................I.................... 29 4. Part 2 — Bumping Rights .......................................................................................................................... 30 a) Voluntary Reduction or Bumping in Lieu of Layoff......................................................I.................... 30 b) Reinstatement/Re-employment Lists .........: .................... .............:........................... ........... 30 c) Qualifications Appeal ..................... .......:. ....... .............::.............................. 30 d) Qualifications Appeal Hearing............................................................................................................ 31 5. Part 3 — Re-employment.......................................................................................................................... 31 a) Re-employ_ment.......................................................................................................................:...........31 b) Status on Re-employment................................................................................................................... 32 ARTICLE XIV-MISCELLANEOUS...... ......................................... :.......................................... 33 A. Grievance Arbitration 33 B. Promotional Procedures 33 1. Tie Scores................................................................................................................................................ 33 2. Salary Upon Promotion........................................................................................................................... 33 C. Labor -Management Relations Committee 34 D. Copies of MOU 34 E. Position Classification Issues 1. Class Specifications........................................................................ 2. Reclassification Impact.................................................................: 3. Surveyor Party Chief............................................................................................................................... 35 4.. Certificated Distribution Operator ... :..................................... ... ........................................... ............ 35 F. Class A and B Driver License Fees 35 G. Job Sharing 35 H. Deferred Compensation Loan Prog am 35 I. Performance Evaluations/Written Reprimand' Appeals 35 J. Employee Performance Evaluations 35 K. MEA Letter of Introduction 36 ARTICLE XV - CITY COUNCIL APPROVAL......................................................................... 36 LISTOF MOU EXHIBITS ......................................................................................................... 37 EXHIBIT A - CLASSISALARYSCHEDULE........................................................................... 38 EXHIBIT B - UNIFORM POLICY..........'........................................:........................................ 43 A. General 43 B. Affected Personnel 43 C. Basic Uniform Components and Standard Allowances. 43 D. Employee Responsibilities 44 E. City Responsibilities 44 F. Department Head Responsibilities 45 G. Purchases and Exceptions 45 2003 MEA MOU Final.doc iv 12/12/2002.8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page EXHIBIT C - VEHICLE USE POLICY.................................................................................... 47 Section 1 Purpose 47 Section 2 Scope 47 Section 3 - Policy 47 Section 4 — Vehicle Use Criteria 47 Section 5 — Insurance Requirements 49 EXHIBIT D - EMPLOYEE HEALTH PLAN BROCHURE ...............:.................................... 51 EXHIBIT E - DELTA CARE (PMI) DENTAL PLAN BROCHURE ........................................ 52 EXHIBIT F - DELTA DENTAL PLAN BROCHURE............................................................. 53 EXHIBIT G - VISION (VSP) PLAN BROCHURE.................................................................. 54 EXHIBIT H - LONG TERM DISABILITY PLAN BROCHURE ............................................ 55 EXHIBIT I - PROVISIONS OF THE RETIREE S UBSID Y MEDICAL PLAN .................... 56 EXHIBIT J - 9180 WORK SCHED ULE..................................................................................... 64 EXHIBIT K - 4110 WORK SCHEDULE.................................................................................... 67 2003 MEA MOU Final.doc v 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 Memorandum of Understanding between The City of Huntington Beach (hereinafter called City) and The Huntington Beach Municipal Employees' Association (hereinafter called Association or MEA) 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 period December 21, 2002 through December 19, 2003; and WHEREAS, the representatives of the City and the Association desire to reduce their agreements to writing, NOW THEREFORE, this Memorandum of Understanding is made to become effective December 21, 2002 and it is agreed as follows: ARTICLE I —TERM OF MOU A. This Memorandum of Understanding shall be in effect for a term commencing on December 21, 2002 through December 19, 2003. B. This Agreement constitutes the entire agreement of the parties with respect to improvements or changes in the salaries and monetary benefits for employees represented by the Association for the duration of this Agreement. ARTICLE II — REPRESENTATIONAL UNIT/CLASS It is recognized that the ASSOCIATION is the employee organization which has the right to meet and confer in good faith with the CITY on behalf of permanent employees of the CITY within those class titles set out in Exhibit "A" attached hereto and incorporated herein. The term "permanent" employee is used only to determine entitlement to certain benefits provided by this MOU and is defined as follows; an employee that has completed or is in the process of completing a probationary period in a permanent position in the competitive service in which the employee regularly works twenty hours or more per week. Additionally, the representation unit shall include all non -safety, non -management classifications which are created after execution of this agreement and are not included in another representation unit or determined in accordance with the Employer -Employee Relations Resolution to be more appropriately designated as non -associated classifications. 2003 MEA MOU Final.doc 1 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE III — MANAGEMENT RIGHTS Except as expressly abridged or modified herein, the CITY retains all rights, powers and authority with respect to the management and direction of the performance of CITY services and the work forces performing such services, provided that nothing herein shall change the City's obligation to meet and confer as to the effects of any such management decision upon wages, hours and terms and conditions of employment or be construed as granting the CITY the right to make unilateral changes in wages, hours and terms and conditions of employment. Such rights include, but are not limited to, consideration of the merits, necessity, level or organization of CITY services, including establishing of work stations, nature of work to be performed, contracting for any work or operation, reasonable employee performance standards, including reasonable work and safety rules and regulations in order to maintain the efficiency and economy desirable for the performance of CITY services. ARTICLE IV — EXISTING CONDITIONS Except as expressly provided herein, the adoption of this Memorandum of Understanding shall not change existing benefits, and terms and conditions of employment which have been established in prior Memoranda of Understanding, and/or provided for in the Personnel Rules of the City of Huntington Beach. ARTICLE V — SEVERABILITY If any article, sub -article, sentence, clause, phrase or portion of this Agreement, or the application thereof to any person, is for any reason held to be invalid or unenforceable by the decision of any court of competent jurisdiction, such decision shall not affect the validity of the remaining portions of this Agreement or its application to other persons. The City and the Association hereby agree that in the event any state or federal legislative, executive or administrative provision purports to nullify or otherwise adversely affect the wages, hours and other terms and conditions of employment contained in this Agreement or similarly purports to restrict the ability of the parties to negotiate a successor agreement, the City and the Association shall, without prejudice to either party's judicial remedies, endeavor to agree to alternative contractual provisions which are not adversely affected by said legislative, executive or administrative provision. ARTICLE VI — SALARY SCHEDULE A. Classification and Salary Rates Permanent employees shall be compensated at hourly salary rates by job type and pay grade including a three percent (3%) increase, effective December 21, 2002 as set forth in Exhibit A attached hereto and incorporated herein by this reference. All association represented employees hired after March 29, 2002 shall be required to utilize direct deposit of payroll checks. 2003 MEA MOU Final.doc 2 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE VII — SPECIAL PAY A. Education 1. Tuition Reimbursement Upon approval of the Department Head and the Human Resources Manager, permanent employees may be compensated for courses from accredited educational institutions. Tuition reimbursement shall be limited to job related courses or job related educational degree objectives and requires prior approval by the Department Head and Human Resources Manager. Education costs shall be reimbursed to permanent employees on the basis of a full refund for tuition, books, parking (if a required fee) and any other required fees upon presentation of receipts. However, the maximum reimbursement shall be not more than one thousand five hundred dollars ($1,500 in any fiscal year period. Reimbursements shall be made when the employee presents proof to the Human Resources Manager that he/she has successfully completed the course with a grade of "C" or better; or a "Pass" if taken for credit. B. Acting Assignment If a permanent employee is formally assigned to work in a higher classification on a temporary basis for greater than three (3) consecutive weeks, the employee shall be compensated for all hours worked in the higher classification, in the same manner provided in Article XIV.13.2. C. Assignment Pay Leadworker Differential Any permanent employee classified as "Leadworker" shall receive sixteen (16) ranges on the "Universal Salary Schedule" above the highest classification, which is assigned to the Leadworker to lead. 2. Shift Differential a. Afternoon Shift Permanent employees required to work on a regular assigned shift that occurs between the hours of 4:00 PM and midnight, shall be paid a premium equal to five percent (5%) of the employee's base hourly rate for all work performed during said shift. 2003 MEA MOU Final.doc 3 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING b. Night Shift Permanent employees required to work on a regularly assigned shift that occurs between midnight and 8:00 AM shall be paid a premium equal to ten (10%) percent of the employee's base hourly rate. c. Shifts Defined Permanent employees will be considered as assigned to the afternoon shift (4:00 PM to midnight) or the night shift (midnight to 8:00 AM) when five (5) or more hours of their regularly assigned shifts occur in the afternoon or night shift as defined herein. 3. Court Standby Time Crime Scene Investigators, Parking/Traffic Control Officers, Criminalists, Senior Criminalists, and Latent Fingerprint Examiners who are required to be on standby for a court appearance during other than their scheduled working hours shall receive a minimum of three hours straight time pay (including differentials in Article VI) for each morning and afternoon court session. 4. Court Appearance Time Crime Scene Investigators, Parking/Traffic Control Officers, Criminalists, Senior Criminalists, and Latent Fingerprint Examiners required to appear in court during other than their scheduled working hours shall receive a minimum of three hours pay at time and one half; provided, however, that if such time overlaps with the employee's scheduled working hours, said premium rate shall be limited to those hours occurring prior to or after the employee's scheduled work time. D. Special Certification/Skill Pay 1. Bilingual Skill Permanent employees who are required by their Department Head to use Spanish, Vietnamese, or Sign Language skills as part of their job assignment, shall be paid an additional five -percent (5%) of their basic hourly rate in addition to their, regular bi-weekly salary. Permanent employees may accept assignments utilizing bilingual skills in other languages on a short-term assignment with approval by the City Administrator. Such employees shall receive the additional five percent (5%) for every bi-weekly pay period that the assignment is in effect. In order to be eligible for said compensation, employee's language proficiency will be tested and certified by the Human Resources Manager or designee. 2003 MEA MOU Final.doc 4 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2. Shorthand Skill Employees who have successfully passed a shorthand skill test and who are required to use shorthand regularly in their jobs shall receive additional compensation in the amount of forty-six dollars and fifteen cents ($46.15) bi- weekly. Shorthand skill may be required for selected positions classified as Administrative Secretary, Secretary Legal Senior, Secretary Legal, Office Specialist (Typing), Office Assistant II (Typing), Deputy City Clerk II, and Deputy City Clerk I. Employees who have not passed a shorthand skills test will not be required to use shorthand. 3. Plan Checker, Building a. Plans Examiner ICBO Certification Incumbents who have completed their probationary period in the class of Plan Checker, Building who have attained certification as Plans Examiner by I.C.B.O. (International Conference of Building Officials) shall receive additional compensation in the amount of forty-six dollars and fifteen cents ($46.15) bi-weekly, provided that active certification is maintained. b. EIT/AA Degree in Engineering Incumbents in the classification of Plan Checker, Building who have successfully completed the State of California examination for Engineer -in -Training or who have obtained an Associate of Arts degree in engineering or equivalent major, shall receive additional compensation in the amount of sixty-nine dollars and twenty-three cents ($69.23) bi-weekly ARTICLE Vill — UNIFORMS, CLOTHING, TOOLS AND EQUIPMENT A. Uniforms and Safety Shoes The City's Uniform and Safety Shoe Policy shall be set forth in Exhibit "B" a copy of which is attached hereto and incorporated herein by this reference, provided however, that employees represented by MEA working in the Police Department shall be issued property in accordance with the equipment issue form for the particular position to which they are assigned. Uniform replacement for employees represented by MEA who are assigned to the Police Department shall be as stated in the Police Department Manual of Rules and Regulations. 1. Safety Shoes — Cost The CITY shall furnish safety shoes in accordance with the procedures and guidelines as set forth in Exhibit "B", provided however, that the maximum amount to be reimbursed for a pair of safety shoes will not exceed one hundred and eighty-five dollars ($185.00) per pair every six months or sooner, if necessary. 2003 MEA MOU Final.doc 5 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING B. Tool Allowance Those permanent employees, who are required to furnish their own personal tools for use on the job, shall be provided with a tool allowance to offset a portion of the cost for said tools that are lost, stolen or broken when in use on the job. Such allowance shall be eight hundred ($800) per year, payable in January of each year, separate from payroll checks to those. employees on active duty. In the event a permanent employee is hired or separates his/her tool allowance for that calendar year shall be prorated on the basis of the total number of months in which he/she was employed on the first working day of the year. It is understood that the employee has the responsibility to exercise care and diligence in preventing the loss, theft and breakage of his or her personal tools. C. Vehicle Use The City Vehicle Use Policy shall be indicated in the document attached hereto and by this reference incorporated herein as Exhibit C. Approval is required by the City Administrator or designee for any City vehicle to be taken home by an association employee. D. Process Owner Assignment Pay Those employees performing assignments designated by the City as "process owner" assignments shall receive premium pay equal to ten percent (10%) of the employee's base hourly rate. Process owner assignments are designated by the employee's department head and approved by the City Administrator or his designee. Designated employees are responsible for JD Edwards applications setup, design, troubleshooting and training. Process owners have system coordination responsibilities as distinguished from users of the system. ARTICLE IX — HOURS OF WORK/OVERTIME A. Work Schedule It is the intent of the city to provide an opportunity for MEA employees to select a flex schedule and/or alternative work schedule that is consistent with the city's objective that such schedules shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. 1. Work Periods under Fair Labor Standards Act It is understood that the city may establish a work period for each covered employee which meets the requirements of the Fair Labor Standards Act (FLSA) and which will not result in overtime compensation as part of a normal work schedule. 2003 MEA MOU Finai.doc 6 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2. Flex Schedule and Alternative Work Schedule - Civic Center Employees Effective February 1, 2003, with supervisor and Department Head approval, MEA employees may flex regular scheduled start times between the hours of 7:00 a.m. to 9:00 a.m. in half-hour increments (i.e. 7:00 a.m., 7:30 a.m., 8:00 a.m., 8:30 a.m., and 9:00 a.m.). Flex schedules shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. Effective February 1, 2003, MEA employees will have the option of working a 5/40 or 9/80 work schedule with supervisor and Department Head approval. MEA employees assigned to the Police Department shall retain the option of working the 4/10 work schedule with supervisor and Department Head approval. In order to maintain service to the public, departmental effectiveness, productivity and/or efficiency a Department Head may assign an employee a different work schedule that is in compliance with the requirements of FLSA with City Administrator approval. a. 5/40 Work Schedule The 5/40 work schedule shall be defined as working five (5) eight (8) hour days Monday through Friday each week plus a one -hour lunch during each work shift, totaling a forty (40) hours work week. The assigned 5/40 work schedule must be in compliance with the requirements of FLSA. b. 9/80 Work Schedule The 9/80 work schedule, as outlined in Exhibit J, shall be defined as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours (Friday), plus a one -hour lunch during each work shift, totaling forty (40) hours in each FLSA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. c. 4/10 Work Schedule The 4/10 work schedule, as outlined in Exhibit K, shall be defined as working four (4) ten (10) hour days each week plus a one -hour lunch during each work shift, totaling a forty (40) hours in each FLSA work week. The assigned 4/10 work schedule must be in compliance with the requirements of FLSA. The 4/10 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. 2003 MEA MOU Final.doc 7 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING d. Existing Alternative Work Schedules Non Civic Center MEA employees who had an alternative work schedule (9/80 or 4/10) prior to February 1, 2003 shall retain that alternative work schedule. Civic Center MEA employees who had an alternative work schedule (9/80) prior to February 1, 2003 may revert to that alternative work schedule (9/80) in the event his or her supervisor and/or Department Head determine that the 9/80 schedule *set forth in this article is inappropriate for the employee's classification. B. Hours of Work Defined General leave, holidays, sick leave and compensatory time shall be counted as hours worked. C. Overtime/Compensatory Time It shall remain the policy of the City that overtime is to be used only as needed or under emergency conditions as approved by the City Administrator. FLSA "non-exempt" employees shall receive overtime pay or compensatory time for hours worked over forty (40) hours in a work week at time and one half of the employee's FLSA regular rate of pay. The employee's supervisor shall determine if employee receives overtime pay or compensatory, time. Consideration shall be given to effectuating the request of the"employee. Once per fiscal year an employee may cash out up to sixty (60) hours of banked compensatory time. The employee shall give payroll two (2) weeks advance notice of their decision to exercise such option. If an employee is formally assigned to work in an FLSA "exempt" classification on a temporary basis for greater than three (3) consecutive weeks, the employee shall be compensated for hours worked over forty in a work week with compensatory time off and shall not be eligible for overtime pay, beginning after the third consecutive week working in the FLSA exempt classification. Employees shall accrue compensatory time on an hour for hour basis. FLSA non-exempt overtime pay and compensatory time rules, as stated above, shall apply for temporary FLSA exempt assignments that are less than three (3) weeks. Upon promotion to an FLSA "exempt" classification all compensatory time off shall be cashed out prior to promotion at the employee's current FLSA regular rate of pay in the "non-exempt". classification. 1. Callback The City will reimburse permanent employees called back to work a minimum of two (2) hours of pay at the rate of time and one-half (1 Y2) their regular hourly rate. A supervisor shall notify an employee, in advance, of the need to work overtime. Where overtime is worked as an extension of the 2003 MEA MOU Final.doc 8 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING workday, it shall not be considered call back. While overtime may be required to be worked, it is the City's policy to discourage the working of overtime, and to provide reasonable notification to an employee should overtime be required. 2. Mandatory Standby A permanent or probationary employee who is placed on standby status by their supervisor shall be compensated at an hourly rate equal to 0.180 of their base hourly rate for the entire period of such assignment. 3. Holiday Overtime Permanent employees who are required to work on a legal holiday as designated in Article XII.A.2 shall be compensated at the rate of time and one-half the hourly rate exclusive of any other premiums for all hours worked on said holiday. Holiday pay (time and one-half) will be compensated for work performed on the actual holidays as designated in Article XII. ARTICLE X — HEALTH AND OTHER INSURANCE BENEFITS A. Health The city shall continue to make available group medical, dental and vision benefits to all MEA employees. B. Eligibility Criteria and Cost 1. City Paid Medical Insurance — Employees and Dependents The City shall pay for health insurance for qualified employees and dependents, effective the first of the month following one month of continuous service as a permanent employee, except that a permanent part-time employee assigned to a work schedule of less than 2,080 hours, but more than 1,560 hours per year, must complete eighteen (18) months of continuous service, and a permanent part-time employee assigned to a work schedule of less than 1,560 hours, but more than 1,040 hours per year must complete two (2) years of continuous service before the CITY shall make such payments as set forth above. For purposes of determining continuous service, there shall be no accrual of hours for the period of time an employee is on a non -pay status for a complete pay period. A permanent employee is considered to be continuously employed where there has been no separation from City service. 2003 MEA MOU Final.doc 9 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2. Year 2003 Premiums The city "caps" its contributions for 2003 premiums at the level set forth in the chart below: Monthly City Paid Premium City Plan HMO Dental (PPO) Dental (PMI) Vision EE $336.05 $236.31 $42.88 $23.00 $17.58 EE + 1 664.53 517.79 81.82 39.11 17.58 EE + 2 or more 813.62 682.46 116.36 59.81 17.58 Effective January 4, 2003 employee bi-weekly payroll deduction contributions for 2003 premiums are set forth in the chart below: Bi-Weekly Dental Dental Employee Paid City Plan HMO (PPO) (PMI) Vision Premium EE $12.00 $5.95 $1.89 $0.00 $0.23 EE + 1 23.72 13.05 3.66 0.00 0.23 EE + 2 or more 29.04 17.20 5.12 0.00 0.23 3. Future Premiums The city "caps" its contributions toward monthly group medical, dental and vision plan premiums, by category (EE, EE + 1, and EE + 2 or more) and plan, at the year 2003 level. Until the City Council approves a successor to this Memorandum -of - Understanding, the city's 2003 contribution caps will remain in place in 2004 and beyond, even if premium increases result in these additional costs being borne by the employee. C. COBRA Permanent employees who terminate their employment with the City and dependents of permanent employees shall have any and all the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) benefits to which the law entitles them. D. Life and Accidental Death and Dismemberment The City shall provide for each permanent employee, at.City's cost, $25,000 of life insurance and $10,000 accidental death and dismemberment insurance. The City shall also provide for the availability of optional supplemental life and accidental death and dismemberment insurance coverage at the employee's cost. 2003 MEA MOU Final.doc 10 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING E. Long Term Disability Insurance The City shall provide for each permanent employee at the City's expense a long-term disability insurance plan comparable to the Group Disability Insurance Plan in effect on February 1, 1995 (Exhibit "J"). Such plan shall be modified effective November 21, 1988, to provide benefits as outlined in Plan B of Exhibit "J". The parties agree to exclude the first year of job related illness or injury from coverage on condition that the plan provides for a coordination with sick leave, general leave and holidays which is satisfactory to the Association. F. Medical Cash -Out If an employee is covered by a medical program outside of a city -provided, program (evidence of which must be supplied to the Administrative Services Department), they may elect to discontinue City medical coverage and receive ninety-two dollars and thirty-one cents ($92.31) bi-weekly to deposit into their Deferred Compensation account or any other pre-tax program offered by the City. G. Section 125 Plan This plan allows employees to use pre-tax salary to pay for regular childcare, adult dependent care and/or medical expenses. H. Miscellaneous Nothing in this Article shall be deemed to restrict the City's right to change insurance carriers or self -fund should circumstances warrant. City shall, however, notify the Association of any proposed change, and allow the Association an opportunity to review any proposed change and make recommendations to the City. 2. Nothing in this Article shall be deemed to obligate the City to improve the benefits outlined in this Article. 3. When the City grants an employee leave without pay for reason of medical disability, the City shall maintain the City paid employees' insurance premiums for the time the employee is in a non -pay status for the length of said leave not to exceed twenty-four (24) months. The City shall provide timely written notification of employee rights under this Article and the Long Term Disability Plan and will assist the employee in processing LTD claims so that undue delay in receiving LTD payments is avoided. 4. The City and the Association agree to establish and participate -in a citywide joint labor and management insurance and benefits advisory committee to discuss and study issues relating to insurance benefits available for employees. 5. Health Plan Over -Payments - Unit members shall be responsible for accurately reporting changes in the status of dependent(s) which affect their eligibility for health plan coverage ninety (90) days after the date of 2003 MEA MOU Final.doc 11 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING such status change. The City shall use its best efforts to advise all unit members of their obligation to report changes in the status of dependent(s), which affect their eligibility. If an employee fails to report a status change that affects eligibility within ninety (90) days, the City shall have the right to recover any premiums paid by the City, on behalf of ineligible dependents. Recovery of such overpayments shall be made as follows: a. The employee's bi-weekly salary warrant shall be reduced 'by one- half of the amount of the bi-weekly overpayment. Such reduction shall continue until the entire amount of the overpayment is recovered. b. The City shall be entitled to recover a maximum of 12 months premium overpayments. Neither the employee nor the dependent shall be liable to the City other than as provided herein. ARTICLE XI — RETIREMENT A. Benefits Self -Funded Supplemental Retirement Benefit Employees hired prior to December 27, 1997 are eligible for the Self - Funded Supplemental Retirement Benefit, which provides that: a. In the event a PERS member elects Option #2 (Section 21456) or Option #3 (Section 21457) of the Public Employees' Retirement law, the City shall pay the difference between such .elected option and the unmodified allowance which the retiree would leave received for his or her life alone. This payment shall be made only to the retiree shall be payable by the City during the life of the member, and upon that retiree's death, the City's obligation shall cease. The method of funding this benefit shall be the sole discretion of the City. This benefit is vested for permanent employees covered by this Agreement (Note: The options provide that the allowance is payable to the retiree until his or her death, and then either the entire allowance ([Option #2] or one- half of the allowance [Option #3] is paid to the beneficiary for life.) b. Employees hired on or after December 27, 1997 shall not be eligible for this benefit referenced in A.1.a. herein above. 2. Deferred Compensation (Retiree Medical Fundin The City and the Association agree to continue the existing funding mechanism whereby permanent employees may set aside funds that, at retirement may be used for funding their medical insurance premiums. The parties agree to utilize the existing Deferred Compensation Plan as said funding mechanism. Any permanent employee who contributes one dollar 2003 MEA MOU Final.doc 12 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION (MEMORANDUM OF UNDERSTANDING ($1.00) or more per pay period to his or her deferred compensation account shall receive an employer contribution to the employee's deferred compensation account in the amount of five dollars and fifty cents ($5.50) per pay period. 3. Medical Insurance for Retirees a. Upon retirement, whether service or disability, each permanent employee shall have the following options in regards to - medical insurance under City sponsored plans: 1) With no change in benefits, retirees can stay in any of the plans offered by the City, at the retiree's own expense, for ' the maximum time period required by Federal Law (COBRA), or 2) Retirees retiring after approval of this MOU may participate in the Retiree Medical Plan, attached hereto as Exhibit K, as amended, or the Health Maintenance Organization (HMO) plan currently being offered to retirees, based upon the eligibility requirements described in Exhibit K. b. Retired employees exercising either option pursuant to Article XI.A.3a. above may cause the premiums owed by the retiree to be paid by the City out of any available funds due and owing them for unused sick leave benefits upon retirement, as provided in Article XII.A.3.; provided, however, that whenever any such retired employee does not have any such available funds with which to cause the premiums to be paid, he or she shall have. the opportunity to. provide the City with sufficient funds to pay the premiums. At retirement, the sick leave hours remaining shall be converted to a dollar figure, as provided in Article XII.A.3. and an estimate shall be provided by the City to the retired employee as to the approximate number of months the group insurance can be paid by such sick leave dollars. The City shall notify any retired employee whose funds for unused sick leave benefits are about to be exhausted of such fact in writing by certified mail, return receipt requested, at the retired employee's most recent address of record with the City no later than three (3) months prior to the date upon which there will not be sufficient funds to pay premiums. It shall be the individual retiree's responsibility either to insure that there are sufficient sick leave dollars available to pay premiums or to make premium payments at least one (1) month in advance to continue the group insurance in effect. If, following exhaustion of sick leave funds, a retired employee fails to provide the City with sufficient additional funds to pay premiums, the City shall have the right to notify said retired employee in the manner prescribed above that it intends to cause his or her coverage to be terminated for non-payment of premiums, and the further right to terminate such 2003 MEA MOU Final.doc 13 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING coverage if such default has not been cured within thirty five (35) days of mailing notice. Any retired employee electing to obtain such medical insurance coverage after retirement shall have the further option to terminate such coverage following the provision of thirty (30) days written notice to the City, whereupon any funds due and owing him or her for unused sick leave benefits that have not been exhausted to pay these health insurance premiums shall be paid in a lump sum to the retired employee within thirty (30) days following receipt by the City of such notice; provided, however, that once such retired employee elects to terminate such coverage, he or she shall be precluded from securing it at a later date at the group rate. B. Public Employees' Retirement System Employee's Contribution Each permanent employee covered by this Agreement shall be reimbursed an amount equal to seven percent (7%) of the employee's base salary as a pickup of the employee's contribution to the Public Employees' Retirement System. The above PERS pickup is not base salary, but is done pursuant to Section 414 (h)(2) of the Internal Revenue Code. 2. Two Percent at Age 55 Formula Unit employees shall be covered by the two percent at age 55 formula (2% @ 55) as identified in Section 21354. 3. Pre -Retirement Optional Settlement 2 Death Benefit Employees shall be covered by the Pre -Retirement Optional Settlement 2 Death Benefit as identified in Section 21548 when approved by the City Council. 4. Fourth Level of 1959 Survivor Benefits Employees shall be covered by the Fourth Level of the 1959 Survivor Benefit as identified in Section 21574 when approved by the City Council. 5. Review of Contract Amendment Cost Analysis Upon receipt of the contract amendment cost analyses for the retirement formulas of 2.5%@55, 2.7%@55 and 3%@60 from CalPERS, (which have already been requested from CalPERS) the city and association shall jointly review the contract amendment cost analyses. This joint review shall not be a reopener nor shall it commit the city to make any amendments to its contract with CalPERS. 2003 MEA MOU Final.dcc 14 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE XII — LEAVE BENEFITS A. Leave With Pay 1. General Leave a) Accrual Employees accrue leave at the accrual rates outlined below. General leave may be used for any purpose, including vacation, sick leave, and personal leave. Years of Service General Leave Allowance First through Fourth Year 176 Hours Fifth through Ninth Year 200 Hours Tenth through Fourteenth Year 224 Hours Fifteenth Year and Thereafter 256 Hours b) Eligibility and Approval General leave must be pre -approved except for illness, injury or family sickness, which may require a physician's statement for approval. Accrued general leave may not be taken prior to six (6) months; service. except for illness, injury or family sickness. General leave accrued time is to be computed from hiring date anniversary. Members shall not be permitted to take general leave in excess of actual time earned. Members shall not accrue general leave in excess of six hundred hours (600), Employees may not use their general leave to advance their separation date on retirement or other separation from employment. c) Family Sick Leave As required by law, employees will be allowed to use up to one-half of their annual General Leave accrual for family sick leave, pursuant to the provisions of California Labor Code Section 233. The city will provide family and medical care leave for eligible employees that meet all requirements of State and Federal law. Rights and obligations are set forth in the Department of Labor Regulations implementing the Family Medical Leave Act (FMLA), and the regulations of the California Fair Employment and Housing Commission implementing the California Family Rights Act (CFRA). d) Conversion to Cash Once during each fiscal year, each employee shall have the option to convert into a cash payment or deferred compensation up to a total of one hundred twenty (120) hours of earned general leave benefits. The value of each hour of conversion is the employee's current base hourly 2003 MEA MOU Final.doc 15 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING rate, as reflected by job type in Exhibit A. The employee shall give two (2) weeks advance notice of his/her desire to exercise such option. e) One Week Minimum Vacation Requirement Employees in the following positions, or their reclassified equivalent, in the Office of the City Treasurer or the Administrative Services department, shall take a minimum of one week (i.e., five consecutive work days) paid vacation each calendar year: Office of the City Treasurer - Accounting Technician I; Accounting Technician 11; Senior Accounting Technician; Supervisor Accounting Technician; Field Service Representative: Administrative Services Department - Senior Accountant (responsible for bank reconciliation). 2. Holidays All permanent employees represented by the Association shall have the following legal holidays with eight (8) hours of pay: 1. New Year's Day 2. Martin Luther King Day (third Monday in January) 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. Veteran's Day (November 11) 8. Thanksgiving Day (fourth Thursday in November) 9. The Friday after Thanksgiving 10. Christmas Day (December 25) Any day declared by the President of the United States to be a national holiday or by the Governor of the State of California to be a state holiday and adopted as an employee holiday by the City Council of Huntington Beach. Holidays which fall on Sunday shall be observed the following Monday, and those falling on Saturday shall be observed the preceding Friday. 3. Sick Leave a) Accrual No employee shall accrue sick leave. b) Credit Employees hired prior to March 30, 2002 shall be credited with their sick leave accrued as of March 29, 2002. 2003 MEA MOU Final.doc 16 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING c) Usage Employees may use accrued sick leave for the same purposes for which it was used prior to March 30, 2002. d) Family Sick Leave As stated in Personnel Rule 18-8. e) Payoff at Termination Upon termination, all permanent employees shall be paid, 'at their current salary rate, for twenty-five percent (25%) of unused, earned sick leave from 480 hours through 720 hours, and for fifty percent (50%) of all unused, earned sick leave in excess of 720 hours. d) Extended Absences Sick leave shall not be used to extend absences due to work related (industrial) injuries or illnesses. 4. Bereavement Leave Permanent employees shall be entitled to bereavement leave not to exceed (3) work shifts in each instance of death in the immediate family. Immediate family is defined as father, mother, sister, brother, spouse, children, grandfather, grandmother, stepfather, stepmother, step grandfather, step grandmother, grandchildren, stepsisters, stepbrothers, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, stepchildren, or wards of which the employee is the legal guardian. 5. Association Business An allowance of 50 hours per year shall be established for the purpose of allowing duly authorized representatives of the Association to conduct lawful Association activities. 6. Jury Duty Employees who are regularly scheduled to work on swing or graveyard shifts shall be placed on a day shift if they are required to appear for jury duty or selection for a period of more than one day. 7. Paternity Leave The city will provide family and medical care leave for eligible employees that meet all requirements of State and Federal law. Rights and obligations are set forth in the Department of Labor Regulations implementing the Family Medical Leave Act (FMLA), and the regulations of the California Fair Employment and Housing Commission implementing the California Family Rights Act (CFRA). 2003 MEA MOU Final.doc 17 12/12/2002 8:52 AM MUNICIPAL EMPLOYEES' ASSOCIATION Exhibit A for Res. No. 2002-133 MEMORANDUM OF UNDERSTANDING ARTICLE XIII — CITY RULES A. Personnel Rules The City and the Association agree to implement the following rules and accordingly revise the Personnel Rules as described herein: 1. Rule 5 — Recruitment and Examination Procedure a) 5-4 — Order of Certification Whenever certification is to be made, the eligibility lists, if active and not exhausted shall be used in the following order" 1) Re-employment list 2) Promotional list 3) Employment List If fewer than five (5) names of persons willing to accept appointment are on the list from which certification is to be made, then additional eligibles shall be certified from the various lists next lower in order of preference until five (5) names are certified. If there are fewer than five (5) names on such lists, there shall be certified the number thereon. In such case, the appointing authority may demand certification of five (5) names and examinations shall be conducted until five (5) names may be certified. In the event the appointing authority does not choose to appoint from the five (5) names certified, a new examination may be requested. In the event another examination is conducted, those names shall be merged with others already on the list in order of scores. b) 5-14 — Promotional Exams Promotional examinations may be conducted whenever, in the opinion of the Human Resources Manager, after consultation with the department head, the need of the service so requires; provided, however, a promotional examination may not be given unless there are two (2) or more candidates eligible. Only employees who meet the requirements for the vacant position may compete in promotional examinations. Promotional examinations may include any of the selection techniques, or any combination thereof, mentioned in Section 5-13. Additional factors including, but not limited to, performance rating and length of service may be considered. A promotional employment list shall be established after the administration of a promotional examination, and such list shall contain the name(s) of those that passed the examination. c) 5-20 — Duration of Employment Lists Employment lists shall remain in effect for one (1) year from the date of the last examination, unless sooner exhausted. Promotional lists and entry level employment lists may be extended prior to expiration date by the Human Resources Manager when requested by the Department 2003 MEA MOU Final.doc 18 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 2 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING Head, for additional periods but in no event shall an employment list remain in effect for more than two (2) years. Names placed on such lists shall be merged with others already on the list in order of scores. Rule 7 — Discipline a) 7-2 — Causes for Discipline 12) Possession, use or sale of illegal narcotics or habit-forming drugs, while on -duty or on City property. 14) Conviction of any felony or a misdemeanor with a job nexus. A plea or verdict of guilt, or a conviction following a plea of nolo contendere, is deemed to be a conviction within the meaning of this section. 15) Participating in an unlawful strike, work stoppage, slowdown, or using or attempting to use sick leave to accomplish the same purpose as a strike, work stoppage, or slowdown. 3. Rule 8 — Termination a) 8-1 — Medical Examination. Evaluation of Employee's Work Capacity. Demotion, Transfer or Termination of Appointment At any time a department head has reasonable cause to believe that an employee may not be able to perform the duties of his/her position for physical or psychological reasons, such department head shall consult with the Human Resources Manager regarding such belief. If the Human Resources Manager concurs, the department head may order the employee to submit to a medical or psychological examination. The employee shall be offered the opportunity, in writing, to select from a panel of three to five physicians or psychologists to conduct the examination. The cost of such examination shall be paid by the City and, to the extent practicable, shall be scheduled during the work hours with no loss of pay. The department head shall review the medical or psychological report and shall consult with the Human Resources Manager regarding the physician's assessment of the employee's ability to perform the duties of his/her position. Any decision regarding such employee shall be made in accordance with the Americans with Disabilities Act. Notwithstanding any other provision of this rule, an employee being evaluated for medical or psychological fitness to perform the duties of his/her position may apply for another position in the competitive service for which he/she has qualified. If such employee is qualified and can perform the duties of a lower paying vacant position for which he/she has applied, he/she will be placed in such position, without 2003 MEA MOU Final.doc 19 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING competitive examination, subject to the approval of the department head. (The City and Association agree to meet biannually to discuss the 8-1 process).. b) 8-3 — Layoff in Accordance with Length of Service The City and the Association agree that the first sentence in Personnel Rule 8-3 shall be modified to read as follows: Layoff shall be made in accordance with the relative length of the last period of continuous service of the employees in the class of layoff, provided, however, that no permanent employee shall be laid off until all temporary, acting and probationary employees in the competitive service holding positions in the same class are first laid off. c) 8-11 — Re -Employment With the approval of the Human Resources Manager, an employee who has resigned in good standing from the competitive service may be re-employed to his/her former position, if vacant, or to a vacant position in the same or comparable class within one (1) year from date of resignation in accordance with Rule 5-21. If such re-employment commences within ninety days of the effective date of resignation, the employee shall not be considered a new employee for vacation and seniority purposes. 4. Rule 9 — Probation a) 9-4 — Rejection of Probationary Employee Any employee rejected during the probationary period following a promotional appointment, shall receive a performance evaluation for the probationary period served and be reinstated to the position from which the employee was promoted unless charges are filed and the employee is discharged_ . When an employee is returned to his/her former class under the provisions of this Section, the employee shall serve the remainder of any uncompleted probationary period in the former class. 5. Rule 12 — Classification Plan a) 12-10 — Temporary Employees Employment on a basis other than permanent or probationary to a permanently budgeted position not to exceed 1000 hours in any twelve (12) month period. Employees occupying temporary positions shall not be included in the competitive service and shall not be subject to these rules and regulations. 2003 MEA MOU Final.doc 20 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 6. Rule 14 — Additional Pay and Pay Adjustments a) 14-6 — Salary Advancements to Meet Recruiting Problems or to Give Credit for Prior Service. Application for Other Advancements The Department Head, through the Human Resources Manager and with the approval of the City Administrator may make an appointment at any step above the minimum salary rate to classes or positions in order to meet recruiting problems to obtain a person who has extraordinary qualifications, or to give credit for prior city service in connection with appointments, promotions, reinstatements, transfers, reclassifications, or demotions. Salary adjustments within the salary range for the class, other than merit salary adjustments authorized by Section 14-1, may be approved by the City Administrator, upon recommendation of the department head through the Human Resources Manager. Such recommendation shall include the reason(s) for the adjustment, whether the advancement is to be permanent or temporary, and an effective date. 7. Rule 18 — Attendance and Leaves a) 18-8 — Sick Leave The parties agree to modify Section 18-8(d) of the Personnel Rules to provide: Sick leave may be used for an absence due to illness of the employee's spouse, child, stepchild or parent when the employee's presence is required at home, provided that such absence shall be limited to five (5) days per calendar year. b) 18-16 — Industrial Accident Leave In the event a permanent employee, who is a miscellaneous member of the Public Employees' Retirement System (PERS), is temporarily totally disabled as a result of an injury or illness arising out of and in the course of employment and covered by the State of California Workers' Compensation Insurance and Safety Act, resulting light duty assignments due to the injury or illness or absences from work shall be considered Industrial Accident Leave as that term is defined by this rule. A permanent employee eligible for Industrial Accident Leave shall receive compensation from the City in an amount equal to the employee's regular rate of salary during such period .of temporary total disability. Benefits received under this rule shall be in lieu of statutory Workers' Compensation benefits. Industrial Accident Leave shall continue during all absences resulting from the injury or illness, including those absences attributable to doctor's appointments, therapy, or other follow-up medical visits, but in no case exceeding one year of accumulated absences attributable to the same injury or illness. In the event an employee is temporarily, totally disabled by coinciding 2003 MEA MOU Final.doc 21 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING qualifying injuries or illnesses, periods of absences shall be applied concurrently to all qualifying injuries or illnesses. Industrial Accident Leave compensation shall begin on the first day an eligible employee is absent due to a qualifying injury or illness as defined above. Industrial accident Leave compensation will terminate on the earliest of the following: 1) The date upon which the injury or illness giving rise to eligibility for compensation under this rule is declared permanent and stationary by a treating or examining physician; or 2) The date PERS approves an application for disability retirement benefits filed by the employee or by the City; or 3) The employee receives thirty (30) days advance notice and refuses to submit to a medical examination ordered by PERS pursuant to Government Section 21154 or otherwise refuses to cooperate with PERS in determining whether the employee is incapacitated for the performance of duty; or 4) The employee receiving Industrial Accident Leave Compensation applies for service -connected retirement benefits; or 5) The employment of the affected employee is otherwise separated. If an injured worker remains temporarily disabled after receiving one year of Industrial Accident Leave for accumulated absences or light duty work attributable to the same injury or illness, the employee will receive temporary total disability benefits as specified by the State of California Workers' Compensation Insurance and Safety Act. Any period of time during which an employee is absent from work by reason of injury or illness for which he or she is entitled to receive Industrial Accident Leave compensation will not constitute a break in continuous service for the purposes of salary adjustments, sick leave, vacation accruals, and length of service computation. In the event an employee who is receiving or has received Industrial Accident Leave compensation makes a claim or initiates legal action against a third party for allegedly causing or contributing to the injury or illness resulting in the inability to work, the employee is required to notify in writing the City's Risk Management Division of the claim or commencement of such action within ten (10) days of the claim or such commencement. The City retains its rights of subrogation in all such instances. 2003 MEA MOU Final.doc 22 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING c) 18-19 — Maternity Leave The City and the Association agree to modify the present Personnel Rule 18-19 Maternity Leave to read as follows: "A permanent' employee shall be entitled to a leave of absence without pay due to inability to work due to pregnancy. The employee will be entitled to use available sick leave during this period. Said leave must be requested in writing from the Department Head and must include written notification from the employees physician stating the last day the employee may. work and the estimated duration of leave. The employee must obtain written authorization to return to work from the attending physician. Said authorization must be filed with the Department Head and the Human Resources Manager." d) 18-20 — Leave of Absence without Pay The City and the Association agree that the following sub -paragraph "C" shall be added to Personnel Rule 18-20. Leave of Absence without Pay: Leave of absence without pay, for medical disability reasons, shall be restricted to six (6) months. 8. Rule 19 — Grievance Procedure Non -Disciplinary Matters a) 19-5 Grievance Procedure 1) Step 4 — City Administrator If the grievance is not settled under Step 3, the grievance may be presented to the City Administrator in accordance with the following procedure: Within fifteen (15) days after the time the decision is rendered under Step 3 above, a written statement of the grievance shall be filed with the Human Resources Manager who shall act as hearing officer and shall set the matter for hearing within fifteen (15) days thereafter and shall cause notice to be served upon all interested parties. The Human Resources Manager, or his representative, shall hear the matter de novo and shall make recommended findings, conclusions and decision in the form of a written report and recommendation to the City Administrator within five (5) days following such hearing. The City Administrator may, in his discretion, receive additional evidence or argument by setting the matter for hearing within ten (10) days following his receipt of such report and causing notice of such hearing to be served upon all interested parties. Within five (5) days after receipt of report, or the hearing provided for above, if such hearing is set by the City Administrator, the City Administrator shall make written decision and cause such to be served upon the employee or employee organization and the Human Resources Manager. 2003 MEA MOU Final.doc 23 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2) Step 5 — Personnel Board Hearing Hearing. As soon as practicable thereafter, the Human Resources Manager shall set the matter for hearing before a hearing officer either selected by mutual consent of the parties or from a list provided by the Personnel Commission. Ratification of the hearing officer selected by mutual consent of the parties, if from a list approved by the Personnel Commission, shall not require separate approval or -ratification by the Personnel Commission. The hearing officer shall hear the case and make recommended findings, conclusions and decision in the form of a written report and recommendation to the Personnel Commission. In lieu of the hearing officer process, the Personnel Commission may agree to hear a case directly upon submission of the case by mutual consent of the parties. 9. Rule 20 —Disciplinary Procedure and Appeal a) 20-1 — Purpose The purpose of this rule is to provide a procedure for recommending and imposing discipline against City employees, and a means by which an employee's may administratively appeal any such disciplinary action. b) 20-2 — Disciplinary Procedures 1) Notice of Proposed Adverse Action For disciplinary demotions, suspensions or dismissals, an employee shall be served a written Notice of Proposed Adverse Action by the employee's department head, or his/her designee, or by certified mail, prior to the proposed disciplinary action taking effect. The notice shall state the reasons for and charges upon which the proposed action is based, and the effective date of the action the right to respond and the employer's right to representation. A copy of all materials upon which the proposed action is based shall be attached to the notice. 2) Employee's Right to Respond The employee shall be given a minimum of ten (10) calendar days to respond orally and/or in writing to the charges upon which the proposed action is based. The employee's response: shall be made to and/or before his/her department head. 3) Time Off The employee shall be given reasonable time off with pay to attend disciplinary meetings. 2003 MEA MOU Final.doc 24 12/12/2002 8:52 AM MUNICIPAL EMPLOYEES' ASSOCIATION Exhibit A for Res. No. 2002-133 MEMORANDUM OF UNDERSTANDING 4) Final Notice of Decision After an employee has responded to or waived his/her right to respond to the proposed adverse action, the employee shall be served with a final Notice of Decision from his/her department head. The final written Notice of Decision shall state whether or not the proposed action shall be taken or modified, and the reasons therefore and effective date or the action. c) 20-3 — Appeal to Personnel Commission Disciplinary action involving the termination, suspension, demotion or other reduction in pay may be appealed to the Personnel Commission for de novo hearing and final determination in accordance with the following procedure: 1) Request for Appeal Within five (5) days after the employee's receipt of a final Notice of Discipline, a written request for an appeal to the Personnel Commission shall be submitted to the Human Resources Manager. 2) Hearin As soon as practicable thereafter, the Human Resources Manager shall set the matter for hearing before a hearing officer. The hearing officer shall hear the case without the Board and shall make recommended findings, conclusions and decision in the form of a written report and recommendation to the Board. 3) Final Decision The Board shall consider the written report and recommendations of the hearing officer and after due deliberation in executive session, shall render a decision in the matter which shall be final and binding on all parties, and from which there shall be no further appeal. d) 20-4 — Supplemental Hearing by Personnel Board 1) The Board may, in its sole discretion, after it has received the written report and recommendation of the hearing officer, set the matter for private hearing for the purpose of receiving additional evidence or argument. In the event the Board sets a private hearing for such purposes, the Human Resources Manager shall give written notice to all parties concerned in such matter. 2003 MEA MOU Final.doc 25 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING - 2) The Board, following a consideration of the hearing officer's written report and recommendation and deliberation thereon and any supplemental hearing before the Board, shall make findings, conclusions and decisions which shall be final and binding on all parties and from which there shall be no further appeal. e) 20-5 — Employee Status on Pending Appeal Notwithstanding the provisions of Rule 7, Section 7-4 (Suspension with Pay), the disciplinary action shall be effective pending an appeal to the Personnel Commission. 10. Rule 21 —Grievance Procedures -General a) 21-7 Hearing Officers The hearing officer provided for in Rules 19 and 20 shall be from a list provided by the Personnel Commission or one selected by mutual consent of the parties. b) 21-11 Time. Computation of The period of time in which any act must occur, as provided in these rules, shall be computed by excluding the first and including the last day of such period, and in the event the last day falls on a Saturday. Sunday or legal holiday, such acts may be accomplished on the next succeeding working day. As used in Rules 19 and 10, all references to days shall be interpreted to mean calendar days. c) 21-12 Time. Extension of The City and the employee, or employee organization may, by mutual consent, extend the time period within which an act must occur in the processing of grievances. C. Rules Governing Layoff, Reduction in Lieu of Layoff and Re -Employment 1. Part 1 — Layoff Procedure a) General Provisions 1) Whenever it is necessary, because of lack of work or funds to reduce the staff of a City department, employees may be laid off pursuant to these rules. 2) Whenever an employee is to be separated from the competitive service because the tasks assigned are to be eliminated or substantially changed due to management -initiated changes, including but not limited to automation or other technological changes, it is the policy of the City that steps be taken by the Personnel Division on an interdepartmental basis to assist such 2003 MEA MOU Final.doc 26 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING - employee in locating, preparing to qualify for, and being placed in other positions in the competitive service. This shall not be construed as a restriction on the City government in effecting economies or in making organizational or other changes to increase efficiency. 3) A department shall reduce staff by identifying which positions within the department are to be eliminated. 4) The employee who has the least City-wide service credit in the class within the department shall have City-wide transfer rights in the class pursuant to Part 1, Section 3, Transfer or Reduction to Vacancies in Lieu of Layoffs, or within the occupational series pursuant to Part 2, Bumping Rights. 5) If a deadline within this procedure falls on a day that City Hall is closed, the deadline shall be the next day City Hall is open. b. Service Credit 1) Service credit means total time of full-time continuous service within the City at the time the layoff is initiated, including probation, paid leave or military leave. Permanent part-time employees earn service credit on a pro-rata basis. 2) Except as required by law, leaves of absence without pay shall not earn service credit. 3) As between two or more employees who have the same amount of service credit, the employee who has the least amount of service in class shall be deemed to be the least senior employee. c. Transfer or Reduction to Vacancies in Lieu of Layoff 1) In lieu of layoff, a transfer within class shall be offered to an employee(s) with the least amount of service credit in the class designated for staff reduction within a department subject to the following: a) The employee has the necessary qualifications to perform the duties of the position. b) The employee shall be given the opportunity, in order of service credit, to accept a transfer to a vacant position in the same class within the City, provided the employee has the necessary qualifications to perform the duties of the position. 2003 MEA MOU Final.doc 27 12/12/2002 8:52 AM MUNICIPAL EMPLOYEES' ASSOCIATION Exhibit A for Res. No.2oo2-133 MEMORANDUM OF UNDERSTANDING . c) If no position in the same class is vacant, the employee shall be given the opportunity, in order of service credit, to transfer to the position in the same class that is held by an incumbent in another department with the least amount of service credit whose position the employee has the necessary qualifications to perform. 2) If an employee(s) is not eligible for transfer within the employee's class, the employee shall be offered, in order of service.credit, a reduction to a vacant position in the next lower class within the City in the occupational series in lieu of layoff provided the employee has the necessary qualifications to perform the duties of the position. 3) If the employee refuses to accept a transfer or reduction pursuant to A. or B., above, the employee shall be laid off. d) If the employee(s) in the class with the least amount of service credit is in the position(s) to be eliminated or displaced by transfer, the employee shall be offered bumping rights, pursuant to Part 2, Service Credit. e) Any employee who takes a reduction to a position. in a.' lower class within the occupational series in lieu of layoff shall be placed on the reinstatement/reemployment list(s) pursuant to Part 3., Reemployment. 2. Order of Layoff a) Prior to implementing a layoff, vacant positions that are authorized to be filled shall be identified by Citywide occupational series. If the employee refuses to accept a position pursuant to Section 3., above, the employee shall be laid off. b) No promotional probationary employee or permanent employee within a class in the department shall be laid off until all temporary, nonpermanent part-time and non -promotional probationary employees in the class are laid off. Permanent employees whose positions have been eliminated may exercise citywide bumping rights to a lower class in the occupational series pursuant to Part 2. c) When a position in a class and/or occupational series is eliminated, any employee in the class who is on authorized leave of absence or is holding a temporary acting position in another class shall be included for determining order of service credit and be subject to these layoff procedures as if the employee was in his or her permanent position. 2003 MEA MOU Final.doc 28 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 3. Notification of Employees a) The Personnel Division shall give written notice of layoff to the employee by personal service or by sending it by certified mail to the last known mailing address at least fifteen (15) calendar days prior to the effective date of the layoff. Normally notices will be served on employees personally at work. b) Layoff notices may be initially issued to all employees who -may be subject to layoff as a result of employees exercising voluntary reduction/bumping rights. c) The notice of layoff shall include the reason for the layoff, the effective date of the layoff, the employee's hire date and the employee's service credit ranking. The notice shall also include the employee's right to bump the person in a lower class with the least service credit within the occupational series provided the employee possesses the necessary qualifications to successfully perform the duties in. the lower class and the employee has more service credit than the incumbent in the lower class. d) The written layoff notice given to an employee shall include notice that he or she has seven (7) calendar days from the date of personal service, or date of delivery of mail if certified, to notify the Human. Resources Manager in writing if the employee intends to exercise the employee's bumping rights, if any, pursuant to Part 2, Bumping Rights. e) Whenever practicable, any employee with the least amount of service credit in a lower class within an occupational series which is identified for work force reduction shall also be given written notice that such employee may be bumped pursuant to Part 2. This notice shall include the items referred to in C., above. f) If an employee disagrees with the City's computation of service credit or listed date of hire, the employee shall notify the Human Resources Manager as soon as possible but in no case later than five (5) calendar days after the personal service or certified mail delivery. Disputes regarding date of hire or service credit shall be jointly reviewed by the Human Resources Manager and the employee and/or the employee's representative as soon as possible, but in no case later than five (5) calendar days from the date the employee notifies the Human Resources Manager of the dispute. Within five (5) calendar days after the dispute is reviewed, the employee shall be notified in writing of the decision. 2003 MEA MOU Final.doc 29 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 4. Part 2 — Bumping Rights a) Voluntary Reduction or Bumping in Lieu of Layoff 1) A promotional probationary employee or permanent employee who receives a layoff notice may request a reduction to a position in a lower class within the occupational series provided the employee possesses the necessary qualifications to perform the duties of the position. 2) Employees electing reduction under A above, shall be reduced to a position authorized to be filled in a lower class within the employee's occupational series. The employee may reduce to a lower class in his/her occupational series by: 1) filling a vacancy in that class, or 2) if no vacancy exists, displacing the employee in the class with the least service credit whose position the employee has the necessary qualifications to perform. A displaced employee shall have bumping rights. 3) An employee who receives a layoff notice must exercise bumping rights within seven (7) calendar days of receipt of the notice as specified in Part 1. Failure to respond within the time limit shall result in a reputable presumption that the employee does not intend to exercise any right of reduction or bumping to a lower class. The employee must carry the burden of proof to show that the employee's failure to respond within the time limits was reasonable. If the employee establishes that failure to respond within the time limit was reasonable, to the Human Resources Manager's satisfaction, the employee shall be permitted to exercise bumping rights but shall not be reinstated to a paid position until the employee to be bumped has vacated the position. If the employee disagrees with the Human Resources Manager's decision, the employee may appeal pursuant to the provisions of Sections 3 and 4 below. b) Reinstatement/Re-employment Lists Any employee who takes a reduction to a position in a lower class within the occupational series in lieu of layoff shall be placed on tile reinstatement/re-employment list pursuant to Part 3, Re-employment. c) Qualifications Appeal Any employee who is denied a reduction to a position in a lower class within the occupational series on the basis that the employee does not possess the necessary qualifications to successfully perform the duties of the lower position may appeal the decision. The appeal shall be filed with the Human Resources Manager within five (5) calendar days of the employee's receipt of written notice of the decision and 2003 MEA MOU Final.doc 30 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING reason(s) for denial. The employee's appeal shall be in writing and shall include supporting facts or documents supporting the appeal. d) Qualifications Appeal Hearing 1) Upon receipt of an appeal, the Human Resources Manager shall contact a mediator from the California State Mediation and Conciliation Service to schedule a hearing within two (2) weeks after receipt of the appeal. If the California State Mediation and Conciliation Service is not available within that time frame, the parties shall mutually select a person who is available within the time frame. If the California State Mediation and Conciliation Service and the person mutually selected are not available within tile time frame, the parties shall select the earliest date either is available to conduct the hearing. The parties shall split the cost, if any, of the hearing officer. In addition, the parties shall meet within three (3) workdays to attempt to resolve the dispute. If the dispute remains unresolved, the parties shall endeavor in good faith to submit to the hearing officer a statement of all agreed upon facts relevant to the hearing. 2) Appeal hearings shall be limited to two (2) hours, except as otherwise agreed by the parties or directed by the hearing officer. 3) The hearing officer shall attempt to resolve the dispute by mutual agreement if possible. If no agreement is reached, the hearing officer shall render a decision at the conclusion of the hearing which shall be final and.binding 5. Part 3 — Re-employment a) Re-employment 1) Employees who are laid off or reduced to avoid layoff shall have their names placed upon a reemployment list, for each class in the occupational series, in seniority order at or below the level of the class from which laid off or reduced. 2) Names of persons placed on the reemployment lists shall remain on the list for two (2) years from the date of layoff or reduction. 3) Vacancies shall be filled from the reemployment list for a class, starting at the top of the list, providing that the person meets the necessary qualifications for the position. 4) Names of persons are to be removed from the reemployment list for a class if on two (2) occasions they decline an offer of employment or on two (2) occasions fail to respond to offers of 2003 MEA MOU Final.doc 31 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING employment in a particular class within five (5) calendar days of receipt of written notice of an offer. Any employee who is dismissed from the City service for cause shall have his or her name removed from all re-employment lists. 5) Re-employment lists shall be available to HBMEA and affected employees upon reasonable request, 6) Qualification appeals involving reemployment rights shall be resolved in the same manner as that identified in Part 2., Section 4. b) Status on Re-employment 1) Persons re-employed from layoff within a two (2) year period from the date of layoff shall receive the following considerations and benefits: a) Service credit held upon layoff shall be restored, but no credit shall be added for the period of layoff. b) Prior service credit shall be counted toward sick leave and vacation accruals. c) Employees may cash in sick leave upon layoff or at any time after layoff in the manner and amount set forth in existing Memoranda of Understanding for that employee's unit. Sick leave shall be paid to an employee when the reemployment list(s) expire(s), if not previously paid. d) Upon reinstatement the employee may have his or her sick leave re -credited by repayment to the City the cashed amount. Sick leave accumulation of less than 480 hours shall be restored upon reemployment. e) The employee shall be returned to the salary step of the classification held at the time of the layoff and credited with the time previously served at that step prior to being laid off. f) The probationary status of the employee shall resume if incomplete. 2) Employees who have been reduced in class to avoid layoff and are returned within two (2) years to their former class shall be placed at the salary step of the class they held at the time of reduction and have their merit increase eligibility date recalculated. 2003 MEA MOU Final.doc 32 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE XIV —MISCELLANEOUS A. Grievance Arbitration Any grievance as defined and described in Rules 19 and 20 of the City Personnel Rules (Resolution No. 3960), shall be settled in accordance with the procedures set forth in said Rules except that the parties to the grievance may, by mutual agreement, submit the grievance to a neutral arbitrator whose decision shall be final and binding on the parties. The arbitrator shall be selected by the parties from listings of and pursuant to the rules of the American Arbitration Association. This procedure, if adopted by the parties, shall be in lieu of Step 5 of Rule 19, or Step 4 of Rule 20, and the fees charged by the arbitrator or hearing officer and court reporter shall be paid by the party, which is not the prevailing party. B. Promotional Procedures 1. Tie Scores When promotions are to be made; and two or more employees are found to be equal as a result of promotional examinations conducted by the city, the employee with the greatest length of service with the city shall receive the promotion. 2. Salary Upon Promotion Upon promotion, an employee shall be compensated at the same step in the salary range for his or her new classification, subject to the following provisions: a. Except for the provisions. of sub -paragraphs b and c below, no employee shall receive greater than ten percent (10%) increase upon promotion. b. If "A" Step of the classification upon promotion is greater than 10% increase, the employee shall be compensated at "A" step upon promotion. c. If the employee would be eligible for a step increase within eleven (11) months of the date of promotion in his or her classification before promotion, then the Human Resources Manager may authorize an increase greater than ten percent (10%) upon promotion. 2003 MEA MOU Final.doc 33 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING C. Labor -Management Relations Committee The City and MEA will institute a Labor -Management Relations Committee as follows: 1. The Association and the Employer recognize that the participation of employees in the formulation and implementation of personnel policy and - practices affects their well-being and the efficient administration of!:: Government. The parties further recognize that the entrance into a fotimal agreement with each other is but one act of joint participation, -and that the, success of a labor-management relationship- is further assured if a forum is available and used to communicate with each other. The parties therefore, agree to the structure of Labor -Management Relations. Committees (LMRC) for the purpose of exchanging information and the discussion of matters of concern or interest to each of them, in the broad area of working conditions, wages and hours. 2. The City of Huntington Beach shall have an LMRC. The formation of this LMRC shall not serve as the basis for reopening the meet and confer process to modify this MOU. 3. The LMRC shall meet monthly. The employer shall be represented by the City Administrator (or designee), the Human Resources Manager (or designee), and Department Heads. Four representatives at these meetings shall represent the Association. 4. The Employer agrees that any meeting conducted under this article shall be conducted in facilities furnished by the Employer, and Association representatives shall be released from their duties to attend the LMRC. 5. The parties shall exchange agenda items five workdays before each scheduled LMRC meeting described in this section. Matters not on the agenda may be discussed by mutual consent. If either party timely forwards an agenda, the meeting will be held. D. Copies of MOU The City agrees to print this Memorandum of Understanding for each employee requesting a copy. E. Position Classification Issues Class Specifications The City shall send the Association a copy of each new job description approved for classifications within the representation unit. 2003 MEA MOU Final.doc 34 12/1212002 8:52 AM MUNICIPAL EMPLOYEES' ASSOCIATION Exhibit A for Res. No. 2002-133 MEMORANDUM OF UNDERSTANDING 2. Reclassification Impact It is not the intention of the City to demote or layoff an employee through reclassification. Prior to imposing a Y-rating, or layoff resulting from classification reviews, the City agrees to meet and confer with Association representatives. 3. Surveyor Party Chief The city shall conduct a compensation study through the LMRC of the position of Surveyor Party Chief using Orange County benchmarks, to be completed by May 9, 2003. 4. Certificated Distribution Operator The city shall conduct a compensation study of the positions that are mandated by the State of California Department of Health Services to attain Certified Distribution Operator certifications. The compensation study will use only Orange County benchmarks. The compensation study is to be completed by June 20, 2003. The compensation report shall be a subject of negotiation in a successor MOU. F. Class A and B Driver License Fees The City shall reimburse employee's for costs associated with obtaining and renewing Class A and Class B driver licenses where required by the City for the position. G. Job Sharinq The City shall direct the Labor/Management Relations Committee (LMRC) to review the feasibility of developing and implementing a Job Sharing Program. H. Deferred Compensation Loan Program Employees may begin utilizing this program, under which employees may borrow up to 50% of their deferred compensation funds for critical needs such as medical costs, college tuition, or purchase of a home. Performance Evaluations/Written Reprimand Appeals Employees may appeal the results of performance evaluation or written reprimands. Such appeals shall be initiated through the appropriate chain of command (which may include the LMRC) and any decision made by the department head shall be considered final. J. Employee Performance Evaluations The city and two representatives from MEA will convene an ad -hoc committee to study a new employee performance evaluation system. The ad -hoc committee will finalize its report by June 20, 2003. 2003 MEA MOU Final.doc 35 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING K. MEA Letter of Introduction A one -page letter of introduction from the MEA, and of the MEA's choosing, regarding the benefits and purpose of joining the MEA will be included in all MEA eligible new employee orientation packets. ARTICLE XV — CITY COUNCIL APPROVAL It is the intent of the City and Association that this Memorandum of Understanding represents an "Agreement" between the undersigned within the meaning of Section 8-2 of the Huntington Beach Employer -Employee Relations Resolution; however, this Memorandum of Understanding is of no force or effect whatsoever unless adopted by resolution of the City Council of the City of Huntington Beach. IN WITNESS WHPREOF, the parties hereto have executed this Memorandum of Understanding this _� day of December, 2002. City of Huntington Beach By: Ray Sil er City Administrator By: j Wiliam P. Workman Assist i Admi s By: Clay Martin Admini ative Services Director By: _ Steven M. erliner Chief Negotiator APPROVED AS TO FORM: ennifer M. cGrath City Attorney Huntington Beach Municipal Employe ' Association i By: ohn H. Von Holle n BfMEA President HBMEA Bargaining Committee Robert M. Hidusky HBMEA Bargaining Committee By: Damn L. Kos HBMEA Bargaining Committee By. N Beradino, Chief Negotiator 2003 MEA MOU Final.doc 36 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 MEA LIST OF M®U EXHIBITS EXHIBITS SUBJECT A Class/Salary Schedule B Uniform Policy C Vehicle Use Policy D Employee Health Plan E Delta Care PMI — Dental Plan F Delta Dental — Dental Plan G Vision Service Plan H Long Term Disability Plan I Retiree Medical Plan and Subsidy Program J 9/80 Work Schedule K 4/10 Work Schedule 2003 MEA MOU Final.doc 37 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT A- CLASS/SALARY SCHEDULE EFFECTIVE DECEMBER 21, 2002 Job Type. Description Pa 'Grade Bi- C D E 0106 _Engineering Assistant, Civil 505 27.06 28.55 30.12 31.78 33.53 0108 Planner, Assistant 479 23.76 25.07 26.45 27.91 29.45 0110 Accountant, Senior 502 26.65 28.12 29.67 31.30 33.02 0111 ccountant 474 23.18 1 24.45 25.80 27.22 28.72 0112 Buyer 471 22.83 24.09 25.42 26.82 28.30 0113 Human Services Pro g Suprvsr 480 23.90 25.21 26.60 28.06 29.60 0114 Librarian 452 20.78 21.92 23.13 24.40 25.74 0115 _Info Systems Analyst 1 480 23.90 25.21 26.60 28.06 29.60 0116 _ Info Systems Analyst 11 499 26.27 27.71 29.23 30.84 .32.54 0117 Info Systems Analyst 111 518 28.87 30.46 32.14 33.91 35.78 0118 _Info Systems Analyst IV 537 31.75 33.50 35.34 37.28 39.33 0119 Criminalist 480 23.90 25.21 26.60 28.06 29.60 0120 Criminalist, Sr 520 29.18 30.78 32.47 34.26 36.14 0134 _Deputy City Clerk 393 15.47 16.32 17.22 18.17 19.17 0135 _Deputy City Clerk, Senior 442 19.76 20.85 22.00 23.21 24.49 0136 Planning Aide 436 19.19 20.25 21.36 22.53 23.77 0137 _Video Engineer Supervisor 497 26.01 27.44 28.95 30.54 32.22 0138 _Development Specialist 480 23.90 25.21 26.60 28.06 29.60 0139 _Housing Development Specialist 479 23.76 25.07 26.45 27.91 29.45 0140 Crewleader, Traf Signal/Light 489 24.99 26.36 27.81 29.34 30.95 0141 Crewleader, Electrical Maint 489 24.99 26.36 27.81 29.34 30.95 0142 Crewleader, Equip/Auto Maint 490 25.10 26.48 27.94 29.48 31.10 0143 Crewleader, Facilities Maint 489 24.99 26.36 27.81 29.34 30.95 0144 Crewleader, Trees Maintenance 484 24.39 25.73 27.14 28.63 30.20 0145 Crewleader, Landscape Maint 484 24.39 25.73 27.14 28.63 30.20 0146 Crewleader, Wastewater Ops 484 24.39 25.73 27.14 28.63 30.20 0147 Crewleader, Water Dist Meters 484 24.39 25.73 27.14 28.63 30.20 0148 Crewleader, Signs & Markings 489 24.99 26.36 27.81 29.34 30.95 0149 Crewleader, Beach Maint 484 24.39 25.73 27.14 28.63 30.20 0150 Crewleader, Streets Maint 484 24.39 25.73 27.14 28.63 30.20 0151 Crewleader, Water Dist Maint 484 24.39 25.73 27.14 28.63 30.20 0152 Crewleader, Water Operations 484 24.39 25.73 27.14 28.63 30.20 0153 Crewleader, Park Maintenance 489 24.99 26.36 27.81 29.34 30.95 0154 Crewleader, Pest Control Advis 484 24.39 25.73 27.14 28.63 30.20 0155 Crewleader, Irrigation 484 24.39 25.73 27.14 28.63 30.20 0156 Water Quality Coordinator 484 24.39 25.73 27.14 28.63 30.20 0162 Civilian Check Investigator 425 18.17 19.17 20.22 21.33 22.50 0163 _Latent Fingerprint Examiner 472 22.96 24.22 25.55 26.96 28.44 0164 _Latent Fingerprint ExamTrainee 434 19.00 20.04 21.14 22.30 23.53 0165 _Crime Analyst, Sr 501 26.53 27.99 29.53 31.15 32.86 0168 Printing Services Tech, Sr 437 19.28 20.34 21.46 22.64 23.89 0171 Inspector, Construction Sr 498 26.13 27.57 29.09 30.69 32.38 0172 _Inspector, Construction Traine 458 21.41 22.59 23.83 25.14 26.52 0173 -Fire Training Maint Tech 457 21.30 22.47 23.71 25.01 26.39 0174 Survev Technician 1 1 436 19.19 20.25 21.36 1 22.53 23.77 0175 _Engineering Aide 1 436 19.19 20.25 21.36 1 22.53 23.77 2003 MEA MOU Final.doc 38 1211212002 8:52 AM Exhibit A for Res. No. 2002-133 i6b ly0e Description PaGradei v,, A 0176 Plan Checker, Building 496 25.89 27.31 28.81 30.39 32.06 0177 Parking Meter Repair Tech 443 19.87 20.96 22.11 23.33 24.61 0178 GIS Analyst 499 26.27 27.71 29.23 30.84 32.54 0179 Computer Drafting Technician 489 24.99 26.36 27.81 29.34 30.95 0180 Engineering Technician 489 24.99 26.36 27.81 29.34 30.95 0181 lEngineering Technician Traffic 489 24.99 26.36 27.81 29.34 30.95 0182 Code Enforcement Officer 11 468 22.50 23.74 25.05 26.43 27.88 0183 Survey Party Chief 489 24.99 26.36 27.81 29.34 30.95 0185 Survey Technician 11 452 20.78 21.92 23.13 24.40 25.74 0186 Code Enforcement Officer 1 426 18.25 19.25 20.31 21.43 22.61 0187 Graphics Admin Specialist 426 18.25 19.25 20.31 21.43 22.61 0188 Inspector, Water Construct Sr 489 24.99 26.36 27.81 29.34 30.95 0189 Inspector, Water Construction 469 22.63 23.87 25.18 26.56 28.02 0190 Haz Mat Program Specialist 496 25.89 27.31 28.81 30.39 32.06 0191 lWater Ouality Technician 458 21.41 22.59 23.83 25.14 26.52 0192 lCross Connection Control Spec 468 22.50 23.74 25.05 26.43 27.88 0193 Computer Operator 403 16.28 17.18 18.12 19.12 20.17 0194 Computer Assistant, Library 412 17.00 17.94 18.93 19.97 21.07 0195 Telecommunications Specialist 509 27.62 29.14 30.74 32.43 34.21 0197 Police Photo/Imaging Specialst 457 21.30 22.47 23.71 25,01 26.39 0198 Emergency Services Coordinator 520 29.18 30.78 32.47 34.26 36.14 0200 Computer Operations Supervisor 518 28.87 30.46 32.14 33.91 35.78 0202 Claims Exam, Workers Comp 395 15.63 16.49 17.40 18.36 19.37 0203 ITelevision Producer/Director 470 22.73 23.98 25.30 26.69 28.16 0204 IFire Training Media Specialist 454 20.99 22.14 23.36 24.64 26.00 0205 jPublic Information Specialist 470 22.73 23.98 25.30 26.69 28.16 0206 Media Production Coordinator 442 19.76 20.85 22.00 23.21 24.49 0207 Plan Checker, Public Works 500 26.40 27.85 29.38 31.00 32.70 0208 Inspector 111, Building 498 26.13 27.57 29.09 30.69 32.38 0210 Inspector 1, Building 458 21.41 22.59 23.83 25.14 26.52 0211 Inspector 11, Building 478 23.65 24.95 26.32 27.77 29.30 0212 Info Systems Specialist 1 427 18.35 19.36 20.42 21.54 22.72 0213 Info Systems Specialist 11 446 20.16 21.27 22.44 23.67 24.97 0214 Info Systems Specialist IV 485 24.50 25.85 27.27 28.77 30.35 0215 Police Systems Coordinator 446 20.16 21.27 22.44 23.67 24.97 0232 Emergency Medical Srvcs Coord 550 33.88 35.74 37.71 39.78 41.97 0252 Comm Srvcs Recreation Coord 457 21.30 22.47 23.71 25.01 26.39 0254 [Alarm Services Coordinator 447 20.25 21.36 1 22.54 23.78 25.09 0255 lCrime Scene Investigator 458 21.41 22.59 23.83 25.14 26.52 0257 ILibrary Specialist 415 17.27 18.22 19.22 20.28 21.40 0258 lComm Srvcs Recreation Su 480 23.90 25.21 26.60 28.06 29.60 0259 JProperty Officer 434 19.00 20-04 21.14 22.30 23.53 0260 IFire Safety Program Specialist 450 20.57 21.70 22.89 24.15 25.48 0262 IParking/Traffic Control Ofcr 389 15.18 16.01 16.89 17.82 18.80 0263 lCommunity Relations Specialist 436 19.19 20.25 21.36 22.53 23.77 0264 JPark Naturalist 480 23.90 25.21 26.60 28.06 29.60 0265 Nutrition Transit Coordinator 334 11.54 12.17 12.84 13.55 14.30 0266 Social Worker 447 20.25 21.36 22.54 23.78 25.09 0267 Social Worker, Assistant 406 16.52 17.43 18.39 19.40 20.47 0268 Volunteer Services Coordinator 428 18.43 19.44 20.51 21.64 22.83 2003 MEA MOU Final.doc 39 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133, Job Type jDesq�iiption 40 40 Exhibit A for Res. No_ 2002-133 Job_ T e _ Descri tion _ Pa Grade :�� > -:B_ C 0358 Equip Operator, Beaches 432 18.81 19.84 20.94 22.08 23.29 0359 Equip Operator, Landscape 432 18.81 19.84 20.94 22.08 23.29 0361 Equip Operator, Streets 432 18.81 19.84 20.94 22.08 23.29 0362 _Equip Operator, Wastewater 432 18.81 19.84 20.94 22.08 23.29 0363 Mechanic, Marine Equip Sr 490 25.10 26.48 27.94 29.48 31.10 0364 Equip Operator, Water 448 20.36 21.48 22.66 23.91 25.22 0365 Equip Operator, Trees 432 18.81 19.84 20.94 22.08 23.29 0367 Pest Control Specialist 426 18.25 19.25 20.31 21.43 22.61 0368 Water Systems Technician 1 421 17.81 18.79 19.82 20.91 22.06 0369 Water Systems Technician II 434 19.00 20.04 21.14 1 22.30 23.53 0370 Water Systems Technician III 454 20.99 22.14 23.36 24.64 26.00 0371 Leadworker, Water Operations 470 22.73 23.98 25.30 26.69 28.16 0372 Crewleader, Vehicl Body Repair 471 22.83 24.09 25.42 26.82 28.30 0374 Leadworker,Traf Signal & Light 473 23.07 24.34 25.68 27.09 28.58 0375 Leadworker, Electrical 467 22.39 23.62 24.92 26.29 27.74 0377 Leadworker, Water Dist Meters 448 20.36 21.48 22.66 23.91 25.22 0378 Leadworker, Painter 452 20.78 21.92 23.13 24.40 25.74 0379 Leadworker, Water Dist Maint 464 22.06 23.27 24.55 25.90 27.32 0380 Media Services Specialist 415 17.27 18.22 19.22 20.28 21.40 0382 Crewleader, Equip Services 471 22.83 24.09 25.42 26.82 28.30 0383 _Equip Support Assistant 421 17.81 18.79 19.82 20.91 22.06 0384 Mechanic 1 422 17.89 18.87 19.91 21.01 22.17 0385 Warehousekee er 436 19.19 20.25 21.36 22.53 23.77 0386 Stock Clerk 389 15.18 16.01 16.89 17.82 18.80 0387 Mechanic, Wastewater Pump 427 18.35 19.36 20.42 21.54 22.72 0388 Tire Service Worker T 416 17.36 18.32 19.33 20.39 21.51 0389 Maint Service Worker, Traffic 415 17.27 18.22 19.22 20.28 21.40 0390 Groundsworker 389 15.18 16.01 16.89 17.82 18.80 0391 Facilities Maintenance Tech 423 17.99 18.98 20.02 21.12 22.28 0392 Maint Service Worker 415 17.27 18.22 19.22 20.28 21.40 0394 Maint Worker 389 15.18 16.01 16.89 17.82 18.80 0395 farking Meter Repair Worker 427 18.35 19.36 20.42 21.54 22.72 0396 Water Meter Reader, Sr 425 18.17 19.17 20.22 21.33 22.50 0397 Water Meter Reader 409 16.77 17.69 18.66 19.69 20.77 0398 Field Service Representative 429 18.52 19.54 20.61 21.74 22.94 0399 _Printing Services Technician 400 16.04 16.92 17.85 18.83 19.87 0400 Custodian 394 15.56 16.42 17.32 18.27 19.27 0401 Leadworker, Parking & Camping 448 20.36 21.48 22.66 23.91 25.22 0402 Leadworker, Landscape Maint 448 20.36 21.48 22.66 23.91 25.22 0404 Leadworker, Wastewater O s 448 20.36 21.48 22.66 23.91 25.22 0406 Leadworker, Streets Maint 458 21.41 22.59 23.83 25.14 26.52 0407 Leadworker; Facilities Maint 439 19.48 20.55 21.68 22.87 24.13 0409 Leadworker, Street Cleaning 452 20.78 21.92 23.13 24.40 25.74 0410 Leadworker, Traffic Markings 448 20.36 21.48 22.66 23.91 25.22 0428 Administrative Aide 470 22.73 23.98 25.30 26.69 28.16 0432 _Library Facilities Coordinator 431 18.70 19.73 20.82 21.96 23.17 0433 Theater/Media Technician 415 17.27 18.22 19.22 20.28 21.40 0434 Code Enforcement Officer Sr 488 24.86 26.23 27.67 29.19 30.80 0436 Claims Exam, Workers Comp Sr 477 23.53 24.82 26.19 27.63 29.15 0437 Permit Technician, Sr 455 21.10 22.26 23.48 24.77 26.13 2003 MEA MOU Final.doc 41 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 0472 Leadworker, Auto -Equip MaL,*nt_i 471 22.83 24.09 25.42 26.82 28.30 42 Exhibit A for Res. No. 2002-133 EXHIBIT B — UNIFORM POLICY A. General The City, in accordance with agreements now established, shall furnish uniforms to those personnel designated by the various department heads as required to wear a standard uniform for appearance, uniformity and public recognition purposes, in the procedures and guidelines set forth hereinafter. B. Affected Personnel All employees categorized, as field -working assignees shall wear a standard City adopted uniform. Color selection is a light blue shirt and dark blue trousers with appurtenances as described below. Each department head shall determine which group of employees must wear a uniform. C. Basic Uniform Components and Standard Allowances 1. Black safety toe shoes or boots as each assignment dictates. a. Two pair per year. b. Boots will be black, heavy duty and laced. c. Damaged shoes shall be turned into operating supervisor who shall authorize replacement or repair. 2. Five short -sleeved shirts (light blue) the first year, three the second year, and then alternate five uniforms with three uniforms in subsequent years. 3. Five trousers per year (dark blue) the first year, three the second year and then alternate five trousers with three trousers in subsequent years; trousers are to have no cuffs. 4. Dark blue jacket with removable liner, one per year. 5. Four City departmental patches. 6. Absolutely no allowance will be made for socks, underwear, etc. 7. Hardhats, foul weather gear, and steel -toed rubber boots to be furnished each employee with supervisor designated need. 8. Special hazard gloves shall be furnished with supervisor designated need. 9. Safety glasses and face shields shall be furnished with supervisor designated need. 10. Special uniforms shall be furnished. 2003 MEA MOU Final.doc 43 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT B — UNIFORM POLICY Continued 11. Ear protectors, arm and shin guards, steel shoe caps, wood heat resistant soles, and other safety equipment shall be furnished to supervisor for designated employees. 12. R-1 safety vests shall be furnished to all employees having occasion to work within travel ways. D. Employee Responsibilities 1. To wear complete uniform at all times. 2. To wear clean uniform. 3. To wash and provide minimum repair; i.e., buttons, small tears, etc. 4. To provide any alterations necessary including sewing on of City patches. 5. To not wear the uniform for other than City duties or work. 6. To notify supervisor of need to replace due to disrepair or severe staining producing an undesirable appearance. 7. To turn in all patches upon termination prior to receiving final paycheck. 8. To turn in all uniforms upon termination. 9. To turn in all safety equipment upon termination. 10. To wear all safety equipment prescribed by the City safety officer and supervisor of the division. E. City Responsibilities 1. To furnish funding for the agreed uniform allowances. 2. To allow department heads to authorize additions to the basic allowances due to severity of work assignments and frequency of wearing out. 3. To provide and maintain one or more retail clothing outlets for the various allotments. City reserves the right to name vendor. 4. To make arrangements for the standard allotments to be of first line quality work clothing. 2003 MEA MOU Final.doc 44 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT B — UNIFORM POLICY Continued 5. To maintain records of purchases. The Finance Officer will provide forms for uniform requests. 6. To establish an expedient procedure for reimbursement to employees for uniforms purchased by employees. F. Department Head Responsibilities 1. To direct and assure employee compliance with attire rules 2. To inspect clothing requests to be replaced. 3. To determine wear frequencies for employees having needs additional to basic allotment. 4. To insist on replacements of deteriorated clothing with special attention to safety equipment and apparel. 5. To enforce a disciplinary program for repeated violations of employee regulations relative to cleanliness, uniform attire, or safety requirements. 6. To demand and confirm receipt of turn -in required equipment upon termination. G. Purchases and Exceptions 1. Clothing shall be purchased at only those outlets as directed by City, unless prior approval is obtained due to size, out of stock, or special type of clothing problems that exist. 2. Shoes or boots shall be purchased through standard outlets designated unless last creates discomfort or injury risk. 3. Safety glasses must be purchased only through designated outlet for City specified amount of dollars, with employee paying the cost for the examination by a private optometrist to obtain a prescription and cost of cosmetic lenses and frames. 4. All safety and foul weather gear shall be purchased by the City. 5. Uniform appearance: a. Patch to be worn above left shirt or jacket pocket. b. Pants to have no cuffs. c. Worn with pride in appearance to public, i.e., shirt buttoned, shirttail tucked in, etc. 9nn3 MFA MOIL Final.doc 45 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT B — UNIFORM POLICY Continued 6. Exceptions at discretion of department heads: a. Supervisors need not wear uniform; however, in so electing, must pay for their own clothing. b. Employees who have foot deformities or conditions, which do not allow wearing of safety -toed shoes, shall wear external caps affording equal protection. c. Additional patches shall be furnished to equip the special clothing over the basic allotments. 7. Disposition of Turned -In Clothing — The City shall determine a procedure as to disposition of turned in clothing. ')�nnQ once IkAnl t Final rinc 46 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT C —VEHICLE USE POLICY Section 1 - Purpose The purpose of these regulations is to establish and implement City policies and procedures relative to the assignment, utilization and control of City -owned vehicles as transportation for employees who engaged in official City business, to establish reimbursement procedures for privately -owned vehicles use d for City business and to clarify the City's responsibility for damage and/or liability for private vehicles used on official City business. Section 2 - Scope These regulations cover the use of City and private vehicles for conducting official City business and shall be applicable to all City departments and employees. Section 3 - Policy When necessary during the course of an employee's official duties, transportation or reimbursement therefore shall be provided by the City. In the event no City vehicle is available, the employee may use the personal vehicle with the approval of the department head. Employees authorized to drive either their own or a City -owned vehicle on official business must possess a valid California driver license for the class of vehicle they will be operating. -The transportation method authorized will be determined in terms of the best interests of the City. The general program set forth in this regulation will be implemented by the City Administrator's Office upon approval of the City Council and administered by the department heads in accordance with the policies herein established. It is the responsibility of each department head to enforce the provisions of this regulation as it relates to employees of his/her department. City -owned vehicles shall only be used for official City business. City -owned vehicles shall not be driven to and kept at the employee's home or any location other than the regular work location or Corporation Yard, except as provided by this regulation. Section 4 — Vehicle Use Criteria Assigned Vehicles: A. Assigned City Vehicles may be taken home by employees whose residence is within ten (10) miles of City Hall for the uses as described below: 1. Executive use includes the City Administrator, Assistant City Administrator and Department Heads. 2. Emergency Response Units: 2003 MEA MOU Final.doc 47 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT C — VEHICLE USE POLICY Continued a. Employees who are required to respond more than once per week on an average without delay in order to protect the public health, safety and property. b. Employees who are required to carry special emergency equipment in their vehicles, which must be utilized on a regular and frequent basis. (A radio in and of itself does not constitute special emergency equipment.) 3. Continuous use outside of regular working hours -- Employees who are called back on an unscheduled basis to perform official city- business outside of regular working hours more than once per week on an average and who meet one of the following criteria: a. Mileage driven on official City business exceeds an average of 500 miles per month, or b. Who regularly and frequently supervises subordinates or conducts inspections in the field, or c. Whose duties require the employee to be a way from his or her base workstation greater than 50% of his or her working time, on an average. B. City vehicles, which shall not be taken home, may be assigned based on meeting one of the following criteria: 1. Monthly mileage driven exceeds an average of 500 miles per month and the vehicle is used for the purpose of supervision or inspection in the field, or 2. Duties require the employee to be away from his or her work, station greater than 50% of his or her working time on an average. II. Reimbursement of Use of Personal Vehicle: A. Executive Use — The City Administrator, Assistant City Administrator and Department Heads may, at their option, receive the automobile allowance as established by Resolution. gnn3 MFA Mnt1 Finai.doc 48 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT C —VEHICLE USE POLICY Continued B. Mileage Reimbursement -- Employees, upon authorization of their department head, may use their own vehicles on official City business and shall be reimbursed at the rate of 27d per mile driven on official City business. 1. Employees shall submit monthly claims for reimbursement to the Finance Officer Through their Department Head on forms prescribed by the Finance Officer. 2. Employees shall not be reimbursed for commuting to and from work, except 42 that employees who are required to attend scheduled meetings outside of normal working hours may be reimbursed for mileage required. Section 5 — Insurance Requirements All privately -owned vehicles authorized to be used on official City business shall be insured by the individual employee in the minimum amount of S50,000 public liability for any one person and $100,000 public liability for all persons, any one accident. They must also be insured for $25,000 property damage and $15,000 for any one uninsured motorist and $30,000 for all uninsured motorists any one accident. A current certificate of insurance must be filed with the Finance Officer. Employee private vehicle information shall be reviewed and updated annually by the respective departments. The record maintained should containthe following current information. • Name of Employee Operator's License • Insurance Company ® Driver's License. Expiration Date ® Insurance Policy Number • Insurance Expiration Date • Amount of Coverage It shall be the department head's responsibility to insure that no privately owned vehicle is operated on City business without insurance coverage and a valid operators license as required by this regulation. gnm MFA MOU Final.doc 49 12/122002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT C — VEHICLE USE POLICY Continued Clarification on City Liability on Use of Private Vehicle: In the event of damage to private vehicles, while on City business where a third party is negligent, the employee should collect damages (including insurance deductibles) from the third party. Where the employee is negligent, the City cannot be held liable for damages to the automobile, but the City can be held responsible for liability to third parties. The City shall be responsible to such employee for the first $100 of comprehensive and/or collision damages suffered b such employee to the extent that such employee's personal automobile insurance policy does not cover such first $100 damage. The employee's insurance policy is considered as the primary coverage, and -the City liability begins after the limitations of the employee's coverage is exhausted. In the event a City employee's personal vehicle is damaged due to accident/collision while being used for official City business and the employee is deprived the use thereof, the City shall furnish such employee with a vehicle during such time as is reasonably required to repair said employee's vehicle. 2003 MFA MOU Final.doc 50 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT D — EMPLOYEE HEALTH PLAN BROCHURE A copy of the Employee Health Plan Brochure may be obtained from the Administrative Services Department 7rinl MFA Mrll I Final Mr. 51 12/12/2002 8:52 AM v O O ui z .............. .............. Q { 's LLJ L # X r Nm� N. Ng. �� k} `{ti. ,{,}f}i, Sf:..,..:::•: }#:k. c �{ . +.S< { . { f� •{{m<',<t{;.S{M't<§k>.js;!t•:q:t{,,{{$S${{{{FfS::,::'i,{.:r{{f{�'`'� ;i;i{';{.;F','{k?k # ����itkk��is<€i£,?'Y#£� # ., . � £i��',�; ,"� <#, }{?F? f>?- '} Fit •: eft �E ' •:FsitF?...z• 3 4�1kkfkkkkM55ifV^'iff� - skkkk#'sYkk.�f4ff5 . . . . . . . . . . . LLM f7CL %£? � tn,? #fs�»��•�33, .,' #;?fish � � r££FSF, ' is , i' F,'• ;;}' f j fef?f 6.® #�it`S'E<<<?sSSS£ s r?S'ii ?s�;3}' � f t• > >t > - in 4 m/p Vh 9— rt . R i R i equ ce Exhibit A for Res. No. 2002-133 IlL MEMBERSHIP A .' . ." •` • MAIN* Exhibit A for Res. No. 2002-133 EXHIBIT E — DELTA CARE (PIVII) DENTAL PLAN BROCHURE A copy of the Delta Care (PMI) Brochure may be obtained from the Administrative Services Department 2003 MEA MOU Final.doc 52 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 "ELTACA RE - h9 "A 4 A A d, m ir;s te re d by: Private Medica!-Care, Inc. 12898 Towne Center Drive Cerritos, CA 90703-8579 California FA M Fk" 1.ir O.MSr Exhibit A for Res. No. 2002-133 EXHIBIT F — DELTA DENTAL PLAN BROCHURE A copy of the Delta Dental Plan Brochure may be obtained from the Administrative Services Department 2003 MEA MOU Final.doc 53 12/12/2002 8:52 AM BENEFIT HIGHLIGHTS FOR CITY OF HUNTINGTON BEACH GROUP NO.4729 PRINCIPAL BENEFITS AND COVERED SERVICES* SERVICES THAT ARE NorCOVERED WHO'S COVERED" Primary enrollee and spouse as well as r dependent children to age 19 and full- time students to age 25.`; DEDUCTIBLES AND,, ._ $25 per person, $75 per family, per. BENEFITS MIAXIMUIIA ,: / ; calendar year. The maximum benefit �� ` ` . • �'� `� �� :paid per'calendar year Is.$1000 per . ,r erson DIAGNOSTiC<ANR PREVENT•IVEt t ;A;t °, 85% of Delta dentists fee Tx ? x BENEFIT$",,;- ='oral examinations,ki cleanings,,x�rays; e�iarnlnations,of tissue bio s fluarid9a[eatmeritt"Space ma ntyineCa, specl'iist'c nsUlta, on@W a t �'yb '�'!?kr.4AC.,t9'�i � "v�L i ,, ':.},� Q S iW'•�''1Ff"ti �.".` U,.M• .~'� : �+ ,,',X�Fa .x�, .r+''.y� ' �, - ". ti t i bey >% t 4£.;. BASIC BENEFITS° oral sur er `� n 9 Y a 85 /o of Delta dentist's fee �.. (extractions)1,t`�tissue,reirtoval'(biopsy); r, r �! ,.+� fillings; root canals,i!oriodontla;(�g{u y� t.i.'tt$k',Mip: t(S�' � �'�,^',Y� �t�((�f?',r„ :treatment,.sp'alarits 1�t�`x��iy�}N}•,�"^M �{'�'14�M•'t� �v' /�r tR'k�k�i �;J�''�'�Y{`�`Y}' ^t +(� �.27•!ta'�>i, ,} ,$iM�. ,F Y$�"MSS.^` r`��• 4 �`w4, "ti,.}��uX rp ^a�A A'.N�f S il.•;'C k' ",5'ifi ".4+'• t`•{j;F gj:"'v}.f�;r w2�k �r'�' DOwS'e'a't.rrx'w: CROWNS"sJACKETS'ANT.,HE38,CASTa..85%�of:pelta�dentist'safee,t,',<� RESTORATION4 Yat�d�d1 �� . ;.. r�''� ;,��'`: s , �� �<r�- • �s �, •,, t } , � , < �� n;; ..•i� � 'y,:{s,,.".�R•r.�tl`4.i.T`���"5^'i��•�bd'CiC��, LSS°M,:yi4�"�.,+�� Y;S! i.A •:tp. �+�";, k'�ihCl'4, �^W�,7 .1't �� o w{ �`M � '� i�i�`�.R, "IAi'w�'if:?y„$'�•i �� '�}�n +7d�1�'y�'�G���.r `�1�f�1�(� p .�r *, R'tl �'. } � ,PROSTHO[)ONT,IQ B�FIEFIT,S' .ff� Delta�dentiGSt's..fee`(den`4ure - ��5 bridges, partialdentures `full dentu{rges x .60%of subject to a maximum allowance) '�^r ' .._" ' ti � °+V"�u „? �'s�.;?a.• � `'� +�„K �;��1-r9kt„>�+4, ,1, � '. ��4$ �.. n " r C ORTHODONTIC.=BENEFITS:,=for.aduits/� �60oo"of Deita'dentist'sfee,(subjectto-a,= and eligible'depentle�lY,children,(c��' �x`n $3000 lifetime maximum per person) .f�,r,»�. DENTAL-ACIDENT BEN EFITS*:"-r'' ".1i 'i' , ' 100%of Delta de.ntist's'fee Although your plan covers many of the most commonly needed services, some services are not covered. If you are unsure whether a particular procedure is covered, or how much of it is paid for by your plan, check with Delta before proceeding. -,The, following are not covered by the plan: o Services for injuries or conditions covered under Workers' ,Compensation or Employer's Liability Laws ® Cosmetic'surgery.'or dentistry or services to correct congenital malformation e Experimental procedures o, '., Therapeutic drugs, premedication or: pain relievers ®1.,,Hospitai costs.or:extra charges for hospital treatment o' `Anesthesia (except for.general anesthesia for oral surgery) o Extra -oral grafts," implants and implant removal ' Litt o ;'Treatment.related to the temporomandibular joint (TMJ) , • :�he,'„ W a The,preceding Information Is not Intended for use as a summary,plan description,, nor is it designed to serve as an �. Evidence of Coverage, for the plan. �� fik � afy '4 ,, { "{r 'n. .•rlfJL.,. .P;>.. Delta ,remierplan Is"adminlstered by Delta Dental Plan of ).California: If , 6t,have.,speclfic questions regarding benefit ,y:,ystructure, .limitations or exclusions, consultthe Evidence of 4<,Coyerage.or�contact Delta's.Customer and Member Service artp'tent�5 r y'r}' 1 x ' 3 Yj" A f„ r q,y�1e{{,��•'jiti�f'�'C 1�,q'[ �,e�.1 �'•ri r4 r . t , ' , .� �. ®ELTA' ®EMa L Delta Dental Plan of California. . t P.O. Box 773(i'` t r x San Francisco, California 94120 For customer service and eligibility/benefits Information: " .(888) DELTA CS (888.335 8227) or {i.r�it d�,., �1}",';,(��}` j,', •�w'Y4ry .;'$'" '`'l"+[_'.':xf`,' +y'++:.. vgy'1' ''°';'�, a /'• i d sQdelta.org -*Please'refer.to your Evidence°of-Coverage forllmitatlons,on these benefits. Some examples:`of limitations'; on services'are the, number of cleanings and, oral. exams For online or faxed, eligibility/benefits information: covered in,a calendar year; and tlme.iimitations on filling and crown'rep/acements N `www,deltadentalca:org or, x 4y bra T;F (888),DELTA CS (888.335-8227) and press 1 °}a r,, ±r r� '`4 �'rs���' `n("R�ie9��: + r , -4,F +, „r r , . - • - For a list offDelta dentists: ` (800) 4-AREA-DR (800-427 3237) or. wx www,deltedentaica.org £ P Muster Rev. 6101 (croup 4729.9/01 sp) ( ) '`...�sq'i;'3gt•i�;'�.k i f . Y •Y , 4nir. ��r �iJ€ EXHIBIT G —VISION (VSP) PLAN BROCHURE A copy of the Vision (VSP) Brochure may be obtained from the Administrative Services Department 2003 MEA MOU Final.doc 54 12/12/2002 8:52 AM KAMEFuCA�S jlASJ,.V'ST.1 C-HOKE>FOR'-EY ECARE'_ 12 Materials A�M Friet cx.:i F1,6itTY"CNUIIEF Once every 12 months Once every 12 months Once every 12 months $10.00 Services from a Non -Participating Provider up to $ 40.00 up to $ 40.00 up to $ 60.00 up to $ 80.00 up to $125.00 frames. up to $ 45.00 up to $ 5.00 air of prescription glasses) ayment up to $210.00 up to $105.00 / D, / /7 — in vision care services, call a VSP doctor to make an appointment. For details tative or call VSP at 800-877-7195 to request a VSP doctor listing. Make sure rovide the covered member's social security number. The VSP doctor will 11 also obtain authorization for services and materials. If you are not currently Gating this to you. VSP will pay the doctor directly for covered services and 1'/33 and materials obtained from an out -of -network provider will be reimbursed up f-network reimbursement, pay the entire bill when you receive services, then ion to VSP. Claims must be submitted to VSP within six months from your ;ords and send the originals to the following address: Vision Service Plan, Out- 95899-7105. also available to those covered under this VSP WellVision" Plan. It is .en obtained through VSP contracted doctors, surgeons and laser centers. This ocedures, laser -assisted in -situ keratomileusis (LASIK) and photorefractive participating in the program. Doctors can also be located on VSP's Web site at ttor, the patient will have no out-of-pocket expense other than the copayment, unless not limited to, oversize lenses (61 mm or larger), coated lenses, no -line multifocal ,6eds the plan allowance. VSP doctors offer valuable savings including a 20 percent t and frame). Services must be received within 12 months from the same VSP doctor ve 15 percent off the cost of your contact lens exam when you receive contact lens ;act lens materials.) i ,;choose a frame that is covered in full or one that exceeds the plan allowance. If you he difference you'll pay is based on VSP's low, discounted member pricing. Have your VSP coverage. 09/02 e contact lens exam. The allowance is applied to both the contact lens exam (fitting ana evaluanon) ana the contact lenses. Any costs exceeamg this allowance are the patient's responsibility. The contact lens exam is a special exam for ensuring proper fit of your contacts and evaluating your vision with the contacts. Medically necessary contact lenses must be prescribed by your doctor (as required for certain medical conditions) and approved by VSP. THIS IS ONLY A SUMMARY FOR FURTHER INFORMATION, SEE YOUR EMPLOYER'S BENEFIT REPRESENTATIVE O US ER SERVICE (800) 877-7195 14tA ® e sit ttp://WWW.vsp.com Exhibit A for Res. No. 2002-133 EXHIBIT H — LONG TERM DISABILITY PLAN BROCHURE A copy of your Long Term Disability Plan Brochure may be obtained from the Administrative Services Department 55 2003 MEA MOU Final.doc 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 STANDARD INSURANCE COMPANY A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon 97204-1282 (503) 321-7000 People. Not jurt Pokier.® CERTIFICATE: GROUP LONG TERM DISABILITY INSURANCE Policyowner: City of Huntington Beach Policy Number: 332175MM-LTD Effective Date: February 1, 1995 A Group Policy has been issued to the Policyowner. We certify that you will be insured as provided by the terms of the Group Policy. If your coverage is changed by an amendment to the Group Policy, we will provide the Policyowner with a revised Certificate or other notice to be given to you. Possession of this Certificate does not necessarily mean you are insured. You are insured only if you meet the requirements set out in this Certificate. "We", "us" and 'bur" mean Standard Insurance Company. "You". and "your" mean the Member. All ,other defined terms appear with the initial letter capitalized. Section headings, and references to them, appear in boldface type. G. V President GC190-LTD ILA 1400 - EX411BIT +I v� CoPrinted on nxcyded paper. Exhibit A for Res. No. 2002-133 EXHIBIT I — PROVISIONS OF THE RETIREE SUBSIDY MEDICAL PLAN An employee who has retired from the City shall be entitled to participate in the City sponsored medical insurance plans and the City shall contribute toward monthly premiums for coverage in an amount as specified in accordance with this Plan, provided: A. At the time of retirement the employee has a minimum of ten (10) years of continuous City service or is granted an industrial disability retirement; and B. At the time of retirement, the employee is employed by the City; and C. Following official separation from the City, the employee is granted a retirement allowance by the California Public Employees' Retirement System. The City's obligation to pay the monthly premium as indicated shall be modified downward or cease during the lifetime of the retiree upon the occurrence of any one of the following: During any period the retired employee is eligible to receive or receives health insurance coverage at the expense of another employer, the payment will be suspended. "Another employer" as used herein means private employer or public employer or the employer of a spouse. As a condition of being eligible to receive the premium contribution as set forth in this plan, the City shall have the right to require any retiree to annually certify that the retiree is not receiving or eligible to receive any such health insurance benefits from another employer. If it is later discovered that a misrepresentation has occurred, the retiree will be responsible for reimbursement of those amounts inappropriately expended and the retiree's eligibility to receive further benefits will cease. 2. On the first of the month in which a retiree or dependent reaches age 65 or on the date the retiree or dependent can first apply and become eligible, automatically or voluntarily, for medical coverage under Medicare (whether or not such application is made) the City's obligation to pay monthly premiums may be adjusted downward or eliminated. Benefit coverage at age 65 under the City's medical plans shall be governed by applicable plan document. 3. In the event the Federal Government or State Government mandates an employer -funded health plan or program for retirees, or mandates that the City make contributions toward a health plan (either private or public) for retirees, the City's contribution rate as set forth in this plan shall first be applied to the mandatory plan. If there is any excess, that excess may be applied toward the City medical plan as supplemental coverage provided the retired employee pays the balance necessary for such coverage, if any. 4. In the event of the death of any employee, whether retired or not, the amount of the retiree medical insurance subsidy benefit which the deceased employee was receiving at the time of his/her death would be eligible to receive if he/she were retired at the time of death, shall be paid on behalf of the spouse or family for a period not to exceed twelve (12) months. 2003 MEA MOU Final.doc 56 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 SCHEDULE OF BENEFITS A. Minimum Eligibility for Benefits - With the exception of an industrial disability retirement, eligibility for benefits begin after an employee has completed ten (10) years of continuous service with the City of Huntington Beach. Said service must be continuous unless prior service is reinstated at the time of his/her rehire in accordance with the City's Personnel Rules. B. Disability Retirees - Industrial disability retirees with less than ten .(10) years of service shall receive a maximum monthly payment toward the premium for health insurance of $121. Payments shall be in accordance with the stipulations and conditions that exist for all retirees. Payment shall not exceed dollar amount that is equal to the full cost of premium for employee only. C. Maximum Monthly Subsidy_ Payments - All retirees, including those retired as a result of disability whose number of years of service prior to retirement exceeds ten (10), shall be entitled to maximum monthly payment of premiums by the City for each year of completed City service as follows: Maximum Monthly Payment For Retirements After: Years of Service Subsidy 10 $ 121 11 136 12 151 13 166 14 181 15 196 16 211 17 226 18 241 19 256 20 271 21 286 22 300 23 315 24 330 25 344 Note: The above payment amounts may be reduced each month as dependent eligibility ceases due to death, divorce or loss of dependent child status. However, the amount shall not be reduced if such reduction would cause insufficient funds needed to pay the full premium for the employee and the remaining dependents. In the event no reduction occurs and the remaining benefit premium is not sufficient to pay the premium amount for the employee and the eligible dependents, said needed excess premium amount shall be paid by the employee. 2003 MEA MOU Final.doc 57 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 INDEMNITY HEALTH PLAN, EMPLOYEES/RETIREES' Benefits' City Plan - Employees City.Plan - Subsidized Non -Subsidized Retirees Retirees COBRA -eligibles Deductible per person $200 $200 Deductible per family $500 $500 Maximum Out of Pocket $1000 per person $1,000 per person $2000 per family $2,000 per family Note: Retirees who elect to participate in the HMO shall be entitled to benefits of the program chosen. This summary has been used to list only those benefit provisions that differ between active and subsidized Retiree Plans. Currently, there are no differences, however, this exhibit is not intended to require that future changes to active employee benefits be applied to retirees as well. The Employee Health Plan Document should be consulted for detailed questions about specific benefits. Benefits are subject to modification through the meet and confer process. 2003 MEA MOU Final.doc 58 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED A. Eligibility: The effective start-up date of the Retiree Subsidy Medical Plan for the various employee groups shall be the first of the month following retirement date. 2. A retiree may change plans, add dependents, etc., during annual open enrollment. Personnel shall notify covered retirees of this opportunity each year. 3. Years of service computed for the Retiree Subsidy Medical Plan are actual years of completed service with the City of Huntington Beach. 4. When a retiree is eligible for medical plan coverage at the expense of another employer due to post -retirement employment of the retiree or spouse of the retiree, the retiree and his/her spouse must take that coverage regardless of benefit level and shall be deleted from any City Plan coverage. Exceptions to this requirement are limited to the following: a. A retiree is not required to enroll in such "other" medical plan coverage if there is significant disparity between the benefits provided by the `tithe►" medical plan and the Retiree Subsidy Medical Plan as defined below. "Significant disparity" means coverage available under the "other' medical plan is restrictive or limited in one or more of the following ways: 1) No in -patient hospitalization coverage. 2) No major medical benefits 3) Annual deductible is $1,000 or greater per person. 4) Major medical benefits are paid at 60% or less of covered expenses. b. The Risk Manager will have the authority to provide additional exceptions following review of the "other" medical plan policy. Exceptions will be made only if the "other" medical plan benefit provisions are comparable to the guidelines under B above. 2003 MEA MOU Final.doc 59 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED c. Miscellaneous Provisions: 1. Benefits provided under the Retiree Subsidy Medical Plan will be coordinated with the "other" medical plan as the primary carrier. 2. The City shall have the right to require any retiree to provide a copy of the 'other' medical plan policy for review by the Risk Manager. 5. When a retiree becomes eligible for the other group coverage and then becomes no longer eligible, he/she may have the subsidy reinstated and regain Retiree Subsidy Medical Plan coverage. 6. Dependents of a retiree may follow him/her into the Retiree Subsidy Medical Plan or they may choose to exercise COBRA rights along with the retiree. 7. When a retiree becomes 65 and has eligible dependents under 65; said dependents are eligible to exercise COBRA rights. 8. When a retiree is under 65 and his/her spouse is over 65, the spouse is not covered. B. Benefits: 1. Retiree Subsidy Medical Plan includes Managed Health Network (MHN), Prescription Card System (PCS), Orange County Foundation for Medical Care (OCFMC) and Medical Stop Loss insurance. 2. City Plans are the primary payer for active employees age 65 and over, with Medicare the secondary payer. Retirees age 65 and over have no City Plan options and are eligible only for Medicare. 3. Premium payments are to be received at least one month in advance of the coverage period. 2003 MEA MOU Final.doc 60 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED C. Subsidies: 1. The subsidy payments will pay for: a. Retiree Subsidy Medical Plan. b. HMO c. Part A of Medicare for those retirees not eligible for paid Part A. 2. Subsidy payments will not pay for: a. Part B Medicare. b. Regular City Employee Indemnity Plan. C. Any other employee benefit plan. d. Any other commercially available benefit plan. e. Medicare supplements D. Medicare: 1. All persons are eligible for Medicare coverage at age 65. Those with sufficient credit quarters 'of Social Security will receive Part A of Medicare at no cost. Those without sufficient credited quarters are still eligible for Medicare at age 65, but will have to pay for Part A of Medicare if the individual elects to take Medicare. In all cases, Part B of Medicare is paid for by the participant. 2003 MEA MOU Final.doc 61 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED 2. When a retiree and his/her spouse are both 65 or over, and neither is eligible for paid Part A of Medicare, the subsidy shall pay for Part A for each of them or the maximum subsidy, whichever is less. 3. When a retiree at age 65 is eligible for paid Part A of Medicare and his/her spouse is not eligible for paid Part A, the spouse shall not receive subsidy. When a retiree at age 65 is not eligible for paid Part A of Medicare and his/her spouse who is also age 65 is eligible for paid Part A of Medicare, the subsidy shall be for the retiree's Part A only. E. Cancellation: For retirees/dependents eligible for paid Part A of Medicare, the following cancellation provisions apply: a. Coverage for a retiree under the Retiree Subsidy Medical Plan will be eliminated on the first day of the month in which the retiree reaches age 65. If such retiree was covering dependents under the Plan, dependents will be eligible for COBRA continuation benefits effective as of the retiree's 65th birthday. b. Dependent coverage will be eliminated upon whichever of the following occasions comes first: 1) After 36 months of COBRA continuation coverage, or 2) When the covered dependent reaches age 65 in the event such dependent reaches age 65 prior to the retiree reaching age 65. c. At age 65 retirees are eligible to make application for Medicare. Upon being considered "eligible to make application", whether or not application has been made for Medicare, the Retiree Subsidy Medical Plan will be eliminated. 2. See provisions under "Benefits", "Subsidies", and "Medicare" for those retirees/dependents not eligible for paid Part A of Medicare. 2003 MEA MOU Final.doc 62 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED 3. Retiree Subsidy Medical Plan and COBRA participants shall be notified of non-payment of premium by means of a certified letter from Personnel in accordance with provisions of the Memorandums of Understanding. 4. A retiree who fails to pay premiums due for coverage and is in arrears for sixty (60) days shall be terminated from the Plan and shall not have reinstatement rights. 2003 MEA MOU Final.doc 63 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT J - 9/80 WORK SCHEDULE This work schedule is known as the "9/80". The 9/80 work schedule is designed to be in compliance with the requirements of the Fair Labor Standards Act (FLSA). In the event that there is a conflict with the current rules, practices and/or procedures regarding work schedules and leave plans, then the rules listed below shall govern. 9/80 WORK SCHEDULE DEFINED The 9/80 work schedule shall be defined as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours (Friday), with a one -hour lunch during each work shift, totaling forty (40) hours in each FLSA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. A. Forty (40) Hour FLSA Work Week — The actual FLSA work week is from Friday at mid -shift (p.m.) to Friday at mid -shift (a.m.). No employee working the 9/80 work schedule will be able to flex their Friday start time nor the time they take their lunch break, which will be from 12:00 p.m. to 1:00 p.m. on Fridays. All employee work shifts will start at 8:00 a.m. on their Friday worked. The start of the FLSA work week is 12:00 noon Friday. B. Two Week Pay Period -= The pay period for employees starts Friday mid -shift (p.m.) and continues for fourteen (14) days until Friday mid -shift (a.m.). During this period, each week is made up of four (4) nine (9) hour work days (thirty-six (36) hours) and one (1) four (4) hour Friday and those hours equal forty (40) work hours in each work week (e.g. the Friday is split into four (4) hours for the a.m. shift, which is charged to work week one and four (4) hours for the p.m. shift, which is charged to work week two). C. A/B Schedules — To continue to provide service to the public every Friday, employees are to be divided between two schedules, known as the "A" schedule and the "B" schedule, based upon the departmental needs. For identification purposes, the "A" schedule shall be known as the schedule with a day off on the Friday in the middle of the pay period, or, "off on payday", the "B" schedule shall have the first Friday (p.m.) and the last Friday (a.m.) off, or "working on payday. An example is listed below: SIBIU _MM=0nnnnnnMMnnnnW! �B Schedul D. A/B Schedule Changes — FLSA non-exempt employees cannot change schedules without prior approval of their supervisor, Department Head, and the Human Resources Manager or designee. The purpose of this authorization is to review the impact on overtime. FLSA exempt employees may change A/B 2003 MEA MOU Final.doc 64 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 schedules at the beginning of any pay period with supervisor and Department Head approval. E. Emergencies — All employees on the 9/80 work schedule are subject to be called to work any time to meet any and all emergencies or unusual conditions which, in the opinion of the City Administrator, Department Head or designee may require such service from any of said employees. OVERTIME DEFINED FLSA Non -Exempt Employees — All non-exempt employees under the 9180 work schedule shall earn overtime for all hours worked after the first forty (40) hours in an FLSA work week (Friday 12:00:00 p.m. to Friday 11:59:59 a.m.) as required under FLSA. Employees are required to obtain supervisor authorization prior to working any overtime. 1. Overtime Compensation — As stated in Memorandum -of -Understanding 2. Compensatory Time — As stated in Memorandum -of -Understanding LEAVE BENEFITS When an employee is off on a scheduled workday under the 9/80 work schedule, then nine (9) hours of eligible leave per workday shall be charged against the employee's leave balance or eight (8) hours shall be charged if the day off is a Friday. All leaves shall continue under the current accrual, eligibility, request and approval requirements. 1. General Leave — As stated in Memorandum -of -Understanding 2. Sick Leave — As stated in Memorandum -of -Understanding 3. Bereavement Leave — As stated in Memorandum -of -Understanding 4. Holidays - a. For a recognized city holiday, eight (8) hours, as stated in Article XI1.2, are earned for each holiday. For the charging of hours on a scheduled holiday, the employee must use eight (8) hours of holiday time off and one (1) hour from the employees General Leave or Compensatory Time banks for a nine (9) hour workday charge or eight (8) hours holiday time off for a Friday. 2003 MEA MOU Final.doc 65 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 b. If a holiday falls on an FLSA non-exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. If the employee cannot take the work shift before or after the holiday off the employee will be granted eight (8) hours of general leave. c. If a holiday falls on an FLSA exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. FLSA exempt employees shall not be granted any administrative/general leave or any added compensation for not taking a work shift off on a scheduled holiday. 5. Jury Duty — The provisions of the Personnel Rules shall continue to apply, however, if an FLSA exempt employee is called to serve on jury duty during a normal Friday off, Saturday, or Sunday, or on a city holiday, then the jury duty shall be considered the same as having occurred during the employees day off work, therefore, the employee will receive no added compensation. 2003 MEA MOU Final.doc 66 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 EXHIBIT K - 4/10 WORK SCHEDULE This work schedule is known as the "4/10" and is only available to employees assigned to the Police Department. The 4/10 work schedule is designed to be in compliance with the requirements of the Fair Labor Standards Act (FLSA). In the event that there is a conflict with the current rules, practices and/or procedures regarding work schedules and leave plans, then the rules listed below shall govern. 4/10 WORK SCHEDULE DEFINED The 4/10 work schedule shall be defined as working four (4) days for forty (40) hours in an FLSA work week by working four (4) days at ten (10) hours per day, plus a .one -hour lunch during each work shift. The FLSA work week shall be defined as Saturday 12:00:00 a.m. to Friday 11:59:59 p.m. The 4/10 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. All employees on the 4/10 work schedule are subject to be called to work any time to meet any and all emergencies or unusual conditions which, in the opinion of the City Administrator, Department Head or designee may require such service from any of said employees. OVERTIME DEFINED FLSA Non -Exempt Employees — All non-exempt employees under the 4/10 work schedule shall earn overtime for all hours worked after the first forty (40) hours in an FLSA work week as required under FLSA. Employees are required to obtain supervisor authorization prior to working any overtime. 1. Overtime Compensation — As stated in Memorandum -of -Understanding 2. Compensatory Time — As stated in Memorandum -of -Understanding LEAVE BENEFITS When an employee is off on a scheduled workday under the 4/10 work schedule, then ten (10) hours of eligible leave per workday shall be charged against the employee's leave balance. All leaves shall continue under the current accrual, eligibility, request and approval requirements. 1. General Leave —As stated in Memorandum -of -Understanding 2. Sick Leave — As stated in Memorandum -of -Understanding . 3. Bereavement Leave — As stated in Memorandum -of -Understanding 2003 MEA MOU Final.doc 67 12/12/2002 8:52 AM Exhibit A for Res. No. 2002-133 4. Holidays - a. For a recognized city holiday, eight (8) hours, as stated in Article XI1.2, are earned for each holiday. For the charging of hours on a scheduled holiday, the employee must use eight (8) hours of holiday time off and two (2) hour from the employees General Leave or Compensatory Time banks for a ten (10) hour workday. b. If a holiday falls on an FLSA non-exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. If the employee cannot take the work shift before or after the holiday off the employee will be granted eight (8) hours of general leave. c. If a holiday falls on an FLSA exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. FLSA exempt employees shall not be granted any administrative/general leave or any added compensation for not taking a work shift off on a scheduled holiday. 5. Jury Duty — The provisions of the Personnel Rules shall continue to apply, however, if an FLSA exempt employee is called to serve on jury duty during a normal Friday off, Saturday, or Sunday, or on a city holiday, then the jury duty shall be considered the same as having occurred during the employees day off work, therefore, the employee will receive no added compensation. 2003 MEA MOU Final.doc 68 12/12/2002 8:52 AM ATTACHMENT #3 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page PREAMBLE...................................................................................................................................1 ARTICLEI - TERM OF MO ..................................................................................................... 1 ARTICLE H - REPRESENTATIONAL UNITICLASS..............................................................1 ARTICLE III - MANAGEMENT RIGHTS................................................................................. 2 ARTICLE IV- EXISTING CONDITIONS................................................................................. 2 ARTICLEV - SSEVERABILITY................................................................................................... 2 ARTICLE VI - SALAR Y SCHED ULE ......................................................................................... 2 A. Classification and Salary Rates 12 ARTICLE PH — SPECIAL PAY................................................................................................... 3 A. Education 3 1. Tuition Reimbursement............................................................................................................................. 3 B. Acting Assignment 3 C. Assignment Pay 3 1. Leadworker Differential............................................................................................................................ 3 2. Shift Differential........................................................................................................................................ 3 a. Afternoon Shift..................................................................................................................................... 3 b. Night Shift............................................................................................................................................. 4 C. Shifts Defined....................................................................................................................................... 4 3. Court Standby Time................................................................................................................................... 4 4. Court Appearance Time............................................................................................................................. 4 D. Special Certification/Skill Pay 4 1. Bilingual Skill............................................................................................................................................ 4 2. Shorthand Skill.......................................................................................................................................... 5 3. rb—poke,- cenip . Plan Checker. Building......................................................................................... 5 a. Plans Examiner ICBO Certification...................................................................................................... 5 b. EIT/AA Degree in Engineering ............................................................................................................ 5 4- Plan Checker G,.,»-diRate ........................... 5 a-. Plans 1pspeetoF WBO-Ceftificatien ....................................................................... 5 ARTICLE VIII - UNIFORMS, CLOTHING, TOOLS AND EQUIPMENT .............................. 6 A. Uniforms and Safely Shoes 6 1. Safety Shoes — Cost................................................................................................................................... 6 B. Tool Allowance C. Vehicle Use 2 0 D. Process Owner Assignment Pay 6 ARTICLE IX — HOURS OF WORK/OVERTIME....................................................................... 7 A. Work Schedule 7 4-. u,.,,. ; Af j,x7Ar E s,,,a-................................................................................................................................. 7 1. Work Periods under Fair Labor Standards Act FLSA........................................................................... 7 2. Flex Schedule and Alternative Work Schedule - Civic Center Employees ......................................... 7 2003 MEA MOU Draft.doc i 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page B. Hours of Work Defined 8 C. Overtime/Compensatory Time 9 4- Pei O*e (time a: ReRff ................................................................................................................................................... 9 ................................................................................................................ 9 2-. Compe sate .., Time................................................................................................................................. 10 at Exempt Eri,.., .,00r............................................................................................................................. 10 1. Callback...................................................................................................................................................10 2. Mandatory Standby.................................................................................................................................. 10 3. Holiday Overtime.................................................................................................................................... 10 ARTICLE X — HEALTH AND 0THER INSURANCE BENEFITS ........................................ I A. Health 11 -L NUdieal.................................................................................................................................................... 11 Dental......................................................................................................................................................11 Vision...................................................................................................................................................... 11 B. Eligibility Criteria and Cost 11 1. City Paid Medical Insurance — Employees and Dependents.................................................................. 11 1. Year 2003 Premiums............................................................................................................................. 12 2. Future Premiums................................................................................................................................... 13 C. COBRA 13 D. Life and Accidental Death and Dismemberment 13 E. Long Term Disability Insurance 13 F. Medical Cash -Out 13 G. Section 125 Plan 13 H. Miscellaneous 14 ARTICLE XI— RETIREMENT..................................................................................................1 S A. Benefits 15 1. Self -Funded Supplemental Retirement Benefit....................................................................................... 15 2. Deferred Compensation (Retiree Medical Funding)................................................................................ 15 I Medical Insurance for Retirees................................................................................................................ 15 B. Public Employees' Retirement S stem 17 1. Employee's Contribution 17 «nonlever ................................................................................................................................................ 17 2-3. Two Percent at Age 55 Formula 17 3. Pre -Retirement Optional Settlement 2 Death Benefit 17 4. Fourth Level of 1959 Survivor Benefits 17 5. Review of Contract Amendment Cost Analysis 17 ARTICLE XII — LEAVE BENEFITS......................................................................................... 18 A. Leave With Pay 18 1. General Leave.......................................................................................................................................... 18 2003 MEA MOU Draft.doc ii 12/12/2002 8:44 AM 2. 3. 4. 5. 6. 7. MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page a) Accrual................................................................................................................................................ is b) Eligibility and Approval ..................................................................................................................... 18 c) Family Sick Leave............................................................................................................................. 18 d) Conversion to Cash............................................................................................................................. 19 e) Cash &a -nee .................................................................................................................................... 19 f) One Week Minimum Vacation Requirement...................................................................................... 19 Holidays................................................................................................................................................... 19 SickLeave............................................................................................................................................... 20 a) Accrual................................................................................................................................................20 b) Credit.................................................................................................................................................. 20 c) Usage.................................................................................................................................................. 20 d) Family Sick Leave.............................................................................................................................. 20 e) Payoff at Termination......................................................................................................................... 20 d) Extended Absences............................................................................................................................. 20 BereavementLeave................................................................................................................................. 20 AssociationBusiness............................................................................................................................... 21 JuryDuty................................................................................................................................................. 21 Paternity Leave ........................................................................................................................................ 21 ARTICLE XIII — CITY RULES .................................................................................................. 21 0 1. 2. 3. 4. 5. 6. 7. S. 9. Personnel Rules 21 Rule 5 — Recruitment and Examination Procedure.................................................................................. 21 a) 5-4 — Order of Certification................................................................................................................ 21 b) 5-14 — Promotional Exams.................................................................................................................. 22 c) 5-20 — Duration of Employment Lists................................................................................................ 22 Rule7 — Discipline.................................................................................................................................. 22 a) 7-2 — Causes for Discipline................................................................................................................. 22 Rule8 — Termination........................................................................................................................'....... 22 a) 8-1 — Medical Examination. Evaluation of Employee's Work Capacity. Demotion, Transfer or Terminationof Appointment........................................................................................................................ 23 b) 8-3 — Layoff in Accordance with Length of Service........................................................................... 23 c) 8-11 — Re-Employment....................................................................................................................... 23 Rule9 — Probation................................................................................................................................... 24 a) 9-4 — Rejection of Probationary Employee......................................................................................... 24 Rule12 — Classification Plan................................................................................................................... 24 a) 12-10 — Temporary Employees........................................................................................................... 24 Rule 14 — Additional Pay and Pay Adjustments...................................................................................... 24 a) 14-6 — Salary Advancements to Meet Recruiting Problems or to Give Credit for Prior Service. Application for Other Advancements........................................................................................................... 24 Rule 18 — Attendance and Leaves............................................................................................................ 24 a) 18-8 — Sick Leave............................................................................................................................... 24 b) 18-16 — Industrial Accident Leave...................................................................................................... 25 c) 18-19 — Maternity Leave..................................................................................................................... 26 d) 18-20 — Leave of Absence without Pay.............................................................................................. 26 Rule 19 — Grievance Procedure Non -Disciplinary Matters..................................................................... 26 a) 19-5 Grievance Procedure................................................................................................................... 26 1) Step 4 — City Administrator........................................................................................................... 26 2) Step 5 — Personnel Board Hearing................................................................................................. 27 Rule 20 —Disciplinary Procedure and Appeal.......................................................................................... 27 a) 20-1 — Purpose.................................................................................................................................... 27 b) 20-2 — Disciplinary Procedures........................................................................................................... 28 1) Notice of Proposed Adverse Action............................................................................................... 28 2) Employee's Right to Respond........................................................................................................ 28 2003 MEA MOU Draft.doc iii 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page 3) Time Off......................................................................................................................................... 28 4) Final Notice of Decision................................................................................................................ 28 c) 20-3 —Appeal to Personnel Commission............................................................................................ 28 1) Request for Appeal......................................................................................................................... 28 2) Hearing...........................................................................................................................................28 3) Final Decision................................................................................................................................ 29 d) 20-4 — Supplemental Hearing by Personnel Board............................................................................. 29 e) 20-5 — Employee Status on Pending AMeal....................................................................................... 29 10. Rule 21 — Grievance Procedures - General......................................................................................... 29 a) 21-7 Hearing Officers......................................................................................................................... 29 b) 21-11 Time Computation of.............................................................................................................. 29 c) 21-12 Time. Extension of................................................................................................................... 30 -L C. NUdifisatien of Seetien 7 Desert-ifeAti�4i a d Wdifieatien................................................................ Rules Governing Layoff, Reduction in Lieu of Layoff and Re -Employment 30 30 31 1. Part 1 — Layoff Procedure........................................................................................................................ 31 2. Order of Layoff ........................................................................................................................................ 33 3. Notification of Employees.............................................................................................. 4. Part 2 — Bumping Rights.......................................................................................................................... 34 a) Voluntary Reduction or Bumping in Lieu of Layoff.......................................................................... 34 b) Reinstatement/Re-employment Lists.................................................................................................. 35 cQualifications Appeal ............................................................................................... ......................... 35 d) Qualifications Appeal Hearing............................................................................................................ 35 5. Part 3 — Re-employMent.......................................................................................................................... 36 a) Re-employment...................................................................................................................................36 b) Status onRe-employment................................................................................................................... 37 ARTICLE XIV MISCELLANEOUS......................................................................................... 38 A. Grievance Arbitration 38 B. Promotional Procedures 38 1. Tie Scores................................................................................................................................................ 38 2. Salary Upon Promotion........................................................................................................................... 38 C. Labor -Management Relations Committee 39 D. Copies of MOU 39 E. Position Classification Issues 39 1. Class Specifications................................................................................................................................. 39 2. Reclassification Impact............................................................................................................................ 40 3. Surveyor Party Chief.........................................................................................................:................... 40 4. Certificated Distribution Operator...................................................................................................... 40 F. Class A and B Driver License Fees 40 G. Job Sharing 40 H. Deferred Compensation Loan Program 40 I. Performance Evaluations/Written Reprimand Appeals 40 J. Employee Performance Evaluations 40 K. MEA Letter of Introduction 41 2003 MEA MOU Draft.doc iv 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING TABLE OF CONTENTS Page ARTICLE XV — CITY COUNCIL APPROVAL......................................................................... 41 LISTOF MOUEXHIBITS......................................................................................................... 42 EXHIBIT A — CLASSISALARYSCHEDULE........................................................................... 49 EXHIBIT B — UNIFORM POLICY............................................................................................ 54 A. General 54 B. Affected Personnel 54 C. Basic Uniform Components and Standard Allowances 54 D. Employee Responsibilities 55 E. City Responsibilities 55 F. Department Head Responsibilities 56 G. Purchases and Exceptions 56 EXHIBIT C — VEHICLE USE POLICY.................................................................................... 58 Section 1 - Purpose 58 Section 2 - Scope 58 Section 3 - Policy 58 Section 4 — Vehicle Use Criteria 58 Section 5 — Insurance Requirements 60 E-Y ITD --A494 FL 4 Kxempt C ss#w- o im s................................................................... 62 EXHIBIT D E — EMPLOYEE HEALTH PLAN BROCHURE ................................................ 63 EXHIBIT E F — DELTA CARE (PMI) DENTAL PLAN BROCHURE ................................... 64 EXHIBIT F G — DELTA DENTAL PLAN BROCHURE.......................................................... 65 .................................................. 66 EXHIBIT G I — VISION (VSP) PLAN BROCHURE................................................................ 67 EXHIBIT H J — LONG TERM DISABILITY PLAN BROCHURE ......................................... 68 EXHIBIT I K— PROVISIONS OF THE RETIREE S UBSID Y MEDICAL PLAN ................. 69 EXHIBIT J - 9180 WORK SCHEDULE..................................................................................... 77 EXHIBIT K - 4110 WORK SCHED ULE.................................................................................... 80 2003 MEA MOU Draft.doc v 12/12/2002 8:44 AM Memorandum of Understanding between The City of Huntington Beach (hereinafter called City) and The Huntington Beach Municipal Employees' Association (hereinafter called Association or MEA) 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 period December 21, 2002 through December 19, 2003 Desembe r 22, 2001 thmugh Oeeernber 20, 2002; and WHEREAS, the representatives of the City and the Association desire to reduce their agreements to writing, NOW THEREFORE, this Memorandum of Understanding is made to become effective December 21, 2002 DeGember22,2001 and it is agreed as follows: ARTICLE I — TERM OF MOLD A. This Memorandum of Understanding shall be in effect for a term commencing at 12,00.00 o.nn on December 21, 2002 Oesernb€F 22,-2001 through and +dr�ig#t erg December 19, 2003 DeGe ber 20, 2002 B. This Agreement constitutes the entire agreement of the parties with respect to improvements or changes in the salaries and monetary benefits for employees represented by the Association for the duration of this Agreement. ARTICLE II — REPRESENTATIONAL UNIT/CLASS It is recognized that the ASSOCIATION is the employee organization which has the right to meet and confer in good faith with the CITY on behalf of permanent employees of the CITY within those class titles set out in Exhibit "A" attached hereto and incorporated herein. The term "permanent" employee is used only to determine entitlement to certain benefits provided by this MOU and is defined as follows; an employee that has completed or is in the process of completing a probationary period in a permanent position in the competitive service in which the employee regularly works twenty hours or more per week. Additionally, the representation unit shall include all non -safety, non -management classifications which are created after execution of this agreement and are not included in another representation unit or determined in accordance with the Employer -Employee Relations Resolution to be more appropriately designated as non -associated classifications. 2003 MEA MOU Drakdoc 1 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE III — MANAGEMENT RIGHTS Except as expressly abridged or modified herein, the CITY retains all rights, powers and authority with respect to the management and direction of the performance of CITY services and the work forces performing such services, provided that nothing herein shall change the City's obligation to meet and confer as to the effects of any such management decision upon wages, hours and terms and conditions of employment or be construed as granting the CITY the right to make unilateral changes in wages, hours and terms and conditions of employment. Such rights include, but are not limited to, consideration of the merits, necessity, level or organization of CITY services, including establishing of work stations, nature of work to be performed, contracting for any work or operation, reasonable employee performance standards, including reasonable work and safety rules and regulations in order to maintain the efficiency and economy desirable for the performance of CITY services. ARTICLE IV — EXISTING CONDITIONS Except as expressly provided herein, the adoption of this Memorandum of Understanding shall not change existing benefits, and terms and conditions of employment which have been established in prior Memoranda of Understanding, and/or provided for in the Personnel Rules of the City of Huntington Beach. ARTICLE V — SEVERABILITY If any article, sub -article, sentence, clause, phrase or portion of this Agreement, or the application thereof to any person, is for any reason held to be invalid or unenforceable by the decision of any court of competent jurisdiction, such decision shall not affect the validity of the remaining portions of this Agreement or its application to other persons. The City and the Association hereby agree that in the event any state or federal legislative, executive or administrative provision purports to nullify or otherwise adversely affect the wages, hours and other terms and conditions of employment contained in this Agreement or similarly purports to restrict the ability of the parties to negotiate a successor agreement, the City and the Association shall, without prejudice to either party's judicial remedies, endeavor to agree to alternative contractual provisions which are not adversely affected by said legislative, executive or administrative provision. ARTICLE VI — SALARY SCHEDULE A. Classification and Salary Rates Permanent employees shall be compensated at hourly salary rates by job type and pay grade including a three percent (3%) increase, effective December 21, 2002 danuary19, 2002 as set forth in Exhibit A attached hereto and incorporated herein by this reference. All association represented employees hired after March 29, 2002 shall be required to utilize direct deposit of payroll checks. 2003 MEA MOU Draft.doc 2 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE VII — SPECIAL PAY A. Education 1. Tuition Reimbursement Upon approval of the Department Head and the Human Resources Manager Offtser, permanent employees may be compensated for courses from accredited educational institutions. Tuition reimbursement shall be limited to job related courses or job related educational degree objectives and requires prior approval by the Department Head and Human Resources Manager Officer. Education costs shall be reimbursed to permanent employees on the basis of a full refund for tuition, books, parking (if a required fee) and any other required fees upon presentation of receipts. However, the maximum reimbursement shall be not more than one thousand five hundred dollars ($1,500) in any fiscal year period. Reimbursements shall be made when the employee presents proof to the Human Resources Manager 9ff+ser that he/she has successfully completed the course with a grade of "C" or better; or a "Pass" if taken for credit. B. Acting Assignment If a permanent employee is formally assigned to work in a higher classification on a temporary basis for greater than three (3) consecutive weeks, the employee shall be compensated for all hours worked in the higher classification, in the same manner provided in Article XIV.13.2. C. Assignment Pay Leadworker Differential Any permanent employee classified as "Leadworker" shall receive sixteen (16) ranges on the "Universal Salary Schedule" above the highest classification, which is assigned to the Leadworker to lead. 2. Shift Differential a. Afternoon Shift Permanent employees required to work on a regular assigned shift that occurs between the hours of 4:00 PM and midnight, shall be paid a premium equal to five percent (5%) of the employee's base hourly rate for all work performed during said shift. 2003 MEA MOU Draft.doc 3 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING b. Night Shift Permanent employees required to work on a regularly assigned shift that occurs between midnight and 8:00 AM shall be paid a premium equal to ten (10%) percent of the employee's base hourly rate. c. Shifts Defined Permanent employees will be considered as assigned to the afternoon shift (4:00 PM to midnight) or the night shift (midnight to 8:00 AM) when five (5) or more hours of their regularly assigned shifts occur in the afternoon or night shift as defined herein. 3. Court Standby Time Crime Scene Investigators, Parking/Traffic Control Officers, Criminalists, Senior Criminalists, and Latent Fingerprint Examiners Field Sense—CffiGers, D—ParkkiRg—wort rncr l Offri%FGGTirMrrrtRalists, SneRieT v who are required to be on standby for a court appearance during other than their scheduled working hours shall receive a minimum of three hours straight time pay (including differentials in Article VI) for each morning and afternoon court session. 4. Court Appearance Time Crime Scene Investigators, Parking/Traffic Control Officers, Criminalists, Senior Criminalists, and Latent Fingerprint Examiners Fief eWin�� trnl OffiG GFimin SeRinr ,mod—S�, P,�, 9#+sers, D--Ger����er�;�rrat-is#��„� required to appear in court during other than their scheduled working hours shall receive a minimum of three hours pay at time and one half; provided, however, that if such time overlaps with the employee's scheduled working hours, said premium rate shall be limited to those hours occurring prior to or after the employee's scheduled work time. D. Special Certification/Skill Pay 1. Bilingual Skill Permanent employees who are required by their Department Head to use Spanish, Vietnamese, or Sign Language skills as part of their job assignment, shall be paid an additional five -percent (5%) of their basic hourly rate in addition to their regular bi-weekly salary. Permanent employees may accept assignments utilizing bilingual skills in other languages on a short-term assignment with approval by the City Administrator. Such employees shall receive the additional five percent (5%) for every bi-weekly pay period that the assignment is in effect. In order to be eligible for said compensation, employee's language proficiency will be tested and certified by the Human Resources Manager 9#fser or designee. 2003 MEA MOU Draft.doc 4 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2. Shorthand Skill Employees who have successfully passed a shorthand skill test and who are required to use shorthand regularly in their jobs shall receive additional compensation in the amount of forty-six dollars and fifteen cents ($46.15) bi- weekly. Shorthand skill may be required for selected positions classified as Administrative Secretary, Secretary Legal Senior, Secretary Legal, Office Specialist (Typing), Office Assistant II (Typing), Deputy City Clerk II, and Deputy City Clerk I. Employees who have not passed a shorthand skills test will not be required to use shorthand. 3. PlaR QheGkef-SeniGf Plano Checker, Building a. Plans Examiner ICBO Certification Incumbents who have completed their probationary period in the class of Plan Checker, Building ,Senior who are regularly assigned te the who have attained certification as Plans Examiner by I.C.B.O. (International Conference of Building Officials) shall receive additional compensation in the amount of forty-six dollars and fifteen cents ($46.15) bi-weekly, provided that active certification is maintained. b. EIT/AA Degree in Engineering Incumbents in the classification of Plan Checker, Building P4an Gh8Gker Senier who are regularly 000innerd to the Build ng Divisien nerd who have successfully completed the State of California examination for Engineer -in -Training or who have obtained an Associate of Arts degree in engineering or equivalent major, shall receive additional compensation in the amount of sixty-nine dollars and twenty-three cents ($69.23) bi-weekly � -. �. .. . 2003 MEA MOU Drakdoc 5 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE VIII — UNIFORMS, CLOTHING, TOOLS AND EQUIPMENT A. Uniforms and Safety Shoes The City's Uniform and Safety Shoe Policy shall be set forth in Exhibit "B" a copy of which is attached hereto and incorporated herein by this reference, provided however, that employees represented by MEA working in the Police Department shall be issued property in accordance with the equipment issue form for the particular position to which they are assigned. Uniform replacement for employees represented by MEA who are assigned to the Police Department shall be as stated in the Police Department Manual of Rules and Regulations. 1. Safety Shoes — Cost The CITY shall furnish safety shoes in accordance with the procedures and guidelines as set forth in Exhibit "B", provided however, that the maximum amount to be reimbursed for a pair of safety shoes will not exceed one hundred and eighty-five dollars ($185.00) per pair every six months or sooner, if necessary. B. Tool Allowance Those permanent employees, who are required to furnish their own personal tools for use on the job, shall be provided with a tool allowance to offset a portion of the cost for said tools that are lost, stolen or broken when in use on the job. Such allowance shall be eight hundred ($800) per year, payable in January of each year, separate from payroll checks to those employees on active duty. In the event a permanent employee is hired or separates his/her tool allowance for that calendar year shall be prorated on the basis of the total number of months in which he/she was employed on the first working day of the year. It is understood that the employee has the responsibility to exercise care and diligence in preventing the loss, theft and breakage of his or her personal tools. C. Vehicle Use The City Vehicle Use Policy shall be indicated in the document attached hereto and by this reference incorporated herein as Exhibit C. Approval is required by the City Administrator or designee for any City vehicle to be taken home by an association employee. D. Process Owner Assignment Pay Those employees performing assignments designated by the City as "process owner" assignments shall receive premium pay equal to ten percent (10%) of the employee's base hourly rate. Process owner assignments are designated by the employee's department head and approved by the City Administrator or his designee. Designated employees are responsible for JD Edwards applications setup, design, troubleshooting and training. Process owners have system coordination responsibilities as distinguished from users of the system. 2003 MEA MOU Draft.doc 6 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE IX — HOURS OF WORK/OVERTIME A. Work Schedule It is the intent of the city to provide an opportunity for MEA employees to select a flex schedule and/or alternative work schedule that is consistent with the city's objective that such schedules shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. - ffip-m— M;:W- dr-T�72172TTW W.. r r r: r.721 K 3. - - Work Periods under Fair Labor Standards Act €4z-&A It is also understood that the City may establish a work period for each covered employee which meets the requirements of the Fair Labor Standards Act (FLEA) and which will not result in overtime compensation as part of a normal work schedule. 2. Flex Schedule and Alternative Work Schedule - Civic Center Employees Effective February 1, 2003, with supervisor and Department Head approval, MEA employees may flex regular scheduled start times between the hours of 7:00 a.m. to 9:00 a.m. in half-hour increments (i.e. 7:00 a.m., 7:30 a.m., 8:00 a.m., 8:30 a.m., and 9:00 a.m.). Flex schedules shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. Effective February 1, 2003, MEA employees will have the option of working a 5/40 or 9/80 work schedule with supervisor and Department Head approval. MEA employees assigned to the Police Department shall retain the option of working the 4110 work schedule with supervisor and Department Head approval. In order to maintain service to the public, departmental effectiveness, productivity and/or efficiency a Department Head may assign an employee a different work schedule that is in compliance with the requirements of FLSA with City Administrator approval. 2003 MEA MOU Draft.doc 7 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING a. 5/40 Work Schedule The 5/40 work schedule shall be defined as working five (5) eight (8) hour days Monday through Friday each week plus a one -hour lunch during each work shift, totaling a forty (40) hours work week. The assigned 5/40 work schedule must be in compliance with the requirements of FLEA. b. 9/80 Work Schedule The 9180 work schedule, as outlined in Exhibit J, shall be defined as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours (Friday), plus a one -hour lunch during each work shift, totaling forty (40) hours in each FLSA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. c. 4/10 Work Schedule The 4/10 work schedule, as outlined in Exhibit K, shall be defined as working four (4) ten (10) hour days each week plus a one -hour lunch during each work shift, totaling a forty (40) hours in each FLEA work week. The assigned 4/10 work schedule must be in compliance with the requirements of FLSA. The 4/10 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. d. Existing Alternative Work Schedules Non Civic Center MEA employees who had an alternative work schedule (9/80 or 4110) prior to February 1, 2003 shall retain that alternative work schedule. Civic Center MEA employees who had an alternative work schedule (9/80) prior to February 1, 2003 may revert to that alternative work schedule (9/80) in the event his or her supervisor and/or Department Head determine that the 9180 schedule set forth in this article is inappropriate for the employee's classification. B. Hours of Work Defined General leave VaeafiGR, holidays, sick leave and compensatory time shall be counted as hours worked. 2003 MEA MOU Draft.doc 8 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING C. Overtime/Compensatory Time DE)1in" a. �-yrro-r It shall remain the policy of the City that overtime is to be used only as needed or under emergency conditions as approved by the City Administrator. FLEA "non-exempt" employees shall receive overtime pay or compensatory time for hours worked over forty (40) hours in a work week at time and one half of the employee's FLSA regular rate of pay. The employee's supervisor shall determine if employee receives overtime pay or compensatory time. Once per fiscal year an employee may cash out up to sixty (60) hours of banked compensatory time. The employee shall give payroll two (2) weeks advance notice of their decision to exercise such option. Consideration shall be given to effectuating the request of the employee. If an employee is formally assigned to work in an FLSA "exempt" classification on a temporary basis for greater than three (3) consecutive weeks, the employee shall be compensated for hours worked over forty in a work week with compensatory time off and shall not be eligible for overtime pay, beginning after the third consecutive week working in the FLSA exempt classification. Employees shall accrue compensatory time on an hour for hour basis. FLSA non-exempt overtime pay and compensatory time rules, as stated above, shall apply for temporary FLSA exempt assignments that are less than three (3) weeks. Upon promotion to an FLSA "exempt" classification all compensatory time off shall be cashed out prior to promotion at the employee's current FLSA regular rate of pay in the "non- exempt" classification. _Jim .-. WIN 2003 MEA MOU Draft.doc 9 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ._Cr■ 1. Callback The City will reimburse permanent employees called back to work a minimum of two (2) hours of pay at the rate of time ene and one-half #+me (1 '/2) their his eF her regularly hourly rate. A supervisor shall notify an employee, in advance, of the need to work overtime. Where overtime is worked as an extension of the workday, it shall not be considered call back. While overtime may be required to be worked, it is the City's policy to discourage the working of overtime, and to provide reasonable notification to an employee should overtime be required. 2. Mandatory Standby A permanent or probationary employee who is placed on standby status by their his or he supervisor shall be compensated at an hourly rate equal to 0.180 of their base hourly rate for the entire period of such assignment shall r esoiye four (4) ho„rS stFaigh4 ' o pay for oanh twenty 3. Holiday Overtime Permanent employees who are required to work on a legal holiday as designated in Article XII.A.2 shall be compensated at the rate of time and one-half the hourly rate exclusive of any other premiums for all hours worked on said holiday. Holiday pay (time and one-half) will be compensated for work performed on the actual holidays as designated in Article XII. 2003 MEA MOU Draft.doc 10 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE X — HEALTH AND OTHER INSURANCE BENEFITS A. Health The city shall continue to make available group medical, dental and vision benefits ��.fJtoall MEA employees. T-1ih ed *GQ—t r • • I 0_1 - J � r • I • i.. B-e R. r W. L - B. Eligibility Criteria and Cost City Paid Medical Insurance — Employees and Dependents The City shall pay for health insurance for qualified employees and dependents, subjeot te the li itata„Gset feFt"� AFtiGle X.A effective the first of the month following one month of continuous service as a permanent employee, except that a permanent part-time employee assigned to a work schedule of less than 2,080 hours, but more than 1,560 hours per year, must complete eighteen (18) months of continuous service, and a permanent part-time employee assigned to a work schedule of less than 1,560 hours, but more than 1,040 hours per year must complete two (2) years of continuous service before the CITY shall make such payments as set forth above. For purposes of determining continuous service, there shall be no accrual of hours for the period of time an employee is on a non -pay status for a complete pay period. A permanent employee is considered to be continuously employed where there has been no separation from City service. 2003 MEA MOU Draft.doc 11 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ►��7.T.T.r• r r •• - • - r 1. Year 2003 Premiums The city "caps" its contributions for 2003 premiums at the level set forth in the chart below: Monthly City Paid Premium city Plan HMO Dental (PPO) Dental (PMI) Vision EE $336.05 $236.31 $42.88 $23.00 $17.58 + 1 664.53 517.79 81.82 39.11 17.58 EEE EE + 2 or more 813.62 682.46 116.36 59.81 17.58 Effective January 4, 2003 employee bi-weekly payroll deduction contributions for 2003 premiums are set forth in the chart below: Bi-!Weekly City Dental Dental Employee Paid Plan HMO (PPO) (PMI) Vision Premium EE $12.00 $5.95 $1.89 $0.00 $0.23 EE + 1 23.72 13.05 3.66 0.00 0.23 EE + 2 or more 29.04 17.20 5.12 0.00 0.23 2003 MEA MOU Draft.doc 12 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2. Future Premiums The city "caps" its contributions toward monthly group medical, dental and vision plan premiums, by category (EE, EE + 1, and EE + 2 or more) and plan, at the year 2003 level. Until the City Council approves a successor to this Memorandum -of - Understanding, the city's 2003 contribution caps will remain in place in 2004 and beyond, even if premium increases result in these additional costs being borne by the employee. C. COBRA Permanent employees who terminate their employment with the City and dependents of permanent employees shall have any and all the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) benefits to which the law entitles them. D. Life and Accidental Death and Dismemberment The City shall provide for each permanent employee, at City's cost, $25,000 of life insurance and $10,000 accidental death and dismemberment insurance. The City shall also provide for the availability of optional supplemental life and accidental death and dismemberment insurance coverage at the employee's cost. E. Long Term Disability Insurance The City shall provide for each permanent employee at the City's expense a long-term disability insurance plan comparable to the Group Disability Insurance Plan in effect on February 1, 1995 (Exhibit "J"). Such plan shall be modified effective November 21, 1988, to provide benefits as outlined in Plan B of Exhibit "J". The parties agree to exclude the first year of job related illness or injury from coverage on condition that the plan provides for a coordination with sick leave, general leave vasatiees and holidays which is satisfactory to the Association. F. Medical Cash -Out If an employee is covered by a medical program outside of a city -provided program (evidence of which must be supplied to the Administrative Services Department,, Empleyee—B Refts Di ces), they may elect to discontinue City medical coverage and receive ninety-two dollars and thirty-one cents ($92.31) bi- weekly to deposit into their Deferred Compensation account or any other pre-tax program offered by the City. G. Section 125 Plan This plan allows employees to use pre-tax salary to pay for regular childcare, adult dependent care and/or medical expenses. 2003 MEA MOU Draft.doc 13 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING H. Miscellaneous 1. Nothing in this Article shall be deemed to restrict the City's right to change insurance carriers or self -fund should circumstances warrant. City shall, however, notify the Association of any proposed change, and allow the Association an opportunity to review any proposed change and make recommendations to the City. 2. Nothing in this Article shall be deemed to obligate the City to improve the benefits outlined in this Article. 3. When the City grants an employee leave without pay for reason of medical disability, the City shall maintain the City paid employees' insurance premiums for the time the employee is in a non -pay status for the length of said leave not to exceed twenty-four (24) months. The City shall provide timely written notification of employee rights under this Article and the Long Term Disability Plan and will assist the employee in processing LTD claims so that undue delay in receiving LTD payments is avoided. 4. The City and the Association agree to establish and participate in a citywide joint labor and management insurance and benefits advisory committee to discuss and study issues relating to insurance benefits available for employees. 5. Health Plan Over -Payments - Unit members shall be responsible for accurately reporting changes in the status of dependent(s) which affect their eligibility for health plan coverage ninety (90) days after the date of such status change. The City shall use its best efforts to advise all unit members of their obligation to report changes in the status of dependent(s), which affect their eligibility. If an employee fails to report a status change that affects eligibility within ninety (90) days, the City shall have the right to recover any premiums paid by the City, on behalf of ineligible dependents. Recovery of such overpayments shall be made as follows: a. The employee's bi-weekly salary warrant shall be reduced by one- half of the amount of the bi-weekly overpayment. Such reduction shall continue until the entire amount of the overpayment is recovered. b. The City shall be entitled to recover a maximum of 12 months premium overpayments. Neither the employee nor the dependent shall be liable to the City other than as provided herein. 2003 MEA MOU Draft.doc 14 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE XI — RETIREMENT A. Benefits Self -Funded Supplemental Retirement Benefit Employees hired prior to December 27, 1997 are eligible for the Self - Funded Supplemental Retirement Benefit, which provides that: a. In the event a PERS member elects Option #2 (Section 21456) or Option #3 (Section 21457) of the Public Employees' Retirement law, the City shall pay the difference between such elected option and the unmodified allowance which the retiree would leave received for his or her life alone. This payment shall be made only to the retiree shall be payable by the City during the life of the member, and upon that retiree's death, the City's obligation shall cease. The method of funding this benefit shall be the sole discretion of the City. This benefit is vested for permanent employees covered by this Agreement (Note: The options provide that the allowance is payable to the retiree until his or her death, and then either the entire allowance ([Option #2] or one- half of the allowance [Option #3] is paid to the beneficiary for life.) b. Employees hired on or after December 27, 1997 shall not be eligible for this benefit referenced in A.1.a. herein above. 2. Deferred Compensation (Retiree Medical Funding) The City and the Association agree to continue the existing funding mechanism whereby permanent employees may set aside funds that, at retirement may be used for funding their medical insurance premiums. The parties agree to utilize the existing Deferred Compensation Plan as said funding mechanism. Any permanent employee who contributes one dollar ($1.00) or more per pay period to his or her deferred compensation account shall receive an employer contribution to the employee's deferred compensation account in the amount of five dollars and fifty cents ($5.50) per pay period. 3. Medical Insurance for Retirees a. Upon retirement, whether service or disability, each permanent employee shall have the following options in regards to medical insurance under City sponsored plans: 1) With no change in benefits, retirees can stay in any of the plans offered by the City, at the retiree's own expense, for the maximum time period required by Federal Law (COBRA), or 2003 MEA MOU Draft.doc 15 12/12/2002 8:44 AM MUNICIPAL EIMPLOVEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2) Retirees retiring after approval of this MOU may participate in the Retiree Medical Plan, attached hereto as Exhibit K, as amended, or theF e the Health (Maintenance Organization (HMO) plans currently being offered to retirees, based upon the eligibility requirements described in Exhibit K. b. Retired employees exercising either option pursuant to Article XI.A.3a. above may cause the premiums owed by the retiree to be paid by the City out of any available funds due and owing them for unused sick leave benefits upon retirement, as provided in Article XII.A.3.; provided, however, that whenever any such retired employee does not have any such available funds with which to cause the premiums to be paid, he or she shall have the opportunity to provide the City with sufficient funds to pay the premiums. At retirement, the sick leave hours remaining shall be converted to a dollar figure, as provided in Article XII.A.3. and an estimate shall be provided by the City to the retired employee as to the approximate number of months the group insurance can be paid by such sick leave dollars. The City shall notify any retired employee whose funds for unused sick leave benefits are about to be exhausted of such fact in writing by certified mail, return receipt requested, at the retired employee's most recent address of record with the City no later than three (3) months prior to the date upon which there will not be sufficient funds to pay premiums. It shall be the individual retiree's responsibility either to insure that there are sufficient sick leave dollars available to pay premiums or to make premium payments at least one (1) month in advance to continue the group insurance in effect. If, following exhaustion of sick leave funds, a retired employee fails to provide the City with sufficient additional funds to pay premiums, the City shall have the right to notify said retired employee in the manner prescribed above that it intends to cause his or her coverage to be terminated for non-payment of premiums, and the further right to terminate such coverage if such default has not been cured within thirty five (35) days of mailing notice. Any retired employee electing to obtain such medical insurance coverage after retirement shall have the further option to terminate such coverage following the provision of thirty (30) days written notice to the City, whereupon any funds due and owing him or her for unused sick leave benefits that have not been exhausted to pay these health insurance premiums shall be paid in a lump sum to the retired employee within thirty (30) days following receipt by the City of such notice; provided, however, that once such retired employee elects to terminate such coverage, he or she shall be precluded from securing it at a later date at the group rate. 2003 MEA MOU Draft.doc 16 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING B. Public Employees' Retirement System Employee's Contribution Each permanent employee covered by this Agreement shall be reimbursed an amount equal to seven percent (7%) of the employee's base salary as a pickup of the employee's contribution to the Public Employees' Retirement System. The above PERS pickup is not base salary, but is done pursuant to Section 414 (h)(2) of the Internal Revenue Code. 2 3.Two Percent at Age 55 Formula Unit employees shall be covered by the two percent at age 55 formula (2% @ 55) as identified in Section 21354. 3. Pre -Retirement Optional Settlement 2 Death Benefit Employees shall be covered by the Pre -Retirement Optional Settlement 2 Death Benefit as identified in Section 21548 when approved by the City Council. 4. Fourth Level of 1959 Survivor Benefits Employees shall be covered by the Fourth Level of the 1959 Survivor Benefit as identified in Section 21574 when approved by the City Council. 5. Review of Contract Amendment Cost Analysis Upon receipt of the contract amendment cost analyses for the retirement formulas of 2.5%@55, 2.7%@55 and 3%@60 from CalPERS, (which have already been requested from CaIPERS) the city and association shall Jointly review the contract amendment cost analyses. This Joint review shall not be a reopener nor shall it commit the city to make any amendments to its contract with CaIPERS. 2003 MEA MOU Draft.doc 17 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE XII — LEAVE BENEFITS A. Leave With Pay 1. General Leave a) Accrual Employees accrue leave at the accrual rates outlined below. General leave may be used for any purpose, including vacation, sick leave, and personal leave. .. ■ 71 .. Years of Service General Leave Allowance First through Fourth Year 176 Hours Fifth through Ninth Year 200 Hours Tenth through Fourteenth Year 224 Hours Fifteenth Year and Thereafter 256 Hours b) Eligibility and Approval General leave must be pre -approved except for illness, injury or family sickness, which may require a physician's statement for approval. Accrued general leave may not be taken prior to six (6) months; service except for illness, injury or family sickness. General leave accrued time is to be computed from hiring date anniversary. Members shall not be permitted to take general leave in excess of actual time earned. E eG ive MaFGh 30, 2002, Members shall not accrue general leave in excess of six hundred hours (600). Employees may not use their general leave to advance their separation date on retirement or other separation from employment. c) Family Sick Leave As required by law, employees will be allowed to use up to one- half of their annual General Leave accrual for family sick leave, pursuant to the provisions of California Labor Code Section 233. The city will provide family and medical care leave for eligible employees that meet all requirements of State and Federal law. Rights and obligations are set forth in the Department of Labor Regulations implementing the Family Medical Leave Act (FMLA), 2003 MEA MOU Draft.doc 18 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING and the regulations of the California Fair Employment and Housing Commission implementing the California Family Rights Act (CFRA). d) Conversion to Cash Once during each fiscal year, each employee shall have the option to convert into a cash payment or deferred compensation up to a total of one hundred twenty (120) hours of earned general leave benefits. The value of each hour of conversion is the employee's current base hourly rate, as reflected by job type in Exhibit A. The employee shall give two (2) weeks advance notice of his/her desire to exercise such option. UPOR one week written n0tifiGation te the PayrQI1 ■ _ , SGIledyled f) One Week Minimum Vacation Requirement Employees in the following positions, or their reclassified equivalent, in the Office of the City Treasurer or the Administrative Services department, shall take a minimum of one week (i.e., five consecutive work days) paid vacation each calendar year: Office of the City Treasurer - Accounting Technician I; Accounting Technician II; Senior Accounting Technician; Supervisor Accounting Technician; Field Service Representative RFes�at+ves/aki -sieri CS' Customer SeFV!Ge-RepFes ix+�^�ste Se y mine-�..epFeSeRtatives SeRieF; Gustemer R Ge RepFeSentatives`"'di Supew+sing-Gustemer SeN+se-R pFesen+ t . f Administrative Services Department - Senior Accountant (responsible for bank reconciliation). 2. Holidays All permanent employees represented by the Association shall have the following legal holidays with eight (8) hours of pay: 1. New Year's Day 2. Martin Luther King Day (third Monday in January) 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. Veteran's Day (November 11) 8. Thanksgiving Day (fourth Thursday in November) 9. The Friday after Thanksgiving 10. Christmas Day (December 25) k)-- 2003 MEA MOU Draft.doc 19 12/12/2002 8:44 AM 3 MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING Any day declared by the President of the United States to holiday or by the Governor of the State of California to be and adopted as an employee holiday by the City Council Beach. Holidays which fall on Sunday shall be observed Monday, and those falling on Saturday shall be observed Friday. Sick Leave be a national a state holiday of Huntington the following the preceding a) Accrual No employee shall accrue sick leave ,a#or Mar-.h 29, 2002 b) Credit Employees hired prior to March 30, 2002 shall be credited with their sick leave accrued as of March 29, 2002. c) Usage Employees may use accrued sick leave for the same purposes for which it was used prior to March 30, 2002. d) Family Sick Leave As stated in Personnel Rule 18-8. L leave mw ho used eRGe due to illnoo of the �� � ed�9�afl ab s �--���5—�.--R ompin�i�Ssp erg -the empivyee's procor�no is roo�Wirod r''C����r�o`'!�`vi ed that a sseRGeshall s f.''`I'IJc�rrbe limited to fide (5) play e) Payoff at Termination Upon termination, all permanent employees shall be paid, at their current salary rate, for twenty-five percent (25%) of unused, earned sick leave from 480 hours through 720 hours, and for fifty percent (50%) of all unused, earned sick leave in excess of 720 hours. d) Extended Absences Sick leave shall not be used to (industrial) injuries or illnesses. extend absences due to work related 4. Bereavement Leave Permanent employees shall be entitled to bereavement leave not to exceed (3) work shift days in each instance of death in the immediate family. Immediate family is defined as father, mother, sister, brother, spouse, children, grandfather, grandmother, stepfather, stepmother, step grandfather, step grandmother, grandchildren, stepsisters, stepbrothers, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, stepchildren, or wards of which the employee is the legal guardian. 2003 MEA MOU Draft.doc 20 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 5. Association Business An allowance of 50 hours per year shall be established for the purpose of allowing duly authorized representatives of the Association to conduct lawful Association activities. 6. Jury Duty Employees who are regularly scheduled to work on swing or graveyard shifts shall be placed on a day shift if they are required to appear for jury duty or selection for a period of more than one day. 7. Paternity Leave The city will provide family and medical care leave for eligible employees that meet all requirements of State and Federal law. Rights and obligations are set forth in the Department of Labor Regulations implementing the Family Medical Leave Act (FMLA), and the regulations of the California Fair Employment and Housing Commission implementing the California Family Rights Act (CFRA). GOrnpensatery time, of take unpaid —leave, t() Gararcfor their—rfe�"�hcar newborn e time)� p to a tntnl of, one hundred s"Ay (160) hei ire annn inlly � ....N w a.. wau� v� v� �v � �u� �u rvu vr�c� � � vv� -r�vaa r�-ar��rcun,i' ARTICLE XIII — CITY RULES A. Personnel Rules The City and the Association agree to implement the following rules and accordingly revise the Personnel Rules as described herein: 1. Rule 5 — Recruitment and Examination Procedure a) 5-4 — Order of Certification Whenever certification is to be made, the eligibility lists, if active and not exhausted shall be used in the following order" 1) Re-employment list 2) Promotional list 3) Employment List If fewer than five (5) names of persons willing to accept appointment are on the list from which certification is to be made, then additional eligibles shall be certified from the various lists next lower in order of preference until five (5) names are certified. If there are fewer than five (5) names on such lists, there shall be certified the number thereon. In such case, the appointing authority may demand certification of five (5) names and examinations shall be conducted until five (5) names may be certified. In the event the appointing authority does not choose to appoint from the five (5) names certified, a new examination may be requested. In the event another examination is conducted, those 2003 MEA MOU Drakdoc 21 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING names shall be merged with others already on the list in order of scores. b) 5-14 — Promotional Exams Promotional examinations may be conducted whenever, in the opinion of the Human Resources Manager Officer, after consultation with the department head, the need of the service so requires; provided, however, a promotional examination may not be given unless there are two (2) or more candidates eligible. Only employees who meet the requirements for the vacant position may compete in promotional examinations. Promotional examinations may include any of the selection techniques, or any combination thereof, mentioned in Section 5-13. Additional factors including, but not limited to, performance rating and length of service may be considered. A promotional employment list shall be established after the administration of a promotional examination, and such list shall contain the name(s) of those that passed the examination. c) 5-20 — Duration of Employment Lists Employment lists shall remain in effect for one (1) year from the date of the last examination, unless sooner exhausted. Promotional lists and entry level employment lists may be extended prior to expiration date by the Human Resources Manager O#iser when requested by the Department Head, for additional periods but in no event shall an employment list remain in effect for more than two (2) years. Names placed on such lists shall be merged with others already on the list in order of scores. 2. Rule 7 — Discipline a) 7-2 — Causes for Discipline 12) Possession, use or sale of illegal narcotics or habit-forming drugs, while on -duty or on City property. 14) Conviction of any felony or a misdemeanor with a .job nexus. A plea or verdict of guilt, or a conviction following a plea of nolo contendere, is deemed to be a conviction within the meaning of this section. 15) Participating in an unlawful strike, work stoppage, slowdown, or using or attempting to use sick leave to accomplish the same purpose as a strike, work stoppage, or slowdown. 3. Rule 8 — Termination 2003 MEA MOU Draft.doc 22 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING a) 8-1 — Medical Examination. Evaluation of Employee's Work Capacity. Demotion, Transfer or Termination of Appointment At any time a department head has reasonable cause to believe that an employee may not be able to perform the duties of his/her position for physical or psychological reasons, such department head shall consult with the Human Resources Manager OffiGef regarding such belief. If the Human Resources Manager OffiGe concurs, the department head may order the employee to submit to a medical or psychological examination. The employee shall be offered the opportunity, in writing, to select from a panel of three to five physicians or psychologists to conduct the examination. The cost of such examination shall be paid by the City and, to the extent practicable, shall be scheduled during the work hours with no loss of pay. The department head shall review the medical or psychological report and shall consult with the Human Resources Manager 8fficer regarding the physician's assessment of the employee's ability to perform the duties of his/her position. Any decision regarding such employee shall be made in accordance with the Americans with Disabilities Act. Notwithstanding any other provision of this rule, an employee being evaluated for medical or psychological fitness to perform the duties of his/her position may apply for another position in the competitive service for which he/she has qualified. If such employee is qualified and can perform the duties of a lower paying vacant position for which he/she has applied, he/she will be placed in such position, without competitive examination, subject to the approval of the department head. (The City and Association agree to meet biannually to discuss the 8-1 process). b) 8-3 — Layoff in Accordance with Length of Service The City and the Association agree that the first sentence in Personnel Rule 8-3 shall be modified to read as follows: Layoff shall be made in accordance with the relative length of the last period of continuous service of the employees in the class of layoff, provided, however, that no permanent employee shall be laid off until all temporary, acting and probationary employees in the competitive service holding positions in the same class are first laid off. c) 8-11 — Re -Employment With the approval of the Human Resources Manager 8ffise , an employee who has resigned in good standing from the competitive service may be re-employed to his/her former position, if vacant, or to a vacant position in the same or comparable class within one (1) year from date of resignation in accordance with Rule 5-21. If such re- 2003 MEA MOU Draft.doc 23 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING employment commences withi resignation, the employee shall vacation and seniority purposes. 4. Rule 9 — Probation n ninety days of the effective date of not be considered a new employee for a) 9-4 — Refection of Probationary Employee Any employee rejected during the probationary period following a promotional appointment, shall receive a performance evaluation for the probationary period served and be reinstated to the position from which the employee was promoted unless charges are filed and the employee is discharged. When an employee is returned to his/her former class under the provisions of this Section, the employee shall serve the remainder of any uncompleted probationary period in the former class. 5. Rule 12 — Classification Plan a) 12-10 — Temporary Employees Employment on a basis other than permanent or probationary to a permanently budgeted position not to exceed 1000 hours in any twelve (12) month period. Employees occupying temporary positions shall not be included in the competitive service and shall not be subject to these rules and regulations. 6. Rule 14 — Additional Pay and Pay Adjustments a) 14-6 — Salary Advancements to Meet Recruiting Problems or to Give Credit for Prior Service. Application for Other Advancements The Department Head, through the Human Resources Manager O##iser and with the approval of the City Administrator may make an appointment at any step above the minimum salary rate to classes or positions in order to meet recruiting problems to obtain a person who has extraordinary qualifications, or to give credit for prior city service in connection with appointments, promotions, reinstatements, transfers, reclassifications, or demotions. Salary adjustments within the salary range for the class, other than merit salary adjustments authorized by Section 14-1, may be approved by the City Administrator, upon recommendation of the department head through the Human Resources Manager O iser. Such recommendation shall include the reason(s) for the adjustment, whether the advancement is to be permanent or temporary, and an effective date. 7. Rule 18 — Attendance and Leaves a) 18-8 — Sick Leave The parties agree to modify Section 18-8(d) of the Personnel Rules to provide: Sick leave may be used for an absence due to illness of the 2003 MEA MOU Draft.doc 24 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING employee's spouse, child, stepchild or parent when the employee's presence is required at home, provided that such absence shall be limited to five (5) days per calendar year. b) 18-16 — Industrial Accident Leave In the event a permanent employee, who is a miscellaneous member of the Public Employees' Retirement System (PERS), is temporarily totally disabled as a result of an injury or illness arising out of and in the course of employment and covered by the State of California Workers' Compensation Insurance and Safety Act, resulting light duty assignments due to the injury or illness or absences from work shall be considered Industrial Accident Leave as that term is defined by this rule. A permanent employee eligible for Industrial Accident Leave shall receive compensation from the City in an amount equal to the employee's regular rate of salary during such period of temporary total disability. Benefits received under this rule shall be in lieu of statutory Workers' Compensation benefits. Industrial Accident Leave shall continue during all absences resulting from the injury or illness, including those absences attributable to doctor's appointments, therapy, or other follow-up medical visits, but in no case exceeding one year of accumulated absences attributable to the same injury or illness. In the event an employee is temporarily, totally disabled by coinciding qualifying injuries or illnesses, periods of absences shall be applied concurrently to all qualifying injuries or illnesses. Industrial Accident Leave compensation shall begin on the first day an eligible employee is absent due to a qualifying injury or illness as defined above. Industrial accident Leave compensation will terminate on the earliest of the following: 1) The date upon which the injury or illness giving rise to eligibility for compensation under this rule is declared permanent and stationary by a treating or examining physician; or 2) The date PERS approves an application for disability retirement benefits filed by the employee or by the City; or 3) The employee receives thirty (30) days advance notice and refuses to submit to a medical examination ordered by PERS pursuant to Government Section 21154 or otherwise refuses to cooperate with PERS in determining whether the employee is incapacitated for the performance of duty; or 4) The employee receiving Industrial Accident Leave Compensation applies for service -connected retirement benefits; or 2003 MEA MOU Draft.doc 25 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 5) The employment of the affected employee is otherwise separated. If an injured worker remains temporarily disabled after receiving one year of Industrial Accident Leave for accumulated absences or light duty work attributable to the same injury or illness, the employee will receive temporary total disability benefits as specified by the State of California Workers' Compensation Insurance and Safety Act. Any period of time during which an employee is absent from work by reason of injury or illness for which he or she is entitled to receive Industrial Accident Leave compensation will not constitute a break in continuous service for the purposes of salary adjustments, sick leave, vacation accruals, and length of service computation. In the event an employee who is receiving or has received Industrial Accident Leave compensation makes a claim or initiates legal action against a third party for allegedly causing or contributing to the injury or illness resulting in the inability to work, the employee is required to notify in writing the City's Risk Management Division of the claim or commencement of such action within ten (10) days of the claim or such commencement. The City retains its rights of subrogation in all such instances. c) 18-19 — Maternity Leave The City and the Association agree to modify the present Personnel Rule 18-19 Maternity Leave to read as follows: "A permanent employee shall be entitled to a leave of absence without pay due to inability to work due to pregnancy. The employee will be entitled to use available sick leave during this period. Said leave must be requested in writing from the Department Head and must include written notification from the employees physician stating the last day the employee may work and the estimated duration of leave. The employee must obtain written authorization to return to work from the attending physician. Said authorization must be filed with the Department Head and the Human Resources Manager O#+cer." d) 18-20 — Leave of Absence without Pay The City and the Association agree that the following sub -paragraph "C" shall be added to Personnel Rule 18-20. Leave of Absence without Pay: Leave of absence without pay, for medical disability reasons, shall be restricted to six (6) months. 8. Rule 19 — Grievance Procedure Non -Disciplinary Matters a) 19-5 Grievance Procedure 1) Step 4 — City Administrator 2003 MEA MOU Draft.doc 26 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING If the grievance is not settled under Step 3, the grievance may be presented to the City Administrator in accordance with the following procedure: Within fifteen (15) days after the time the decision is rendered under Step 3 above, a written statement of the grievance shall be filed with the Human Resources Manager Of#+ser who shall act as hearing officer and shall set the matter for hearing within fifteen (15) days thereafter and shall cause notice to be served upon all interested parties. The Human Resources Manager Off-ise , or his representative, shall hear the matter de novo and shall make recommended findings, conclusions and decision in the form of a written report and recommendation to the City Administrator within five (5) days following such hearing. The City Administrator may, in his discretion, receive additional evidence or argument by setting the matter for hearing within ten (10) days following his receipt of such report and causing notice of such hearing to be served upon all interested parties. Within five (5) days after receipt of report, or the hearing provided for above, if such hearing is set by the City Administrator, the City Administrator shall make written decision and cause such to be served upon the employee or employee organization and the Human Resources Manager Of#iser. 2) Step 5 — Personnel Board Hearing Hearing. As soon as practicable thereafter, the Human Resources Manager Officer shall set the matter for hearing before a hearing officer either selected by mutual consent of the parties or from a list provided by the Personnel Commission. Ratification of the hearing officer selected by mutual consent of the parties, if from a list approved by the Personnel Commission, shall not require separate approval or -ratification by the Personnel Commission. The hearing officer shall hear the case and make recommended findings, conclusions and decision in the form of a written report and recommendation to the Personnel Commission. In lieu of the hearing officer process, the Personnel Commission may agree to hear a case directly upon submission of the case by mutual consent of the parties. 9. Rule 20 —Disciplinary Procedure and Appeal a) 20-1 — Purpose The purpose of this rule is to provide a procedure for recommending and imposing discipline against City employees, and a means by which an employee's may administratively appeal any such disciplinary action. 2003 MEA MOU Draft.doc 27 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING b) 20-2 — Disciplinary Procedures 1) Notice of Proposed Adverse Action For disciplinary demotions, suspensions or dismissals, an employee shall be served a written Notice of Proposed Adverse Action by the employee's department head, or his/her designee, or by certified mail, prior to the proposed disciplinary action taking effect. The notice shall state the reasons for and charges upon which the proposed action is based, and the effective date of the action the right to respond and the employer's right to representation. A copy of all materials upon which the proposed action is based shall be attached to the notice. 2) Employee's Right to Respond The employee shall be given a minimum of ten (10) calendar days to respond orally and/or in writing to the charges upon which the proposed action is based. The employee's response shall be made to and/or before his/her department head. 3) Time Off The employee shall be given reasonable time off with pay to attend disciplinary meetings. 4) Final Notice of Decision After an employee has responded to or waived his/her right to respond to the proposed adverse action, the employee shall be served with a final Notice of Decision from his/her department head. The final written Notice of Decision shall state whether or not the proposed action shall be taken or modified, and the reasons therefore and effective date or the action. c) 20-3 — Appeal to Personnel Commission Disciplinary action involving the termination, suspension, demotion or other reduction in pay may be appealed to the Personnel Commission for de novo hearing and final determination in accordance with the following procedure: 1) Request for Appeal Within five (5) days after the employee's receipt of a final Notice of Discipline, a written request for an appeal to the Personnel Commission shall be submitted to the Human Resources Manager 9#ase . 2) Hearing 2003 MEA MOU Draft.doc 28 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING As soon as practicable thereafter, the Human Resources Manager Offiser shall set the matter for hearing before a hearing officer. The hearing officer shall hear the case without the Board and shall make recommended findings, conclusions and decision in the form of a written report and recommendation to the Board. 3) Final Decision The Board shall consider the written report and recommendations of the hearing officer and after due deliberation in executive session, shall render a decision in the matter which shall be final and binding on all parties, and from which there shall be no further appeal. d) 20-4 — Supplemental Hearing by Personnel Board 1) The Board may, in its sole discretion, after it has received the written report and recommendation of the hearing officer, set the matter for private hearing for the purpose of receiving additional evidence or argument. In the event the Board sets a private hearing for such purposes, the Human Resources Manager Officer shall give written notice to all parties concerned in such matter. 2) The Board, following a consideration of the hearing officer's written report and recommendation and deliberation thereon and any supplemental hearing before the Board, shall make findings, conclusions and decisions which shall be final and binding on all parties and from which there shall be no further appeal. e) 20-5 — Employee Status on Pending Appeal Notwithstanding the provisions of Rule 7, Section 7-4 (Suspension with Pay), the disciplinary action shall be effective pending an appeal to the Personnel Commission. 10. Rule 21 —Grievance Procedures- General a) 21-7 Hearing Officers The hearing officer provided for in Rules 19 and 20 shall be from a list provided by the Personnel Commission or one selected by mutual consent of the parties. b) 21-11 Time. Computation of The period of time in which any act must occur, as provided in these rules, shall be computed by excluding the first and including the last day of such period, and in the event the last day falls on a Saturday. Sunday or legal holiday, such acts may be accomplished on the next 2003 MEA MOU Draft.doc 29 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING succeeding working day. As used in Rules 19 and 10, all references to days shall be interpreted to mean calendar days. c) 21-12 Time. Extension of The City and the employee, or employee organization may, by mutual consent, extend the time period within which an act must occur in the processing of grievances. o IN ;,. ._IN 110. WW ._ ._ ._ -_ .. ;,. ._ ._ - � 2003 MEA MOU Draft.doc 30 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING Mr - 0 F"M ,,Mr. ._ ._ -Nif C. Rules Governing Layoff, Reduction in Lieu of Layoff and Re -Employment 1. Part 1 — Layoff Procedure a) General Provisions 1) Whenever it is necessary, because of lack of work or funds to reduce the staff of a City department, employees may be laid off pursuant to these rules. 2) Whenever an employee is to be separated from the competitive service because the tasks assigned are to be eliminated or substantially changed due to management -initiated changes, including but not limited to automation or other technological changes, it is the policy of the City that steps be taken by the Personnel Division on an interdepartmental basis to assist such employee in locating, preparing to qualify for, and being placed in 2003 MEA MOU Draft.doc 31 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING other positions in the competitive service. This shall not be construed as a restriction on the City government in effecting economies or in making organizational or other changes to increase efficiency. 3) A department shall reduce staff by identifying which positions within the department are to be eliminated. 4) The employee who has the least City-wide service credit in the class within the department shall have City-wide transfer rights in the class pursuant to Part 1, Section 3, Transfer or Reduction to Vacancies in Lieu of Layoffs, or within the occupational series pursuant to Part 2, Bumping Rights. 5) If a deadline within this procedure falls on a day that City Hall is closed, the deadline shall be the next day City Hall is open. b. Service Credit 1) Service credit means total time of full-time continuous service within the City at the time the layoff is initiated, including probation, paid leave or military leave. Permanent part-time employees earn service credit on a pro-rata basis. 2) Except as required by law, leaves of absence without pay shall not earn service credit. 3) As between two or more employees who have the same amount of service credit, the employee who has the least amount of service in class shall be deemed to be the least senior employee. c. Transfer or Reduction to Vacancies in Lieu of Layoff 1) In lieu of layoff, a transfer within class shall be offered to an employee(s) with the least amount of service credit in the class designated for staff reduction within a department subject to the following: a) The employee has the necessary qualifications to perform the duties of the position. b) The employee shall be given the opportunity, in order of service credit, to accept a transfer to a vacant position in the same class within the City, provided the employee has the necessary qualifications to perform the duties of the position. c) If no position in the same class is vacant, the employee shall be given the opportunity, in order of service credit, to transfer 2003 MEA MOU Draft.doc 32 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING to the position in the same class that is held by an incumbent in another department with the least amount of service credit whose position the employee has the necessary qualifications to perform. 2) If an employee(s) is not eligible for transfer within the employee's class, the employee shall be offered, in order of service credit, a reduction to a vacant position in the next lower class within the City in the occupational series in lieu of layoff provided the employee has the necessary qualifications to perform the duties of the position. 3) If the employee refuses to accept a transfer or reduction pursuant to A. or B., above, the employee shall be laid off. d) If the employee(s) in the class with the least amount of service credit is in the position(s) to be eliminated or displaced by transfer, the employee shall be offered bumping rights, pursuant to Part 2, Service Credit. e) Any employee who takes a reduction to a position in a. lower class within the occupational series in lieu of layoff shall be placed on the reinstatement/reemployment list(s) pursuant to Part 3., Reemployment. 2. Order of Layoff a) Prior to implementing a layoff, vacant positions that are authorized to be filled shall be identified by Citywide occupational series. If the employee refuses to accept a position pursuant to Section 3., above, the employee shall be laid off. b) No promotional probationary employee or permanent employee within a class in the department shall be laid off until all temporary, nonpermanent part-time and non -promotional probationary employees in the class are laid off. Permanent employees whose positions have been eliminated may exercise citywide bumping rights to a lower class in the occupational series pursuant to Part 2. c) When a position in a class and/or occupational series is eliminated, any employee in the class who is on authorized leave of absence or is holding a temporary acting position in another class shall be included for determining order of service credit and be subject to these layoff procedures as if the employee was in his or her permanent position. 3. Notification of Employees a) The Personnel Division shall give written notice of layoff to the employee by personal service or by sending it by certified mail to the 2003 MEA MOU Draft.doc 33 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING last known mailing address at least fifteen (15) calendar days prior to the effective date of the layoff. Normally notices will be served on employees personally at work. b) Layoff notices may be initially issued to all employees who may be subject to layoff as a result of employees exercising voluntary reduction/bumping rights. c) The notice of layoff shall include the reason for the layoff, the effective date of the layoff, the employee's hire date and the employee's service credit ranking. The notice shall also include the employee's right to bump the person in a lower class with the least service credit within the occupational series provided the employee possesses the necessary qualifications to successfully perform the duties in. the lower class and the employee has more service credit than the incumbent in the lower class. d) The written layoff notice given to an employee shall include notice that he or she has seven (7) calendar days from the date of personal service, or date of delivery of mail if certified, to notify the Human Resources Manager O#iser in writing if the employee intends to exercise the employee's bumping rights, if any, pursuant to Part 2, Bumping Rights. e) Whenever practicable, any employee with the least amount of service credit in a lower class within an occupational series which is identified for work force reduction shall also be given written notice that such employee may be bumped pursuant to Part 2. This notice shall include the items referred to in C., above. f) If an employee disagrees with the City's computation of service credit or listed date of hire, the employee shall notify the Human Resources Manager O#ise as soon as possible but in no case later than five (5) calendar days after the personal service or certified mail delivery. Disputes regarding date of hire or service credit shall be jointly reviewed by the Human Resources Manager Of#iser and the employee and/or the employee's representative as soon as possible, but in no case later than five (5) calendar days from the date the employee notifies the Human Resources Manager O#iser of the dispute. Within five (5) calendar days after the dispute is reviewed, the employee shall be notified in writing of the decision. 4. Part 2 — Bumping Rights a) Voluntary Reduction or Bumping in Lieu of Layoff 1) A promotional probationary employee or permanent employee who receives a layoff notice may request a reduction to a position in a 2003 MEA MOU Draft.doc 34 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING lower class within the occupational series provided the employee possesses the necessary qualifications to perform the duties of the position. 2) Employees electing reduction under A above, shall be reduced to a position authorized to be filled in a lower class within the employee's occupational series. The employee may reduce to a lower class in his/her occupational series by: 1) filling a vacancy in that class, or 2) if no vacancy exists, displacing the employee in the class with the least service credit whose position the employee has the necessary qualifications to perform. A displaced employee shall have bumping rights. 3) An employee who receives a layoff notice must exercise bumping rights within seven (7) calendar days of receipt of the notice as specified in Part 1. Failure to respond within the time limit shall result in a reputable presumption that the employee does not intend to exercise any right of reduction or bumping to a lower class. The employee must carry the burden of proof to show that the employee's failure to respond within the time limits was reasonable. If the employee establishes that failure to respond within the time limit was reasonable, to the Human Resources Manager's OffiseFe satisfaction, the employee shall be permitted to exercise bumping rights but shall not be reinstated to a paid position until the employee to be bumped has vacated the position. If the employee disagrees with the Human Resources Manager's O#iser's decision, the employee may appeal pursuant to the provisions of Sections 3 and 4 below. b) Reinstatement/Re-employment Lists Any employee who takes a reduction to a position in a lower class within the occupational series in lieu of layoff shall be placed on tile reinstatement/re-employment list pursuant to Part 3, Re-employment. c) Qualifications Appeal Any employee who is denied a reduction to a position in a lower class within the occupational series on the basis that the employee does not possess the necessary qualifications to successfully perform the duties of the lower position may appeal the decision. The appeal shall be filed with the Human Resources Manager Officer within five (5) calendar days of the employee's receipt of written notice of the decision and reason(s) for denial. The employee's appeal shall be in writing and shall include supporting facts or documents supporting the appeal. d) Qualifications Appeal Hearing 2003 MEA MOU Draft.doc 35 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 1) Upon receipt of an appeal, the Human Resources Manager 9#iser shall contact a mediator from the California State Mediation and Conciliation Service to schedule a hearing within two (2) weeks after receipt of the appeal. If the California State Mediation and Conciliation Service is not available within that time frame, the parties shall mutually select a person who is available within the time frame. If the California State Mediation and Conciliation Service and the person mutually selected are not available within tile time frame, the parties shall select the earliest date either is available to conduct the hearing. The parties shall split the cost, if any, of the hearing officer. In addition, the parties shall meet within three (3) workdays to attempt to resolve the dispute. If the dispute remains unresolved, the parties shall endeavor in good faith to submit to the hearing officer a statement of all agreed upon facts relevant to the hearing. 2) Appeal hearings shall be limited to two (2) hours, except as otherwise agreed by the parties or directed by the hearing officer. 3) The hearing officer shall attempt to resolve the dispute by mutual agreement if possible. If no agreement is reached, the hearing officer shall render a decision at the conclusion of the hearing which shall be final and binding 5. Part 3 — Re-employment a) Re-employment 1) Employees who are laid off or reduced to avoid layoff shall have their names placed upon a reemployment list, for each class in the occupational series, in seniority order at or below the level of the class from which laid off or reduced. 2) Names of persons placed on the reemployment lists shall remain on the list for two (2) years from the date of layoff or reduction. 3) Vacancies shall be filled from the reemployment list for a class, starting at the top of the list, providing that the person meets the necessary qualifications for the position. 4) Names of persons are to be removed from the reemployment list for a class if on two (2) occasions they decline an offer of employment or on two (2) occasions fail to respond to offers of employment in a particular class within five (5) calendar days of receipt of written notice of an offer. Any employee who is dismissed from the City service for cause shall have his or her name removed from all re-employment lists. 2003 MEA MOU Draft.doc 36 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 5) Re-employment lists shall be available to HBMEA and affected employees upon reasonable request, 6) Qualification appeals involving reemployment rights shall be resolved in the same manner as that identified in Part 2., Section 4. b) Status on Re-employment 1) Persons re-employed from layoff within a two (2) year period from the date of layoff shall receive the following considerations and benefits: a) Service credit held upon layoff shall be restored, but no credit shall be added for the period of layoff. b) Prior service credit shall be counted toward sick leave and vacation accruals. c) Employees may cash in sick leave upon layoff or at any time after layoff in the manner and amount set forth in existing Memoranda of Understanding for that employee's unit. Sick leave shall be paid to an employee when the reemployment list(s) expire(s), if not previously paid. d) Upon reinstatement the employee may have his or her sick leave re -credited by repayment to the City the cashed amount. Sick leave accumulation of less than 480 hours shall be restored upon reemployment. e) The employee shall be returned to the salary step of the classification held at the time of the layoff and credited with the time previously served at that step prior to being laid off. f) The probationary status of the employee shall resume if incomplete. 2) Employees who have been reduced in class to avoid layoff and are returned within two (2) years to their former class shall be placed at the salary step of the class they held at the time of reduction and have their merit increase eligibility date recalculated. 2003 MEA MOU Draft.doc 37 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING ARTICLE XIV —MISCELLANEOUS A. Grievance Arbitration Any grievance as defined and described in Rules 19 and 20 of the City Personnel Rules (Resolution No. 3960), shall be settled in accordance with the procedures set forth in said Rules except that the parties to the grievance may, by mutual agreement, submit the grievance to a neutral arbitrator whose decision shall be final and binding on the parties. The arbitrator shall be selected by the parties from listings of and pursuant to the rules of the American Arbitration Association. This procedure, if adopted by the parties, shall be in lieu of Step 5 of Rule 19, or Step 4 of Rule 20, and the fees charged by the arbitrator or hearing officer and court reporter shall be paid by the party, which is not the prevailing party. B. Promotional Procedures 1. Tie Scores When promotions are to be made, and two or more employees are found to be equal as a result of promotional examinations conducted by the city, the employee with the greatest length of service with the city shall receive the promotion. 2. Sala!y Upon Promotion Upon promotion, an employee shall be compensated at the same step in the salary range for his or her new classification, subject to the following provisions: a. Except for the provisions of sub -paragraphs b and c below, no employee shall receive greater than ten percent (10%) increase upon promotion. b. If "A" Step of the classification upon promotion is greater than 10% increase, the employee shall be compensated at "A" step upon promotion. C. If the employee would be eligible for a step increase within eleven (11) months of the date of promotion in his or her classification before promotion, then the Human Resources Manager Office may authorize an increase greater than ten percent (10%) upon promotion. 2003 MEA MOU Draft.doc 38 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING C. Labor -Management Relations Committee The City and MEA will institute a Labor -Management Relations Committee as follows: 1. The Association and the Employer recognize that the participation of employees in the formulation and implementation of personnel policy and - practices affects their well-being and the efficient administration of the Government. The parties further recognize that the entrance into a formal agreement with each other is but one act of joint participation, and that the, success of a labor-management relationship is further assured if a forum is available and used to communicate with each other. The parties therefore, agree to the structure of Labor -Management Relations Committees (LMRC) for the purpose of exchanging information and the discussion of matters of concern or interest to each of them, in the broad area of working conditions, wages and hours. 2. The City of Huntington Beach shall have an LMRC. The formation of this LMRC shall not serve as the basis for reopening the meet and confer process to modify this MOU. 3. The LMRC shall meet monthly. The employer shall be represented by the City Administrator (or designee), the Human Resources Manager 9ffiser (or designee), and Department Heads. Four representatives at these meetings shall represent the Association. 4. The Employer agrees that any meeting conducted under this article shall be conducted in facilities furnished by the Employer, and Association representatives shall be released from their duties to attend the LMRC. 5. The parties shall exchange agenda items five workdays before each scheduled LMRC meeting described in this section. Matters not on the agenda may be discussed by mutual consent, if either party timely forwards an agenda, the meeting will be held. D. Copies of MOU The City agrees to print this Memorandum of Understanding, except Exhibit c for each employee requesting a copy. E. Position Classification Issues 1. Class Specifications The City shall send the Association a copy of each new job description approved for classifications within the representation unit. 2003 MEA MOU Draft.doc 39 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING 2. Reclassification Impact It is not the intention of the City to demote or layoff an employee through reclassification. Prior to imposing a Y-rating, or layoff resulting from classification reviews, the City agrees to meet and confer with Association representatives. 3. Surveyor Party Chief The city shall conduct a compensation study through the LMRC of the position of Surveyor Party Chief using Orange County benchmarks, to be completed by May 9, 2003. 4. Certificated Distribution Operator The city shall conduct a compensation study of the positions that are mandated by the State of California Department of Health Services to attain Certified Distribution Operator certifications. The compensation study will use only Orange County benchmarks. The compensation study is to be completed by June 20, 2003. The compensation report shall be a subject of negotiation in a successor MOU. F. Class A and B Driver License Fees The City shall reimburse employee's for costs associated with obtaining and renewing Class A and Class B driver licenses where required by the City for the position. G. Job Sharing The City shall direct the Labor/Management Relations Committee (LMRC) to review the feasibility of developing and implementing a Job Sharing Program. H. Deferred Compensation Loan Program Effes#+ve-Januar-1,2000,-employees may begin utilizing this program, under which employees may borrow up to 50% of their deferred compensation funds for critical needs such as medical costs, college tuition, or purchase of a home. Performance Evaluations/Written Reprimand Appeals Employees may appeal the results of performance evaluation or written reprimands. Such appeals shall be initiated through the appropriate chain of command (which may include the LMRC) and any decision made by the department head shall be considered final. J. Employee Performance Evaluations The city and two representatives from MEA will convene an ad -hoc committee to study a new employee performance evaluation system. The ad -hoc committee will finalize its report by June 20, 2003. 2003 MEA MOU Draft.doc 40 12/12/2002 8:44 AM MUNICIPAL EMPLOYEES' ASSOCIATION MEMORANDUM OF UNDERSTANDING K. MEA Letter of Introduction A one -page letter of introduction from the MEA, and of the MEA's choosing, regarding the benefits and purpose of joining the MEA will be included in all MEA eligible new employee orientation packets. ARTICLE XV — CITY COUNCIL APPROVAL It is the intent of the City and Association that this Memorandum of Understanding represents an "Agreement" between the undersigned within the meaning of Section 8-2 of the Huntington Beach Employer -Employee Relations Resolution; however, this Memorandum of Understanding is of no force or effect whatsoever unless adopted by resolution of the City Council of the City of Huntington Beach. IN WITNESS WHEREOF, the parties hereto have executed this Memorandum of Understanding this day of December, 2002. City of Huntington Beach Huntington Beach Municipal Employees' Association By: By: Ray Silver John H. Von Holle City Administrator HBMEA President By: By: William P. Workman William E. Applebee Assistant City Administrator HBMEA Bargaining Committee By: By: Clay Martin Robert M. Hidusky Administrative Services Director HBMEA Bargaining Committee By: By: Steven M. Berliner Darrin L. Kossky Chief Negotiator HBMEA Bargaining Committee By: Nick Beradino, Chief Negotiator APPROVED AS TO FORM: Jennifer M. McGrath City Attorney 2003 MEA MOU Draft.doc 41 12/12/2002 8:44 AM MEA LIST OF MOU EXHIBITS EXHIBITS --SUBJECT A Class/Salary Schedule B Uniform Policy C Vehicle Use Policy D € Employee Health Plan E Delta Care (PMI) — Dental Plan F G Delta Dental — Dental Plan # S7� afd Dental Dental Pkan G I Vision Service Plan H 4 Long Term Disability Plan I K Retiree Medical Plan and Subsidy Program J 9/80 Work Schedule K 4/10 Work Schedule 2003 MEA MOU Draft.doc 42 12/12/2002 8:44 AM • @ &t 6 s E & t Q 9 E 2 � � & I 9 h � � p � E E t t � t � � � � t � t E i E I mum rim ar .. r .. ar • ar • , .. ar • o ar • ar •r ar . ar ., .. r o ar r w , r •n . •o r .n , •o r a •o Ir r r .. r o • .i �� .ir .rr .. „ „ • .. 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I 1 1 O •I U ' � ' 1 . 1 ' ' , , •1 1 , ' • 1 1 • ■r ■ 1 • . . 1 1 u • • " 1 ■ ■� Ii 1 1 1 • 1' 1 1' I 1 1 1 1 1 1 1 1 1 1 1 1 ■1 ■1 1 U ■I •I •1 U O •I O •1 a U O N D O 2 w u 0 .o ■r r r .� .� r .r .r . r r .n Ir •r Ir �r .r Ir .� •r .ir Ir .r .. ., .� r •r .r .� CEO .r No EIIIIIIIIIIIIIIIIII 111EIIIIISEIIIIIIIIIII o 0 u � o r 1 1 ' o I� u . u r •I r 1' 1' •r I u '� '� �� I I' r •r I' 'I 'I " u 1 u u ,r u o • .r I, I, Ir r . r ' •r u o I' I, .r I II I 1 � .r 1 1 1 .1 I 1 11 11 1 1 1 11 11 1 r � ; ' I' I I I I 1 •� 1 1 1 1 Q v v 00 0 O N N N Ib Z) cQ C Q W M O O 04 EXHIBIT A - CLASS/SALARY SCHEDULE EFFECTIVE DECEMBER 21, 2002 ;JobZype� C P 'n piG=� - A 0106 Engineering Assistant, Civil 505 27.06 28.55 30.12 31.78 33.53 0108 Planner, Assistant 479 23.76 25.07 26.45 27.91 29.45 0110 Accountant, Senior 502 26.65 28.12 29.67 31.30 33.02 0111 Accountant 474 23.18 24.45 25.80 27.22 28.72 0112 Buyer 471 22.83 24.09 25.42 26.82 28.30 0113 Human Services Pro g Suprvsr 480 23.90 25.21 26.60 28.06 29.60 0114 Librarian 452 20.78 21.92 23.13 24.40 25.74 0115 Info Systems Analyst 1 480 23.90 25.21 26.60 28.06 29.60 0116 Info Systems Analyst 11 499 26.27 27.71 29.23 30.84 32.54 0117 Info Systems Analyst 111 518 28.87 30.46 32.14 33.91 35.78 0118 Info Systems Analyst IV 537 31.75 33.50 35.34 37.28 39.33 0119 Criminalist 480 23.90 25.21 26.60 28.06 29.60 0120 Criminalist, Sr 520 29.18 30.78 32.47 34.26 36.14 0134 Deputy City Clerk 393 15.47 16.32 17.22 18.17 19.17 0135 Deputy City Clerk, Senior 442 19.76 20.85 22.00 23.21 24.49 0136 Planning Aide 436 19.19 20.25 21.36 22.53 23.77 0137 Video Engineer Supervisor 497 26.01 27.44 28.95 30.54 32.22 0138 Development Specialist 480 23.90 25.21 26.60 28.06 29.60 0139 Housing Development Specialist 479 23.76 25.07 26.45 27.91 29.45 0140 Crewleader, Traf Signal/Light 489 24.99 26.36 27.81 29.34 30.95 0141 Crewleader, Electrical Maint 489 24.99 26.36 27.81 29.34 30.95 0142 Crewleader, Equip/Auto Maint 490 25.10 26.48 27.94 29.48 31.10 0143 Crewleader, Facilities Maint 489 24.99 26.36 27.81 29.34 30.95 0144 Crewleader, Trees Maintenance 484 24.39 25.73 27.14 28.63 30.20 0145 Crewleader, Landscape Maint 484 24.39 25.73 27.14 28.63 30.20 0146 Crewleader, Wastewater Ops 484 24.39 25.73 27.14 28.63 30.20 0147 Crewleader, Water Dist Meters 484 24.39 25.73 27.14 28.63 30.20 0148 Crewleader, Signs & Markings 489 24.99 26.36 27.81 29.34 30.95 0149 Crewleader, Beach Maint 484 24.39 25.73 27.14 28.63 30.20 0150 Crewleader, Streets Maint 484 24.39 25.73 27.14 28.63 30.20 0151 Crewleader, Water Dist Maint 484 24.39 25.73 27.14 28.63 30.20 0152 Crewleader, Water Operations 484 24.39 25.73 27.14 28.63 30.20 0153 Crewleader, Park Maintenance 489 24.99 26.36 27.81 29.34 30.95 0154 Crewleader, Pest Control Advis 484 24.39 25.73 27.14 28.63 30.20 0155 Crewleader, Irrigation 484 24.39 25.73 27.14 28.63 30.20 0156 Water Quality Coordinator 484 24.39 25.73 27.14 28.63 30.20 0162 Civilian Check Investigator 425 18.17 19.17 20.22 21.33 22.50 0163 Latent Fingerprint Examiner 472 22.96 24.22 25.55 26.96 28.44 0164 Latent Fingerprint ExamTrainee 434 19.00 20.04 21.14 22.30 23.53 0165 Crime Analyst, Sr 501 26.53 27.99 29.53 31.15 32.86 0168 Printing Services Tech, Sr 437 19.28 20.34 21.46 22.64 23.89 0171 Inspector, Construction Sr 498 26.13 27.57 29.09 30.69 32.38 0172 Inspector, Construction Traine 458 21.41 22.59 23.83 25.14 26.52 0173 Fire Training Maint Tech 457 21.30 22.47 23.71 25.01 26.39 0174 Survey Technician 1 436 19.19 20.25 21.36 22.53 23.77 0175 Engineering Aide 436 1 19.19 20.25 21.36 22.53 1 23.77 2003 MEA MOU Draft.doc 49 12/12/2002 8:44 AM WS Ow, 0176 Plan Checker, Building 496 25.89 27.31 28.81 30.39 32.06 0177 Parking Meter Repair Tech 443 19.87 20.96 22.11 23.33 24.61 0178 GIS Analyst 499 26.27 27.71 29.23 30.84 32.54 0179 Computer Drafting Technician 489 24.99 26.36 27.81 29.34 30.95 0180 Engineering Technician 489 24.99 26.36 , 27.81 29.34 30.95 0181 Engineering Technician Traffic 489 24.99 26.36 27.81 29.34 30.95 0182 Code Enforcement Officer 11 468 22.50 23.74 25.05 26.43 27.88 0183 Survey Party Chief 489 24.99 26.36 27.81 29.34 30.95 0185 Survey Technician 11 452 20.78 21.92 23.13 24.40 25.74 0186 Code Enforcement Officer 1 426 18.25 19.25 20.31 21.43 22.61 0187 Graphics Admin Specialist 426 18.25 19.25 20.31 21.43 22.61 0188 Inspector, Water Construct Sr 489 24.99 26.36 27.81 29.34 30.95 0189 Inspector, Water Construction 469 22.63 23.87 25.18 26.56 28.02 0190 Haz Mat Program Specialist 496 25.89 27.31 28.81 30.39 32.06 0191 Water Quality Technician 458 21.41 22.59 23.83 25.14 26.52 0192 Cross Connection Control Spec 468 22.50 23.74 25.05 26.43 27.88 0193 Computer Operator 403 16.28 17.18 18.12 19.12 20.17 0194 Computer Assistant, Library 412 17.00 17.94 18.93 19.97 21.07 0195 Telecommunications Specialist 509 27.62 29.14 30.74 32.43 34.21 0197 Police Photo/Imaging Specialst 457 21.30 22.47 23.71 25.01 26.39 0198 Emergency Services Coordinator 520 29.18 30.78 32.47 34.26 36.14 0200 Computer Operations Supervisor 518 28.87 30.46 32.14 33.91 35.78 0202 Claims Exam, Workers Comp 395 15.63 16.49 17.40 18.36 19.37 0203 Television Producer/Director 470 22.73 23.98 25.30 26.69 28.16 0204 fire Training Media Specialist 454 20.99 22.14 23.36 24.64 26.00 0205 jPublic Information Specialist 470 22.73 23.98 25.30 26.69 28.16 0206 Media Production Coordinator 442 19.76 20.85 22.00 23.21 24.49 0207 Plan Checker, Public Works 500 26.40 27.85 29.38 31.00 32.70 0208 Inspector III, Building 498 26.13 27.57 29.09 30.69 32.38 0210 Inspector 1, Building 458 21.41 22.59 23.83 25.14 26.52 0211 Inspector 11, Building 478 23.65 24.95 26.32 27.77 29.30 0212 Info Systems Specialist 1 427 18.35 19.36 20.42 21.54 22.72 0213 Info Systems Specialist 11 446 20.16 21.27 22.44 23.67 24.97 0214 Info Systems Specialist IV 485 24.50 25.85 27.27 28.77 30.35 0215 Police Systems Coordinator 446 20.16 21.27 22.44 23.67 24.97 0232 Emergency Medical Srvcs Coord 550 33.88 35.74 37.71 39.78 41.97 0252 Comm Srvcs Recreation Coord 457 21.30 22.47 23.71 25.01 26.39 0254 Alarm Services Coordinator 447 20.25 21.36 22.54 23.78 25.09 0255 Crime Scene Investigator 458 21.41 22.59 23.83 25.14 26.52 0257 Library Specialist 415 17.27 18.22 19.22 20.28 21.40 0258 Comm Srvcs Recreation Su 480 23.90 25.21 26.60 28.06 29.60 0259 Property Officer 434 19.00 20.04 21.14 22.30 23.53 0260 Fire Safety Program Specialist 450 20.57 21.70 22.89 24.15 25.48 0262 Parking/Traffic Control Ofcr 389 15.18 16.01 16.89 17.82 18.80 0263 Community Relations Specialist 436 19.19 20.25 21.36 22.53 23.77 0264 Park Naturalist 480 23.90 25.21 26.60 28.06 29.60 0265 Nutrition Transit Coordinator 334 11.54 12.17 12.84 13.55 14.30 0266 Social Worker 447 20.25 21.36 22.54 23.78 25.09 0267 Social Worker, Assistant 406 16.52 17.43 18.39 19.40 20.47 0268 Volunteer Services Coordinator 428 18.43 19.44 20.51 21.64 22.83 2003 MEA MOU Draft.doc 50 12/12/2002 8:44 AM 4. Holidays a. For a recognized city holiday, eight (8) hours, as stated in Article XI1.2, are earned for each holiday. For the charging of hours on a scheduled holiday, the employee must use eight (8) hours of holiday time off and two (2) hour from the employees General Leave or Compensatory Time banks for a ten (10) hour workday. b. If a holiday falls on an FLSA nonexempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. If the employee cannot take the work shift before or after the holiday off the employee will be granted eight (8) hours of general leave. c. If a holiday falls on an FLSA exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. FLSA exempt employees shall not be granted any administrative/general leave or any added compensation for not taking a work shift off on a scheduled holiday. 5. Jury Duty — The provisions of the Personnel Rules shall continue to apply, however, if an FLSA exempt employee is called to serve on jury duty during a normal Friday off, Saturday, or Sunday, or on a city holiday, then the jury duty shall be considered the same as having occurred during the employees day off work, therefore, the employee will receive no added compensation. 2003 MEA MOU Draft.doc 81 12/12/2002 8:44 AM 49b Tyfiq�: 110 0282 Police Records Tech 375 14.16 14.94 15.76 16.63 17.54 0283 Police Records Supervisor 426 18.25 19.25 20.31 21.43 22.61 0284 Customer Service Rep 401 16.11 17.00 17.94 18.93 19.97 0285 Claims Exam, Medical 395 15.63 16.49 17.40 18.36 19.37 0286 0286 Accounting Technician 1 401 16.11 17.00 17.94 18.93 19.97 0287 Accounting Technician 11 420 17.73 18.70 19.73 20.81 21.95 0288 Accounting Technician, Sr 439 19.48 20.55 21.68 22.87 24.13 0289 Administrative Secretary MEA 413 17.10 18.04 19.03 20.08 21.18 0290 Office Specialist 395 15.63 16.49 17.40 18.36 19.37 0294 A counting Technician, Supvsr 449 20.46 21.59 22.78 24.03 25.35 0295 Permit Technician 406 16.52 17.43 18.39 19.40 20.47 0296 Arts Education Coordinator 420 17.73 18.70 19.73 20.81 21.95 0297 Art Program Curator 447 20.25 21.36 22.54 23.78 25.09 0298 Preparator 409 16.77 17.69 18.66 19.69 20.77 0299 Cultural Services Aide 447 20.25 21.36 22.54 23.78 25.09 0300 Legal Secretary 419 17.63 18.60 19.62 20.70 21.84 0302 Literary Program Specialist 452 20.78 21.92 23.13 24.40 25.74 0303 Mail Services Clerk 360 13.15 13.87 14.63 15.43 16.28 0304 Office Assistant 11 384 14.81 15.62 16.48 17.39 18.35 0305 Library Clerk Specialist (T) 360 13.15 13.87 14.63 15.43 16.28 0306 Office Assistant 1 347 12.31 12.99 13.70 14.45 15.24 0307 Police Records Specialist 395 15.63 16.49 17.40 18.36 19.37 0308 Police Services Specialist 415 17.27 18.22 19.22 20.28 21.40 0309 Library Services Clerk, Sr 399 15.95 16.83 17.76 18.74 19.77 0310 Library Processing Clerk 380 14.52 15.32 16.16 17.05 17.99 0311 Library Clerk 360 13.15 13.87 14.63 15.43 16.28 0312 Court Liaison Specialist 413 17.10 18.04 19.03 20.08 21.18 0313 Info Systems Specialist 111 475 23.30 24.58 25.93 27.36 28.86 0334 Helicopter Maint Tech, Sr 505 27.06 28.55 30.12 31.78 33.53 0335 Communications Technician 458 21.41 22.59 23.83 25.14 26.52 0336 Electrician, Traffic Signal 468 22.50 23.74 25.05 26.43 27.88 0337 Helicopter Maint Tech 454 20.99 22.14 23.36 24.64 26.00 0338 Leadworker, Signs 452 20.78 21.92 23.13 24.40 25.74 0339 Electrician 465 22.16 23.38 24.67 26.03 27.46 0340 Car enter 450 20.57 21.70 22.89 24.15 25.48 0341 Painter 450 20.57 21.70 22.89 24.15 25.48 0342 Plumber 460 21.62 22.81 24.06 25.38 26.78 0343 Facilities Maintenance Tech Sr 455 21.10 22.26 23.48 24.77 26.13 0344 Masonry Worker 450 20.57 21.70 22.89 24.15 25.48 0345 Concrete Finisher 442 19.76 20.85 22.00 23.21 24.49 0346 Telemetry Instrument Tech 460 21.62 22.81 24.06 25.38 26.78 0347 Mechanic 111 455 21.10 22.26 23.48 24.77 26.13 0348 Mechanic 11 443 19.87 20.96 22.11 23.33 24.61 0349 Mechanic, Wastewater Pump Sr 432 18.81 19.84 20.94 22.08 23.29 0350 Vehicle Body Technician, Sr 443 19.87 20.96 , 22.11 23.33 24.61 0351 Vehicle Body Technician 390 15.25 16.09 16.98 17.91 18.89 0352 Equip Operator, Grader 448 20.36 21.48 22.66 23.91 25.22 0354 Equip Operator, Signs/Markings 432 18.81 19.84 20.94 22.08 23.29 0356 Water Meter Repair Technician 431 1870 19.73 20.82 21.96 23.17 0357 Irrigation Specialist 426---r 18.25 19.25 20.31 21.43 22.61 2003 MEA MOU Draft.doc 51 12/12/2002 8:44 AM rip G 44 1 0358 Equip Operator, Beaches 432 18.81 19.84 20.94 22.08 23.29 0359 Equip Operator, Landscape 432 18.81 19.84 20.94 22.08 23.29 0361 Equip Operator, Streets 432 18.81 19.84 20.94 22.08 23.29 0362 Equip Operator, Wastewater 432 18.81 19.84 20.94 22.08 23.29 0363 Mechanic, Marine Equip Sr 490 25.10 26.48 27.94 29.48 31.10_ 0364 Equip Operator, Water 448 20.36 21.48 22.66 23.91 25.22 0365 Equip Operator, Trees 432 18.81 19.84 20.94 22.08 23.29 0367 Pest Control Specialist 426 18.25 19.25 20.31 21.43 22.61 0368 Water Systems Technician 1 421 17.81 18.79 19.82 20.91 22.06 0369 Water Systems Technician 11 434 19.00 20.04 21.14 22.30 23.53 0370 Water Systems Technician 111 454 20.99 22.14 23.36 24.64 26.00 0371 Leadworker, Water Operations 470 22.73 23.98 25.30 26.69 28.16 0372 Crewleader, Vehicl Body Repair 471 22.83 24.09 25.42 26.82 28.30 0374 Leadworker,Traf Signal & Light 473 23.07 24.34 25.68 27.09 28.58 0375 ILeadworker, Electrical 467 22.39 23.62 24.92 26.29 27.74 0377 Leadworker, Water Dist Meters 448 20.36 21.48 22.66 23.91 25.22 0378 Leadworker, Painter 452 20.78 21.92 23.13 24.40 25.74 0379 Leadworker, Water Dist Maint 464 22.06 23.27 24.55 25.90 27.32 0380 Media Services Specialist 415 17.27 18.22 19.22 20.28 21.40 0382 lCrewleader, Equip Services 471 22.83 24.09 25.42 26.82 28.30 0383 Equip Support Assistant 421 17.81 18.79 19.82 20.91 22.06 0384 Mechanic 1 422 17.89 18.87 19.91 21.01 22.17 0385 Warehousekeeper 436 19.19 20.25 21.36 22.53 23.77 0386 Stock Clerk 389 15.18 16.01 16.89 17.82 18.80 0387 Mechanic, Wastewater Pump 427 18.35 19.36 20.42 21.54 22.72 0388 Tire Service Worker (T) 416 17.36 18.32 19.33 20.39 21.51 0389 Maint Service Worker, Traffic 415 17.27 18.22 19.22 20.28 21.40 0390 Groundsworker 389 15.18 16.01 16.89 17.82 18.80 0391 Facilities Maintenance Tech 423 17.99 18.98 20.02 21.12 22.28 0392 Maint Service Worker 415 17.27 18.22 19.22 20.28 21.40 0394 Maint Worker 389 15.18 16.01 16.89 17.82 18.80 0395 Parking Meter Repair Worker 427 18.35 19.36 20.42 21.54 22.72 0396 Water Meter Reader, Sr 425 18.17 19.17 20.22 21.33 22.50 0397 Water Meter Reader 409 16.77 17.69 18.66 19.69 20.77 0398 field Service Representative 429 18.52 19.54 20.61 21.74 22.94 0399 P inting Services Technician 400 16.04 16.92 17.85 18.83 19.87 0400 Custodian 394 15.56 16.42 17.32 18.27 19.27 0401 Leadworker, Parking & Camping 448 20.36 21.48 22.66 23.91 25.22 0402 Leadworker, Landscape Maint 448 20.36 21.48 22.66 23.91 25.22 0404 Leadworker, Wastewater Ops 448 20.36 21.48 22.66 23.91 25.22 0406 Leadworker, Streets Maint 458 21.41 22.59 23.83 25.14 26.52 0407 Leadworker, Facilities Maint 439 19.48 20.55 21.68 22.87 24.13 0409 Leadworker, Street Cleaning 452 20.78 21.92 23.13 24.40 25.74 0410 Leadworker, Traffic Markings 448 20.36 21.48 22.66 23.91 25.22 0428 Administrative Aide 470 22.73 23.98 25.30 26.69 28.16 0432 Library Facilities Coordinator 431 18.70 19.73 20.82 21.96 23.17 0433 Theater/Media Technician 415 17.27 18.22 19.22 20.28 21.40 0434 Code Enforcement Officer Sr 488 24.86 26.23 27.67 29.19 30.80 0436 Claims Exam, Workers Comp Sr 477 23.53 24.82 26.19 27.63 29.15 0437 Permit Technician, Sr 455 21.10 22.26 23.48 24.77 26.13 2003 MEA MOU Draft.doc 52 12/12/2002 8:44 AM 50"IT p es cr Q11 C, c< 0438 .......... Crewleader, Painting 489 24.99 26.36 27.81 29.34 30.95 0445 Admin Environmental Specialist 505 27.06 28.55 !1 30.12 31.78 33.53 0448 Mechanic, Marine Equipment 469 22.63 23.87 25.18 26.56 28.02 0449 Water Utility Locator 458 21.41 22.59 23.83 25.14 26.52 0450 Library Specialist, Sr 433 18.89 19.93 , 21.03 22.19 23.41 0451 Library Services Clerk 380 14.52 15.32 16.16 17.05 17.99 0452 Maint Service Worker, Beach 415 17.27 18.22 19.22 20.28 21.40 0454 Maint Service Worker, Wastewtr 415 17.27 18.22 19.22 20.28 21.40 0455 Parking/Traffic Control Coord 436 19.19 20.25 21.36 22.53 23.77 0456 Distribution Services Clerk 390 15.25 16.09 16.98 17.91 18.89 0459 Crewleader, Parking/Camping 484 24.39 25.73 27.14 28.63 30.20 0460 11-eadworker, Trees Maint 448 20.36 21.48 22.66 23.91 25.22 0461 Water Service Worker 421 17.81 18.79 19.82 20.91 22.06 0462 Crossing Guard Coordinator 436 19.19 20.25 21.36 22.53 23.77 0463 Inspector, Consruction 478 23.65 24.95 26.32 27.77 29.30 0465 Crewleader, Park Equipment 490 25.10 26.48 27.94 29.48 31.10 0470 Forensic Systems Specialist 446 20.16 21.27 22.44 23.67 24.97 0472 Leadworker, Auto -Equip Maint 471 22.83 . 24.09 , 25.42 26.82 1 28.30 0478 11-eadworker, Street Services 458 21.41 1 22.59 123.83 25.14 1 26.52 1 2003 MEA MOU Draft.doc 53 12/12/2002 8:44 AM EXHIBIT B — UNIFORM POLICY A. General The City, in accordance with agreements now established, shall furnish uniforms to those personnel designated by the various department heads as required to wear a standard uniform for appearance, uniformity and public recognition purposes, in the procedures and guidelines set forth hereinafter. B. Affected Personnel All employees categorized, as field -working assignees shall wear a standard City adopted uniform. Color selection is a light blue shirt and dark blue trousers with appurtenances as described below. Each department head shall determine which group of employees must wear a uniform. C. Basic Uniform Components and Standard Allowances 1. Black safety toe shoes or boots as each assignment dictates. a. Two pair per year. b. Boots will be black, heavy duty and laced. c. Damaged shoes shall be turned into operating supervisor who shall authorize replacement or repair. 2. Five short -sleeved shirts (light blue) the first year, three the second year, and then alternate five uniforms with three uniforms in subsequent years. 3. Five trousers per year (dark blue) the first year, three the second year and then alternate five trousers with three trousers in subsequent years; trousers are to have no cuffs. 4. Dark blue jacket with removable liner, one per year. 5. Four City departmental patches. 6. Absolutely no allowance will be made for socks, underwear, etc. 7. Hardhats, foul weather gear, and steel -toed rubber boots to be furnished each employee with supervisor designated need. 8. Special hazard gloves shall be furnished with supervisor designated need. 9. Safety glasses and face shields shall be furnished with supervisor designated need. 10. Special uniforms shall be furnished. 2003 MEA MOU Draft.doc 54 12/12/2002 8:44 AM EXHIBIT B — UNIFORM POLICY Continued 11. Ear protectors, arm and shin guards, steel shoe caps, wood heat resistant soles, and other safety equipment shall be furnished to supervisor for designated employees. 12. R-1 safety vests shall be furnished to all employees having occasion to work within travel ways. D. Employee Responsibilities 1. To wear complete uniform at all times. 2. To wear clean uniform. 3. To wash and provide minimum repair; i.e., buttons, small tears, etc. 4. To provide any alterations necessary including sewing on of City patches. 5. To not wear the uniform for other than City duties or work. 6. To notify supervisor of need to replace due to disrepair or severe staining producing an undesirable appearance. 7. To turn in all patches upon termination prior to receiving final paycheck. 8. To turn in all uniforms upon termination. 9. To turn in all safety equipment upon termination. 10. To wear all safety equipment prescribed by the City safety officer and supervisor of the division. E. City Responsibilities 1. To furnish funding for the agreed uniform allowances. 2. To allow department heads to authorize additions to the basic allowances due to severity of work assignments and frequency of wearing out. 3. To provide and maintain one or more retail clothing outlets for the various allotments. City reserves the right to name vendor. 4. To make arrangements for the standard allotments to be of first line quality work clothing. 2003 MEA MOU Draft.doc 55 12/12/2002 8:44 AM EXHIBIT B — UNIFORM POLICY Continued 5. To maintain records of purchases. The Finance Officer will provide forms for uniform requests. 6. To establish an expedient procedure for reimbursement to employees for uniforms purchased by employees. F. Department Head Responsibilities 1. To direct and assure employee compliance with attire rules 2. To inspect clothing requests to be replaced. 3. To determine wear frequencies for employees having needs additional to basic allotment. 4. To insist on replacements of deteriorated clothing with special attention to safety equipment and apparel. 5. To enforce a disciplinary program for repeated violations of employee regulations relative to cleanliness, uniform attire, or safety requirements. 6. To demand and confirm receipt of turn -in required equipment upon termination. G. Purchases and Exceptions 1. Clothing shall be purchased at only those outlets as directed by City, unless prior approval is obtained due to size, out of stock, or special type of clothing problems that exist. 2. Shoes or boots shall be purchased through standard outlets designated unless last creates discomfort or injury risk. 3. Safety glasses must be purchased only through designated outlet for City specified amount of dollars, with employee paying the cost for the examination by a private optometrist to obtain a prescription and cost of cosmetic lenses and frames. 4. All safety and foul weather gear shall be purchased by the City. 5. Uniform appearance: a. Patch to be wom above left shirt or jacket pocket. b. Pants to have no cuffs. c. Worn with pride in appearance to public, i.e., shirt buttoned, shirttail tucked in, etc. 2003 MEA MOU Draft.doc 56 12/12/2002 8:44 AM EXHIBIT B — UNIFORM POLICY Continued 6. Exceptions at discretion of department heads: a. Supervisors need not wear uniform; however, in so electing, must pay for their own clothing. b. Employees who have foot deformities or conditions, which do not allow wearing of safety -toed shoes, shall wear external caps affording equal protection. c. Additional patches shall be furnished to equip the special clothing over the basic allotments. 7. Disposition of Turned -In Clothing — The City shall determine a procedure as to disposition of turned in clothing. 2003 MEA MOU Draft.doc 57 12/12/2002 8:44 AM EXHIBIT C — VEHICLE USE POLICY Section 1 - Purpose The purpose of these regulations is to establish and implement City policies and procedures relative to the assignment, utilization and control of City -owned vehicles as transportation for employees who engaged in official City business, to establish reimbursement procedures for privately -owned vehicles use d for City business and to clarify the City's responsibility for damage and/or liability for private vehicles used on official City business. Section 2 - Scope These regulations cover the use of City and private vehicles for conducting official City business and shall be applicable to all City departments and employees. Section 3 - Policy When necessary during the course of an employee's official duties, transportation or reimbursement therefore shall be provided by the City. In the event no City vehicle is available, the employee may use the personal vehicle with the approval of the department head. Employees authorized to drive either their own or a City -owned vehicle on official business must possess a valid California driver license for the class of vehicle they will be operating. -The transportation method authorized will be determined in terms of the best interests of the City. The general program set forth in this regulation will be implemented by the City Administrator's Office upon approval of the City Council and administered by the department heads in accordance with the policies herein established. It is the responsibility of each department head to enforce the provisions of this regulation as it relates to employees of his/her department. City -owned vehicles shall only be used for official City business. City -owned vehicles shall not be driven to and kept at the employee's home or any location other than the regular work location or Corporation Yard, except as provided by this regulation. Section 4 — Vehicle Use Criteria Assigned Vehicles: A. Assigned City Vehicles may be taken home by employees whose residence is within ten (10) miles of City Hall for the uses as described below: 1. Executive use includes the City Administrator, Assistant City Administrator and Department Heads. 2. Emergency Response Units: 2003 MEA MOU Draft.doc 58 12/12/2002 8:44 AM EXHIBIT C — VEHICLE USE POLICY Continued a. Employees who are required to respond more than once per week on an average without delay in order to protect the public health, safety and property. b. Employees who are required to carry special emergency equipment in their vehicles, which must be utilized on a regular and frequent basis. (A radio in and of itself does not constitute special emergency equipment.) 3. Continuous use outside of regular working hours -- Employees who are called back on an unscheduled basis to perform official city business outside of regular working hours more than once per week on an average and who meet one of the following criteria: a. Mileage driven on official City business exceeds an average of 500 miles per month, or b. Who regularly and frequently supervises subordinates or conducts inspections in the field, or c. Whose duties require the employee to be a way from his or her base workstation greater than 50% of his or her working time, on an average. B. City vehicles, which shall not be taken home, may be assigned based on meeting one of the following criteria: 1. Monthly mileage driven exceeds an average of 500 miles per month and the vehicle is used for the purpose of supervision or inspection in the field, or 2. Duties require the employee to be away from his or her work, station greater than 50% of his or her working time on an average. II. Reimbursement of Use of Personal Vehicle: A. Executive Use — The City Administrator, Assistant City Administrator and Department Heads may, at their option, receive the automobile allowance as established by Resolution. 2003 MEA MOU Draft.doc 59 12/12/2002 8:44 AM EXHIBIT C — VEHICLE USE POLICY Continued B. Mileage Reimbursement -- Employees, upon authorization of their department head, may use their own vehicles on official City business and shall be reimbursed at the rate of 27d per mile driven on official City business. 1. Employees shall submit monthly claims for reimbursement to the Finance Officer Through their Department Head on forms prescribed by the Finance Officer. 2. Employees shall not be reimbursed for commuting to and from work, except 42 that employees who are required to attend scheduled meetings outside of normal working hours may be reimbursed for mileage required. Section 5 — Insurance Requirements All privately -owned vehicles authorized to be used on official City business shall be insured by the individual employee in the minimum amount of S50,000 public liability for any one person and $100,000 public liability for all persons, any one accident. They must also be insured for $25,000 property damage and $15,000 for any one uninsured motorist and $30,000 for all uninsured motorists any one accident. A current certificate of insurance must be filed with the Finance Officer. Employee private vehicle information shall be reviewed and updated annually by the respective departments. The record maintained should contain the following current information. • Name of Employee • Operator's License • Insurance Company • Driver's License Expiration Date • Insurance Policy Number • Insurance Expiration Date • Amount of Coverage It shall be the department head's responsibility to insure that no privately owned vehicle is operated on City business without insurance coverage and a valid operators license as required by this regulation. 2003 MEA MOU Draft.doc 60 12/12/2002 8:44 AM EXHIBIT C — VEHICLE USE POLICY Continued Clarification on City Liability on Use of Private Vehicle: In the event of damage to private vehicles, while on City business where a third party is negligent, the employee should collect damages (including insurance deductibles) from the third party. Where the employee is negligent, the City cannot be held liable for damages to the automobile, but the City can be held responsible for liability to third parties. The City shall be responsible to such employee for the first $100 of comprehensive and/or collision damages suffered b such employee to the extent that such employee's personal automobile insurance policy does not cover such first $100 damage. The employee's insurance policy is considered as the primary coverage, and -the City liability begins after the limitations of the employee's coverage is exhausted. In the event a City employee's personal vehicle is damaged due to accident/collision while being used for official City business and the employee is deprived the use thereof, the City shall furnish such employee with a vehicle during such time as is reasonably required to repair said employee's vehicle. 2003 MEA MOU Draft.doc 61 12/12/2002 8:44 AM 2003 MEA MOU Draft.doc 62 12/12/2002 8:44 AM EXHIBIT D € — EMPLOYEE HEALTH PLAN BROCHURE A copy of the Employee Health Plan Brochure may be obtained from the Risk ManarveM8Rt 9iV inn Administrative Services Department 2003 MEA MOU Draft.doc 63 12/12/2002 8:44 AM HUNTINGTON BEACH MEMBERSHI HANDBOOKLI MEA ASSOCIATION NON ASSOCIATE® � F {t < r { s t� _ va 2 , :, � :.5;•.tti::i: > r��.-' ors y� tt r s.r - x 2 '% h; 2rvey o-rSp,S , t o _v"I.<M - �S r#' .{,f{•Rrt022. r vf• $E,:<<>%42k, '>tr+.,*#r r5{5{ry taC.s# �: All . i., r > {'{t .:^x 5.'•5". i• it .s. {.:< :553 ,rsr•r•':rM:'•{'i .,..<::{..:::{{t{>+.! '. • ..{........ � t • 'ict.r5::t!`•'.v .#.: # »#•.:+: F:<; : :t.:t•:.;.,.:': •r.: •+> • y,{:rr::..:.:+. iv.. :.r:•�+2 .,<k'�•!:{{;9;.i#'<•':t`•#%##/ ;s;'#•'•`#•{.%':%vf:•:•#••: , ` � i ; ,Y<2tt3e{t,• .k2ki'a`is#Ci# # 't ' : ; �::. .#tttit±;ttkfb2##2# #` ,' :%::#it;;2'tstvh:2t'ts#t<tt2; '. - . { : ,;:>.#2;it. #ik ##'t# >;}; t':ti,2#i#ii l: i5 /$ .. • -, ti##3a .trs "•3',S2.tFk;tsidKJs{� {3;\ +Fqf r t,# .r i#r":. y;. ${ +.•{;; k:;.; ; {^ ;ir?tr} ail �. i �, , , wt{ {{#s#' ..{� t, �';.}.~:sssea�r .. i , , } # } zv�,t% , .3s ``ct,E, • k>a t�,•� dow a Y. 1.d k 2 a � , a' ••O77 W'I uu - EXHIBIT E F — DELTA CARE (PMI) DENTAL PLAN BROCHURE A copy of the Delta Care (PMI) Brochure may be obtained from the Risk Management Diyi-inn Administrative Services Department 2003 MEA MOU Draft.doc 64 12/12/2002 8:44 AM .'I c a� � 0 n c Dmwm op°4 w m .0 EXHIBIT F 6 — DELTA DENTAL PLAN BROCHURE A copy of the Delta Dental Plan Brochure may be obtained from the Risk MaRa ement Divic inn Administrative Services Department 2003 MEA MOU Draft.doc 65 12/12/2002 8:44 AM �q BENEFIT,-�*HIGHLIGHTSFOR ,'CITY --',.OF HUNTINGTON,",BEACH :'--,"-�,:;-"�:;"�,'�'�',,� GROUP NO 4729 �S ER'V' F'i 4'9�`:dOVEREMZ ICE'SI SERVICES THAT RE NorCOVERED PRINCIPAL 13"EN'E-' ---------------- T 7 . . . . . . . . . . . - WHO'S POVERED-A-`xV,,- 1' A I L. a 1 ,,ppoUs§, dependent children to age 19 and full50 Z A X p 2, iBEX '4NEFITSAA Mu ,,yea(��-_Tlj Tom. ene _d * K M t. Vr DiAGNOST.Ide At' ENTIVEO�-1-i," 'rBE FIT"'4 beA144 cl"� ,,blops ;maintainerss� W� V BASICAENERT d6h n6 .treat ,CROW :,,.ORTHODONTIC,';,BENEFI,T,S-?����- W, _EEiFTW I DEN`A* A�f_ 1 0 Ihti StOACID Qm o � A E " R-.I. -I.... Qk__.__ 1-1-�'M12 ,_ M , N dWWVId6n6dLdflC , 40ts�P1046iferad i ,vX. Alth6obhyoue,.-plah:o6,yers;mahy-6f:-the,-most commonly, needed much of it is., aid for by, ',,'ch6ck• ng. .�viih Delta befor� �roc6edi _.�'pai h' Th'616 lowing'arenot..,gpyftCed.by,,,I q ,p N -C 6haiti 66s,,,covered Onder'Workers' C Iaw E ;pv;, omppnsabpnfprt mployers__Liability 'S d intistry.or,services,to correct:.;7-...- PKW4�,� f -v?,.-congenItaI',Mal prmatoW',-,,`, i ent a l procedures', d"' herapot A pA!9.,,re ievers..,, R I h" h pItA �'Rosts'ti.,or_.extrwd argesjor� ospital,treatrhent.:_� ��',.�,.'Anestnesia�(6�660t.',foe.,�gengtal!•aoq§,tops!cA'..tor.iDraI surger y 'grafts,'! m 01 anW�and A m pl ant,'rp MqV4,i ,,,pa ,i,�.TreathlE ` Ao"t int.,relMeq, be,",,tempde6tnandibularldint,(TMJ p fi brmation _P�as maryplawi egcrp I PQ j qn;�nqrs ssy trr, 10 s. g e� ,p qK`'`7', gar "-,z:evidence o.y qtjhe' 1 peage, W �� 64eltaore, x -Ap�q f 1 _idi6d",be`nefIIV",-,' 1 6 4Uestl6hsi46i ........... bfigb,bricohti�i:st ry ce de j� 4� g n, W-R R V 11"R 4il. g W.- ex enefits Worm Kgjrqr�� mv4�6i,6116/6 '335w8227),, -DELTA LT# p s Xwr g -Rg MS g C e NUR,-,& �s, X f P��Kq d latig.1 laqeMents.,Q at, P,- • D A`CS�'(88'8-b65f6' i�k Ir"K , , . , �� p •W V, N, '�F z; sy _%Six StS:-r A-V �O�oe N2 P" A F o r, a Zl��, -A X, . ffIw {Yp G 0, -e L-7 477 .-yr- c ""RIP -1 W�,. V 0 Tr "A r e a 7 T" b Y" 2003 MEA MOU Draft.doc 66 12/12/2002 8:44 AM EXHIBIT C 1— VISION (VSP) PLAN BROCHURE A copy of the Vision (VSP) Brochure may be obtained from the Risk Management Diyioinn Administrative Services Department 2003 MEA MOU Draft.doc 67 12/12/2002 8:44 AM 'AME RICAS rI RST CHOICE FOR '.EY�ECARE p 1 i� It"! Ca'S, PI LSF CHOIE'[ FDR EY ECARF. . using your v1S10n1 0 Once every 12 months Once every 12 months Once every 12 months $10.00 Services from a Qt Non -Participating Provider up to $ 40.00 up to $ 40.00 up to $ 60.00 up to $ 80.00 up to $125.00 frames. up to $ 45.00 up to $ 5.00 it of prescription glasses) yment up to $210.00 up to $105.00 n vision care services, call a VSP doctor to make an appointment. For details live or call VSP at 800-877-7195 to request a VSP doctor listing. Make sure vide the covered member's social security number. The VSP doctor will also obtain authorization for services and materials. If you are not currently ting this to you. VSP will pay the doctor directly for covered services and d materials obtained from an out -of -network provider will be reimbursed up -network reimbursement, pay the entire bill when you receive services, then n to VSP. Claims must be submitted to VSP within six months from your rds and send the originals to the following address: Vision Service Plan, Out- 5899-7105. so available to those covered under this VSP WellVision' Plan. It is i obtained through VSP contracted doctors, surgeons and laser centers. This ;edures, laser -assisted in -situ keratomileusis (LASIK) and photorefractive irticipating in the program. Doctors can also be located on VSP's Web site at service p an the patient will have no out-of-pocket expense other than the copayment, unless Itt limited to, oversize lenses (61 mm or larger), coated lenses, no -line multifocal b eneliit the plan allowance. VSP doctors offer valuable savings including a 20 percent V frame). Services must be received within 12 months from the same VSP doctor 15 percent off the cost of your contact lens exam when you receive contact lens dens materials.) �I iose a frame that is covered in full or one that exceeds the plan allowance. If you difference you'll pay is based on VSP's low, discounted member pricing. Have 09/02 it VSP coverage. -intact lens exam. The allowance is applied to both the contact lens exam (fitting and evaluation) and the contact lenses. Any costs exceeding this allowance are the patient's responsibility. The contact lens exam is a special exam for ensuring proper fit of your contacts and evaluating your vision with the contacts. Medically necessary contact lenses must be prescribed by your doctor (as required for certain medical conditions) and approved by VSP. THIS IS ONLY A SUMMARY FOR FURTHER INFORMATION, SEE YOUR EMPLOYER'S BENEFIT REPRESENTATIVE �� Mo jj IMPC"Ji% a sit�ttp //www sp colm77-7195 EXHIBIT H d — LONG TERM DISABILITY PLAN BROCHURE A copy of your Long Term Disability Plan Brochure may be obtained from the [tick Management Diy.sion Administrative Services Department 2003 MEA MOU Draft.doc 68 12/12/2002 8:44 AM STANDARD INSURANCE COMPANY A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon 97204-1282 (503) 321-7000 People. Not Just Policies. CERTIFICATE: GROUP LONG TERM DISABILITY INSURANCE Policyowner: City of Huntington Beach Policy Number: 332175MM-LTD Effective Date: February 1, 1995 A Group Policy has been issued to the Policyowner. We certify that you will be insured as provided by the terms of the Group Policy. If your coverage is changed by an amendment to the Group Policy, we will provide the Policyowner with a revised Certificate or other notice to be given to you. Possession of this Certificate does not necessarily mean you are insured. You are insured only if you meet the requirements set out in this Certificate. "We", "us" and "our" mean Standard Insurance Company. "You" and "your" mean the Member. All other defined terms appear with the initial letter capitalized. Section headings, and references to them, appear in boldface type. President GCIWLTD MEA MOU - EX4116VT �I Printed on recycled paper. EXHIBIT I K — PROVISIONS OF THE RETIREE SUBSIDY MEDICAL PLAN An employee who has retired from the City shall be entitled to participate in the City sponsored medical insurance plans and the City shall contribute toward monthly premiums for coverage in an amount as specified in accordance with this Plan, provided: A. At the time of retirement the employee has a minimum of ten (10) years of continuous City service or is granted an industrial disability retirement; and B. At the time of retirement, the employee is employed by the City; and C. Following official separation from the City, the employee is granted a retirement allowance by the California Public Employees' Retirement System. The City's obligation to pay the monthly premium as indicated shall be modified downward or cease during the lifetime of the retiree upon the occurrence of any one of the following: 1. During any period the retired employee is eligible to receive or receives health insurance coverage at the expense of another employer, the payment will be suspended. "Another employer" as used herein means private employer or public employer or the employer of a spouse. As a condition of being eligible to receive the premium contribution as set forth in this plan, the City shall have the right to require any retiree to annually certify that the retiree is not receiving or eligible to receive any such health insurance benefits from another employer. If it is later discovered that a misrepresentation has occurred, the retiree will be responsible for reimbursement of those amounts inappropriately expended and the retiree's eligibility to receive further benefits will cease. 2. On the first of the month in which a retiree or dependent reaches age 65 or on the date the retiree or dependent can first apply and become eligible, automatically or voluntarily, for medical coverage under Medicare (whether or not such application is made) the City's obligation to pay monthly premiums may be adjusted downward or eliminated. Benefit coverage at age 65 under the City's medical plans shall be governed by applicable plan document. 3. In the event the Federal Government or State Government mandates an employer -funded health plan or program for retirees, or mandates that the City make contributions toward a health plan (either private or public) for retirees, the City's contribution rate as set forth in this plan shall first be applied to the mandatory plan. If there is any excess, that excess may be applied toward the City medical plan as supplemental coverage provided the retired employee pays the balance necessary for such coverage, if any. 4. In the event of the death of any employee, whether retired or not, the amount of the retiree medical insurance subsidy benefit which the deceased employee was receiving at the time of his/her death would be eligible to receive if he/she were retired at the time of death, shall be paid on behalf of the spouse or family for a period not to exceed twelve (12) months. 2003 MEA MOU Draft.doc 69 12/12/2002 8:44 AM SCHEDULE OF BENEFITS A. Minimum Eligibility for Benefits - With the exception of an industrial disability retirement, eligibility for benefits begin after an employee has completed ten (10) years of continuous service with the City of Huntington Beach. Said service must be continuous unless prior service is reinstated at the time of his/her rehire in accordance with the City's Personnel Rules. B. Disability Retirees - Industrial disability retirees with less than ten (10) years of service shall receive a maximum monthly payment toward the premium for health insurance of $121. Payments shall be in accordance with the stipulations and conditions that exist for all retirees. Payment shall not exceed dollar amount that is equal to the full cost of premium for employee only. C. Maximum Monthly Subsidy Payments - All retirees, including those retired as a result of disability whose number of years of service prior to retirement exceeds ten (10), shall be entitled to maximum monthly payment of premiums by the City for each year of completed City service as follows: Maximum Monthly Payment For Retirements After: Years of Service Subsidy 10 $ 121 11 136 12 151 13 166 14 181 15 196 16 211 17 226 18 241 19 256 20 271 21 286 22 300 23 315 24 330 25 344 Note: The above payment amounts may be reduced each month as dependent eligibility ceases due to death, divorce or loss of dependent child status. However, the amount shall not be reduced if such reduction would cause insufficient funds needed to pay the full premium for the employee and the remaining dependents. In the event no reduction occurs and the remaining benefit premium is not sufficient to pay the premium amount for the employee and the eligible dependents, said needed excess premium amount shall be paid by the employee. 2003 MEA MOU Draft.doc 70 12/12/2002 8:44 AM INDEMNITY HEALTH PLAN, EMPLOYEES/RETIREES Benefits' City Plan - Employees City Plan - Subsidized Non -Subsidized Retirees Retirees COBRA -eligibles Deductible per person $200 $200 Deductible per family $500 $500 Maximum Out of Pocket $1000 per person $1,000 per person $2000 per family $2,000 per family Note: Retirees who elect to participate in the HMO Health Net shall be entitled to benefits of the program chosen. This summary has been used to list only those benefit provisions that differ between active and subsidized Retiree Plans. Currently, there are no differences, however, this exhibit is not intended to require that future changes to active employee benefits be applied to retirees as well. The Employee Health Plan Document should be consulted for detailed questions about specific benefits. Benefits are subject to modification through the meet and confer process. 2003 MEA MOU Draft.doc 71 12/12/2002 8:44 AM RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED A. Eligibility: The effective start-up date of the the various employee groups shall retirement date. Retiree Subsidy Medical Plan for be the first of the month following 2. A retiree may change plans, add dependents, etc., during annual open enrollment. Personnel shall notify covered retirees of this opportunity each year. 3. Years of service computed for the Retiree Subsidy Medical Plan are actual years of completed service with the City of Huntington Beach. 4. When a retiree is eligible for medical plan coverage at the expense of another employer due to post -retirement employment of the retiree or spouse of the retiree, the retiree and his/her spouse must take that coverage regardless of benefit level and shall be deleted from any City Plan coverage. Exceptions to this requirement are limited to the following: a. A retiree is not required to enroll in such "other' medical plan coverage if there is significant disparity between the benefits provided by the "other" medical plan and the Retiree Subsidy Medical Plan as defined below. "Significant disparity" means coverage available under the "other" medical plan is restrictive or limited in one or more of the following ways: 1) No in -patient hospitalization coverage. 2) No major medical benefits 3) Annual deductible is $1,000 or greater per person. 4) Major medical benefits are paid at 60% or less of covered expenses. b. The Risk Manager will have the authority to provide additional exceptions following review of the "other" medical plan policy. Exceptions will be made only if the "other' medical plan benefit provisions are comparable to the guidelines under B above. 2003 MEA MOU Draft.doc 72 12/12/2002 8:44 AM RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED c. Miscellaneous Provisions: 1. Benefits provided under the Retiree Subsidy Medical Plan will be coordinated with the "other" medical plan as the primary carrier. 2. The City shall have the right to require any retiree to provide a copy of the `other" medical plan policy for review by the Risk Manager. 5. When a retiree becomes eligible for the other group coverage and then becomes no longer eligible, he/she may have the subsidy reinstated and regain Retiree Subsidy Medical Plan coverage. 6. Dependents of a retiree may follow him/her into the Retiree Subsidy Medical Plan or they may choose to exercise COBRA rights along with the retiree. 7. When a retiree becomes 65 and has eligible dependents under 65, said dependents are eligible to exercise COBRA rights. 8. When a retiree is under 65 and his/her spouse is over 65, the spouse is not covered. B. Benefits: 1. Retiree Subsidy Medical Plan includes Managed Health Network (MHN), Prescription Card System (PCS), Orange County Foundation for Medical Care (OCFMC) Preferred Qer Grganizatien and Medical Stop Loss insurance. 2. City Plans are the primary payer for active employees age 65 and over, with Medicare the secondary payer. Retirees age 65 and over have no City Plan options and are eligible only for Medicare. 3. Premium payments are to be received at least one month in advance of the coverage period. 2003 MEA MOU Draft.doc 73 12/12/2002 8:44 AM RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED C. Subsidies: 1. The subsidy payments will pay for: a. Retiree Subsidy Medical Plan. b. HMO Health Net c. ` Part A of Medicare for those retirees not eligible for paid Part A. 2. Subsidy payments will not pay for: a. Part B Medicare. b. Regular City Employee Indemnity Plan. C. Any other employee benefit plan. d. Any other commercially available benefit plan. e. Medicare supplements D. Medicare: 1. All persons are eligible for Medicare coverage at age 65. Those with sufficient credit quarters of Social Security will receive Part A of Medicare at no cost. Those without sufficient credited quarters are still eligible for Medicare at age 65, but will have to pay for Part A of Medicare if the individual elects to take Medicare. In all cases, Part B of Medicare is paid for by the participant. 2003 MEA MOU Draft.doc 74 12/12/2002 8:44 AM RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED 2. When a retiree and his/her spouse are both 65 or over, and neither is eligible for paid Part A of Medicare, the subsidy shall pay for Part A for each of them or the maximum subsidy, whichever is less. 3. When a retiree at age 65 is eligible for paid Part A of Medicare and his/her spouse is not eligible for paid Part A, the spouse shall not receive subsidy. When a retiree at age 65 is not eligible for paid Part A of Medicare and his/her spouse who is also age 65 is eligible for paid Part A of Medicare, the subsidy shall be for the retiree's Part A only. E. Cancellation: 1. For retirees/dependents eligible for paid Part A of Medicare, the following cancellation provisions apply: a. Coverage for a retiree under the Retiree Subsidy Medical Plan will be eliminated on the first day of the month in which the retiree reaches age 65. If such retiree was covering dependents under the Plan, dependents will be eligible for COBRA continuation benefits effective as of the retiree's 65th birthday. b. Dependent coverage will be eliminated upon whichever of the following occasions comes first: 1) After 36 months of COBRA continuation coverage, or 2) When the covered dependent reaches age 65 in the event such dependent reaches age 65 prior to the retiree reaching age 65. c. At age 65 retirees are eligible to make application for Medicare. Upon being considered "eligible to make application", whether or not application has been made for Medicare, the Retiree Subsidy Medical Plan will be eliminated. 2. See provisions under "Benefits", "Subsidies", and "Medicare" for those retirees/dependents not eligible for paid Part A of Medicare. 2003 MEA MOU Draft.doc 75 12/12/2002 8:44 AM RETIREE SUBSIDY MEDICAL PLAN/MISCELLANEOUS PROVISIONS CONTINUED 3. Retiree Subsidy Medical Plan and COBRA participants shall be notified of non-payment of premium by means of a certified letter from Personnel in accordance with provisions of the Memorandums of Understanding. 4. A retiree who fails to pay premiums due for coverage and is in arrears for sixty (60) days shall be terminated from the Plan and shall not have reinstatement rights. 2003 MEA MOU Draft.doc 76 12/12/2002 8:44 AM EXHIBIT J - 9/80 WORK SCHEDULE This work schedule is known as the "9/80". The 9/80 work schedule is designed to be in compliance with the requirements of the Fair Labor Standards Act (FLSA). In the event that there is a conflict with the current rules, practices and/or procedures regarding work schedules and leave plans, then the rules listed below shall govern. 9180 WORK SCHEDULE DEFINED The 9/80 work schedule shall be defined as working nine (9) days for eighty (80) hours in a two week pay period by working eight (8) days at nine (9) hours per day and working one (1) day for eight (8) hours (Friday), with a one -hour lunch during each work shift, totaling forty (40) hours in each FLEA work week. The 9/80 work schedule shall not reduce service to the public, departmental effectiveness, productivity and/or efficiency as determined by the City Administrator or designee. A. Forty (40) Flour FLSA Work Week — The actual FLEA work week is from Friday at mid -shift (p.m.) to Friday at mid -shift (a.m.). No employee working the 9180 work schedule will be able to flex their Friday start time nor the time they take their lunch break, which will be from 12:00 p.m. to 1:00 p.m. on Fridays. All employee work shifts will start at 8:00 a.m. on their Friday worked. The start of the FLSA work week is 12:00 noon Friday. B. Two Week Pay Period — The pay period for employees starts Friday mid - shift (p.m.) and continues for fourteen (14) days until Friday mid -shift (a.m.). During this period, each week is made up of four (4) nine (9) hour work days (thirty-six (36) hours) and one (1) four (4) hour Friday and those hours equal forty (40) work hours in each work week (e.g. the Friday is split into four (4) hours for the a.m. shift, which is charged to work week one and four (4) hours for the p.m. shift, which is charged to work week two). C. A/B Schedules — To continue to provide service to the public every Friday, employees are to be divided between two schedules, known as the "A" schedule and the "B" schedule, based upon the departmental needs. For identification purposes, the "A" schedule shall be known as the schedule with a day off on the Friday in the middle of the pay period, or, "off on payday", the "B" schedule shall have the first Friday (p.m.) and the last Friday (a.m.) off, or "working on payday". An example is Posted below: Alai Pi41 °,; A�l1 P,: Ati .:.F, Pl�l F :: F S,, M W._z: h F F:..:: 5 S ''Nf" ..,T W Th F A Schedule 4 4 - - 9 9 9 9 - - - - 9 9 9 9 4 4 B Schedule - - - - 9 9 9 9 4 4 - - 9 9 9 9 - - 2003 MEA MOU Draft.doc 77 12/12/2002 8:44 AM D. A/B Schedule Changes — FLSA non-exempt employees cannot change schedules without prior approval of their supervisor, Department Head, and the Human Resources Manager or designee. The purpose of this authorization is to review the impact on overtime. FLSA exempt employees may change A/B schedules at the beginning of any pay period with supervisor and Department Head approval. E. Emergencies — All employees on the 9/80 work schedule are subject to be called to work any time to meet any and all emergencies or unusual conditions which, in the opinion of the City Administrator, Department Head or designee may require such service from any of said employees. OVERTIME DEFINED FLSA Non -Exempt Employees — All non-exempt employees under the 9/80 work schedule shall earn overtime for all hours worked after the first forty (40) hours in an FLSA work week (Friday 12:00:00 p.m. to Friday 11:59:59 a.m.) as required under FLSA. Employees are required to obtain supervisor authorization prior to working any overtime. 1. Overtime Compensation — As stated in Memorandum -of -Understanding 2. Compensatory Time — As stated in Memorandum -of -Understanding LEAVE BENEFITS When an employee is off on a scheduled workday under the 9/80 work schedule, then nine (9) hours of eligible leave per workday shall be charged against the employee's leave balance or eight (8) hours shall be charged if the day off is a Friday. All leaves shall continue under the current accrual, eligibility, request and approval requirements. 1. General Leave — As stated in Memorandum -of -Understanding 2. Sick Leave — As stated in Memorandum -of -Understanding 3. Bereavement Leave — As stated in Memorandum -of -Understanding 4. Holidays - a. For a recognized city holiday, eight (8) hours, as stated in Article X11.2, are earned for each holiday. For the charging of hours on a scheduled holiday, the employee must use eight (8) hours of holiday time off and one (1) hour from the employees General Leave or Compensatory Time banks for a nine (9) hour workday charge or eight (8) hours holiday time off for a Friday. 2003 MEA MOU Draft.doc 78 12/12/2002 8:44 AM b. If a holiday falls on an FLSA non-exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. If the employee cannot take the work shift before or after the holiday off the employee will be granted eight (8) hours of general leave. c. If a holiday falls on an FLSA exempt employee's Friday off, the employee must then take the work shift before or after the holiday off with supervisor and Department Head approval. FLSA exempt employees shall not be granted any administrative/general leave or any added compensation for not taking a work shift off on a scheduled holiday. 5. Jury Duty — The provisions of the Personnel Rules shall continue to apply, however, if an FLSA exempt employee is called to serve on jury duty during a normal Friday off, Saturday, or Sunday, or on a city holiday, then the jury duty shall be considered the same as having occurred during the employees day off work, therefore, the employee will receive no added compensation. 2003 MEA MOU Draft.doc 79 12/12/2002 8:44 AM EXHIBIT K - 4110 WORK SCHEDULE This work schedule is known as the "4/10" and is only available to employees assigned to the police Department. The 4/10 work schedule is designed to be in compliance with the requirements of the Fair Labor Standards Act (FLSA). In the event that there is a conflict with the current rules, practices and/or procedures regarding work schedules and leave plans, then the rules listed below shall govern. 4/10 WORK SCHEDULE DEFINED The 4/10 work schedule shall be defined as working four (4) days for forty (40) hours in an FLSA work week by working four (4) days% ten (10) hours per day, plus a one -hour lunch during each work shift. The FLStwork week shall be defined as Saturday 12:00:00 a.m. to Friday 11:59:59 p.m. The 400 work schedule shall not reduce service to the public, departmental effectiven .-n productivit" and/or efficiency as determined by the City Administrator or desig All employees on the 4/10 work schedule are subject to be called to work any time to meet any and all emergencies or unusual conditions which, in the opinion of the City Administrator, Department Head or designee may require such service from any of said employees. OVERTIME DEFINED FLSA Non -Exempt Employees — All non-exempt employees under the 4110 work schedule shall earn overtime for all hours worked after the first forty (40) hours in an FLSA work week as required under FLSA. Employees are required to obtain supervisor authorization prior to working any overtime. 1. Overtime Compensation — As stated in Memorandum -of -Understanding 2. Compensatory Time — As stated in Memorandum -of -Understanding LEAVE BENEFITS When an employee is off on a scheduled workday under the 4/10 work schedule, then ten (10) hours of eligible leave per workday shall be charged against the employee's leave balance. All leaves shall continue under the current accrual, eligibility, request and approval requirements. 1. General Leave — As stated in Memorandum -of -Understanding 2. Sick Leave — As stated in Memorandum -of -Understanding 3. Bereavement Leave — As stated in Memorandum -of -Understanding 2003 MEA MOU Draft.doc 80 1.2/12/2002 8:44 AM 11,J�I This booklet provides a brief description of the important features of your health insurance coverage. It is not a contract and only the provisions of the Plan Document will control. Payments under this plan are based on Usual, Customary and Reasonable charges. Revised April 2001 TABLE OF CONTENTS Highlights of the Employee Health Plan 1 CoPayment and Benefit Percentages 2 Definitions 3 Persons Covered and Effective Dates 6 Preferred Provider and Exclusive Provider Organization Deductibles and Out of Pocket Expenses 8 Covered Medical Expenses 10 Prescriptions 12 Chiropractic and Physical Therapy 12 Preventive Medical Care 12 Well Baby Care 12 General Exclusions and Limitations 13 When You Have a Claim 15 Claims Payment and Appeals 15 Coordination with Other Plans 16 Termination of Coverage 17 Highlights of the Employee Health Plan The Employee Health Plan was created for the purpose of providing medi- cal benefits for eligible employees and their eligible dependents. This section is intended only as a brief summary of the Plan's benefits. All maximums are per person unless specifically noted as per family. Please refer to the subsequent sections for a more detailed description of covered expenses and benefits exclusions and limitations. Eligible Employees A permanent City employee Eligibility Date (See Persons,Covered and Effective Dates section for enrollment details and effective dates) Open Enrollment The open enrollment period is the month of November. Coverage for a participant enrolling during Open Enrollment will be effective Jan. 1. Lifetime Maximum Benefit The lifetime maximum benefit is $1,000,000. This is the absolute limit on what the Plan will pay for each participant's covered expenses. Calendar Year Maximum Benefit The calendar year maximum benefits listed below are the limits on what this Plan will pay for each participant's covered expenses in a calendar year for the corresponding type of benefit: Mental/Emotional Disorder and or Substance Abuse: Administered by Managed Health Network. No benefits available through the Employee Health Plan. Refer to MHN brochures for further informa- tion. Inpatient Hospitalization 100 days (during each period of disability) Chiropractic Care $2,000 or 24 visits (whichever occurs first) Wellness Benefit $200 per year 1 Deductible: Per Person $200 Per Family $500 Out of Pocket: Per Person $1,000 Per Family $2,000 (Deductibles and Out of Pocket apply per calendar year) NOTE: The out ofpocket expenses do not include any charges that ex- ceed Usual, Customary and Reasonable rates, any expenses for treatment of a mental/emotional disorder and or/substance abuse, charges for pre- scription drugs or the EPO copayments. Copayment and Benefit Percentage Benefits Description EPO% PPO% Non PPO% Annual Deductible None $200/$500 $200/$500 Office Visits $5 copay 90% 50% UCR Wellness No charge $200 max $200 max Inpatient $150 copay 90% 50% Hospitalization (day 1-4) then 100% Emergency Services $5 copay 90% 50% Outpatient Services $5 copay 90% 50% (Durable Medical $5 copay 90% 50% Equipment Prescription -pharmacy $5 generic/$8 brand Prescription —mail order $4 generic/$6 brand (Definitions Calendar Year A period of twelve months commencing January 1 and ending December 31 of the same year. Custodial Care Means services or supplies for persons who are physically or mentally dis- abled but who are not currently receiving medical, surgical or psychiatric treatment to reduce their disability and to enable them to live without cus- todial care. Emergency A sudden, unexpected, acute illness or injury that, without immediate medical treatment, could result in death or cause impairment to bodily functions. Extended Care or Skilled Nursing Facility A licensed facility operating pursuant to law which is primarily engaged in providing skilled nursing care on an inpatient basis during the convales- cent state of illness or injury under 24 hours a day supervision of a physi- cian or registered graduate nurse. Such a facility must maintain complete medical records on each patient and have established methods and proce- dures for the dispensing and administering of drugs. In no event shall the term include a facility that is primarily: • A rest home, retirement home or home for the aged • A school or similar institution • Engaged in the care and treatment of substance abuse, or of mentally ill or senile persons ® Engaged in custodial care Hospital An institution operated pursuant to law that is accredited by the appropri- ate national regulatory body for hospital accreditation. It must be primar- ily engaged in providing medical, diagnostic and surgical facilities for the care and treatment of sick and injured individuals on an inpatient basis. It must also provide such facilities under the supervision of a staff of physi- cians and with 24 hour a day nursing services by registered graduate nurses. The definition of hospital shall not include any institution or part thereof which is used principally as a rest facility, extended care facility, nursing facility or facility for the aged. Inpatient A person who is confined in a hospital as a registered bed patient and who is charged at least one day's room and board by the hospital. 2 Medical Necessary or Medical Necessity Describes medical treatment that: • Is appropriate and consistent with the diagnosis • Is in accordance with accepted medical standards, it would not have been omitted without adversely affecting the patient's condition or the quality of medical care rendered • Is not primarily custodial care Mental Health Disorder Any disorder characterized by abnormal functioning of the mind or emotions and in which psychological, intellectual, emotional or behav- ioral disturbances are the dominate features. Mental health disorders include mental disorders, mental illnesses, psychiatric illnesses, mental conditions and psychiatric conditions, whether organic or non -organic, whether biological, non -biological, genetic, chemical, or non -chemical origin, and irrespective of cause, basis or inducement. Nurse A licensed Registered Nurse (R.N.) or licensed Practical Nurse (LPN) or licensed Vocational Nurse (LVN) who does not live with the patient and is not a member of the family. Outpatign A person who is not admitted as an inpatient but who receives medical care. Outpatient Surgery Surgery performed on an outpatient basis at a hospital, ambulatory sur- gical facility, or physician's office. An ambulatory surgical facility is defined as a licensed, specialized facility, within or outside the hospital facility that meets the following criteria: Is established, equipped and operated in accordance with the applicable state laws and is primarily for the purpose of per- forming surgical procedures Is operated under the supervision of a Medical Doctor (M.D.) who is devoted full time to such supervision Requires, in all cases other than those requiring only local infiltration anesthetics, that a licensed anesthesiologist admin- ister the anesthetics and remain present through the surgery. Physician A duly licensed Doctor of Medicine (M.D.), Osteopath, Podiatrist, Chi- ropractor or any other practitioner providing a covered service and act- ing within the scope of his/her license. ' 4 Plan Administrator The Risk Management Division is the Plan Administrator for purposes of this Plan's claims administration. Retiree Any retired employee of the City who (a) has retired on a service or dis- ability retirement and (2) is not eligible for Medicare, and (3) has not at- tained age 65. Usual, Customary and Reasonable Charges made for medical services or supplies essential to the care of the participant will be considered reasonable and customary if they are the amount normally charged by the provider for similar services and supplies and do not exceed the amount ordinary charged by most providers of com- parable services and supplies in the geographic area where the services or supplies are received. Whether charges are reasonable and customary shall be determined by the Plan Administrator or its agent in its sole dis- cretion by use of any customary or accepted method. In determining whether charges are reasonable and customary, the Plan Administrator will give due consideration to the nature and severity of the condition be- ing treated and any medical complications or unusual circumstances that require additional time, skill or expertise. Persons Covered and Effective Date Those eligible are: All permanent employees and their spouses Their unmarried children to age 19 Unmarried children from age 19 to 25 if: (a) A full time student, or (b) Lives at home and is dependent upon his/her parent for at least 50% of his/her support New permanent employees are eligible to participate in the Employee Health Plan on the first of the month following 30 days from the date of hire. Effective Date of Dependent Coveraue Check with the Human Resources Division when you want to enroll a new spouse or new child. Appropriate forms must be completed within 60 days of marriage, birth of a child or when the employee becomes legally responsible for an adopted child. Dependent coverage will be effective on the date of marriage, date of birth or the newborn child or the date of adoption or the date of placement of an adopted child in your home. Change in Family Status Once you are enrolled in the Employee Health Plan, you must notify the Plan Administrator or Human Resources Division within 60 days of any family status change, such as a newborn baby, or when you no longer need a certain family member covered, or when a family member is no longer eligible as defined by this Plan. Notice to Employees Waiving, Coverage If you decide to decline coverage under this Plan for yourself or your Eli- gible Dependents for whatever reason, you must execute a waiver of cov- erage on a form provided by the Human Resources Division at the time coverage is declined, and return such form to Human Resources. If you are declining enrollment for yourself or your Eligible Dependents because of other health insurance coverage, you may, in the future, be able to enroll yourself or your Eligible Dependents in the Plan, provided that you request enrollment within thirty (30) days after your other coverage ends. Preferred Provider Organization (PPO) Exclusive Provider Organization (EPO) The Preferred Provider Organization (PPO) and Exclusive Provider Or- ganization (EPO) is a statewide network of physicians, hospitals and other health care providers established specifically to provide comprehensive medical service to Plan participants at reduced rates. As a participant in the Plan, you will receive a directory of providers that belong to the PPO and EPO networks. If you choose the PPO/EPO option, please follow the procedures for its use carefully. If your doctor refers you to another provider, make sure that the new provider is also an EPO or PPO before services are rendered. The copayments and applicable benefit percentages are shown in the Highlights section. If you go to a PPO provider, do not pay for services at the time of your visit. PPO providers are required to submit their medical bills to the Employee Health Plan first. The Employee Health Plan will then calculate the Usual, Customary and Reasonable (UCR) rate and then issue an Explanation of Benefits (EOB) to the PPO and the participant. The PPO provider will then issue a statement to the participant for the co - payment and deductible if applicable. If you go to an EPO, the provider may request payment of the $5 copay at the time of your visit: You are not responsible for any other charges other than the $5 copay. If you are admitted to a hospital, your copay will be $150 per day to a maximum of $600 per period of hospitalization. 6• Deductibles and Out of Pocket Expenses Family Out of Pocket Expense Deductibles and out of pocket expenses represent the portion that the par- If the dollar amount of the family out of pocket expense amount, shown in ticipant pays for covered expenses. This section generally describes these the Highlights section, is satisfied by the combined covered expenses ap- cost sharing provisions of the Plan. plied to the individual out of pocket expense amount of several covered family members, no additional out of pocket expense amount is required Calendar Year Deductible to be satisfied by the covered persons of that family for the remainder of The calendar year deductible is the amount of covered expenses incurred the calendar year. Once a covered family member has satisfied the individ- by a participant during a calendar year for which no benefits will be paid. ual out of pocket expense amount no additional covered expenses for that After you, or a covered dependent, has satisfied the calendar year deducti- person will be counted towards the family out of pocket expense amount. ble, the Plan pays a certain percentage of the covered expenses for that individual during the rest of the calendar year. Deductible accumulation period is January 1 through December 31. Family Calendar Year Deductible If the dollar amount of the family calendar year deductible, shown in the Highlights section, is satisfied by the combined covered expenses applied to the individual deductibles of several covered family members, no addi- tional calendar year deductible amount is required to be satisfied by the covered persons of that family for the remainder of the calendar year. Once a covered family member has satisfied the individual deductible, no additional covered expenses for that person will be counted toward the family deductible. Three Month Carryover Any covered expenses incurred in the last three months of the calendar year that are used to satisfy the calendar year deductible for that year will be applied towards to deductible for the following year. Out of Pocket Expenses Out of pocket expense is the amount of covered expenses you must pay after the satisfaction of the calendar year deductible before certain benefits begin to be paid at 100%. If, during the calendar year, your out of pocket expenses satisfy the out of pocket expense amount, the rate of payment for certain covered charges will be increased to a full one hundred percent (1001/o). The one hundred percent (100%) will continue until the end of that calendar year. You must satisfy your deductible plus your out of pocket amount before these benefits will be paid at 100%. In no event will this provision apply to the deductible, any expenses for treatment of a mental/emotional disorder and/or substance abuse, charges for prescription drugs, charges that exceed Usual, Customary and Reason- able charges, or the EPO copayments. Covered Medical Expenses List of Covered Medical Expenses The following expenses are covered by the Plan. Reimbursement is based upon the lifetime maximum and calendar year limits, benefit percentages and other limitations previously described in the Highlights section. 1. Charges for services and supplies used in the administration of anesthesia, when not duplicated in the hospital charges. 2. Transportation by a professional ambulance service to a local hospital or convalescent facility for inpatient care, if medically necessary, or to the nearest hospital for emergency care. Ex- penses for transportation by air will be covered only if an air am- bulance is medically necessary. The first $50 of charges will be paid at 100%. 3. Rental or durable medical equipment when such equipment is deemed medically necessary, including, but not limited to, a wheelchair, hospital bed, respirator, and equipment for the ad- ministration of oxygen. Such equipment may be purchased, if, in the judgment of the Plan Administrator, purchase of the equip- ment would be less expensive than rental or the equipment is not available for rental. 4. Hospital room and board, at the semi -private hospital room and board rate. If medical necessity requires an intensive care or in- termediate care unit, the Plan will cover the room and board rate charged by the hospital. 5. Other hospital services and supplies furnished by the hospital for medical care during confinement, exclusive of physician's and other professional services. 6. Radiology (x-rays) and laboratory charges in connection with treatment of an illness or injury. 7. Outpatient surgery charges for necessary services and supplies for surgical procedures performed on an outpatient basis at a hos- pital, ambulatory surgical facility, or physician's office, provided that benefits for such charges would be payable if the procedure were performed during a hospital confinement. 8. Physician's fees for medical care and treatment of an illness or injury covered under the terms of this Plan 9. Prescription drugs necessary for the treatment of an illness or in- jury, if obtainable only on a physician's written prescription and dispensed by a licensed pharmacist. 10. X-ray an4 radium treatments, and treatments with other radioac- tive substances. 11. Speech therapy by a qualified speech therapist. The therapy must be to restore or rehabilitate speech loss due an illness or in- jury, or due to surgery for an illness or injury. If speech loss is due to a congenital anomaly, surgery to correct the anomaly must have been performed prior to therapy. 12. Elective surgery for sterilization, including tubal ligation and va- sectomy. 13. Medical supplies necessary for treatment including but not lim- ited to, an electronic heart pacemaker, surgical dressings, casts, splints, and crutches. 14. Surgeon's fees for the performance of surgical procedures, in- cluding necessary related postoperative care by a physician, sub- ject to the reasonable and customary fees in the area. 15. Wellness care (see Highlights section for details) 16. Chiropractic and Physical Therapy subject to Plan limitations 17. Occupational Therapy performed by a licensed occupational therapist and ordered by a physician. It must be considered pro- gressive therapy, not maintenance therapy, and must not be per- formed for the purpose of vocational rehabilitation. Covered ex- penses do not include either recreational programs or supplies used in occupational therapy. 18. Emergency services. In the event of emergency services, the Plan will pay at the PPO rate for Non PPO providers. Emergency service is defined as follows: services which are immediately required to treat a sudden serious and unexpected illness or in- jury, including services to alleviate pain associated with sudden, serious and unexpected illness and/or injury. 10 11 Prescriptions All prescription drug payments shall be made through the Advance Prescrip- tion Card Service (PCS) and shall be on the basis of a copayment by the par- ticipant of $5 for each generic drug prescription or $8 for each brand name drug prescription. No payments for any prescription drug shall be made through the Employee Health Plan. Prescription drugs are available by mail order at a cost of $4 for generic and $6 for brand name prescriptions. Claims forms are available in the Risk Management Office. Chiropractic and Physical Therapy Guidelines Benefits are provided as follows: 3 times a week for the first month 2 times a week for the second month Once a week for the third month 2 times a month for fourth month and thereafter These guidelines may be modified on an individual case -by -case basis pur- suant to the -recommendation of our Medical Advisor. Chiropractic Limitations Benefits will be provided to a maximum of 24 treatments per year or $2,000, whichever occurs first. Said limits are per person and commence January 1 of each year. Preventive Medical Care Benefits will be provided up to $200 per person for preventive medical care per year. This care shall iticlude preventive medical options such as an an- nual physical exam, PAP tests, flu shots, chest x-rays, EKG, PSA and other diagnostic tests if certified by the physician that such procedures are in- cluded under a routine physical examination and are not in connection with the diagnosis or treatment of any illness or disease. Well Baby Exams Three well baby examinations for an infant for the first year of life will be allowed subject to the $200 maximum benefit. All innoculations for infants/ children will be provided and coverage is not limited to the $200 maximum benefit. 12 General Exclusions and Limitations Benefits for the following shall not be covered: Occupational Injuries or Illnesses. Any illness or injury arising out of, or in the course of, employment is excluded. Unnecessag Services or Supplies. Any services or supplies not rea- sonably necessary for the medical care of the participant's illness or injury are excluded. Weekend Admissions. If admitted to the hospital on a Friday, Satur- day or Sunday, charges for these days will be excluded unless admit- ted due to an emergency or if surgery is performed within 24 hours. Excess of Usual, Customary and Reasonable. The portion of any charge for any services or supplies in excess of the reasonable and customary charge is excluded. Mouth and Teeth Conditions. Treatment on or to the teeth, extraction of teeth, treatment of dental abscesses or granuloma, dental examina- tion or treatment of gingival tissues other than for tumors is excluded. Hearing Aids. Examinations to determine the need for, or the proper adjustment of hearing aids, are excluded. Vision Care. Physicians services in connection with eye refractions or any other examinations to determine the need for, or the proper ad- justment of, eyeglasses or contact lenses are excluded. Radial keratot- omy, Lasik and similar procedures are also excluded. Cosmetic Surgery. Charges in connection with cosmetic surgery are excluded unless performed for the correction of functional disorders as a result of accidental injury occurring while the individuals are covered. Other General Exclusions: Hospital admissions primarily for diagnostic study when in- patient care would not otherwise have been required. Custodial care Personal or convenience items Services or supplies not connected with the care and treat- mgnt of an actual illness, disease or injury 13 6 10. 11, 12. 13, 14, 15. 16. 17. 18, 19. U Any illness or injury due to war, declared or undeclared, or any act of war is excluded Any means of artificial fertilization, including but not limited to artificial insemination, in -vitro fertilization or gamete intra- fallopian transfer Reversing prior surgical sterilization procedures Any charges for weight control or weight reduction program No benefits will be provided for any condition of pregnancy for dependent daughters. Sales tax on prescription drugs or on any other covered item No benefits will be provided for any mental health care. Mental health services are provided by Managed Health Network Treatment, services, equipment, new technology, drugs, proce- dures or supplies considered experimental or investigational at the time the procedure is performed or service or supply is pro- vided Air conditioners, dehumidifiers, air purifiers, arch supports, cor- rective or orthopedic shoes, heating pads, hot water bottles, home enema equipment, etc. are not covered. Any items for which the participant is not legally required to pay, or for which a charge would not have been made if the participant did not have this coverage. Benefits available under the Plan may be reduced or eliminated based upon the coordination of benefits or subrogation rules. Charges for failure to keep a scheduled visit, completion of claim forms or providing supplemental information. Charges for vitamins (except pre -natal vitamins), minerals, nutri- tional or food supplements or any other over the counter item. Any charges not listed in `Covered Expenses" Nursing Facility. Any services furnished by an institution which is primarily a place of rest, a place for the aged, a nursing or con- valescent home or any institution of like character, unless other- wise specifically provided for herein. Smoking cessation program. 14 When you have a Claim Before submitting a claim for medical expenses, review this brochure and the bills you have accumulated. Be sure you are submitted itemized bills for which benefits are payable. Save all of your bills, including those being accumulated to satisfy a de- ductible. In most instances they will serve as evidence of your claim. Submit the original bill, not a copy. Each bill must be complete and item- ized and should show the patient's full name, date or dates of service, na- ture of the illness or injury, and type of service provided. Claim forms are available in the Risk Management office. A separate claim form is re- quired for each family member. Please mail all completed forms to: City of Huntington Beach Employee Health Plan Risk Management Division 2000 Main Street Huntington Beach, CA 92648 All claims must be received no later than 12 months from the date of ser- vice. Claims submitted after this time period will be rejected. Claims Payment and Appeals Notice of Decision A notice of decision will be sent to you within 30 days after receipt of a properly completed claim. If there is some reason your claim cannot be processed within that time, you will be given notice of the reason for the delay. Claim Appeal Procedure If your claim is denied in whole or in part, you and your physician will be provided with written notification explaining the reason. If you have rea- son to believe that the denial of your claim was not correct under the terms of the Plan Document, a request for review must be made within 60 days from the notice of the claim denial. The claim, as well as all supporting documentation, will be submitted to Medical Review for review by physi- cians at the Foundation for Medical Care. You and your provider will be notified in writing of the claim decision as soon as possible but not later than 120 days after receipt of the request. 15 Coordination with Other Plans The Employee Health Plan contains a provision to prevent double pay- ment for covered expenses. This provision works by coordinating the benefits under this Plan with other similar plans under which a person is covered, so the total benefits available will not exceed one hundred per- cent of allowable expenses. This provision is commonly called "Coordination of Benefits". When a claim is made, the primary plan (as described below) pays its benefits without regard to any other plans. The secondary plans adjust their benefits so that the total benefits available will not exceed the allow- able expenses. No plan pays more than it would otherwise pay without this coordination provision, A plan without a coordination of benefits provision is always the primary plan. If all plans have such a provision: (1) the plan covering the patient directly (e.g., employee or retiree), rather than as a dependent, is primary and the others secondary: (2) if a child is covered under both parents' plans, the parent whose birthday, falls earlier in the year is primary, or, if both parents have the same birthday, the plan covering the parent longer is primary, but when the parents are separated or divorced, their plans pay in this order: (a) the plan of the,parent with custody of the child; (b) the plan of the parent not having custody of the child (c) the plan of the spouse of the parent with custody of the child; , and (d) the plan of the spouse of the parent not having custody of the child. When the order of benefits is not determined by the preceding paragraphs, the benefits of the plan covering the person as an employee who is actively employed (neither laid off nor retired), are determined before those of a plan covering a person who is inactive. If the other plan does not have this provision and, as a result, the plans do not agree on the order of benefits, this provision is ignored. If none of the preceding provisions determine the order of benefits, the benefits of the plan that,covered a person longer are determined first. If none of the preceding provisions of this section make it able to deter- mine which plan.is primary, the allowable expenses shall be shared equally between the plans. Termination of Coverage Coverage will terminate for an employee on the last day of the month in which employment terminates. Coverage for a dependent will cease on the earliest of the following: • Last day of the month in which the employee's coverage termi- nates • Date the dependent enters active service with the armed forces • Date the dependent ceases to be an eligible dependent • For a dependent spouse, on the date of divorce • For dependent child/children, the date of the child's marriage or attainment of the maximum age limit of 25. Continuation of Benefits If a covered employee ceases active employment due to an authorized leave of absence, participation may be continued under COBRA or Family and Medical Leave Act (FMLA). Please refer any questions regarding the continuation of health insurance coverage to the Employee Benefits Divi- sion of the City of Huntington Beach. 17 TABLE OF CONTENTS PART I - DEFINITIONS........................................................................................................... 'I A. "CALENDAR YEAR"............................................................................................................... 'I B. "SKILLED NURSING FACILITY"................................................................................................ I C. "EFFECTIVE DATE"............................................................................................................... 1 D. "FAMILY MEMBER"................................................................................................................ 1 E. "LEGALLY OPERATED HOSPITAL".......................................................................................... 'I F. "MASCULINE GENDER".......................................................................................................... 'I G. "PARTICIPANT"..................................................................e.................................................. 2 H. "PHYSICIAN" OR "SURGEON"................................................................................................ 2 1. "EMPLOYEE".......................................................................................................................... 2 "PLAN" J. PLAN a..e.............a.ae.a..s...e................................................................................................... "CITY" K.CITY .............................................................................................................................. M. "RETIREE"...................�..................................................................................................... 2 IYI. "ACCIDENT"...................,.................................................................................................... 2 N. "RELATIVE VALUE STUDIES'(RVS)99....................................................................................... 2 O. "MEDICALLY NECESSARY".................................................................................................... 2 P. "USUAL, CUSTOMARY AND REASONABLE (UCR) CHARGE" ..................................................... 2 Q. "SECOND SURGICAL OPINION".............................................................................................. 3 R. "PPO OR PPO PROVIDER"................................................................................................... 3 S. "NON—PPO PROVIDER"......................................................................................................... 3 T. "SUBSIDIZED RETIREE"......................................................................................................... 3 U. "CLAIMS ADMINISTRATOR".................................................................................................... 3 V. "CUSTODIAL CARE".............................................................................................................. 3 W. "MENTAL OR NERVOUS DISORDERS"..................................................................................... 3 X. "TOTALLY DISABLED"............................................................................................................ 4 Y. "UTILIZATION REVIEW".......................................................................................................... 4 Z. "UTILIZATION REVIEW ORGANIZATION"................................................................................... 4 AA. "HOSPITAL PRE -ADMISSION NOTIFICATION"......................................................................... 4 BB. "MEDICAL REVIEW ADVISERS"............................................................................................ 4 CC. "SUBSTANCE ABUSE"........................................................................................................ 4 PART 11- ELIGIBILITY AND RECORDS................................................................................. 4 A. ELIGIBLE PARTICIPANTS......................................................................................................... 4 B. ADDING FAMILY MEMBERS..................................................................................................... 4 C. PRE—EXISTING CONDITIONS.................................................................................................... 5 D. RETIREES............................................................................................................................. 5 E. FAMILY MEMBERS BECOMING INELIGIBLE................................................................................ 6 F. BENEFIT BOOKLET................................................................................................................. 6 PART III - CONDITIONS UNDER WHICH BENEFITS WILL BE PAYABLE IN A HOSPITAL OR SKILLED NURSING FACILITY......................................................................................... 6 A. CARE FOR ILLNESS OR ACCIDENT........................................................................................... 7 B. BED CARE............................................................................................................................ 7 C. EFFECTIVE DATE................................................................................................................... 7 TABLE OF CONTENTS D. IDENTIFICATION CARD............................................................................................................ 7 E. DAYS OF CARE...................................................................................................................... 7 F. MEDICALLY NECESSARY SERVICES......................................................................................... 7 PARTIV - EXCLUSIONS.........................................................................................................7 A. DIAGNOSTIC STUDY............................................................................................................... 7 B. RECOVERABLE BENEFITS.......................................................................................................7 C. SERVICES/SUPPLIES..............................................................................................................8 D. NO CHARGE SERVICES/SUPPLIES........................................................................................... 8 E. UNITED STATES FEDERAL OR FOREIGN GOVERNMENT AGENCY ................................................ 8 F. SERVICES SUPPLIES NOT SPECIFIED HEREIN........................................................................... 8 G. CARE AND TREATMENT OF ACTUAL ILLNESS/INJURY................................................................ 8 H. TREATMENT TO THE TEETH/EYES/EARS.................................................................................. 8 1. COSMETIC.............................................................................................................................. 8 J. ACTS OF WAR........................................................................................................................ 8 K. NURSING FACILITIES.............................................................................................................. 8 L. CUSTODIAL CARE.................................................................................................................. 8 M. MEDICARE............................................................................................................................ 8 N. SEX TRANSFORMATIONS........................................................................................................ 9 O. RECONSTRUCTION OF STERILIZATION PROCEDURE..................................................................9 P. CHARGES IN EXCESS OF UCR................................................................................................9 Q. EXPERIMENTAL..................................................................................................................... 9 R. PREGNANCY FOR DEPENDENT DAUGHTERS............................................................................. 9 S. OUTPATIENT PSYCHIATRIC CARE............................................................................................ 9 T. SUPPLIES..............................................................................................................................9 U. WEIGHT CONTROL.................................................................................................................9 V. SERVICES PROVIDED BY MEMBERS OF HOUSEHOLD................................................................9 W. UNKEPT APPOINTMENTS....................................................................................................... 9 X. FALSE STATEMENTS............................................................................................................10 Y. SERVICES OR SUPPLIES....................................................................................................... 10 Z. TREATMENT BY OTHER THAN A LICENSED PHYSICIAN.............................................................10 AA. DISCOUNTS THROUGH ANOTHER PLAN............................................................................... 10 BB. RESIDENTS/INTERNS.........................................................................................................10 CC. INJURY INCURRED DURING COMMISSION OF A CRIME...........................................................10 DD. IRS REGULATIONS............................................................................................................10 EE. HYPNOSIS.........................................................................................................................10 FF. DIGESTIVE AIDS, VITAMINS, SUPPLEMENTS......................................................................... 10 GG. SMOKING CESSATION........................................................................................................10 HH. SPAS OR SWIMMING POOLS..............................................................................................10 II. MANAGED HEALTH NETWORK............................................................................................... 10 ' PART V - COORDINATION OF BENEFITS..........................................................................11 A. BENEFITS............................................................................................................................11 B. DEFINITIONS........................................................................................................................11 1. "CLAIMS DETERMINATION PERIOD".................................................................................... 11 2. "COVERED INDIVIDUAL"....................................................................................................11 TABLE OF CONTENTS 3. "COVERED SERVICES"..................................................................................................... 11 4. "THIS DOCUMENT"........................................................................................................... 11 5. "PLAN"...........................................................................................................................11 C. EFFECT ON BENEFITS.......................................................................................................... 11 D. FACILITY OF PAYMENT......................................................................................................... 13 E. RIGHT OF RECOVERY........................................................................................................... 13 F. RIGHT TO RECEIVE AND RELEASE NECESSARY INFORMATION ................................................. 13 PART VI - CONTINUATION BENEFIT..................................................................................14 PART VII - GENERAL PROVISIONS....................................................................................15 A. PLAN DOCUMENT................................................................................................................ 15 B. WORKER'S COMPENSATION INSURANCE............................................................................... 15 C. CHIROPRACTOR OR PSYCHOLOGIST...................................................................................... 15 D. CHARTER............................................................................................................................ 15 E. EMPLOYER RESPONSIBILITY FOR FURNISHING HOSPITAL CARE .............................................. 16 F. DUPLICATE COVERAGE........................................................................................................ 16 I. NOTICE OF CLAIM.................................................................................................................. 16 J. PRESCRIPTIONS................................................................................................................... 16 G. NON TRANSFERABLE BENEFITS........................................................................................... 16 H. LIMITATION OF LIABILITY....................................................................................................... 16 PART VIII - SECOND OPINION SURGICAL PROGRAM.....................................................17 A. DEFINTION, EFFECTIVE 1-1-84............................................................................................. 17 B. ELECTIVE SURGERY............................................................................................................ 17 C. BOARD CERTIFIED............................................................................................................... 17 D. SECOND OPINION FEES PAID BY PLAN.................................................................................. 18 E. COVERAGE BY EMPLOYEE ORGANIZATION............................................................................. 18 PART IX - BASIC BENEFITS................................................................................................ 18 A. DEFINITION.......................................................................................................................... 18 B. SUBSTANCE ABUSE TREATMENT.......................................................................................... 18 C. OUT -PATIENT PRE -HOSPITAL ADMISSION TESTING................................................................ 18 D. OUT -PATIENT SURGERY...................................................................................................... 18 E. BASIC PROFESSIONAL BENEFITS.......................................................................................... 19 F. AMBULANCE BENEFIT.......................................................................................................... 20 G. PREVENTATIVE MEDICAL CARE............................................................................................ 20 PART X - MAJOR MEDICAL................................................................................................ 21 A. DEFINITION.......................................................................................................................... 21 B. SPECIAL CONDITIONS IN REGARD TO HOSPITAL BENEFITS...................................................... 23 C. BENEFITS FOR SERVICES AND SUPPLIES IN ELIGIBLE SKILLED NURSING FACILITIES ................. 24 D. CARE FOR CONDITIONS OF PREGNANCY................................................................................ 25 E. CHIROPRACTIC AND PHYSICAL THERAPY GUIDELINES............................................................ 25 F. TREATMENT BY CALIFORNIA LICENSED CERTIFIED ACUPUNCTURIST ........................................ 25 G. SUBSIDIZED RETIREE BENEFITS........................................................................................... 25 H. MUNICIPAL EMPLOYEES ASSOCIATION (MEA)....................................................................... 26 TABLE OF CONTENTS PART XI - RETIREE SUBSIDY MEDICAL PLAN.................................................................. 25 A. ELIGIBILITY..........................................................................................................................25 B. SCHEDULE OF BENEFITS...................................................................................................... 26 C. BENEFIT SUMMARY.............................................................................................................. 29 D. MISCELLANEOUS PROVISIONS / ELIGIBILITY........................................................................... 29 BENEFITS............................................................................................................................. 31 SUBSIDIES............................................................................................................................ 31 MEDICARE............................................................................................................................ 31 CANCELLATION..................................................................................................................... 32 PART XII - TERMINAL BENEFITS........................................................................................ 32 A. BENEFIT CONTINUANCE AT TIME OF TERMINATION OF EMPLOYMENT ....................................... 33 B. TERMINAL BENEFITS FOR TOTAL DISABILITY.......................................................................... 33 C. DEFINITION OF TOTAL DISABILITY.......................................................................................... 33 D. EXCLUSION OF TERMINAL BENEFITS..................................................................................... 33 PART XIII - ADMINISTRATION OF THE PLAN.................................................................... 33 A. APPOINTMENT OF THE CLAIMS ADMINISTRATOR..................................................................... 33 B. POWERS OF THE CLAIMS ADMINISTRATOR............................................................................. 33 C. CLAIMS PROCEDURE............................................................................................................34 D. APPEAL PROCEDURE........................................................................................................... 34 E. LIMITATION OF LIABILITY.......................................................................................................35 PART XIV - DURATION AND AMENDMENT OF THE PLAN...............................................35 A. PERMANENCE OF THE PLAN.................................................................................................. 35 B. RIGHT TO AMEND................................................................................................................. 35 C. SEVERABILITY..................................................................................................................... 35 PART XV - ADMINISTRATIVE PROVISIONS....................................................................... 36 A. MANAGEMENT RIGHTS......................................................................................................... 36 B. PARTICIPANT'S RESPONSIBILITIES......................................................................................... 36 C. MISSING PERSON................................................................................................................ 36 D. GOVERNING LAW................................................................................................................. 36 AMENDMENTNO. 1.............................................................................................................37 AMENDMENTNO. 2.............................................................................................................38 AMENDMENTNO. 3.............................................................................................................39 AMENDMENTNO.4.............................................................................................................40 AMENDMENTNO. 5.............................................................................................................41 EMPLOYEE HEALTH PLAN DOCUMENT Nothing contained in this document shall in any manner restrict or interfere with the right of any individual entitled to service and care to select the hospital, skilled nursing facility or to make a free choice of his attending physician or surgeon who shall be holder of a valid and unrevoked physician's or surgeon's certificate and who is a member of, or acceptable to, the attending staff and Board of Directors of the facility in which services are to be provided and rendered. PAIN I - DEFINITIONS A. "Calendar Year" - Is the twelve-month period commencing January 1 st of each year at 12:01 A.M., Pacific Standard Time. B. "Skilled Nursing Facility" - Means an institution which (1) provides skilled nursing care under 24 hour supervision of a doctor or graduate registered nurse, (2) has available at all times the services of a doctor who is a staff member of a hospital, (3) provides 24 hours a day nursing service by a graduate registered nurse on duty at least 8 hours per day, and (4) maintains a daily medical record for each patient. It shall specifically exclude any institution which is primarily a place of rest, a place for the aged or a facility operated by the Federal Government or any agency thereof. C. "Effective Date" - Is the date on which this Document becomes effective. D. "Family Member" - Shall be the spouse of the Employee and children from birth to nineteen (19) years of age, provided such children are unmarried, and dependent upon the Employee for support and maintenance. Refer to Part II, Eligibility and Records, Section E for further clarification. The term "children" shall include natural children, legally adopted children, and stepchildren. E. "Legally Operated Hospital" - Is an institution operated in accordance with the laws of the jurisdiction in which it is located pertaining to institutions identified as hospitals and which, for compensation from its patients and on an inpatient basis, is primarily engaged in providing diagnostic and therapeutic facilities for surgical and medical diagnosis, treatment and care of injured and sick persons by or under the supervision of a staff of licensed physicians or surgeons, and which continuously provides 24 hours a day nursing service by registered graduate nurses. It shall specifically exclude care provided by any institution or any affiliate or unit of a legally operated hospital which is primarily a place of rest, a place for the aged, a nursing or convalescent home, or a facility operated by the Federal Government or any agency thereof. F. "Masculine Gender" - Includes the feminine in context. G. "Participant" - Is the eligible employee or retired employee of the City whose Enrollment Form has been accepted by the Claims Administrator in accordance with the enrollment regulations of this Document and in whose name the City's Identification Card is issued. 0011662.01 4- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT H. "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. Physicians include Acupuncturists, Chiropractors, and Physical Therapists when acting within the scope of their license. 1. "Employee" - Means all permanent employees of the City of Huntington Beach working at least 20 hours per week. J. "Plan" - Means Huntington Beach Employee Health Plan. K. "City" - Means City of Huntington Beach. L. "Retiree" - Means any retired Employee of the City who (1) has retired on a service or disability retirement, and (2) is not eligible for Medicare, and (3) has not attained age 65. M. "Accident" - Means a sudden, unexpected and unplanned event occurring by chance which is caused by an independent external force and which results in definite physical trauma. N. "Relative Value Studies (RVS)" - Is a listing of medical and surgical procedures published by the California Medical Association with "Units" assigned to each procedure in accordance with various medical criteria. The City provides benefits which are valued by assigning a monetary value to the RVS Unit for covered procedures. O. "Medically Necessary" - Services and/or supplies are services or supplies which the Claims Administrator's medical advisors determine to be reasonably necessary and which are provided in accordance with local community standards for care and treatment of the illness or injury involved. The Plan will provide benefits only for these services and supplies which are determined to have been medically necessary at the time P. "Usual, Customary and Reasonable (UCR) Charge" - Is the amount charged or the amount the Claims Administrator determines to be the prevailing charge within the general area in which the service was provided, whichever is the lesser. 0011662.01 -2- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT Q. "Second Surgical Opinion" - Means certain surgical procedures done on an elective basis shall be mandated to have a second surgical opinion in order to be payable at normal plan benefits, as specified in this Plan Document. These surgical procedures are as listed: Cataract Surgery Varicose Vein Ligation Cholecystostomy Tonsillectomy & Adenoidectomy Hernia Repair Knee Surgery (Menisectomy) Hysterectomy Hemorrhoidectomy Laminectomy Dilation and Curettage Mastectomy Repair of Deviated Septum Onychotomy Spinal Fusion Prostatectomy R. "PPO or PPO Provider" - A doctor or other health care professional or hospital who belong to the Orange County Foundation Preferred Provider Organization (OCPPO) or similar organization if OCPPO is replaced. S. "Non-PPO Provider" - A doctor, hospital, or other health care professional not belonging to the Orange County Preferred Provider Organization. T. "Subsidized Retiree" - A subsidized retiree is an employee, who, at the .time of retirement has a minimum of ten years of continuous City service or is granted an industrial disability retirement and elects to participate in the Retiree Subsidy Medical Plan. U. "Claims Administrator" - Means the person(s) with whom the City has contracted to provide the services described in Section XIII. V. "Custodial Care" - Means services or supplies provided for persons who are physically or mentally disabled but who are not currently receiving medical, surgical or psychiatric treatment to reduce their disability and to enable them to live without Custodial Care W. "Mental or Nervous Disorders" - Are those conditions listed in the International Classification of Diseases in the section on Mental Disorders (Diagnostic Codes 290-319), including drug or alcohol intoxification or dependence and learning problems. These disorders may be of physical or functional etiology. X. `Totally Disabled" - Is physically prevented from engaging in his or her regular or customary occupation. A Dependent is Totally Disabled if prevented solely because of Sickness or Injury, from engaging in substantially all of the normal activities of an individual of similar age. Certification of Total Disability must be made by a Physician. 0011662.01 -3- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT Y. "Utilization Review" - Means systematically evaluating the appropriateness and necessity of medical care. Utilization Review consists of, but is not limited to: 1. Pre -certifying the appropriateness and necessity of non -emergency confinements; 2. Reviewing, on a concurrent basis, the continued appropriateness and necessity of confinement or home health care; 3. Determining the necessity of second opinions for Elective Surgical Operations; and 4. Providing case management services. Z. "Utilization Review Organization" - Means the organization that conducts Utilization Review for the Plan. AA. "Hospital Pre -Admission Notification" - Means complying with all the rules set forth by the Utilization Review Organization. BB. "Medical Review Advisers" - Means the consultants of employees hired by the Utilization Review Organization or Claim Administrator to provide advise as to whether services are Medically Necessary. CC. "Substance Abuse" - Means conditions listed in the International Classification of Diseases as alcoholic psychoses, drug psychoses, alcohol dependence syndrome, drug dependence or non-dependent abuse of drugs (Diagnostic Codes 291 through 292.9 and 303 through 305.9). PART Il - ELIGIBILITY AND RECORDS A. Eligible Participants - Shall be all permanent Employees and Retirees. B. Adding Family Members - The Participants may add, upon notice to the Claims Administrator, other eligible Family Members, subject to enrollment regulations in effect with the City. Immediate coverage will be provided from and after the moment of birth for each newborn child of a Participant covered by a "Participant and one or more dependent" type coverage without requiring evidence of insurability. Extension of coverage for any condition commencing beyond thirty-one days from the date of birth of a newborn child of a Participant covered under a "Participant and one dependent" type coverage shall be contingent upon application to the Claims Administrator by the Participant in respect to each newborn child provided such application is made within sixty days from date of birth of a child in accordance with the enrollment regulations. An application for coverage for a new spouse or new child must be completed within sixty days of marriage. An individual who fails to enroll when first eligible must submit satisfactory evidence of good health when the application for enrollment is made except during open enrollment. 0011662.01 -4- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT C. Pre -Existing Conditions - The Medical Plan shall exclude coverage of pre-existing medical conditions of new employees and dependents, except under the following conditions: 1. The employee or dependent is free from treatment for the pre-existing condition for three months after the effective date of coverage under the plan. 2. A pre-existing condition of the employee is covered after the employee completes six month of continuous employment. 3. A pre-existing condition of any dependent who has been enrolled on the plan is covered after the employee completes twelve months of continuous service. D. Retirees - All Retirees and their eligible Dependents shall be covered if: 1. They were approved for coverage and covered by the prior plan on October 31, 1979. 2. They retired on or after 11 /1 /79, and: a. Made application within 31 days of retiring, and b. Paid a quarterly premium, as 'determined by the City in advance. Retirees must continue to pay the quarterly premium monthly cost, as determined by the City, in advance to maintain coverage. 3. On the first of the month in which the retiree reached age 65 or on the date the retiree can first apply and become eligible for medical coverage under Medicare (whether or not such application is made), benefits under this Document will be terminated. 4. Effective 1-1-86 if the spouse of an industrial disability retiree becomes an employee of the City of Huntington Beach and elects family coverage under the Employee Health Plan, the retiree can elect to cancel his insurance coverage and be insured as a dependent of his spouse. Upon the spouse's termination of City insurance benefits, the retiree can, without evidence of insurability, become reinstated to the Employee Health Plan at his own cost. E. Family Members Becoming Ineligible - Family members become ineligible under the following circumstances: 1. When the Participant becomes ineligible. 2. When a child attains the age of nineteen years, or upon prior marriage, except that: a. In respect to an unmarried child attaining the age of nineteen years, should he continue to be dependent upon his parent(s) to the extent of not less than fifty percent of his subsistence and support, his eligibility for benefits here under shall continue while he remains in such status 0011662.01 4- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT until he attains age twenty-three; Effective 1-1-86 the definition of dependent child is changed to require that children between the ages of nineteen to twenty-three be either: 1) A full time student or 2) Lives at home and are dependent on the parent/employee for more than fifty percent (50%) of his/her support. b. In respect to an unmarried child attaining the age of nineteen years, or twenty-three years when qualifying as set forth in Paragraph a. above, should he at such time be incapable of self-sustaining employment by reason of mental retardation or physical handicap and continue to be dependent upon his parent(s) to the extent of not less than fifty percent of his subsistence and support, his eligibility for benefits hereunder shall continue regardless of his age while he remains in such status. Evidence of such incapacity and dependency shall be required within thirty-one days of the dependent's attainment of age nineteen years or twenty-three years whichever is applicable, and periodically thereafter as may be required by the Claims Administrator, but not more frequently than annually after a two-year period following such dependent's attainment of the aforementioned age limitation. Determination of eligibility by the Claims Administrator shall be conclusive. 3. A spouse upon entry of final decree of divorce or annulment. F. Benefit Booklet - The Claims Administrator shall issue for delivery to each Participant an individual benefit booklet, setting forth a statement of benefits to which the Participant and his eligible Family Members are entitled, and an Identification Card. PART III - CONDITIONS UNDER WHICH BENEFITS WILL BE PAYABLE IN A HOSPITAL OR SKILLED NURSING FACILITY Benefits will be provided for expenses incurred in any Legally Operated Hospital or skilled nursing facility under the following conditions: A. Care for Illness or Accident - Benefits shall be provided for expenses incurred in connection with illness or accident, but limited to those expenses billed by the Hospital or Skilled Nursing Facility which are necessary for treatment of the condition requiring such care. B. Bed Care - The attending Physician or Surgeon must certify that bed care is Medically Necessary. C. Effective Date - Admission must occur on or after the Participant's or Family Member's Effective Date hereunder. D. Identification Card - The Participant's Identification Card must be presented at time of admission or during the confinement stay. If such is not done because of factors 0011662.01 -6- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT beyond the control of the patient, benefits will be allowed only if claim is made within ninety days from date of admission or thirty days from date of discharge, whichever is later, accompanied by a receipted bill and such supporting statements as are necessary to establish the claim. E. Days of Care - Days of care under the above provisions shall be counted against total days of care available under this Document. F. Medically Necessary Services - Services for inpatient bed care must be Medically Necessary and not capable of being performed on an outpatient basis. PART IV - EXCLUSIONS Benefits shall not be provided for: A. Diagnostic Study - Admissions primarily for diagnostic study when inpatient bed care would not otherwise have been required, unless otherwise specified herein. B. Recoverable Benefits - Any condition for which benefits of any nature are recovered or found to be recoverable, whether by adjudication or settlement, under any Workers' Compensation or Occupational Disease Law, even though the participant or family member fails to claim his rights to such benefits. C. Services/Supplies - Services or supplies for which the participant or family member is not legally required to pay. D. No Charge Services/Supplies - Services or supplies for which no charge is made. E. United States Federal or Foreign Government Agency - Care or treatment obtained from, or for which payment is made by, any United States Federal or foreign government agency. F. Services Supplies not Specified Herein - Services or supplies not specifically provided for herein. G. Care and Treatment of Actual Illness/Injury - Services or supplies not connected with care and treatment of an actual illness, disease or injury. H. Treatment to the Teeth/Eyes/Ears - Treatment on or to the teeth, extraction of teeth, treatment of dental abscess or granuloma, dental examinations, or treatment of gingival tisues (gums) other than for tumors; eye glasses, eye refractions, eye examinations for the correction of vision or fitting of glasses; or the furnishing or replacement of hearing aids; except as specifically provided for under Major Medical if such benefits are included in this document. 0011662.01 -7- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT I. Cosmetic - Services or supplies for cosmetic purposes, unless performed for correction of functional disorders or as a result of accidental injury occurring while the individual is covered hereunder. J. Acts of War - Conditions caused by or arising out of an act of war, armed invasion or aggression, or any illness or injury occurring after the effective date of this document and caused by atomic explosion or other release of nuclear energy, whether or not the result of war. K. Nursing Facilities - Any services furnished by an institution which is primarily a place of rest, a place for the aged, a nursing or convalescent home or any institution of like character, unless otherwise specifically provided for herein. L. Custodial Care. M. Medicare - Any services or supplies payable by Medicare, whether or not claim for such Medicare benefits is made. On the first of the month in which the Participant or eligible dependent who becomes age 65 or on the date the Participant can first apply and become eligible for any type of Medicare coverage (whether or not such application is made), benefits under this Document will be modified and reduced so as to supplement Medicare coverage. N. Sex Transformations - Any procedure or treatment designed to alter physical characteristics of the Participant to those of the opposite sex, and any other treatment or studies related to sex transformations. O. Reconstruction of Sterilization Procedure - Reconstruction of prior surgical sterilization procedures. E. Charges in Excess of UCR - That portion of charges in excess of Usual, Customary and Reasonable Charges, as determined by the Claims Administrator. Q. Experimental - Experimental or investigative therapy, including any type of therapy not generally recognized as of value by the medical community and its societies, as determined by the Claims Administrator in the reasonable exercise of its discretion, is not covered; all other charges, as for office visits or laboratory procedures, incurred in conjunction with non -covered therapy will be considered non -covered. R. Pregnancy for Dependent Daughters - No benefits will be provided for any condition of pregnancy for dependent daughters. S. Outpatient Psychiatric Care - No benefits will be provided for any psychiatric services performed on an outpatient basis. T. Supplies - Orthopedic Shoes (except when joined to braces) or shoe inserts, air purifiers, air conditioners, humidifiers, exercise equipment and supplies for comfort, 0011662.01 -8- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT hygiene or beautification, educational services, nutritional counseling or food supplements. U. Weight Control - Any charges for weight control or weight reduction procedures. V. Services Provided by Members of Household - Charges for services furnished by Immediate Relatives or members of the patient's household. W. Unkept Appointments - Charges for unkept appointments, completion of claim . forms or providing supplementary information or interviews in which the patient is not seen. X. False Statements - Services payable by reason of any false statement. Y. Services or Supplies - Services or supplies that were incurred prior to the date the Employee or Dependent became covered or after termination of coverage, except as otherwise specified. Z. Treatment by Other Than a Licensed Physician - Treatment by anyone except a Physician acting within the scope of his or her license. AA. Discounts Through Another Plan - PPO discounts through another plan. BB. Residents/Interns - Residents or interns of a Hospital. CC. Injury Incurred During Commission of a Crime - Treatment for any injury incurred in the commission of a crime. DD. IRS Regulations - Services not deductible under Section 213 of the Internal Revenue Code. EE. Hypnosis. FF. Digestive Aids, Vitamins, Supplements - Digestive aids, vitamins, laetrile, or mineral supplements, whether taken orally or injected, regardless of whether they are prescribed by a physician. GG. Smoking Cessation - Smoking cessation programs. HH. Spas Or Swimming Pools. II. Managed Health Network - Inpatient mental health care and substance abuse/detoxification will be provided by Managed Health Network, effective March 1, 1994. This applies to POA/PMA/MEO/MEA/NA/MSOA employees. 0011662.01 -9- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT PART V - COORDINATION OF BENEFITS A. Benefits - All of the benefits provided by the Plan are subject to the following provisions and limitation. B. Definitions: 1. "Claims Determination Period" - Is a period beginning with any January 1st and ending at 12 o'clock midnight on the next succeeding December 31 st, or that portion of such period during which the covered individual was covered under this Document. However, should this document specify a benefit year which does not coincide with the standard calendar year, then the "claim determination period" will coincide with, and run concurrently with, the stated benefit year or portion of such benefit year during which the covered individual was covered under this document. 2. "Covered Individual" - Means the Participant or Family Member eligible for covered services under this Document. 3. "Covered Services" - Means any necessary, reasonable and customary item of hospital or medical expense incurred, where at least a portion of said incurred expense is covered under one or more of the Plans covering the person for whom claim is made or service rendered. To the extent legally possible, "covered services" shall be synonymous with allowable expense. 4. "This Document" - Shall have the same meaning as Plan. 5. `Plan" - Means any plan, contract or policy providing benefits or services for or by reason of hospital, surgical, or medical care or treatment, which benefits or services are provided by (a) group, (b) group hospital or medical services organization, group practice, or other type of group service prepayment coverage, (c) any group coverage under labor management trusteed plans, union welfare plans, employer organization plans, or employee benefit organization plans, (d) any coverage under any governmental program, or any coverage required or provided by any statute "other than individual policies or contracts", (e) any group student coverage provided, or sponsored, by a school or other educational institution. C. Effect on Benefits: 1. For any claims determination period to which this provision is applicable, the services due and the benefits that would be payable under this Document in the absence of this provision for the allowable expenses incurred during such claim determination period shall be reduced to the extent necessary so that the sum of (a) such reduced benefits and (b) all the benefits payable for such allowable expenses under all other Plans shall not exceed one hundred percent of Covered Services under all Plans. 2. The services due or the benefits payable under this Document shall be reduced in accordance with the foregoing Subsection I. When the covered individual's other Plan: a. Does not contain a Coordination of Benefits provision. 0011662.01 -10- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT b. The other Plan, has a Coordination of Benefits provision similar to this, and 1) this Document covers the individual as a dependent while the other Plan covers him as an Employee; or 2) this Document covers the Participant as the child of a female Participant while the other Plan covers him as the child of a male Employee; or 3) this Document covers the Participant as the child of a male Participant who has been legally separated or divorced from the mother while the other Plan covers him as the child of the employed mother, except that if valid evidence is submitted establishing that the natural father has legal custody of the dependent child, then in such case the order of benefits determination shall be reversed; or 4) this Document covers the individual as a dependent child of a male Participant who has been divorced from the subsequently remarried mother while the other Plan covers him as the dependent step -child of the Employee step -father except that if valid evidence is submitted establishing that the natural father has legal custody of the dependent child, then in such case the order of benefits determination shall be reversed; or 5) this Document covers the individual as a Participant while the other Plan covers him as an Employee, and the other Plan has covered him for a longer period of time; or 6) this Document covers the individual as a dependent of a Participant while the other Plan covers him as a dependent of the same Employee, and the other Plan has covered him for a longer period of time. 3. Effective January 1, 1987 the Department of Insurance has implemented new Order of Benefit Determination rules called the Birthday Rule. a. Except for cases of dependent children of divorced or separated parents, the health plan of the person whose birthday (month and day, not year) falls earlier in the calendar year will pay first and the plan of the other person covering the dependent will be the secondary payer. b. If persons with the two plans covering the same dependents have the same birthday, the plan of the person which has had coverage longer is the primary payer. c. If one of the two plans has not adopted the Birthday Rule (such as if one plan is in another state) the rules of the plan without the Birthday Rule will determine which plan is primary and which is secondary. d. The divorced/separated parent rule specifies that the health plan of the parent with court ordered financial responsibility is not established the plan of the parent with custody is the primary payer. 0011662.01 -11- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT e. The retiree rule specifies that when a retired employee has two health plans because of coverage under a retirement health plan and as an active worker covered by another health plan, the plan covering the individual as an active employee will pay first and the plan of the company from which the worker is retired will pay second. 4. The Claims Administrator shall not be required to determine the existence of any Plan or the benefits payable under any Plan, when computing the services or benefits due any covered individual under this Document. The services due or the benefits payable under this Document shall be affected only to the extend that other Plan information is supplied by the covered individual, any supplier of covered services hereunder, or any other organization or person. 5. When a Plan provides benefits in the form of services rather than cash payments, the reasonable cash value of each service rendered shall be deemed to be both a covered service and a benefit paid. The reasonable cash value of any services provided to the covered individual by any service organization shall be deemed an expense incurred by said individual, and the liability of the Claims Administrator under this Document will be reduced accordingly. D. Facility of Payment - Whenever payments which should have been made under this Document in accordance herewith have been made under any other Plans, the Claims Administrator shall have the right, -exercisable alone and in its sole discretion, to pay over to any organizations making such other payments, any amounts it shall determine to be warranted in order to satisfy the intent of this provision. Any amounts so paid shall be deemed to be benefits paid under this Document and to the extent of such payments, the Claims Administrator shall be fully discharged from liability under this Document. E. Right of Recovery - Whenever payments for covered services have been made by the Claims Administrator and said payments exceed the maximum amount of payment necessary to satisfy the intent of this provision, irrespective of to whom paid, the Claim Administrator shall have the right to recover such excessive amounts from any persons to, or for, or with respect to whom such payments were made, or from any Insurance Company, or any other organizations or persons. F. Right to Receive and Release Necessary Information - For the purpose of implementing this provision and in the interest thereof, the Claims Administrator may release or obtain any information deemed to be necessary with respect to any person claiming benefits under this Document. Such information may be released or obtained without the consent of, or notice to, the covered individual or any other person or organization. PART VI - CONTINUATION BENEFIT In accordance with the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), continuation benefits will be offered to Participants who experience a qualifying event. 0011662.01 -12- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT The following will be considered qualifying events for the purposes of determining eligibility for continuation benefits due to loss of health care coverage: A. Termination of employment (except for gross misconduct); B. Reduction of work hours; C. Death of Employee or Retiree; D. Divorce or legal separation of Employee or Retiree; E. Dependent child ceasing to be eligible; or P. Bankruptcy proceedings, but only with respect to Retirees. A qualified beneficiary is a Participant who was covered for medical benefits on the date of the qualifying event who, because of the qualifying event, would no longer be covered for benefits as specified by the Plan. If a qualifying event occurs, this Plan will be offered to the qualified beneficiary(ies) until the earliest of the following dates: A. Eighteen (18) months from the date of qualifying events (a) or (b), except this period may be extended for an additional eleven (11) months if the qualified beneficiary notifies the Personnel Division that the Social Security Administration has determined that the qualified beneficiary was disabled as of the date - of the qualifying event. Such notice must be received within sixty (60) days of the date of determination and before the expiration of the initial eighteen (18) month period. The qualified beneficiary is responsible for notifying the Personnel Division within thirty (30) days of the date of any final determination that they are no longer disabled; B. Thirty-six (36) months from the date of qualifying event (c), (d), or (e); C. The end of the period for which contributions were made; D. The date the qualified beneficiary(ies) first becomes covered under another group health plan or entitled to Medicare, except that if the other group health plan excludes or limits a pre-existing condition of the qualified beneficiary, coverage may be continued during the first eighteen (18) months of entitlement to Medicare due to end -stage renal disease; E. The date the City no longer provides group health coverage to any of its Employees; or P. In the case of a bankruptcy proceeding, the date of death of the qualified beneficiary, or in the care of the surviving spouse or dependent children, thirty-six (36) months after the date of death. 0011662.01 -13- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT The qualified beneficiary(ies) electing coverage are responsible for the payment of contributions, plus any additional amounts permitted by law. The qualified beneficiary(ies) must enroll for continuation benefits within sixty (60) days of notification. The qualified beneficiary(ies) will be allowed forty-five (45) days from the date of enrollment to submit payment for all contributions due. Thereafter, the qualified beneficiary(ies) will be allowed a thirty (30) day grace period in which to submit contributions. PART VII - GENERAL PROVISIONS A. Plan Document - This Document, and the individual applications of Employees shall constitute the entire Agreement between the parties and all statements made by the City or by any individual Participant shall, in the absence of fraud, be deemed representations and not warranties, and no such statement shall be used in defense to a claim under this Agreement unless it is contained in a written application. B. Worker's Compensation Insurance - This Medical Benefit Plan is not in lieu of'and does not affect any requirement for, or coverage by Workers' Compensation Insurance. C. Chiropractor or Psychologist - Subject to the conditions and limitations set forth herein, if the Participant or Family Member uses the services of a licensed chiropractor or psychologist performed within the scope of his license, and payment for such services would have been provided by this Document if performed by a Physician or Surgeon, then such services shall be treated as though they had been performed by a Physician or Surgeon for the purposes of determining benefits hereunder. D. Charter - None of the terms or provisions of the charter, constitution of by-laws of the Claims Administrator shall form a part of this Document or be used in the defense of any suit hereunder unless the same is set forth in full herein. E. Employer Responsibility for Furnishing Hospital Care - The Employer and Claims Administrator shall not be responsible for the furnishing of hospital care nor for the quality thereof. P. Duplicate Coverage - If the Participant or Family Member has duplicate coverage with the Claims Administrator, benefits shall be limited to an aggregate amount paid not to exceed 100% of the usual, reasonable, and customary medical expenses incurred. 1. Notice of Claim - Properly completed claim forms itemizing the service received and the charges must be sent to the Claims Administrator by the Participant or the provider of service. These claim forms must be received by the Claims Administrator within 12 months of the date services are rendered. The Claims 0011662.01 -14- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT Administrator is not liable for payment of the benefits if claims are not filed within this time period. J. Prescriptions - All prescription drug payments shall be made through the Prescription Card Service and shall be on the basis of a co -payment by the employee of $5 for each generic drug prescription or $8 for each non -generic drug prescription. No payments for any prescription drug shall be made through the Employee Medical Plan. Effective January 1, 1992 the dispensing limit has been changed from 100 days to 34 days for prescriptions. A 90 day supply will be allowed for mail order prescriptions only: POA/M EO/M EA/P MA/NA/M SOA: Effective January 1, 1994 the mail order drug co -payment shall be $4 for generic and $6 for non -generic prescriptions per 30 day supply. G. Non Transferable Benefits - No person other than the Participant or Family Member is entitled to receive benefits to be furnished by the Claims Administrator under this Document. Such right to hospital care or other benefits is not transferable. H. Limitation of Liability - The hospitals (or Skilled Nursing Facilities) furnishing care or other benefits, to the Participant and Family Member and the Claims Administrator shall not be liable for any claim or demand on account of damages arising out of or in any manner connected with any injuries suffered by the Participant or Family Member while receiving care in any hospital or Skilled Nursing Facility. PART VIII - SECOND OPINION SURGICAL PROGRAM A. Defintion, Effective 1-1-8.4 - Certain surgical procedures done on an elective basis shall be mandated to have a second surgical opinion in order to qualify as a covered benefit. The surgical procedures which would require a second opinion if done on an elective basis are as listed below: 1. Cataract Surgery - excision of a diseased lens of the eye. 2. Cholecystostomy - cutting into and draining of the gallbladder through abdominal wall. 3. Dilation and Curettage - expansion of cervix and scraping of uterine cavity. 4. Hemorrhoidectomy - surgical excision of hemorrhoids (piles). 5. Hernia repair - repair of an inguinal, femoral or umbical hernia. 6. Hysterectomy - removal of the uterus. 7. Knee Surgery (Menisectomy) - removal of meniscus cartilage of the knee. 0011662.01 -15- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT 8. Laminectomy - surgery on the spinal canal through the vertebral arch. 9. Varicose Vein Ligation - repair of varicose vein. 10. Mastectomy - surgical removal of the breast. 11. Onychotomy - surgical removal of the nail of a toe or finger. 12. Prostatectomy - excision of part or all of the prostate gland. 13. Repair of deviated septum (SMR) - sub -mucous resection - plastic surgical procedure to straighten nose. 14. Spinal fusion - surgical fusion of two or more vertebrae. 15. Tonsillectomy and/or Adenoidectomy - surgical removal of tonsils and/or adenoids. B. Elective Surgery - The listed surgical procedures shall be considered elective unless the attending physician certifies that the procedure was performed on an emergency basis without reasonable time for a second opinion. C. Board Certified - The second opinion will be rendered by a physician who is a qualified Board Certified surgeon in the same specialty as the original surgeon. D. Second Opinion Fees Paid by Plan - The second surgical opinion fees will be paid in full by the Employee Health Plan subject to LICR. E. Coverage by Employee Organization: 1. MEO/Non Represented: Should an employee or covered dependent elect a listed surgical procedure without a second opinion or contrary to the recommendation of a second or third opinion, the benefit charge will be reimbursed at 50% of the normal benefits payable. 2. POA/MEA/PMA/FA/MSOA: Should an employee or covered dependent elect a listed surgical procedure without obtaining a second opinion no benefit will be payable. 3. MSOA: Once a second opinion is obtained and the individual elects to have the surgery, the normal benefit will be paid irrespective of the content of the second opinion. 0011662.01 -16- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT PANT IX - BASIC BENEFITS A. Definition - The term "Basic Benefit" as used herein means only those services and supplies listed below. These services are not subject to a deductible and payment shall be based upon charges not exceeding the Usual, customary and Reasonable charges for such services. B. Substance Abuse Treatment: 1. Benefits will be provided for 5 days of in patient detoxification with a life time maximum benefit of $10,000. 2. POA/PMA/MEO/MEA/NA/MSOA: Effective March 1, 1994 this benefit will be provided by Managed Health Network. C. Out -Patient Pre -Hospital Admission Testing - For required medical testing done on an out -patient basis prior to admission to a hospital, benefits will be provided at 100% of Usual, Customary and Reasonable charges. No basic benefits for subsidized retirees. D. Out -Patient Surgery - For surgery requiring the use of hospital surgical facilities, surgical centers or other surgical facilities affiliated with an accredited hospital which satisfies the definition hospital under this Plan Document, AND THE PHYSICIAN'S CHARGES FOR THE SURGICAL PROCEDURE, benefits will be provided at 100% of Usual, Customary, and Reasonable charges. No basic benefits for subsidized retirees. P OA/P MA/M EA/M E O/NA/M S OA: Effective January 1, 1994, benefits will be paid at 100% of usual, customary and reasonable charges for PPO providers. Covered expenses include anesthesia, outpatient surgery, facility use, surgeon and pre -admission. Plan will pay 70% of usual, reasonable and customary charges after the deductible is met for non-PPO providers. E. Basic Professional Benefits - Basic Professional Benefits are provided when they are Medically Necessary. These benefits are based on the California Relative Value Studies - Fifth Edition. The Unit Value used in calculating Basic Professional Benefits for Surgical Services and Doctor Visits in the Hospital is: $65.00 Per Unit: 1. Benefits for Surgical Services a. Surgical Services are defined as Medically Necessary operative and cutting procedures for treatment of diseases and injuries, and for reduction of fractures and dislocations. 0011662.01 -17- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT b. Primary Surgeon: Benefits are determined by multiplying the number of Units specified for each procedure in the California Relative Value Studies - Fifth Edition by the designated Unit Value. c. Assistant Surgeon: If a benefit is paid to the Primary Surgeon and scope of surgery customarily requires an Assistant Surgeon, benefits will be provided for one Assistant Surgeon who is not a hospital intern, resident or house officer. The benefit is 20% of the amount paid to the Primary Surgeon, or one Unit - whichever is greater. d. Benefits for Surgical Services are subject to these conditions and limitations: 1) The service must be performed by a licensed Physician. 2) The service must be performed on or after the Participant's or Family Member's Effective Date of coverage under this Document. However, if the Member is already hospitalized prior to the Effective Date, benefits for surgical services will not be provided until after the Member is discharged from that hospital. 3) If more than one surgical service is performed during one operative session in the same operative area, payment will be made only for the major procedure. 4) If more than one surgical service, is performed during the same operative session in different operative areas, maximum payment is made for the major procedure, plus one-half the allowance for the minor procedure which provides the next greatest allowance. However, the total benefit for the Primary Surgeon under these circumstances shall not exceed 24.62 Units. 2. Professional Anesthetist Benefit a. When the Participant or Family Member is entitled to hospital care and surgical benefits hereunder, the plan shall pay for services of professional anesthetist, in accordance with the Anesthesia Units listed in the California Relative Value Studies - Fifth Edition and at the Unit Value designated in Document. b. The Units appearing in the Anesthesia column represent basic values. To these will be added Time Units, representing the actual time spent administering the anesthetic. Time Units are based on one Unit for each quarter-hour or major part thereof. 3. Physician Visits in the Hospital a. When a Participant or Family Member receives covered care in a Legally Operated Hospital or Skilled Nursing Facility as a result of illness or injury and no surgery is performed, payment toward the cost of visits by the attending Physician shall be: 0011662.01 a18- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT Up to .37 Units for the first visit during eligible confinement, and .123 Units for one visit a day thereafter during the Period of Disability. b. Benefits will be provided for consultation services by a Physician (EXCEPT STAFF CONSULTATIONS REQUIRED BY HOSPITAL REGULATIONS), if the Member is hospitalized and the condition requires special skill or knowledge for diagnosis and treatment. Up to .37 Units will be allowed per bedside consultation for a maximum of one such consultation per admission. F. Ambulance Benefit - Benefits will be provided for expense incurred by the Participant or Family Member for necessary use of local surface ambulance service for transportation to or from the Legally Operated Hospital (or Skilled Nursing Facility if that benefit in included in this Document) up to $50 for each covered inpatient admission or conditions for which outpatient services are payable. G. Preventative Medical Care: Benefits will be provided up to $200 per person per year for preventative medical care. Such care shall include such usual preventative medical options as an every other year physical exam for adults, yearly PAP tests for females, flu shots, chest x-rays, EKG and other diagnostic lab tests if certified by the physician that such procedures are included under a routine physical examination and is not. in connection with the diagnosis or treatment of any illness, disease or accidental bodily injury. Three well baby exams for an infant for the first year of life will be allowed subject to the $200 maximum benefit. All inoculations for infants/children will be provided and coverage is not limited to the $200 maximum benefit. PART X - MAJOR MEDICAL A. Definition - The term "Major Medical" as used herein means only those services and supplies listed below, and only to the extent that they are not provided elsewhere herein. To be eligible for Major Medical, it will be necessary that such be furnished while the patient is covered hereunder in connection with diagnosis or treatment of any illness, disease or accidental bodily injury, and be authorized by a licensed Physician or Surgeon and for only as long as such authorization is given. Upon receipt of due notice and proof that the Participant or Family Member shall have incurred expense for Major Medical, benefits will be provided as follows: Such expense must be incurred on or after the Participant's or Family Member's Effective Date of coverage hereunder, or, in the event such person is already hospitalized prior to such Effective Date, such expense must be incurred subsequent to the date of discharge from the hospital. An expense will be considered to have been incurred on the date that the individual receives the services for which the charge is made. 2. Payment for such services shall be based upon charges not exceeding the Usual, Customary and Reasonable Charges for such services in the community. 0011662.01 -19- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT 3. After the deductible has been met, benefits shall be paid at 90% of usual, customary and reasonable charges for PPO's and 80% for non-PPO's. P OA/P MA/M EA/M E O/NA/M S OA: Effective January 1, 1994, benefits shall be paid at the rate of 90% for PPO's and 70% for non -PPG's of usual, customary and reasonable charges after the deductible has been met. However, in the event of emergency services, the plan will pay 90% of usual, customary and reasonable charges for non PPG's. Emergency services is defined as follows: services which are immediately required to treat a sudden serious and unexpected illness or injury, including services to alleviate pain associated with sudden, serious and unexpected illness and/or injury. 4. The Participant or Family Member will be responsible for the first $100.00 of expense incurred in each calendar year for Major Medical after becoming eligible for benefits hereunder. However, no family shall be required to satisfy more than an aggregate maximum deductible of $300 during any one Calendar Year. Any expense for Major Medical incurred in connection with an illness, disease or injury during the last calendar quarter of any year and applied against such deductible amount for that year shall be carried forward to apply against the deductible amount for the ensuing year. Also, if the Participant and/or one or more Family Members shall suffer a bodily injury as a result of the same Accident, the aggregate deductible amount applicable to all said persons, in connection with total expense for Major Medical incurred for such Accident, shall -be $100.00 for that year in which the accident occurs. Separate deductibles will be required for other than the first year unless such accident occurs during the last calendar quarter of the year. In this event, the above stated provision relating to the carrying forward of expense incurred to the ensuing year will apply, and moreover, the provision relating to the aggregate deductible amount applicable to all said persons will also apply for the ensuing year. Effective 1-1-85, the individual deductible had been increased to $125 and to $375 per family. Deductibles are calculated on a calendar year basis. Effective 1-1-88, the individual deductible had been increased to $150 and to $400 per family. Deductibles are calculated on a calendar year basis. Effective 1-1-90, the individual deductibles is $150 a person and $450 per family. Effective 1-1-90, the deductible for subsidized retirees is $200 a person or $500 per family. 5. Stop -Loss: a. When expenses incurred by the participant or family member for covered services and supplies exceeds the deductible amount, benefits will be provided at 70% of usual, customary, and reasonable charges (90% if PPO provider is used). Once the out-of-pocket expense of $1,000 per individual or $2,000 per family is exceeded during the calendar year, 100% of covered services and supplies will be covered during the remainder of the calendar year. Only the cost 0011662.01 -20- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT of eligible services and supplies can be used to satisfy the out-of- pocket limit. The maximum out-of-pocket expense for subsidized retirees is $1,500 a person or $3,000 per family. b. Mental Disorders: For in -patient psychiatric care benefits will be provided at 50% of Usual, Customary and Reasonable Charges. No stop -loss or 100% benefit will apply. c. POA/PMA/MEA/MEO/NA/MSOA Effective March 1, 1994, all in -patient psychiatric care benefits will be provided by Managed Health Network at 50% of usual, customary and reasonable charges. No stop loss or 100% benefit will apply. 6. The Participant or Family Member who has received at least $1,000.00 of benefits hereunder may apply for reinstatement of maximum benefits by furnishing evidence of good health satisfactory to Claims Administrator. However, notwithstanding the above, the Participant or Family Member who has incurred expense hereunder which has been charged against the aggregate maximum of $1,000,000.00 shall automatically have reinstated toward such maximum as of the last day of each Calendar Year an amount of up to $1,000.00. 7. Eligible services and supplies are: a. Professional services rendered by a licensed Physician or Surgeon. b. Professional services rendered by a licensed Physician or Surgeon or doctor of dental surgery for treatment of a fractured jaw or other accidental injury to natural teeth, providing that injury occurs while the patient is covered hereunder. Such services will be covered only during the six month period immediately following the date of injury. c. Professional nursing services of a registered graduate nurse, other than one who ordinarily resides in the Participant's home or who is related to the Participant by blood or marriage. d. Administration of anesthesia by an anesthetist. e. X-ray, radium and radioactive isotope therapy. Services of a licensed physician or surgeon, or a registered physical therapist, in connection with physical therapy treatments, other than one who ordinarily resides in the Participant's home or who is related to the Participant by blood or marriage. g. Diagnostic X-ray and laboratory tests for treatment of illness or accident. In. Services of a licensed ambulance company for local ambulance services to or from a hospital or Skilled Nursing Facility. Artificial limbs or eyes, casts, splints, trusses, braces, crutches, including rental of wheelchair, hospital -type bed or iron lung required for treatment up to a maximum charge of not to exceed the purchase 0011662.01 -21- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT price of the equipment used. These supplies will be limited to those reasonable required by standard treatment practices for illness, disease or injury occurring while the patient is covered hereunder. Convenience or comfort items are not covered. j. Blood transfusions, including cost of blood and blood plasma. k. Services and supplies furnished and billed by a Legally Operated Hospital, excepts personal services such as charges for radio, telephone, television and the like, and private room charges exceeding the most prevalent rate of the hospital for semi -private (two - bed) accommodations. B. Special Conditions in Regard to Hospital Benefits: 1. Hospital Pre -admission Notification a. A hospital pre -admission notification to the Orange County Medical Review (OCMR) shall be required prior to hospital admittance for non - emergencies. b. If the required notification is not given to OCMR, the benefit entitlement will be subject to a $100 deductible against the charges for hospital costs. 2. Room Accommodations - Benefits will be provided as follows: a. 90% of charges for a room of two or more beds for a PPO, 80% for a non-PPO provider. b. 90% for PPO, 80% for non-PPO charges for care in special treatment units licensed by the State, such as intensive care and coronary care units. c. If a private room is used, benefits will be equivalent to 100% of the Contracting Hospital's or Skilled Nursing Facility's most prevalent charge for a two -bed room. d. POA/MEO/MEA/PMA/NA/MSOA: Effective January 1, 1994 benefits will be paid at the rate of 90% for PPO and 70% for non-PPO 3. Other Inpatient Services: a. When furnished and billed by the Hospital, or Skilled Nursing Facility, all services and supplies Medically Necessary for treatment of the illness or injury requiring the covered confinement will be provided at 90% for PPO or 80% for non PPO charges during eligible days of care, except the acquisition costs of blood and blood plasma and the charges for experimental or investigative procedures and services. 0011662.01 -22- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT b. POA/MEO/MEA/PMA/NA/MSOA: Effective January 1, 1994 benefits will be paid at the rate of 90% for PPO and 70% for non-PPO providers. C. Benefits for Services and Supplies in Eligible Skilled Nursing Facilities: 1. Days of Inpatient Care a. Covered inpatient services of a Skilled Nursing Facility will be paid up to an aggregate of 100 days during each Period of Disability. b. A Period of Disability is a continuous inpatient stay or a series of stays where dates of discharge and re -admission are separated by less than 28 days. However, if inpatient care is required because of an accident within the 28 day period, a new Period of Disability begins. c. Prior care in a hospital is not required before being eligible for care in a Skilled Nursing Facility. d. Admissions or continued stays for custodial or domiciliary care are not covered. D. Care for Conditions of Pregnancy: 1. Benefits will be provided for Normal Delivery, Cesarean Section and other Complications of Pregnancy for active Employees and their spouse. 2. No benefits will be provided dependent daughters. E. Chiropractic and Physical Therapy Guidelines: 1. Benefits will be provided as follows: 3 times a week for the first month of treatment 2 times a week for the second month of treatment 1 time a week for the third month of treatment 2 times a month for the fourth month and thereafter 2. Chiropractic Limits - Benefits are provided under Major Medical to a maximum of 24 treatments per year or $2,000.00 whichever occurs first. Said limits are per person and commence January 1 of each year. 3. These guidelines may be modified on an individual case -by -case basis pursuant to the recommendation of the Medical Review Advisor. F. Treatment by California Licensed Certified Acupuncturist - Will be covered to the extent that treatment is for pain associated with injury or illness. G. Subsidized Retiree Benefits - All eligible major medical expenses and hospital benefits for subsidized retirees will be paid at 80% of UCR. 0011662.01 -23- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT H. Municipal Employees Association (MEA) - Effective January 1, 1995, all eligible major medical expenses and hospital benefits for subsidized retirees will be paid at 70% of usual, customary and reasonable. PART XI - RETIREE SUBSIDY MEDICAL PLAN A. Eligibility - An employee who has retired from the City shall be entitled to participate in the City sponsored medical insurance plans and the City shall contribute toward monthly premiums for coverage in an amount as specified in accordance with this Plan, provided: 1. At the time of retirement the employee has a minimum of ten (10) years of continuous City service or is granted as industrial disability retirement; and 2. At the time of retirement, the employee is employed by the City; and 3. Following official separation from the City the employee is granted a retirement allowance by the California Public Employees Retirement System. The City's obligation to pay the monthly premium as indicated shall be modified downward or cease during the lifetime of the retiree upon the occurrence of any one of the following: a. During any period the retired employee is eligible to receive or receives health insurance coverage at the expense of another employer, the payment will be suspended. "Another employer" as used herein means private employer or public employer or the employer of a spouse. As a condition of being eligible to receive the premium contribution as set forth in this plan, the City shall have the right to require any retiree to annually certify that the retiree is not receiving or eligible to receive any such health insurance benefits from another employer. If it is later discovered that a misrepresentation has occurred, the retiree will be responsible for reimbursement of those amounts inappropriately expended and the retirees' eligibility to receive further benefits will cease. b. On the first of the month in which a retiree or dependent reaches age 65 or on the date the retiree or dependent can first apply and become eligible, automatically or voluntarily, for medical coverage under Medicare (whether or not such application is made) the City's obligation to pay monthly premiums may be adjusted downward or eliminated. Benefit coverage at age 65 under the City's medical plans shall be governed by applicable plan document. c. In the event the Federal Government or State Government mandates an employer -funded health plan or program for retirees, or mandates that the City make contributions toward a health plan (either private or public) for retirees, the City's contribution rate as set forth in this plan shall first be applied to the mandatory plan. If there is any excess, that excess may be applied toward the City medical plan as supplemental coverage provided the retired employee pays the balance necessary for such coverage, if any. 0011662.01 -24- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT d. In the event of the death of any employee, whether retired or not, the amount of the retiree medical insurance subsidy benefit which the deceased employee was receiving at the time of his/her death would be eligible to receive if he/she were retired at the time of death, shall be paid on behalf of the spouse or family for a period not to exceed twelve (12) months. B. Schedule of Benefits: 1. Minimum Eligibility for Benefits - With the exception of an industrial disability retirement, eligibility for benefits begins after an employee has completed ten (10) years of continuous service with the City of Huntington Beach. Said service must be continuous unless prior service is reinstated at the time of his/her rehire in accordance with the City's Personnel Rules. 2. Disability Retirees - Industrial disability retirees with less than ten (10) years of service shall receive a maximum monthly payment toward the premium for health insurance of $40 for retirements after 10/1 /87, $80 after 10/1/88, and $121 after 10/1/89. Payments shall be in accordance with the stipulations and conditions which exist for all retirees. Payment shall not exceed dollar amount which is equal to the full cost of premium for employee only. 0011662.01 -25- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT 3. All retirees, including those retired as a result of disability whose number of years of service prior to retirement exceeds ten (10), shall be entitled to maximum monthly payment of premiums by the City for each year of completed City service as follows: Maximum Monthly Payment for Retirements After: Years :of Service:. 10/1/87, 1011188 10/1/89 10/1/92 % $ 40 $ 80 $ 121 $ 121 11 44 88 132 136 `12 48 97 145 151 13 53 195 157 166 14 57 113 170 181 15 61 122 182 196 .16 65 130 195 211 17 69 138 207 226 18 73 146 220 241 19 77 155 232 256 20 81 163 244 271 21 86 171 257 286 22 90 179 269 300 23 94 188 282 315 24 98 196 294 330 25 102 204 306 344 26. 106 213 319 27 110 221 331 28 115 229 344 (Vote: The above payment amounts may be reduced each month as dependent eligibility ceases due to death, divorce or loss of dependent child status. However, the amount shall not be reduced if such reduction would cause insufficient funds needed to pay the full premium for the employee and the remaining dependents. In the event no reduction occurs and the remaining benefit premium is not sufficient to pay the premium amount for the employee and the eligible dependents, said needed excess premium amount shall be paid by the employee. 0011662.01 -26- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT Note: Retirees who elect to participate in Health Net or Family Health Plan (FHP) shall be entitled to benefits of the program chosen. C. Benefit Summary, effective January 1, 1995: City Plan..: Employees City Plan Non -Subsidized Retirees, Subsidized':.:...: Benefits:.: :.COBRAEligibles: Retiree Plan 90% - (PPO) of UCR 80% of UCR after after deductible deductible Inpatient Hospital 70% (Non-PPO) of UCR MEA: 70% of UCR after after deductible deductible FA: 80% for Non-PPO Deductible Per $150 / $450 $200 / $500 Person Maximum Out of Pocket Expenses $1,000 / $2,000 $1,500 / $3,000 (Excludes Deductible) None None Accident Benefit (Covered Same as Other (Covered Same as Other Expenses) Expenses) Prescription Drugs PCs PCs Deductible Generic $5 / $8 $5 / $8 /Non Generic 90% (PPO) of UCR 80% of UCR after deductible after deductible Major Medical 70% (Non-PPO) of UCR MEA: 70% of UCR after after deductible deductible FA: 80% for Non-PPO D. Miscellaneous Provisions / Eligibility: The effective start-up date of the Retiree Subsidy Medical Plan (80% Plan) for the various employee groups shall be the first of the month following retirement date. 2. A retiree may change plans, add dependents, etc., during annual open enrollment. Personnel shall notify covered retirees of this opportunity each year. 0011662.01 -27- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT 3. Years of service computed for the Retiree Subsidy Medical Plan are actual years of completed service with the City of Huntington Beach. 4. When a retiree is eligible for medical plan coverage at the expense of another employer due to post -retirement employment of the retiree or spouse of the retiree, the retiree and his/her spouse must take that coverage regardless of benefit level and shall be deleted from any City Plan coverage. Exceptions to this requirement are limited to the following: a. A retiree is not required to enroll in such 'other" medical plan coverage if there is significant disparity between the benefits provided by the 'other" medical plan and the Retiree Subsidy Medical Plan as defined below. "Significant disparity" means coverage available under the 'other" medical plan is restrictive or limited in one or more of the following ways: 1) No inpatient hospitalization coverage. 2) No major medical benefits. 3) Annual deductible is $1,000 or greater per person. 4) Major medical benefits are paid at 60% or less of covered expenses. b. The Risk Manager will have the authority to provide additional exceptions following review of the- 'other" medical plan benefit provisions are comparable to the guidelines under "B" above. c. Miscellaneous Provisions: 1) Benefits provided under the Retiree Subsidy Medical Plan will be coordinated with the 'other" medical plan as the primary carrier 2) The City shall have the right to require any retiree to provide a copy of the 'other" medical plan policy for review by the Risk Manager. 5. When a retiree becomes eligible for other group coverage and then becomes no longer eligible, he/she may have the subsidy reinstated and regain Retiree Subsidy Medical Plan coverage. 6. Dependents of a retiree may follow him/her into the Retiree Subsidy Medical Plan or they may choose to exercise COBRA rights along with the retiree. 7. When a retiree becomes 65 and has eligible dependents under 65, said dependents are eligible to exercise COBRA rights. 8. When a retiree is under 65 and his/her spouse is over 65, the spouse is not covered. 0011662.01 -28- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT Benefits: 1. Retiree Subsidy Medical Plan includes Managed Health Network (MHN), Prescription Card System (PCS), Orange County Preferred Provider Organization (OCPPO) and Medical Stop Loss insurance. 2. City Plans are the primary payer for active employees age 65 and over, with Medicare the secondary payer. Retirees age 65 and over have no City Plan options and are eligible only for Medicare. 3. Premium payments are to be received at least one month in advance of the coverage period. Subsidies: 1. The subsidy payments will pay for: a. Retiree Subsidy Medical Plan b. Health Net c. Family Health Plan (FHP) d. Part A of Medicare for those retirees not eligible for paid Part A 2. Subsidy payments will not pay for: . a. Part B Medicare b. Regular City Employee Indemnity Plan c. Any other employee benefit plan d. Any other commercially available benefit plan. e. Medicare supplements 3. Employees who retire on or after the following dates shall be eligible for the subsidy based on years of completed service with the City: October 1, 1987 - MEO, MEA, POA, MSOA, FA, PMA July 1, 1988 - Non -Represented Retirees who retire prior to the above dates are not eligible for any subsidy benefit. Medicare 1. All persons are eligible for Medicare coverage at age 65. Those with sufficient credited quarters of Social Security will receive Part A of Medicare at no cost. Those without sufficient credited quarters are still eligible for Medicare at age 65, but will have to pay for Part A of Medicare if 0011662.01 -29- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT the individual elects to take Medicare. In all cases Part B of Medicare is paid for by the participant. 2. When a retiree and his/her spouse are both age 65 or over, and neither is eligible for paid Part A of Medicare, the subsidy shall pay for Part A for each of them or the maximum subsidy, whichever is less. 3. When a retiree at age 65 is eligible for paid Part A of Medicare and his/her spouse is not eligible for paid Part A, the spouse shall not receive subsidy. When a retiree at age 65 is not eligible for paid Part A of Medicare and his/her spouse who is also age 65 is eligible for paid Part A of Medicare, the subsidy shall be for the retiree's Part A only. Cancellation: 1. For retirees/dependents eligible for paid Part A of Medicare, the following cancellation provisions apply: a. Coverage for a retiree under the Retiree Subsidy Medical Plan will be eliminated on the first day of the month in which the retiree reaches age 65. If such retiree was covering dependents under the Plan, dependents will be eligible for COBRA continuation benefits effective as of the retiree's 65th birthday. b. Dependent coverage will be eliminated upon the whichever of the following occasions come first: 1) After 36 months of COBRA continuation coverage, or 2) When the covered dependent reaches age 65 in the event such dependent reaches age 65 prior to the retiree reaching age 65. c. At age 65 retirees are eligible to make application for Medicare. Upon being considered "eligible to make application", whether or not application has been made for Medicare, the Retiree Subsidy Medical Plan will be eliminated. 2. See provisions under "Benefits", "Subsidies", and "Medicare" for those retirees/dependents not eligible for paid Part A of Medicare. 3. Retiree Subsidy Medical Plan and COBRA participants shall be notified of non-payment of premium by means of a certified letter from Personnel in accordance with provisions of the Memorandums of Understanding. 4. A retiree who fails to pay premiums due for coverage and is in arrears for sixty (60) days shall be terminated from the Plan and shall not have reinstatement rights. PART XII - TERMINAL BENEFITS A. Benefit Continuance at Time of Termination of Employment - Should a Participant or Family Member be totally disabled at the date of termination of coverage and be under treatment of a Physician, the services and benefits set forth 0011662.01 -30- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT in this Document shall be furnished to the extent such services and benefits relate directly to the condition causing such total disability and for no other condition, illness, disease or injury. Terminal Benefits shall be provided only when written certification of the total disability and the cause thereof has been furnished by the attending Physician within 90 days from the date coverage is terminated under this Document. Proof of continuation of total disability shall be furnished to the Claims Administrator not less frequently than 90-day intervals during the period that terminal benefits are available. B. Terminal Benefits for Total Disability - Terminal benefits for total disability shall be provided: 1. Up to a maximum period of 12 consecutive months, or 2. Until the maximum amount of benefits has been paid, or 3. Until the total disability ends, whichever occurs first. C. Definition of Total Disability - For the purposes of this benefit, the Employee shall be considered totally disabled when, as a result of bodily injury or disease, such Employee is unable to engage in any employment or occupation for which he or she is or becomes qualified by reason of education, training or experience and not, in fact, engaged in any employment or occupation for wage or profit. A Family Member shall be considered totally disabled ' when such Member is prevented from performing all regular and customary activities usual for a person of that age and family status. D. Exclusion of Terminal Benefits - Terminal Benefits for total disability shall not be provided if the Participant is required to pay the whole or any part of the subscription charges required under the terms of this Document and such Participant ceases to pay such premiums while this Document is in effect. PANT XIII - ADMINISTRATION OF THE PLAN A. Appointment of the Claims Administrator - The City shall appoint a Claims Administrator who shall handle claims under Plan in accordance with its terms. The person, persons or entity serving as Administrator shall serve at the pleasure of the City. B. Powers of the Claims Administrator - The Claims Administrator shall have such powers as necessary for the proper handling of claims for benefits under the Plan, including, but not limited to, the following: 1. To prescribe procedures to be followed by participants in filing applications for benefits and for furnishing evidence necessary to establish their rights to benefits under the Plan; 0011662.01 -31- 04/24/95 5:49 AM EMPLOYEE HEALTH PLAN DOCUMENT 2. To find facts and make determinations as to the rights of any Participant applying for or receiving benefits under the Plan and to afford any such Participant dissatisfied with any such finding or determination the right to a hearing thereon; 3. To make benefit payments directly to Participants and/or their assignees entitled to benefits under the Plan; 4. To obtain from the City, Participants and others, such information as shall be necessary for the proper administration of the Plan; 5. To keep records regarding the administration of the Plan; 6. To furnish to City upon request such data with respect to the administration of the Plan as is reasonable and appropriate; and 7. To collect, evaluate, analyze and prepare statistical and other data with respect to the administration of the Plan. The Claims Administrator shall have no power to add to or subtract from or to modify any of the provisions of the Plan, to change or add to any benefit provided by the Plan, or to waive or fail to apply any requirements of eligibility for a benefit under the Plan. No determination of the Claims Administrator in one case shall create a basis for retroactive adjustment in any other case. C. Claims Procedure - The Claims Administrator shall be required to give written notice to any Participant who makes a claim for the commencement or continuation of benefits under the Plan which claim is denied. Such notice shall be sent to the Participant's last known address. The notice shall be send forth the specific reason or reasons for the denial of the claim and shall include a specific reference or references to pertinent Plan provisions upon which the denial is based, a description of any additional material or information necessary for the claimant to perfect his claim, which description shall indicate why such material or information is needed, and an explanation of the Plan's claims review procedure. D. Appeal Procedure - In the event that the claim is denied and the claimant wishes to appeal his claim's denial, he or his duly authorized representative shall file a written request for a review, which request must be made within 60 days of the receipt by the claimant of the notice of his claim's denial. The claimant or his representative may review pertinent documents relating to the claim and its denial and may submit issues and comments in writing to the Administrator who shall make a decision on the merits of the claim as soon as practicable but no later than 120 days after receipt of a request for review. The decision on review shall be in writing and shall include specific reasons therefore and specific references to the pertinent Plan provisions on which the decision is based. 0011662.01 -32® 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT In the event the claimant is dissatisfied with the Administrator's final decision, the claimant may request that the claim file be sent to the City's Medical Review Advisors. The claimant shall indicate in writing the reason or reasons for disagreement with the Administrator's decision and shall submit such written materials to the Administrator. The entire file shall be transmitted to the Medical Review Advisors by the Administrator along with any additional written materials submitted by the claimant. The Medical Review Advisors shall review the file and render a written decision on the claim to the claimant and the Administrator and there shall be no further appeals. E. Limitation of Liability - The Claims Administrator shall be entitled to rely upon information from any source in good faith to be correct. PART XIV - DURATION AND AMENDMENT OF THE PLAN A. Permanence of the Plan - The Plan shall continue in full force and effect unless terminated, modified, altered or amended by the City as provided in the article. Although the City has established the Plan with the bona fide intention and expectation that it will be able to make contributions indefinitely, nevertheless the City is not and shall not be under any obligation or liability whatsoever to maintain the Plan for any given length of time. The City may, in its sole and absolute discretion, discontinue or terminate the Plan in accordance with its provisions at any time without liability whatsoever for such discontinuance or termination. E. Right to Amend - The City reserves the right at any time and from time to time to modify, alter, or amend, in whole or in part, any or all of the provisions of the Plan, provided, however, that no such modifications, alteration or amendment which substantially increases the duties, obligations or liabilities shall be made without the consent of the appropriate party. Notwithstanding the foregoing, any modification, alteration or amendment of the Plan may be made retroactive to the Effective Date if necessary or appropriate for the Plan. C. Severability - If any provision of the Plan is held invalid or unenforceable, its invalidity or unenforceability will not affect any other provisions of the Plan, and the Plan will be construed and enforced if such provision had not been included. PART XV - ADMINISTRATIVE PROVISIONS A. Management Rights - No Limitation of Management Rights Participation in the Plan shall not lessen or otherwise affect the responsibility of an Employee to perform fully his duties in a satisfactory and workmanlike manner, nor shall it affect the City's rights to discipline, discharge, or take any other action with respect to an Employee. B. Participant's Responsibilities - Each Participant shall be responsible for providing the Claims Administrator with his current address. Any notices required or permitted 0011662.01 -33- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT to be given hereunder shall be deemed given if directed to such address and mailed by regular United States mail. Neither the Claims Administrator nor the City shall have any obligation or duty to locate a Participant. In the event a Participant becomes entitled to a payment under the Plan and such payment cannot be made because the current address referred to above is incorrect, (ii) because such Participant fails to respond to the notice sent to the current address referred to above, (iii) because of conflicting claims to such payment, or (iv) because of any other reason, the amount of such payment, if and when made, shall be that determined under the provisions of the Plan without interest thereon. C. Missing Person - If, within five years after any amount becomes payable hereunder to a Participant the same shall not have been claimed, provided due and proper care shall have been exercised by the Claims Administrator in attempting to make such payment, the amount thereof shall be forfeited and shall cease to be a liability to the City. O. Governing Law - The Plan shall be governed by and construed in accordance with the federal laws governing employee benefit plans, and in accordance with the laws of the State of California where such laws are not in conflict with the aforementioned federal laws. 0011662.01 -34- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT AMENDMENT NO. 1 THE CITY OF HUNTINGTON BEACH EMPLOYEE HEALTH PLAN PLAN DOCUMENT This Amendment No. 1 to the City of Huntington Beach Health Plan is to be attached to, and made part of, this Employee Health Plan - Plan Document effective as follows: As requested, the City of Huntington Beach Employee Health Plan document is hereby amended in its entirety, effective May 1, 1983. CITY OF HUNTINGTON BEACH / /� h=.. Signature: -'-�i , Typed Name: Karen S. Foster Typed Title: Risk Manager 0011662.01 -35- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT AMENDMENT NO. 2 THE CITY OF HUNTINGTON BEACH EMPLOYEE HEALTH PLAN PLAN DOCUMENT This Amendment No. 2 to the City of Huntington Beach Employee Health Plan is to be attached to and made part of the Employee Health Plan Document effective January 1, 1985 as follows: 1984 MEDICARE - DEFRA ENDORSEMENT The terms of the Medicare Provision shall not apply to certain actively employed Insured Employees covered under this Plan nor to their insured Dependents as shown below: A. Insured Employees will be covered under this Plan for their primary insurance coverage unless they elect, in writing, to have Medicare as their primary coverage. Any Insured employee who elects Medicare as primary coverage will not be covered for health benefits under this Plan, nor will their Dependents be covered under this Plan. B. Spouses of actively employed Insured employees under age 70 who are insured as Dependents under this Policy; and will be covered under this Plan for their primary insurance coverage unless they elect, in writing, to have Medicare as their primary coverage. Any spouse who elects Medicare as primary coverage will not be covered for health benefits under this Plan. CITY OF HUNTINGTON BEACH Signature: v '� Typed Name: Karen S. Foster Typed Title: Risk Manager 0011662.01 -36- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT AMENDMENT NO. 3 RETIREES MEDICAL INSURANCE SUBSIDY BENEFIT (RMIS) Eligible retirees may receive a subsidy for payment of medical insurance premiums. The eligibility requirements and monthly subsidy amounts are available in the Personnel Division. The modification in coverage for the Retiree Medical Insurance subsidy is as follows: Annual deduction for retiree/family $200/$500 Major medical stop loss level $5,000.00 Basic in -patient benefits after deductible 80% Outpatient surgery and pre -admission testing after deductible 80% Accident benefit after deductible 80% Surgery and anesthetics after deductible 80% CITY OF HUNTINGTON BEACH Signature: Typed Name: Karen S. Foster Typed Title: Risk Manager 0011662.01 -37- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT AMENDMENT NO. 4 This amendment No. 4 effective July 1,1993 is hereby adopted. A. Part II.0 page 5 is amended to comply with all the provisions of California AB 1672 as it applies to this self -funded plan. AB1672 states (among other items) the following: Pre-existing conditions are not to be denied, excluded or limited for more than 6 months after the effective date of that person's coverage under the plan. This plan will credit the time the person was covered under qualifying prior coverage but only if the previous coverage was continuous to a date not more than 30 days before the effective date of the new coverage. However, if: an individual's employment has ended; and he lost his group health coverage as a result of termination of employment; or his employer's contribution towards health coverage terminated; then the insurer offering the new group health plan must credit the time the individual was covered under the previous group health plan, but only if the previous coverage was continuous to a date not more than 90 days before the effective date of the new coverage. an eligible employee or a dependent who is a "Late Enrollee" may be excluded from a policy/plan for a maximum of 12 months. The term "Late Enrollee" is defined in AB1672 to exclude a person: who gave a written statement stating that he was declining coverage initially because he was covered under another employer's plan and who later requests coverage within 30 days of termination of coverage under the prior plan; for whom a court has ordered that coverage be provided for a spouse or minor child under a covered employee's health benefit plan and the request for coverage is made within 30 days after the issuance of the court order. 3. Part X Major Medical B. 1. This paragraph is eliminated. There is no 100 day limitation on inpatient hospital care. CITY OF HUNTINGTON BEACH Signature: Typed Name: Karen S. Foster Typed Title: Risk Manager 0011662.01 -38- 04/24/95 8:49 AM EMPLOYEE HEALTH PLAN DOCUMENT AMENDMENT NO. 5 CITY OF HUNTINGTON BEACH EMPLOYEES AND RETIREES INDEMNITY HEALTH PLAN Effective January 1, 1995, coverage is amended as follows: Cit Plan Y Employees City Plan Non -Subsidized Retirees-4 Subsidized Benefits «. COBRA Eligibles Retiree Plan Inpatient Hospital I 90% - (PPO) of UCR after deductible 70% (Non-PPO) of UCR after deductible FA: 80% for Non-PPO after deductible Deductible Per Person/Maximum I $150 / $450 Per Family Maximum Out of Pocket I $1,0001$2,000 Expenses (Excludes Deductible) 80% of UCR after deductible MEA: 70% of UCR after deductible $200 / $500 $1,500 / $3,000 Accident Benefit None None (Medical) (Covered Same as Other (Covered Same as Other Expenses) Expenses) Prescription Drugs PCs PCs Deductible Generic /Non I $5 / $8 Generic Major Medical I 90% (PPO) of UCR after deductible 70% (Non PPO) of UCR after deductible FA: 80% for Non-PPO after deductible $5/$8 80% of UCR after deductible MEA: 70% of UCR after deductible CITY OF HUNTINGTON BEACH Signature: 4 Typed Name: Karen S. Foster Typed Title: Risk Manager 0011662.01 -39- 04/24/95 8:49 AM & BELTACARE° administered by. edical-Care, Inc. vne Center Drive , CA90703-8579 MEA MW — EkHt6%T E c�kmw DeltaCare is a dental program that provides you and your family with quality dental benefits at an affordable cost. The DeltaCare program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. To receive your DeltaCare benefits, you select a primary care network dentist when you enroll. The DeltaCare network consists of private practice dental offices that have been carefully screened for quality. P � ✓ Extensive benefits for you and your family ✓ No restrictions on pre-existing conditions, except for work in progress ✓ Large, stable network of dentists, so you can enjoy a long-term relationship with your dentist. I ✓ No claim forms to complete ✓ Easy access to specialty care ✓ Expanded business hours for toll -free customer service, from 5 a.m. to 6 p.m., Pacific Time ;W— IqT SLR ✓ No deductibles or annual dollar maximum ✓ Out-of-pocket costs are clearly defined ✓ Out -of -area dental emergency coverage up to $100 each 12-month period • Eligibility for you and your family If you meet your group's eligibility requirements for dental coverage, you can enroll in the DeltaCare program. You may also enroll eligible dependents, including your lawful spouse and unmarried children (which includes stepchildren and legally adopted and foster children to the age limit specified by your group). Contact your benefits administrator if you have anyquestions. i Easy enrollment To enroll in the DeltaCare program, simply complete an enrollment form indicating your choice of dentist (from the list of network dental offices) and the name of your group. Return this form as directed by your benefits administrator. • How your DeltaCare program works Your selected primary care network dentist will take care of the dental care needs for your family. If you require treatment from a specialist, your primary care network dentist will handle the referral for you. After you have enrolled, you will receive a PMI membership card and an Evidence of Coverage that fully describes the covered benefits of your dental program. The membership card will have the telephone number and address of your network dentist. Simply call the dentist to make an appointment. Under the DeltaCare program, many services are covered at no cost, while others have copayments (fees you pay your network dentist) for certain procedures. See the "Description of Benefits and Copayments" for a list of your benefits. Please note: Dental services that are not performed by your network dentist must be prior authorized by PMI to be covered by your DeltaCare program. • Provisions for emergency care Under your DeltaCare program, you are covered for out -of -area dental emergencies (35 or more miles from your primary care network dentist). Your program pays up to $100 for emergency dental expenses incurred in each 12-month period. These services are performed as needed and deemed necessary by your attending DeltaCare network dentist subject to the limitations, exclusions and governing administrative policies of the program. ADA Enrollee ADA Enrollee Codes Pays Codes Pays I. DIAGNOSTIC Office visit, per visit (in addition to other services) ......................... No Cost 0120 Periodic oral evaluation ...................................... No Cost 0140 Limited oral evaluation —problem focused ........... No Cost 0150 Comprehensive oral evaluation .......................... No Cost 0160 Detailed and extensive oral evaluation problem focused ............................................ No Cost 0210 Intraoral radiographs - complete series (including bitewings) ............. No Cost 0220,0230 Intraoral periapical film ....................................... No Cost 0240 Intraoral occlusal film .......................................... No Cost 0270, 0272,0274 Bitewing radiograph(s)....................................... No Cost 0330 Panoramicfilm................................................... No Cost II. PREVENTIVE 1110,1120 Prophylaxis (cleaning)--aduft/child 1 per 6 month period ..................................... No Cost 1201 Topical application of fluoride, including prophylaxis (to age 19) 1 per 6 month period ..................................... No Cost 1203 Topical application of fluoride, excluding prophylaxis (to age 19) 1 per 6 month period ..................................... No Cost 1330 Oral hygiene instructions .................................... No Cost 1351 Sealant, per tooth .............................................. No Cost 1510 Space maintainer--fixed--unilateral .................... No Cost 1515 Space maintainer--fixed--bilateral ...................... No Cost 1520 Space maintainer--removable--unilateral ........... No Cost 1525 Space maintainer--removable--bilateral ............. No Cost 1550 Recementation of space maintainers ................. No Cost III. RESTORATIVE (Fillings) (Includes indirect pulp capping, bases, liners and acid etch procedures) 2110 Amalgam --one surface, primary ......................... No Cost 2120 Amalgam --two surfaces, primary ....................... No Cost 2130 Amalgam --three surfaces, primary ..................... No Cost 2131 Amalgam --four or more surfaces, primary........................................................... No Cost 2140 Amalgam --one surface, permanent ................... No Cost 2150 Amalgam --two surfaces, permanent .................. No Cost 2160 Amalgam --three surfaces, permanent ............... No Cost 2161 Amalgam -- four or more surfaces, permanent ................. No Cost 2330 Resin --one surface anterior ............................... No Cost 2331 Resin --two surface anterior ................................ No Cost 2332 Resin --three surface anterior ............................. No Cost 2335 Resin --four or more surfaces or involving incisal angle (anterior) ................. No Cost 2336 Composite resin crown, anterior --primary .......... No Cost 2940 Sedative filling .................................................... No Cost 2951 Pin retention --per tooth, in addition to restoration ................................. No Cost IV. ORAL SURGERY (Includes preoperative and postoperative evaluations and treatment under local anesthetic) 7110,7120 Single tooth extraction/each additional ............... No Cost 7130 Root removal --exposed roots ............................. No Cost 7210 Surgical removal of erupted tooth ...................... No Cost 7220 Removal of impacted tooth --soft tissue .............. No Cost 7230 Removal of impacted toothpartially bony ............ No Cost 7240,7241 Removal of impacted tooth completely bony ............................................. No Cost 7250 Surgical removal of residual tooth roots (cutting procedure) ....................... No Cost 7286 Biopsy of oral tissue --soft ................................... No Cost 7310 Alveoloplasty in conjunction with extractions, per quadrant ........................ No Cost 7320 Alveoloplasty not in conjunction with extractions, per quadrant ........................ No Cost 7470 Removal of exostosis-maxilla or mandible .......... No Cost 7510 Incision and drainage of abscess-- intraoral soft tissue ......................................... No Cost 7960 Frenulectomy--(frenectomy or frenotomy) separate procedure ....................................... No Cost V. PERIODONTICS (Includes preoperative and postoperative evaluations and treatment under a local anesthetic) 4210 Gingivectomyorgingivoplasty,per quadrant ....... NoCost 4211 Gingivectomy or gingivoplasty, per tooth (fewer than six teeth) ...................... No Cost 4220 Gingival curettage surgical, per quadrant ........... No Cost 4240 Gingival flap procedures including root planing (per quadrant) ............................ No Cost 4260 Osseous surgery, flap entry and closure, per quadrant .................................................. No Cost 4341 Periodontal scaling and root planing, per quadrant .................................................. No Cost 4355 Full mouth debridement to enable comprehensive periodontal evaluation and diagnosis ................................................. No Cost 4910 Periodontal maintenance (following active therapy) ................................ No Cost VI. PROSTHETICS (Crowns, bridges and dentures) 2510 Inlay --one surface --base metal noble ................. No Cost 2520,6520 Inlay --two surfaces --base metal noble ............... No Cost 2530,6530 Inlay --three or more surfaces -- base metal noble ............................................ No Cost 2543,6543 Onlay--three surfaces --base metal noble ........... No Cost 2544,6544 Onlay--four or more surfaces -- base metal noble ............................................ No Cost 2710 Crown --resin (laboratory) .................................. No Cost 2740 Crown--porcelain/ceramict................................ No Cost 2750 Crown --porcelain fused to high noble metal*t .... No Cost 2751 Crown --porcelain fused to predominantly base metal ............................ No Cost 2752 Crown --porcelain fused to noble metalt •..........•• No Cost 2790 Crown --full cast high noble metal* ...................... No Cost 2791 Crown --full cast predominantly base metal ......... No Cost 2792 Crown --full cast noble metal ............................... No Cost 2810 Crown--3/4 cast metal noble .............................. No Cost 2910 Recement inlay .................................................. No Cost 2920 Recement crown ................................................ No Cost 7WNS ADA Enrollee ADA Enrollee Codes Pays Codes Pays 2930,2931 Crown --prefabricated stainless steel-- primary/permanent........................................ No Cost 2950 Crown buildup (restorative material and pins) ........................ No Cost 2952 Cast post and core* (in addition to crown) ..................................... No Cost 2954 Prefabricated post and core (in addition to crown) ..................................... No Cost 5110,5120 Denture --complete maxillary or mandibular (upper or lower) ...................... No Cost 5130,5140 Immediate denture --maxillary or mandibular (upper or lower) ....................... No Cost 5213,5214 Denture --maxillary or mandibular (upper or lower) partial with metal lingual or palatal bar, clasps and acrylic saddles, and acrylic base or cast metal framework and teeth ..................... No Cost 5410 Adjust complete denture --maxillary .................... No Cost 5411 Adjust complete denture —mandibular ................ No Cost 5421 Adjust partial denture --maxillary ......................... No Cost 5422 Adjust partial denture --mandibular ..................... No Cost 5510 Repair broken complete denture base..No Cost 5520 Replace missing or broken teeth -- complete denture (per tooth) ......................... No Cost 5610 Repair resin denture base .................................. No Cost 5620 Repair cast framework ....................................... No Cost 5630 Repair or replace broken clasp .......................... No Cost 5640 Replace broken teeth (per tooth) ....................... No Cost 5650 Add tooth to existing partial denture ................... No Cost 5660 Add clasp to existing partial denture ................... No Cost 5730 Reline complete maxillary denture (chairside)...................................................... No Cost 5731 Reline complete mandibular denture (chairside)...................................................... No Cost 5740 Reline maxillary partial denture (chairside)...................................................... No Cost 5741 Reline mandibular partial denture (chairside)...................................................... No Cost 5710 Rebase complete maxillary denture ................... No Cost 5711 Rebase complete mandibular denture ............... No Cost 5720 Rebase maxillary partial denture ........................ No Cost 5721 Rebase mandibular partial denture .................... No Cost 5750 Reline complete maxillary denture (lab) ............. No Cost 5751 Reline complete mandibular denture (lab) .......... No Cost 5760 Reline maxillary partial denture (lab) .................. No Cost 5761 Reline mandibular partial denture (lab) .............. No Cost 5820 Interim partial denture (maxillary) ....................... No Cost 5821 Interim partial denture (mandibular) ................... No Cost 5850,5851 Tissue conditioning --per denture ........................ No Cost 6210 Pontic--cast high noble metal* ............................ No Cost 6211 Pontic--cast predominantly base metal ............... No Cost 6212 Pontic--cast noble metal ..................................... No Cost 6240 Pontic--porcelain fused to high noble metal*t ..... No Cost 6241 Pontic--porcelain fused to predominantly base metalt ............................ No Cost 6242 Pontic—porcelain fused to noble metalt ............. No Cost ti750 Crown --porcelain fused to high noble metal*t .... No Cost 6751 Crown --porcelain fused to predominantly base metalt ............................ No Cost 6752 Crown --porcelain fused to noble metalt............. No Cost 6790 Crown --full cast high noble metal* ...................... No Cost 6791 Crown --full cast predominantly base metal ......... No Cost 6792 Crown --full cast noble metal ............................... No Cost 6930 Recement bridge (fixed partial denture) ............. No Cost 6940 Stress breaker, per unit (in addition to mixed partial denture, retainer) ...................... No Cost 6970 Cast post and core* (includes canal preparation) ........................... No Cost 6972 Prefabricated post and core buildup (including canal preparation, restorative material and any pins) .................. No Cost * Base or noble metal is the benefit. High noble metal (precious), if used, will be charged to the enrollee at the additionallaboratorycost of the high noble metal. This applies to crowns, bridges, cast and post cores, inlays and onlays. t Porcelain on molars is considered optional treatment. VII. ENDODONTICS 3110,3120 Pulp capping (directrndirect) .............................. No Cost 3220 Therapeutic pulpotomy (excluding final restoration) ............................ No Cost 3310 Root canal therapy --anterior (excluding final restoration) ............................ No Cost 3320 Root canal therapy --bicuspid (excluding final restoration) ............................ No Cost 3330 Root canal therapy --molar (excluding final restoration) ............................ No Cost 3410 Apicoectomy/periradicular surgery --anterior ....... No Cost 3421 Apicoectomy/periradicular surgery -- bicuspid (first root) ......................................... No Cost 3425 Apicoectomy/periradicular surgery -- molar (first root) ............................................. No Cost 3426 Apicoectomy/periradicular surgery (each additional root) ........................ No Cost 3430 Retrograde filling, per root ................................. No Cost 3450 Root amputation, per root .................................. No Cost Vill. ADJUNCTIVE GENERAL SERVICES 9110 Palliative (emergency) treatment of dental pain.. No Cost 9211 Regional block anesthesia .................................. No Cost 9212 Trigeminal division block anesthesia ................... No Cost 9215 Local anesthesia ................................................ No Cost 9310 Consultation (diagnostic services provided by dentist or physician other than practitioner providing treatment) ....................................... No Cost 9440 Office visit after regularly scheduled hours ........... $ 20.00 0125 Failed appointment without 24 hour notification, per 15 minutes of appointment time ................ $10.00 IX. ORTHODONTICS Start-up fees (excluding records) ............................................. $250.00 Dependent children to age 19.................................................. $500.00 Adults and covered full-time students ....................................... $500.00 Any procedure not listed is available on a fee -for -service basis. 700INS a DE«CARE Open Offices AGOURA HILLS #125501 AGOURA DENTAL GROUP 29525 CANWOOD ST STE 250 (818) 991-9852 F/T I (SP,TA) (Ei ALHAMBRA #000647 MOHAMMAD DABBOUSI, DDS 401 N GARFIELD AVE (626) 570-0974 FIT I (SP,TA,AR) & ALHAMBRA #051601 DRS LEE AND YEE 157 N GARFIELD AVE (626) 284-5113 F/T 2 PIT I (CH, SP,VI) & ALHAMBRA #00O201 NADIR YAZDANI, DDS 747 S GARFIELD AVE (626) 289-6815 F/T 2 & ALHAMBRA # 1 18001 ALHAMBRA FAMILY DENTISTRY 600 W MAIN STREET STE 102 (62 F61 282-41 19 (SR AR ITCFi ALTA LOMA #002495 DR TOM DENTAL OFFICE 6795 CARNELIAN ST (909) 483-3431 F/T I (SR CH) & ALTA LOMA #198801 CARNELIAN FAMILY DENTISTRY 6626 CARNELIAN ST (909) 987-4113 FIT I (SP, CH) ALTA LOMA #359101 JEFFREY LLOYD, DDS 9310 BASELINE ROAD (909) 989-1868 F/T I (SP) ANAHEIM #001669 ANAHEIM FAMILY DENTAL OFFICE 2170 W LINCOLN AVE (714) 535-3933 FIT I PIT I ANAHEIM #002252 SMILECARE DENTAL GROUP 1 1 12 N MAGNOLIA AVE (714) 828-1211 F/T I P/T 2 (SP,VI) ANAHEIM #003047 STATE COLLEGE DENTAL GROUP 330 N STATE COLLEGE BLVD 105 (714) 772-5005 P/T 3 (SR TA, PE, VI) C ANAHEIM #003048 SOUTH ANAHEIM DENTAL GROUP 2300 S HARBOR BLVD Pq I (S )3030 ANAHEIM #183601 NANDINI MURTHY, DDS 1655 W BROADWAY STE 9 (714) 774-2638 F/T I (SP) PARTICIPATING DENTAL OFFICES Fourth Quarter 2002 - Southern California ANAHEIM #188001 DANNY THOMAS, DDS 601 S EUCLID ST (714) 778-0700 PIT I (VI, SR RU) ANAHEIM #IC0301 UNIVERSAL CARE DENTAL 1808 W LINCOLN STE 201 (714) 780-5665 F/T I PIT I (SP TA, VI) Ok ANAHEIM #IC7301 MANHAR MISTRY DDS INC 303 N EAST ST (714) 772-0770 FIT I (SP) ANAHEIM #235001 SMILES FOR ORANGE COUNTY 9672 BALL ROAD (714) 772-0102 F/T I (SP) ANAHEIM #256401 DRS ANTHONY AND NAOMI WONG 3356 W BALL ROAD STE 215 (714) 995-3051 F/T 2 (SP, CH) ANAHEIM #256501 ANAHEIM FIRST FAMILY DENTAL 1161 N EUCLID ST (714) 999-5050 FIT 2 P/T 2 (SP, CH) ANAHEIM #258301 DALWANI AND DHOLAKIYA 815 N EUCLID STREET (714) 758-0791 F/T 4 (SR CH,JA) 6% ANAHEIM #274701 ANAHEIM OPEN 7 DAYS DENTAL 637 N EUCLID ST (714) 772-2893 F/T 6 P/T I (SR CH,VI,AR, JA) & ANAHEIM #2C 1801 VILLAGE DENTAL GROUP 1210 S BROOKHURST ST (714) 535-7500 PIT 2 (1k ANAHEIM #3C6001 PREFERRED DENTAL CARE 2207 S HARBOR BOULEVARD (714) 971-7800 F/T I PIT 2 (SP, El) ANAHEIM HILLS #000219 STAR DENTAL CARE 5031 E ORANGETHORPE AVE B2 (714) 693-1889 F/T I ANAHEIM HILLS #352101 SUNSHINE DENTAL OFFICE 8285 E SANTA ANA CYN RD 115 (714) 974-5599 FIT I P/T I (SP, EI) ANAHEIM HILLS #3C2201 ANAHEIM HILLS DENTAL GROUP 5731 A SANTA ANA CNYN RD (714) 998-2956 F/T I (SP) APPLE VALLEY #005101 ASPEN DENTAL GROUP 15995 TUSCOLA RD STE 201 (760) 242-2620 F/T I (TA, RU) APPLE VALLEY #128401 SANG PAIK, DDS 20162 HWY 18 STE L (760) 946-1466 FIT I (KO, SP) APPLE VALLEY #2C5001 APPLE VALLEY DENTAL 18245 HIGHWAY 18 STE 4 (760) 242-2977 FIT I (SP) ARCADIA #196501 ARCADIA DENTAL CENTER 75 N SANTA ANITA BLVD 215 (626) 447-5126 FIT 4 (CH) ARCADIA #386201 WILLIAM HOUSTON, DDS 25 N SANTA ANITA AVE SUITE E (626) 254-1948 F/T I P/T I ARCADIA #3C8201 ANDREW LIM, DDS 1043 W HUNTINGTON DRIVE (626) 445-9660 F/T I (KO, SP) C� ARLETA #000223 FAMILY DENTISTRY 9069 1/2 WOODMAN AVENUE (818) 893-8799 F/T 2 (SP) ARLETA #002852 OSBORNE DENTAL OFFICE INC 13205 OSBORNE STREET SUITE F (818) 890-2426 F/T I (SR) & ARLETA #198601 WOODMAN FAMILY DENTISTRY 8725 WOODMAN AVE (818) 891-6670 F/T I (SP) ARTESIA #000733 SARAH CUPINO, DMD 12146 SOUTH STREET SUITE E (562) 924-1007 F/T I (SR TA) Ck ARTESIA # 1 12201 SIOE HWA ONG DDS INC 17906 S PIONEER (562) 860-9612 F/T I P/T 2 (SP, TA) AZUSA #002012 APPLE DENTAL 891 EARROW HWY STE B (626) 332-4788 F/T I BAKERSFIELD #002973 SMILECARE DENTAL GROUP 2750 MING AVE (661) 396-1701 F/T 2 P/T I DENTAL HEALTH PLAN An Affihate of Delta Denial Plan of Califom,.n Volume I BAKERSFIELD #131001 STEPHEN KANN, DDS 1919 G STREET (661) 323-8585 F/T I BAKERSFIELD #164101 SIAN POH, DDS 2721 H ST (661) 324-9709 F/T I BALDWIN PARK #000313 PRAKASH PATEL, DDS 4138 N MAINE AVE STE N3 (626) 960-6395 FIT I (SP) BALDWIN PARK #057801 DAVID KUTNER, DMD 13734 RAMONA BLVD 616 F61 PIT 6 /T(SR KO) & BANNING #169501 ADRIAN ACOSTA, DDS 4240 W RAMSEY AVE (909) 849-4484 FIT 2 (SR RU) BARS TOW #000301 GENTLE DENTAL CARE 113 E MOUNTAIN VIEW (760) 256-2896 FIT I (SP) BELL #002095 ST GEORGE DENTAL CLINIC 6905 1/2 S ATLANTIC BLVD P/T 31773-5029 (SP, AR, RU) Ck BELL GARDENS #328401 MARKETPLACE DENTAL OFFICE 6815 EASTERN AVE STE At F31 SSP 2595 /TGk BELL GARDENS #372001 JIN WE] CHU, DDS 6526 EASTERN AVE (323) 771-3949 F/T 2 (SP) BELLFLOWER #002497 THE DENTAL GRP OF BELLFLOWER 10106 ALONDRA BLVD SUITE A (562) 867-5117 FIT 2 (SR) BELLFLOWER #002498 A ALONDRA DENTAL GROUP 10106 ALONDRA BLVD SUITE B (562) 920-8324 F/T I (SR) BELLFLOWER #002531 GENE MEYER, DDS 9725 FLOWER STREET (562) 867-6196 F/T I (SR TA) BELLFLOWER #003208 MICHAEL BADEA, DDS 9222 E ROSECRANS AVE (562) 272-0222 F/T I P/T 3 (� I c� The wheelchair symbol indicates functional accessibility for individuals with limited mobil'Iry. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer �telations department at (800) 422-4234. d DELTACARE° Open Offices AGOURA HILLS #125501 AGOURA DENTAL GROUP 29525 CANWOOD ST STE 250 F8I (SP,TA52 /T(Fi ALHAMBRA #000647 MOHAMMAD DABBOUSI, DDS 401 N GARFIELD AVE (626) 570-0974 F/T I (SP, TA, AR) 61 ALHAMBRA #051601 DRS LEE AND YEE 157 N GARFIELD AVE (626) 284-5113 F/T 2 P/T I (CH, SP,VI) (t, ALHAMBRA #00O201 NADIR YAZDANI, DDS 747 S GARFIELD AVE (626) 289-6815 F/T 2 61% ALHAMBRA #118001 ALHAMBRA FAMILY DENTISTRY 600 W MAIN STREET STE 102 F61 2SP9 , AR /T& ALTA LOMA #002495 DR TOM DENTAL OFFICE 6795 CARNELIAN ST (909) 483-3431 F/T I (SR CH) 6% ALTA LOMA #198801 CARNELIAN FAMILY DENTISTRY 6626 CARNELIAN ST (909) 987-4113 F/T I (SP, CH) ALTA LOMA #359101 JEFFREY LLOYD, DDS 9310 BASELINE ROAD (909) 989-1868 FIT I (SP) ANAHEIM #001669 ANAHEIM FAMILY DENTAL OFFICE 2170 W LINCOLN AVE (714) S35-3933 F/T I P/T I ANAHEIM #002252 SMILECARE DENTAL GROUP 1 1 12 N MAGNOLIA AVE (714) 828-1211 F/T I P/T 2 (SP,VI) ANAHEIM #003047 STATE COLLEGE DENTAL GROUP 330 N STATE COLLEGE BLVD 105 (714) 772-5005 P/T 3 (SP,TA, PE,VI) 61 ANAHEIM #003048 SOUTH ANAHEIM DENTAL GROUP 2300 S HARBOR BLVD PIT I (SP)3030 L� ANAHEIM #183601 NANDINI MURTHY, DDS 1655 W BROADWAY STE 9 (714) 774-2638 FIT I (SP) PARTICIPATING DENTAL OFFICES Fourth Quarter 2002 - Southern California ANAHEIM #188001 DANNY THOMAS, DDS 601 S EUCLID ST (714) 778-0700 PIT I (VI, SR RU) APPLE VALLEY #005101 ASPEN DENTAL GROUP 15995 TUSCOLA RD STE 201 (760) 242-2620 FIT I (TA, RU) DENTAL HEALTH PLAN An Affiliate of Delta Dental Plan of California Volume I BAKERSFIELD #131001 STEPHEN KANN, DDS 1919 G STREET (661) 323-8585 FIT ANAHEIM # I C0301 APPLE VALLEY #128401 BAKERSFIELD #164101 UNIVERSAL CARE DENTAL SANG PAIK, DDS SIAN POH, DDS 1808 W LINCOLN STE 201 20162 HWY 18 STE L 2721 H ST F/T41 P/T I6(SP,TA,VI) (LI FIT I (KO, SP) F/T1I 9709 ANAHEIM #IC7301 MANHAR MISTRY DDS INC 303 N EAST ST (714) 772-0770 FIT I (SP) ANAHEIM #235001 SMILES FOR ORANGE COUNTY 9672 BALL ROAD (714) 772-0102 FIT I (SP) ANAHEIM #256401 DRS ANTHONY AND NAOMI WONG 3356 W BALL ROAD STE 215 (714) 995-3051 F/T 2 (SR CH) ANAHEIM #256501 ANAHEIM FIRST FAMILY DENTAL 1161 N EUCLID ST (714) 999-5050 F/T 2 P/T 2 (SR CH) ANAHEIM #258301 DALWANI AND DHOLAKIYA 815 N EUCLID STREET (714) 758-0791 F/T 4 (SR CH,JA) (N ANAHEIM #274701 ANAHEIM OPEN 7 DAYS DENTAL 637 N EUCLID ST (714) 772-2893 F/T 6 P/T I (SP, CH,VI,AR, JA) & ANAHEIM #2C1801 VILLAGE DENTAL GROUP 1210 S BROOKHURST ST (714) 535-7500 PIT 2 CILI ANAHEIM #3C6001 PREFERRED DENTAL CARE 2207 S HARBOR BOULEVARD (714) 971-7800 HT I P/T 2 (SR EI) ANAHEIM HILLS #000219 STAR DENTAL CARE 5031 E ORANGETHORPE AVE B2 (714) 693-1889 F/T I ANAHEIM HILLS #352101 SUNSHINE DENTAL OFFICE 8285 E SANTA ANA CYN RD 115 (714) 974-5599 FIT I P/T 1 (SR EI) ANAHEIM HILLS #3C2201 ANAHEIM HILLS DENTAL GROUP 5731 A SANTA ANA CNYN RD (714) 998-2956 F/T I (SP) APPLE VALLEY #2C5001 APPLE VALLEY DENTAL 18245 HIGHWAY 18 STE 4 (760) 242-2977 F/T I (SP) ARCADIA #196501 ARCADIA DENTAL CENTER 75 N SANTA ANITA BLVD 215 (626) 447-5126 F/T 4 (CH) ARCADIA #386201 WILLIAM HOUSTON, DDS 25 N SANTA ANITA AVE SUITE E (626) 254-1948 F/T I P/T I ARCADIA #3C8201 ANDREW LIM, DDS 1043 W HUNTINGTON DRIVE (626) 445-9660 F/T I (KO, SP) L� ARLETA #000223 FAMILY DENTISTRY 9069 1/2 WOODMAN AVENUE (818) 893-8799 F/T 2 (SP) ARLETA #002852 OSBORNE DENTAL OFFICE INC 13205 OSBORNE STREET SUITE F (818) 890-2426 FIT I (SR) (� ARLETA #198601 WOODMAN FAMILY DENTISTRY 8725 WOODMAN AVE (818) 891-6670 F/T I (SP) ARTESIA #000733 SARAH CUPINO, DMD 12146 SOUTH STREET SUITE E (56 FIT21 (SR TA) 7 C� ARTESIA #112201 SIOE HWA ONG DDS INC 17906 S PIONEER (562) 860-9612 F/T I PIT 2 (SP, TA) 6% AZUSA #002012 APPLE DENTAL 891 EARROW HWY STE B (626) 332-4788 F/T I BAKERSFIELD #002973 SMILECARE DENTAL GROUP 2750 MING AVE (661) 396-1701 F/T 2 P/T 1 BALDWIN PARK #000313 PRAKASH PATEL, DDS 4138 N MAINE AVE STE N3 (626) 960-6395 FIT I (SP) BALDWIN PARK #057801 DAVID KUTNER, DMD 13734 RAMONA BLVD 616 F61 PIT 6 /T(SP, KO) (Ilk BANNING #169501 ADRIAN ACOSTA, DDS 4240 W RAMSEY AVE (909) 849-4484 FIT 2 (SR RU) BARSTOW #000301 GENTLE DENTAL CARE 113 E MOUNTAIN VIEW (760) 256-2896 F/T I (SP) BELL #002095 ST GEORGE DENTAL CLINIC 6905 1/2 S ATLANTIC BLVD (323) 773-5029 P/T I (SR AR, RU) I✓1k BELL GARDENS #328401 MARKETPLACE DENTAL OFFICE 6815 EASTERN AVE STE AI (323) 560-2595 F/T I (SP) (� BELL GARDENS #372001 JIN WEI CHU, DDS 6526 EASTERN AVE (323) 771-3949 F/T 2 (SP) BELLFLOWER #002497 THE DENTAL GRP OF BELLFLOWER 10106 ALONDRA BLVD SUITE A F/T22 867-(SR)5117 BELLFLOWER #002498 A ALONDRA DENTAL GROUP 10106 ALONDRA BLVD SUITE B (562) 920-8324 F/T 1 (SR) BELLFLOWER #002531 GENE MEYER, DDS 9725 FLOWER STREET (S62) 867-6196 FIT 1 (SP,TA) BELLFLOWER #003208 MICHAEL BADEA, DDS 9222 E ROSECRANS AVE (562) 272-0222 FIT I P/T 3 & & - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. BELLFLOWER #185501 GERALD SANDARG, DDS 17024 S CLARK AVE STE C (562) 925-7436 F/T I (SP) BELLFLOWER #IC0901 UNIVERSAL CARE DENTAL 17660 LAKEWOOD BLVD (562) 461-1180 F/T i PIT 2 (SP,VI) BELLFLOWER #329301 JOHN LIM, DMD 9202 ALONDRA BLVD FIT21 �Sp) 6644 L� BELLFLOWER #359701 BELLFLOWER FAMILY DTL SERVICE 16925 BELLFLOWER BOULEVARD (562) 866-9739 F/T I (SP) BELLFLOWER #363401 MAURICE VARGAS, DDS 16537 BELLFLOWER BLVD STE B (562) 866-7073 F/T I (SP) BEVERLY HILLS #003120 SMILE MAKERS 998 S ROBERTSON BLVD 103-A P/T 131200 & (SP) BEVERLY HILLS ® #003545 DENTAL GROUP OF BEVERLY HILLS 99 N LA CIENEGA BLVD #300 (310) 289-1818 (SP, TA) CILI BEVERLY HILLS #146801 DENTAL GROUP OF BEVERLY HILLS 250 N ROBERTSON BLVD STE 412 (310) 271-3003 FIT I (SR JA) Ok BEVERLY HILLS #201601 JOEL OVADIA, DDS 8500 WILSHIRE BLVD #602 (310) 289-1101 F/T I (RU,AR) BEVERLY HILLS #305001 KAMBIZ KASHFIAN, DDS 50 N LA CIENEGA BLVD STE 206 (3l0) 659-7949 FIT I BEVERLY HILLS #363001 PACIFIC DENTAL CARE 9025 WILSHIRE BLVD STE 315 (310) 274-7485 PIT 2 (SP) 6k BLOOMINGTON #370001 JACK ACKERMAN, DDS 19059 VALLEY BLVD STE 103 FIT91 (Sp�3660 L� BONITA #271301 BONITA FAMILY DENTAL 4424 BONITA ROAD (619) 479-8703 FIT I (SP) BREA #001673 WALTER DAO, DDS 782 N BREA BLVD (714) 674-0114 FIT 1 (SR FR) & BREA #152701 WILLIAM LOU, DDS 552 E LAMBERT ROAD (7.14) 990-3344 F/T I BREA #IC4801 BERRY IMPERIAL DENTAL GROUP 649 W IMPERIAL HWY STE H (714) 529-1232 F/T 2 (SP) (LI 6.Fi - BREA #3C1501 IMPERIAL DENTAL CARE 200 E IMPERIAL HWY (714) 671-9999 F/T I (IN, SP, FR) BUENA PARK #001687 BUENA PARK DENTAL CENTER 8402 COMMONWEALTH AVE (714) 739-2051 F/T I (AR, FR. SP) BUENA PARK #002515 BEACH DENTISTRY 7841 COMMONWEALTH AVE (714) 739-7173 FIT I (SR AR,) BUENA PARK # 1 17901 MICHAEL CHANG, DDS 7700 ORANGETHORPE AVE STE 6 (714) 994-4482 F/T 2 (CH, SP) BUENA PARK #157001 ST THERESE FAMILY DENTISTRY 6891 LA PALMA AVE F/T41 (TAj6911 BURBANK #000082 SAN GABRIEL DENTAL 255 E ORANGE GROVE STE B (818) 557-0996 F/T 1 (TA,SP) BURBANK #000301 JAMES MATHESON, DDS 2720 W MAGNOLIA (818) 842-4879 F/T I BURBANK #00285S ABC DENTAL GROUP 1319 N SAN FERNANDO BLVD (818) 557-2299 F/T I (AM,AR,) BURBANK ■ #003538 DR MA LOURDES ANDRES-JAVIER 216 E ALAMEDA AVE (818) 848-3026 F/T I (SP) BURBANK #0C4301 RENE GHOTANIAN, DDS 500 E OLIVE AVE STE 460 (818) 846-2600 FIT 1 P/T I (SP) (L CALABASAS #003119 SCHECHTER DENTAL CORP 26560 AGOURA ROAD #102 (81 PIT81 (SR GE)3 L� CALABASAS #356501 CALABASAS DENTAL GROUP 26500 AGOURA ROAD STE 115 FIT8I (SP)0680 C� CALIFORNIA CITY #195301 ASPEN DENTAL GROUP 21007 NEMOPHILA AVE STE B (760) 373-1950 FIT I (SP, TA) CAMARILLO #003118 LAS POSAS DENTAL CARE 3901 LAS POSAS RD STE 209 (805)383-6745 FIT I (CH, SP) CAMARILLO #198701 CAMARILLO DENTAL GROUP 2380 E LAS POSAS ROAD A F/TS2 (S ) 91 I0 CANOGA PARK #000281 AAA DENTAL GROUP 21 123 VICTORY BOULEVARD (818) 888-2700 FIT 2 (SP. RU, HE. AM, TA) CANOGA PARK #001745 CARL JOHNSON, DDS 7241 OWENSMOUTH AVE (818) 346-3040 PIT I CANOGA PARK #002858 SINAI DENTAL CLINIC 7257 VASSAR AVE SUITE #203 (818) 251-9794 F/T I (SR) CANOGA PARK ■■ #003624 SHAWN RABIZADEA DDS 22030 SHERMAN WAY #202 (818) 887-0260 P/T 2 (SP) Ok CANOGA PARK #2C4801 WEST VALLEY DENTAL 6543 TOPANGA CANYON BLVD. (818) 883-7979 FIT 2 P/T I CANOGA PARK #362701 PARY AFRASHTEH, DDS 7259 OWENSMOUTH AVE (81 F/T81 (SR FR) 0 CANOGA PARK #375401 KISHORE SHAH, DDS 21001 13 SHERMAN WAY (818) 346-7032 FIT I P/T 2 (SP,TA) Gk CANYON COUNTRY#146601 ANNA LIBERMAN, DDS 18507 SOLEDAD CANYON RD (661) 252-0020 FIT 3 (SR RU,TA, AM) CARLSBAD #OC8801 CARLSBAD OPEN 7 DAYS DENTAL 5814 VAN ALLEN WAY STE 220 (760) 918-9000 F/T 3 CARLSBAD #2C2001 PLAZA FAMILY DENTAL GROUP 2630 EL CAMINO REAL (760) 434-1761 FIT I (SP) CARSON #002545 RANDOLPH LUM, DDS 21847 S AVALON BLVD (310) 549-9710 F/T 2 (SR CH) (LI CARSON #241101 MICHAEL ALKOV, DDS 550 E CARSON STE C (31 FIT I (SP,TA)4 CARSON #362401 CARE DENTAL CENTER 23517 MAIN ST STE 106 (310) 513-0222 FIT I P/T I (SR CH) Ck CARSON #363701 FAMILY DENTAL CENTER 22813 S FIGUEROA ST (310) 549-3717 F/T I (SR AR) CATHEDRAL CITY #I C3501 GENTRY PLAZA DENTAL CARE 68555 RAMON ROAD STE D i 02 (760) 202-1171 F/T I P/T I CATHEDRAL CITY #309001 ARTHUR WILLARDSEN, DDS 68487 E PALM CANYON DR 1 (760) 328-6208 FIT I (SP) CENTURY CITY #125601 BARRY KASHFIAN, DMD 2080 CENTURY PARK EAST 1406 (310) 553-1578 FIT 2 (SP, TA) CERRITOS #002718 EASTERN DENTAL 11466 SOUTH STREET (562) 402-8166 F/T I (SR KO) CFI CERRITOS #184301 BLOOMFIELD DENTAL CENTER 12657 166TH ST (562) 916-6502 F/T 2 (SR CH,VI,AR) 6Ei CERRITOS #215401 CERRITOS DENTAL CENTER 11135 183RD STREET (562) 860-9639 F/T 7 P/T I (SP,VI, FR) 6k CHATSWORTH #142801 DOUGLAS DILL, DDS 10242 CANOGA AVE (818) 882-5252 F/T I P/T I (SP,TA) CHATSWORTH #284101 DEVONSHIRE PLAZA DENTAL GROUP 10230 CANOGA AVE (818) 341-8400 F/T 1 (SP) CHINO #002337 GALVAN FAMILY DENTISTRY INC 4514 PHILADELPHIA ST STE A (909) 465-1016 F/T I PIT I (SP, TA) 6 % CHINO #031701 ANTHONY KAVORINOS, DDS 12604 CENTRAL AVE (909) 591-1745 F/T I P/T I (SR KO) CHINO #327401 WILLIAM VALDEZ, DDS 4129 RIVERSIDE DR (909) 591-9211 F/T I (SP) Ck CHINO #367601 FAMILY DENTAL CENTER 5436 RIVERSIDE DRIVE (909) 465-5551 F/T 1 (SP) CHINO #3C2701 JENNIFER HUNG, DDS 14335 PIPELINE AVE STE A (909) 628-8911 F/T I (SP, CH, PE, GR) Ck CHINO HILLS #0031 17 CHINO HILLS DENTAL GROUP 3410 GRAND AVE STE C (909) 364-0001 F/T I P/T I (SP) (k CHINO HILLS #176301 ST JUDE DENTAL CARE 14676 PIPELINE AVE UNIT Q F95 (SP)3180 IT611% CHULAVISTA #00022S PREFERRED DENTAL CARE 690 E STREET (619) 426-4264 F/T I PIT I (SP) 2 The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. CAMARILLO #285401 FARID SEHATI, DDS 484 MOBIL AVENUE STE 33 (805) 482-9568 FIT 2 (SR PE) (LI CARSON #368301 GEORGE STRONG, DDS 301 W CARSON ST (310) 787-7053 F/T I (SR TA) CASTAIC #385401 CASTAIC DENTAL CENTER 31886 N CASTAIC ROAD (661) 257-2300 F/T 2 P/T I (SP,TA) 6% CHULAVISTA #003157 PROFESSIONAL DTL CHULA VISTA 301 THIRD AVE (619) 476-1444 F/T 2 P/T I (SR) CHULAVISTA #OC 1801 CHULA VISTA DENTAL ASSOCIATES 345 F ST STE 140 (619) 476-1001 FIT 3 P/T 2 (SP, KO) CHULAVISTA #115501 SUZANNE TULENKO, DMD 230 F ST STE D (619) 427-5262 FIT I PIT I (FR, SP, TA) CHULAVISTA #217001 VERNON SANNA, DDS 401 H ST STE 9 (619) 427-5460 F/T I (SP) CHULAVISTA #253001 FAMILY DENTAL GROUPS 585 TELEGRAPH CANYON ROAD (619) 421-7010 FIT 4 P/T I (SP, TA) CHULAVISTA #360401 MORETT DENTAL GROUP 664 PALOMAR STREET STE 1103 (619) 429-3948 FIT 2 (SP) CITY OF INDUSTRY �##00351 1 SMILECARE DENTAL GRTUP 18025 E GALE AVE P/T2500 I (SP) CTY OF INDUSTRY #370101 CHUNG YANG, DDS 16025 E GALE AVE STE A8 (626) 855-4666 F/T I (CH,VT) (,k, COLTON #003150 COLTON DENTAL PARTNERS 251 E VALLEY BLVD (909) 825-0545 F/T I (SR AR, CH) COLTON #349201 DENTAL ASSOCIATES OF COLTON 1080 E WASHINGTON STE B (909) 783-9099 F/T 2 (SP) (� COLTON #368501 ST PATRICK DENTAL CLINIC 1200 E WASHINGTON STE F2 (909) 422-0885 F/T 1 P/T I (TA, SP) (� COMPTON #002787 SANG CHO, DDS 402 S LONG BEACH BLVD (310) 637-6187 FIT I (SP, KO, TA) COMPTON #038101 SHAILESH PARIKH, DDS 2001 E COMPTON BLVD (310) 639-7970 FIT 2 (SP) COMPTON #2C6401 COMPTON FAMILY DENTAL 1315 N BULLIS ROAD SUITE 3 (310) 639-5330 FIT 2 (SP) CORONA #000224 HARPREET GILL, DDS 360 W FOOTHILL PKWY (909) 279-1172 F/T I CORONA #002502 CORONA DENTAL GROUP. 161 MCKINLEY ST SUITE #102 (909) 73 7-3 746 F/T I (SP, CH, VT) CORONA #002542 DENTAL R US 1303 W 6TH STREET SUITE #103 (909) 898-2101 FIT I (VT, SP) CORONA #OC4601 CORONA DENTAL CENTERS 1074 W 6TH ST STE 104 (909) 279-7650 F/T I P/T 2 (SP) CORONA #351501 CORONA FAMILY DENTAL GROUP 1358 W 6TH STREET (909) 734-4620 F/T 3 (SP, FR, AR) CORONADO #174401 ARTHUR WILLARDSEN, DDS 501A GRAND CARIBE CSWY (619) S75-6644 F/T 2 (SP) COSTA MESA #030101 PACIFIC DENTAL GROUP 2000 HARBOR BLVD 8100 (949) 645-5070 F/T 2 (SP, TA) COSTA MESA #196301 MESA DENTAL CENTER 267 E 17TH ST (949) 646-2411 FIT 2 (SPAR) COVINA #000769 DENTAL GROUP OF COVINA 1406 NORTH AZUSA AVE STE C (626) 858-9940 FIT 2 PIT 2 (SP, CH) & COVINA #005901 COVINA DENTAL OFFICE 1052 N CITRUS AVE (626) 967-6767 FIT I (SP) 6% COVINA #322501 MA MAJEED DDS INC 661 S SECOND AVE (626) 966-3571 FIT 2 (SP, PE) COVINA #360101 OAKTREE DENTAL 626 S SECOND AVE STE A (626) 331-0779 F/T 1 P/T I (SP) & CULVER CITY #000277 SMILE DENTAL 10920 VENICE BLVD (310) 204-6661 FIT I (SP) CULVER CITY #001818 A CULVER CITY FMLY DENTISTRY 4909 S SEPULVEDA BLVD (310) 313-3100 P/T I (SP) (� CULVER CITY #3C3301 THE DENTAL CENTER 5432 S SEPULVEDA (310) 390-3565 F/T I (SP) CYPRESS ® #003509 THE DENTAL GROUP OF CYPRESS 11741 VALLEY VIEW ST STE E F/T41826-3000 P/T I (VI, SP) CEi DIAMOND BAR #2C060I WASSEEM SAMAAN, DDS 750 N DIAMOND BAR BLVD 216 (909) 860-3111 F/T 2 (SP, AR, FR) (k DIAMOND BAR #360001 EDWARD MOUSALLY, DDS 23525 GOLDEN SPRINGS DR C (909) 860-9399 FIT I DIAMOND BAR #3C4401 DIAMOND DENTAL CARE 303 S DIAMOND BAR BLVD #2C (909) 860-7579 P/T I (SP, EI) DOWNEY #000646 PLANET DENTAL 8843 ROSECRANS AVE SUITE A (562) 633-9300 FIT 2 (SP, TA) Ck DOWNEY #002755 SOHEIR AZER, DDS 10800 PARAMOUNT BLVD STE 307 (562) 923-3714 F/T I (SR AR) DOWNEY #002869 BEHZAD ABADI, DMD 11942 PARAMOUNT BLVD #1 (562) 862-8128 PIT I (SP,TA) DOWNEY #034001 FAMILY DENTAL CENTER 10501 LAKEWOOD BLVD STE A (562) 862-2341 FIT DOWNEY #152601 FRED BINA, DDS 11849 S PARAMOUNT BLVD (562) 869-2596 F/T I (SP) DOWNIE #250001 DOWNEY DENTAL CENTER 8515 FLORENCE AVE STE 200 (562) 869-4532 F/T I P/T 3 (SP, PE) Ck DOWNIE #359801 CHARLES STUCKEN, DDS 8847 IMPERIAL HWY STE C 2 (562) 861-4011 F/T I (TA, SP) Ok DOWNEY #361301 P G SHAH FAMILY DENTISTRY 8029 E IMPERIAL HWY (562) 862-6979 F/T DUARTE #001820 BRIGHT SMILE FAMILY DENTAL 2233 E HUNTINGTON DR (626) 359-9898 F/T I P/T I (CH, SP) Ck DUARTE #084101 DALWANI AND DHOLAKIYA 924 BUENA VISTA STE 102 (626) 357-2254 F/T I (SP) E LOSANGELES #002094 B.A. DEIRMENJIAN, DDS 528 S AMALIA AVE (323) 263-1677 PIT 2 (SP) E LOSANGELES #228301 GENTLE CARE DENTAL INC 3500 E WHITTIER BLVD STE 101 F3I -8834 /T(SP) Gk. EL CAJON #000041 PREFERRED DENTAL 700 NORTH JOHNSON AVE STE P (619) 444-3127 FIT I PIT 2 (SP) EL CAJON #00315A..„ SMILECARE DENTAL GROUP 2990 JAMACHA ROAD #132 (619) 670-1700 F/T I PIT 2 (SPAR) EL CAJON ® #003508 SMILECARE DENTAL GROUP 1242 E MAIN STREET (619) 444-6355 F/T 1 PIT 2 (SP) ELCAJON #15430.1 .: COTTONWOOD DENTAL GROUP 2451 JAMACHA ROAD STE 104. `.. (619) 444-0500 FIT 3 PIT I (SP,VI) EL CAJON #2C8201 HORIZON DENTAL GROUP 742 BROADWAY STREET (619) 440-0071 F/T 3 P/T I (k. EL CAJON #320301 EL CAJON VALLEY DENTALGROUP. 850 N SECOND ST (619) 440-1618 F/T I (SP, TA) EL MONTE #0017IS" ': PAINLESS DENTAL CENTER 10755 LOWER AZUSA RD #B (626) 448-2040 FIT I (SP,TA,VT) EL MONTE #001901 " DAVID KUTNER, DMD 3701 SANTA ANITA AVE (626) 442-4582 F/T 1 P/T 2 (SP, CH) & EL MONTE #002096 .' EASTERN LOS ANGELES DENTAL 12015 E GARVEY AVE STE A (626) 454-1888 F/T I (SP, CH) (� EL MONTE #002825"..' FAMILY DENTISTRY 9060 TELSTAR STE 206 (626) 571-5975 FIT I (SP) (k, EL MONTE #003134' , UNIVERSAL FAMILY DENTAL CARE 4202 N PECK ROAD (626) 401-0012 FIT I (SR) (k. EL MONTE #2C 1501 ATLAS DENTAL CARE 3131 SANTA ANITA AVE STE 201 (626) 444-2605 F/T I P/T I (SP) EL MONTE #359601 KHAN DENTAL CORPORATION 4900 N PECK ROAD (626) 579-5158 F/T 2 (SP) ENCINITAS ® #003515 NCH DENTAL 477 N EL CAMINO REAL #C210 (760) 943-8880 P/T I (SR KO) ENCINO #002861 IRAJ EBRAMI, DDS 16311 VENTURA BLVD #640 (818) 905-8337 PIT I (SP, HE, GE) (k. CORONA #001604 CYPRESS #364501 E LOSANGELES #3C5001 ENCINO #164601 JOSEPH RAJABI, DDS KATELLA DENTAL CENTER DURAN AND TANG DDS DAN ROSEN, DDS 900 S MAIN # 107 6929 KATELLA AVE 4065 WHITTIER BLVD#201 16542 VENTURA BLVD STE 505 (909) 734-4170 (714) 952-3044 (323) 268-3877 (818) 907-6736 FIT I (SP) FIT I P/T I (SP,VI) PIT 3 (SP, CH) F/T 2 P/T I (SR HE) (k 3 & - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. ENCINO #179901 RENE GHOTANIAN, DDS 5363 BALBOA BLVD STE 346 (818) 990-3551 FIT I (SR HE) ENCINO #184401 ENCINO DENTAL CENTER 17815 VENTURA BLVD STE 101 (818) 708-1200 F/T I (SP, HE) ENCINO #237501 HERBERT SCHNEIDER, DDS 15720 VENTURA BLVD STE 322 F/T82 (SR FR6HE) 6% ESCONDIDO ® #003541 ACACIA DENTAL CARE 639 S ESCONDIDO BLVD (760) 489-6197 F/T I (SP) ESCONDIDO #154801 EL NORTE FAMILY DENTAL 306 W EL NORTE PKWY STE D&E (760) 480-5600 FIT I (SP) ESCONDIDO # 191801 FAMILY CARE DENTAL 1 1 14 W VALLEY PKY (760) 738-1070 FIT I P/T I (SR TA) ESCONDIDO #196901 VILLAGE DENTAL CENTER 8895 LAWRENCE WELK DRIVE (760) 749-7500 FIT I. PIT I ESCONDIDO #IC9901 DEL LAGO DENTAL GROUP 3440 DEL LAGO BLVD STE C (760) 746-8777 FIT I P/T I (SR TA) ESCONDIDO #360501 JAMSHID KHAZIAN, DMD 727 E GRAND AVE (760) 738-7000 F/T I (SR TA, PE) FONTANA #117301 VILLANUEVA DENTAL OFFICE 17500 FOOTHILL BLVD STE C2 (909) 357-7000 F/T I PIT I (SP) CTi FONTANA #151301 FONTANA DENTAL GROUP 9193 SIERRA AVE STE D (909) 822-2226 FIT 2 (SR AR, VI) FONTANA #195201 SIERRA FAMILY DENTISTRY 9870 B SIERRA AVE (909) 823-2020 FIT I P/T I (SP) FONTANA #325201 GUPTA DENTAL GROUP 11623 CHERRY AVE STE B2 F/T 2 3(SP) 1485 FOUNTAINVALLEY #186301 WADID FATTOUCH, DDS 1 1180 WARNER AVE STE 251 (714) 775-0661 F/T I (SP,VI, PE, FR,AR) C� FOUNTAINVALLEY #260701 PAUL JARUSZEWSKI, DDS 18430 BROOKHURST STE 104 (714) 963-3005 F/T I (SP) Ck FOUNTAINVALLEY #384201 QUALITY DENTAL CARE 17150 EUCLID STE 311 (714) 444-4224 FIT I (AR, FR) & FULLERTON #000288 FARID HANNA, DDS 100 N STATE COLLEGE BLVD #E (714) 738-6001 FIT I (AR. FR, SP) FULLERTON #001690 SUNSHINE DENTAL 506 W COMMONWEALTH (714) 738-7777 F/T I (SR KO) FULLERTON #228001 FULLERTON DENTAL CENTER 446 E COMMONWEALTH AVE F46767 /T2 (SP)& FULLERTON #276001 ERIC MEYER, DDS 2720 N HARBOR BLVD STE 110 (714) 879-7943 F/T I (SP) FULLERTON #364101 ALICE SKUBEN, DDS 170 N RAYMOND AVE (714) 870-2000 FIT I (SR TA) & GARDEN GROVE #000297 PRIMARY DENTAL CARE 12570 BROOKHURST ST SUITE 2 (714) 537-5700 F/T I (SR RU) GARDEN GROVE #127401 UNIVERSAL CARE DENTAL 12852 PALM DRIVE STE 208 P/T49 SSP, VI) GARDEN GROVE #254301 GARDEN GROVE DENTAL CARE 12630 BROOKHURST ST STE B (714) 530-4920 F/T 2 P/T 1 (SP,VI,TA, PE, HE) Ck GARDEN GROVE #353101 BRISTOL DENTAL GROUP 13212 S HARBOR BOULEVARD F/T 41638-9999 P/T 2 (SP) (� GARDENA #001813 CITY DENTAL CENTER OF GARDENA 130O W 155 STREET STE 208 (310) 715-2723 FIT 2 P/T I (SR TA) & GLENDALE #002305 MALOU ANDRES JAVIER, DMD 1 140 E CHEVY CHASE DR FIT83 (SR)3387 GLENDALE #0023,3.1 ADVANCED DENTAL CARE 610 N CENTRAL AVE STE 207 (818) 545-8971 F/T i GLENDALE #002375 SMILE DENTAL PRACTICE 1 1 14 E BROADWAY ST (818) 500-7740 (AM, PE, RU) Gk GLENDALE #002856 SMILECARE DENTAL GROUP 1809 VERDIGO BLVD #340 (818) 790-OS81 F/T 2 PIT I (SR RU) Ck GLENDALE #003132 ARTEMIS SARADJIAN, DDS 205 S VERDUGO ROAD SUITE A (818) 244-4949 F/T 2 (AM, RU, SP, PE) GLENDALE #171801 JOHN GAZARIAN, DDS 230 N MARYLAND AVE STE 205 (818) 502-9990 HT I (AM, TA, SP, PE) L GLENDALE #IC9401 HI CARE DENTAL CENTER INC 819 N PACIFIC AVE (818) 240-1760 F/T 3 P[T 3 (AM, SP) GLENDALE #365701 JERRY KOLESAR, DMD 1122 N BRAND BLVD STE 102 (818) 242-2667 FIT I P/T I (SP) GLENDALE #3C4601 MONTROSE DENTAL GROUP 3600 OCEAN VIEW BLVD #6 (818) 541-9010 F/T 2 (AM, PE) GLENDORA #000307 WOODGLEN DENTAL CENTER 220 S GLENDORA AVE STE B (626) 914-4054 F/T I (SP, AR) GLENDORA # 191001 HARRY PAGES, DDS 1010 E ALOSTA AVE F/T I �S j3068 GLENDORA #288401 GLENDORA DENTAL CENTER 130 W ALOSTA AVE STE 316 (626) 335-7727 FIT I (SPAR) GRANADA HILLS #000632 FAMILY DENTISTRY 17050 CHATSWORTH AVE #109 (818) 832-2087 FIT 1 (SP, TA) FONTANA #368601 GARDENA #173301 GRANADA HILLS SIERRA DENTAL OFFICE PLAZA DENTAL KAMRAN RAFIE, DDS 9647 SIERRA AVE 14240 S VERMONT AVE 10144 BALBOA BLVD (909) 823-5959 6% (310) S 15-5511 (818) 363-0200 FIT I P/T I (SP) FIT I (SP) CEi F/T 2 (SP) FONTANA #3C2901 HERTIAGE DENTAL CARE 7360 CHERRYAVE STE 340 F90 /T91 P/T 2350 SP 6% FOUNTAINVALLEY #002516 DAVID COHEN, DDS 1 1 180 WARNER AVE SUITE #451 (714) 444-4428 FIT 1 6% &I- GLENDALE #001666 ALENOUSH BAGDASARYAN, DDS 457 PALM DR # 100 (818) 956-3733 F/T I (AM, SP) #171701 CTi GRANADA HILLS #320001 JOHN BOSAK, DMD 10727 WHITE OAK AVE STE 213 (818) 368-5676 FIT 2 HACIENDA HGTS #2C3501 MATTHEW TSAY, DDS 17138 E COLIMA ROAD STE C (6254-1826 F/T61 P/T I (SP, CH) & HACIENDA HGTS #2C9401 COMFORT SMILE FMLY DENTISTRY 15724 E GALE AVENUE (626) 333-5244 F/T I (SP, CH) HARBOR CITY #2C9101 CLAUDIA ROMANO. DDS 1537 W LOMITA BLVD F31 IT 2 P/T 1252 SP (� HAWAIIAN GDNS #003202 ANTHONY CAO, DDS 12531 E CARSON STREET (562) 924-2448 F/T I (SP,VI) & HAWTHORNE #001294 CASTLE DENTAL 13220 S HAWTHORNE BLVD F/T 2 P(F 2019 SP Chi HAWTHORNE #001811 KIMS HAWTHORNE DENTAL GROUP 3300 W. ROSECRANS AVE # 105 310679-3300 P/T I (KO. SP) & HAWTHORNE #001815 HAWTHORNE FMLY & COSMETIC DTL 13402 S HAWTHORNE BLVD (310) 675-5050 FIT I P/T I (SP) HAWTHORNE #OC4501 JOHN LEGASPI, DMD 13352 HAWTHORNE BLVD (310) 973-1525 FIT 2 (SP) HAWTHORNE #165901 COMFORT DENTAL CENTER 4277 W EL SEGUNDO BLVD F/T I PIT 09 SP 6, HAWTHORNE #358501 GEORGE SALAMA, DDS 13109 HAWTHORNE BOULEVARD F/T 3 P/T 1600 SP 61 HAWTHORNE #3C4901 CHOICE DENTAL GROUP 12730-D HAWTHORNE BLVD 3104-4000 F/T I (SP) & HEMET #OC6501 ARIEL FERNANDEZ, DDS 810 ST JOHN PLACE (909) 6S2-4040 F/T I (SP) HEMET #125301 SHAILESH PATEL, DDS 475 W STETSON STE L (909) 925-4002 F/T I HESPERIA #000001 DENTAL GROUP OF HESPERIA 15776 MAIN ST STE 18 (760) 949-8484 FIT I C� HESPERIA #360701 DESERT DENTIST INC 15555 MAIN ST STE C3 F/T 2 �SP5047 & HESPERIA #391001 DESERT VALLEY DENTAL GRP 17247 MAIN ST 760244-2625 F/T I (SR RU, VI, TA) C� The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. GLENDALE #001817 GRAND TERRACE #002341 CENTRAL DENTAL CARE AZURE HILLS DENTAL GROUP 607 N CENTRAL SUITE 301 22575 BARTON ROAD (818) 242-4781 (909) 825-6003 PIT I (AR, SP) FIT I (SP) 4 HOLLYWOOD #015901 SAID ALY, DDS 1680 N VINE STREET STE 1020 (323) 464-2033 FIT i (AR, AM, CH) HOLLYWOOD #389001 ARNOLD RIFMAN, DDS 6234 FOUNTAIN AVE (323) 466-2937 F/T I (SP, RU) Ck HUNTINGTON BCH #000185 UNA MUSLEH, DDS 19754 BEACH BLVD (714) 964-8830 F/T I (SP, AR) HUNTINGTON BCH #003093 BEACH DENTAL GROUP 19720 BEACH BLVD (714) 593-1010 F/T I (SP) Ck HUNTINGTON BCH #003209 YORKTOWN DENTAL PRACTICE 9931 YORKTOWN AVENUE (714) 963-9809 FIT I (VI) HUNTINGTON BCH # 176201 PACIFICA DENTAL 18821 DELAWARE ST STE 101 (714) 848-8211 F/T 2 (SP, FR,TA) HUNTINGTON BCH #200701 BEACHSIDE DENTAL GROUP 18800 MAIN ST STE 110 (714) 842-6151 P/T 4 (SP) HUNTINGTON BCH#2C 1601 KOSMAS PAPPAS, DDS 5942 EDINGER (714) 377-4449 P/T 2 (SP) HUNTINGTON PARK#002376 HUNTINGTON PARK FAMILY DENTAL 2711 E SLAUSON AVE (323) 582-4474 F/T 2 (AR, SP 61 HUNTINGTON PARK#002488 PACIFIC FAMILY DENTISTRY 5914 PACIFIC BLVD (323) 581-0100 F/T 1 (SP, KO) LL. HUNTINGTON PARK#158201 YOUR CHOICE DENTAL 6601 RUGBY AVE STE 400 (323) 585-1515 P/T 2 (RU, SP) & HUNTINGTON PARK#270201 KIMS FAMILY DENTISTRY 2750 FLORENCE AVE (323) 587-6600 F/T I (SP, KO) & HUNTINGTON PARK#355801 SEVILLE DENTAL CENTER DDS 7705 SEVILLE AVE STE A (323) 582-6938 F/T I (SP) 6% HUNTINGTON PARK#376101 JUSTIN FAMILY DENTIST 7208 PACIFIC BLVD STE 200 (323) 582-2200 F/T I (SR KO) (� HUNTINGTON PARK#392401 PAYAM MOJAB, DDS 2542 E FLORENCE AVE STE A FITI 582-075 (SP, E) 5 INDIANWELLS #175501 ARTHUR WILLARDSEN, DDS 74-900 HWY I I I SUITE #1 10 (760) 345-8626 FIT 2 (SP) INGLEWOOD #000078 TOOTH SPA 8615 CRENSHAW BLVD (310) 677-1152 F/T 2 (SP) INGLEWOOD #001510 FRANCISCO GONZALEZ, DDS 11254 S CRENSHAW F31 71463 /T (SP) INGLEWOOD #001900 FAMILY DENTAL CENTER 3108 W IMPERIAL HWY (310) 677-2992 P/T 1 (SP) INGLEWOOD #002784 AAA DENTISTRY 2798 W IMPERIAL HWY (323) 418-8888 FIT I (SP, TA) 61 INGLEWOOD #099901 KAUFMAN & WEINER DDS INC 3516 W IMPERIAL HWY (310) 677-9101 F/T 3 P/T 1 (SP) INGLEWOOD #228401 FORUM DENTAL GROUP 400 E REGENT STREET (310) 674-7590 F/T 2 (SP) INGLEWOOD #263001 NARINDER UPPAL, DDS 301 N PRAIRIE AVE #320 (310) 671-6114 F/T I (SP, PE) IRVINE #000596 MALEK MANSOUR, DDS 16100 SAND CANYON AVE #330 (949) 585-1515 &F/T 2 (FR,AR, SP) IRVINE #001816 SEAN FAHIMI, DMD 62 CORPORATE PARK SUITE #225 (949) 559-5595 PIT I (SP,VI,AR) Ck IRVINE #002410 CALIFORNIA SMILE DESIGN 2646 DUPONT DR STE C200 (949) 955-3366 &F/T I (IT, AR, RU) IRVINE #002461 ROYA TOOMARIAN, DDS 4330 BARRANCA PKWY STE 230 (949) 786-0640 FIT I C}i IRVINE #160901 DENTAL 2000 33 CREEK ROAD STE 210 (949) 857-6757 FIT I P/T I IRVINE #181901 GERALD SANDARG, DDS 17655 HARVARD PLACE STE F (949) 833-8884 F/T 2 P/T 1 6% IRVINE #339901 FARZAD SHAYGAN, DDS 4040 BARRANCA PARKWAY 140 F/T 2 (p � 7300 `k LA CRESCENTA #316801 CRESCENTA FAMILY DENTAL 2644 FOOTHILL BLVD (818) 248-9988 F/T I P/T I (KO) LA HABRA #002721 CHESTER JENG DDS INC 744 W LA HABRA BLVD F/T22 691-(SP)0738 LA HABRA #002824 LA HABRA FAMILY DENTAL OFFICE 331 N HARBOR BLVD (562) 694-3511 F/T I P/T I (SP) Gk LA HABRA #IC2401 HARBOR DENTAL 971 N HARBOR BLVD (562) 690-3SS I P/T I (SR CH) & LA HABRA #IC2801 HARBOR DENTAL CARE 1 150 E IMPERIAL HWY (714) 992-2200 FIT I P/T I (SP) 6% LA JOLLA E #003519 RAYMOND TASH DDS PC 9850 GENESEE AVE STE 720 (858) 453-5525 P/T I (SP) LA IOLLA #055201 JOYCE PETERSON, DDS 8950 VILLA LA JOLLA DR 1 105 (858) 455-9614 F/T 3 P/T I (SP,VI, GE) LA JOLLA #OC2101 LA JOLLA DENTAL ARTS 7540 FAY AVE (858) 729-9808 P/T I (SP) LA MESA #000226 PREFERRED DENTAL CARE 8881 FLETCHER PRKWY STE 325 (619) 697-2800 F/T 2 P/T I (SP) LA MESA #003167 SMILECARE DENTAL GROUP 5601 GROSSMONT CENTER DRIVE (619) 462-2272 FIT I P/T 2 (SP,) LA MESA #266701 GROSSMONT DENTAL GROUP 5565 GROSSMONT CTR 459 (619) 464-3383 F/T 7 P/T 3 LA MESA #358801 SMILEHAVEN DENTAL CENTER 4700 SPRING ST STE 210 (619) 464-2801 P/T I (SP) LA MESA #3C1401 LA MESA FAMILY DENTAL 5652 LAKE MURRAY BLVD. (619) 465-3393 F/T I LA MIRADA #002493 IMPERIAL DENTAL 15769 E IMPERIAL HWY (562) 902-9898 `� F/T 2 (CH, SP LA MIRADA #058501 JOHN WESTERMEYER, DDS 11900 LA MIRADA BLVD STE 7 (562) 947-3761 F/T 2 (SP) LA MIRADA #359401 MAGDY & ALINA GAD 12252 LA MIRADA BLVD P21 I51 (CH) /T 6% LA PUENTE #002085 --- LA PUENTE VILLAGE DENTISTRY 401 S AZUSA AVE STE A (626) 810-8222 P/T 2 LA OUINTA #000631' LA QUINTA DENTAL GROUP 78575 HWY I I I SUITE #300 (760) 771-0300 F/T I (SR CH) LAVERNE #172701 ' DENTAL CARE OF LA VERNE 2323 FOOTHILL BLVD (909) 596-1861 P/T I (SP, CH) LAGUNA BEACH #001503 LAGUNA BEACH DENTAL GROUP 31796 S. COAST HWY (949) 415-1020 P/T 2 & ' LAGUNA BEACH #1 15601 MARTIN KRUGER, DDS 385 N COAST HWY (949) 494-7115 F/T I P/T I (SP) LAGUNA HILLS #001890:c'•'" DUC VU, DDS 23595 MOULTON PKWY STE I (949) 454-0499 P/T I (VI, SP LAGUNA HILLS #185901` OAKBROOK DENTAL CENTER 24351 AVE DE LA CARLOTTA N4 (949) 951-7800 F/T I (AR, SP) LAGUNA HILLS #358601 SUSAN MILLAR, DDS 24031 ELTORO RD STE 220 (949) 837-6206 F/T 2 & LAGUNA HILLS #394801 MARTIN KRUGER, DDS 24022 CALLE DE LA PLATA 450` (949) 830-0074 F/T 5 (SP,VI, FR) Ok LAGUNA HILLS #3CO101 RUXANDA GHIBU, DDS 24401 RIDGE RT DR 107A (949) 588-2112 F/T I (SP) LAGUNANIGUEL . #001925 LAGUNA NIGUEL DENTAL GROUP 27901 LA PAZ ROAD SUITE D P/T91 3SP, 9195 Ok LAGUNANIGUEL #170601 RANCHO NIGUEL DENTAL GROUP' 30140 TOWN CENTER DRIVE (949) 249-4180 FIT 4 P/T 2 (GE) LAGUNANIGUEL #IC2701 SEA COUNTRY DENTAL 32341 GOLDEN LANTERN STE B (949) 496-7910 FIT 4 (VI, GE) LAGUNANIGUEL #304801 SOBHI BATNIJI, DDS 30231 GOLDEN LANTERN ST D (949) 363-1200 P/T I (SR AR, FR) IMPERIAL #185301 IRWINDALE #369901 LA MIRADA #175301 LAGUNA WOODS #IC8101 PEOPLES DENTAL OFFICE 369 DENTAL CENTER LA MIRADA FAMILY DENTAL CHRISTINE CHUNG, DDS 2387 HWY 86 13105 RAMONA BLVD STE A 13922 IMPERIAL HWY 24310 MOULTON PKWY STE CI (760) 353-5100 (626) 962-2778 (562) 926-7025 (949) 859-3988 F/T 9 (SP) FIT 2 (SP) 5 F/T I PIT I (SP) FIT 2 PIT I (VI, SP) c� The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. LAKE ELSINORE #002547 ELSINORE HILLS FMLY DENTISTRY 31500 GRAPE SUITE #8 (909) 471-1628 PIT 2 (AM, SP,VT) LAKE ELSINORE #161 201 TUSCANY DENTAL 361 RAILROAD CANYON RD STE A (909) 471-1400 FIT I PIT 3 (SPAR) LAKE ELSINORE #187401 LAKE ELSINORE DENTAL GROUP 32235 MISSION TRAIL STE 8 (909) 674-6808 FIT 5 (SP) LAKE FOREST #000595 DIMENSION DENTISTRY 20671, LAKE FOREST DRIVE B103 (949) 458-2582 FIT I (SP,VT, GE) & LAKE FOREST #OC4801 LAKE FOREST DENTAL GROUP 23082 RIDGE ROUTE DR STE A (949) 770-9355 FIT I PIT I (FR,TA, SP) LAKE FOREST #387801 EL TORO DENTAL CENTER 23684 ELTORO RD STE F FIT92 (SR PE94) BVI) CEi LAKEWOOD #001050 LAKEWOOD CERRITOS DENTAL CTR 5819 ADENMORE (562) 804-2296 FIT 7 (SP, TA, VI) LAKEWOOD #052901 LAKEWOOD DENTAL ARTS 5555 DEL AMO BOULEVARD (562) 866-1735 FIT 2 (SP) LAKEWOOD #210601 DAVID GOREN & ASSOC 5203 LAKEWOOD BLVD FIT225SP 7373 C� LAKEWOOD #329201 JITEN VASA, DDS 11455 E CARSON STE E (562) 860-71 I6 FIT I (SP) LANCASTER #001214 ELITE DENTAL 44439 N 17TH ST W #201 (661) 723-1461 PIT i (SR TA, KO) LANCASTER #001505 SMILECARE DENTAL GROUP 1228 WEST AVE K (661) 949-1970 FIT 2 PIT I (SP,VI) C% LANCASTER #001819 HI DESERT DENTAL CENTER 1745 WEST AVE "K" SUITE C (661) 723-5400 FIT 2 PIT 2 (SR TA, RU) C� LANCASTER #002336 AMERICAN BRIGHT DENTAL 44810 N ELM AVE (661) 945-2645 FIT I (SP) LANCASTER #I80101 FML DTL PRACTICE OF LANCASTER 44558 IOTH STREET WEST (6,61) 723-1111 FIT 2 PIT 1 (SP, FR) LAWNDALE #002490 RANDOLPH LUM, DDS 15655 HAWTHORNE BLVD (310) 675-7111 PIT 3 (SR TA, RU,) & LAWNDALE #148601 ALL SMILES DENTAL CARE 15228 S HAWTHORNE BLVD (310) 679-8000 FIT I (SP, TA) LEMON GROVE #2C7801 GROVE DENTAL 6963 BROADWAY (619) 464-7099 FIT 2 (SP) LOMA LINDA #148301 MOUNTAIN VIEW FMLY DENTISTRY 1 1 175 MOUNTAIN VIEW AVE #N (909) 796-2299 FIT I Ck LOMITA #001898 A DENTISTRY 1816 LOMITA BLVD (310) 326-4117 PIT I (SP, KO, TA) 61 LOMITA #OC6101 PCH DENTAL 2207 PACIFIC COAST HIGHWAY FIT I (S j2633 C� LOMITA #131501 NARINDER UPPAL, DDS 25107 NARBONNE AVE (310) 539-8392 FIT I (EI) LONG BEACH #000633 UNITED FAMILY DENTAL 141-P EAST WILLOW STREET (562) 988-2888 FIT I (SP, PE,VT) Ck LONG BEACH #000901 JASBIR BATRA DDS INC 925 E SAN ANTONIO DR STE 10 (562) 428-4678 PIT I LONG BEACH #001922 SHAMANNA MOHAN, DDS 5399 ORANGE AVE (562) 422-9698 FIT I (SR) LONG BEACH #002517 DONNA MARIE CALIMA, DMD 389 REDONDO AVE (562) 621-9796 FIT I (TA, SP) & LONG BEACH #002792 UNIVERSAL CARE DENTAL 2925 N PA.LO VERDE (562) 429-1642 P/T 3 (SRTA,VT) C LONG BEACH #002864 MAGED ZAKY NESSIM DDS INC 3821 ATLANTIC AVE #F (562) 424-0724 PIT I (SP) LONG BEACH #080501 ALAN GRANT, DDS 3620 LONG BEACH BLVD B6 (562) 426-6458 FIT 5 PIT I (SP,TA, RU) & LONG BEACH #OC6201 FIROZ HAKAKHA, DDS 1 183 E ANAHEIM ST FI22 (P)6600 CEi LONG BEACH #127801 UNIVERSAL CARE DENTAL 2360 PACIFIC AVE P25 31 (SP,VI) ITCk LONG BEACH #188,1.01 LONG BEACH DENTAL GROUP 659 REDONDO AVE (562) 439-0494 FIT I PIT I (SP) LONG BEACH #208701 JAMES SERLES, DDS 4301 ATLANTIC AVE STE 4 (562) 426-9308 FIT I (RU, SP) LONG BEACH #2C6101 ROSS DAY, DDS 6226 E SPRING STREET 200 (562) 421-3336 FIT I C� LONG BEACH #38830I KNOLLS DENTAL GROUP 3703 LONG BEACH BLVD E4 (562) 427-3890 FIT 2 (SP,TA) Ok LOS ALAMITOS #187701 LOS ALAMITOS DENTAL ARTS 3855 KATELLA AVE STE 102 (562) 936-0071 FIT 2 PIT I LOS ALAMITOS #26350 i GOPAL YETURU, DDS 3662 KATELLA AVE STE 206 (562) 598-7914 FIT I (SP) & LOS ALAMITOS #283401 ASHOKKUMAR MEHTA, DDS 10900 LOS ALAMITOS BLVD 133 (562) 596-8888 FIT 3 PIT I Ck LOSANGELES #000034 DENTAL CTR OF HIGHLAND PARK 5807 NORTH FIGUEROA AVE (323) 982-0999 FIT I PIT I (SR) CL. LOSANGELES #000635 CENTRO MEDICO/DENTAL FAMILIAR 514 E WASHINGTON BLVD (213) 749-3934 FIT 2 PIT I (SR RU) 61 LOSANGELES #000637 DAN BENYAMINI, DDS 1826 WEST 7TH STREET FIT32 ASP, 6660 Ck LOSANGELES #000948 DENTAL PROS 906 N VERMONT AVE (323) 953-7700 FIT I (SP, AM,) LOSANGELES #001156 PERSONAL DENTAL 6222 WILSHIRE BLVD #103 (323) 933-4444 FIT 2 PIT 2 (SR TA, JA,) & LOSANGELES #001401 W A STOMEL, DDS 6317 WILSHIRE BLVD #303 (323) 651-3833 FIT 2 & LOSANGELES #001509 DR TSOLARYAN'S DENTAL OFFICE 3161 LOS FELIZ BLVD ) 663-2606 FIT 32 (AM, RU) & LOSANGELES #001747 WHITTIER DENTAL GROUP 2901 WHITTIER BLVD B P3SSP, TA92 IT2 CFi LOSANGELES #001749 DR NAMIAN FAMILY DENTISTRY 609 S ATLANTIC BLVD (323) 980-9768 FIT I PIT I Ck LOS ANGELES #001814 BRIGHTER DENTAL 6221 WHILSHIRE BLVD STE 507 (323) 939-7899 PIT I (SR HE) LOSANGELES #001915 HOLLYWOOD VINE DENTAL OFFICE 5280 HOLLYWOOD BLVD (323) 469-9169 PIT 1 (SR RU, AM) LOSANGELES #001919 NORMA MIRANDA, DDS 1363 SOUTH OLIVE STREET PIT I (SI8 ) (ILI LOSANGELES #002326 CENTURY CITY DENTAL GROUP 10350.SANTA MONICA BLVD 190 F01 1704 IT(SP)& LOSANGELES #002332 KEROMINA DENTAL OFFICE 4738 WHITTIER BLVD (323) 268-3395 FIT I (SPAR) LOSANGELES #002377 LILIA MARTINEZ, DDS 194 S ALVARADO ST FIT31 ASP I500 Ck LOSANGELES #002487 LIBERTY DENTAL GROUP 5877 S VERMONT AVE FIT31 7(SP) 1523 C� LOSANGELES #002507 BRENTWOOD DENTAL GROUP 11980 SAN VICENTE BLVD #660 FIT 19PE-8345 & LOSANGELES #002540 WOODSIDE DENTAL 10921 WILSHIRE BLVD #505 (310) 824-0055 FIT 2 (SR) LOSANGELES #002541 DIVYA PATHAK, DDS 3756 SANTA ROSALIA DR #227 FIT31 (SR)7124 Ck LOSANGELES #002777 BELINDA BALAIS, DMD 2010 WILSHIRE BLVD STE 602 (213) 483-5160 FIT I LOSANGELES #002779 DENTOLOGY DENTAL GROUP 11444 WASHINGTON BLVD #B (310) 572-6167 FIT I PIT 2 (SP) LOSANGELES #002788 SHAUNA LEE, DDS 4146 E OLYMPIC BLVD STE F F�3) (S 9-8007 C LANCASTER #378501 LONG BEACH #OC6301 LOSANGELES #001664 LOSANGELES #002863 KAMRAM SAIDARA, DDS FAMILY DENTAL CARE IGAL ELYASSI, DDS YORK DENTAL OFFICE 2030 WEST AVE STE J 1327 LONG BEACH BLVD 6200 WILSHIRE BLVD #1609 6306 YORK BLVD (661) 949-6757 (562) 218-5555 (323) 549-0900 (323) 254-3451 FIT 5 PIT I (SP) FIT 2 (SP) Ck FIT 3 (SR PE, HE) Ck FIT I PIT I (SR RU, HE, FR,AM,) 6 ck The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. LOSANGELES #002865 CYPRESS DENTAL CLINIC 2135 CYPRESS AVE (323) 223-0731 FIT I (SP) Ck LOSANGELES #002866 JOCELYN CAPISTRANO, DDS 628 N VERMONT #5 3650 F3/T3I (TA) LOSANGELES #002868 ALINA OGANYAN, DDS 1727 N VERMONT AVE STE 109 (323) 644-3366 `� F/T I (AM, RU) LOSANGELES #003153 ADELAIDA QUINGCO, DDS 1 127 WILSHIRE BLVD STE #1 103 (213) 250-3998 L� FIT I (SR) LOSANGELES ® #003540 ARMEN MANSSOUSIAN, DMD 2621 E I ST ST (323) 268-9386 F/T I P/T I (SR JA) LOSANGELES ® #003544 ALVARADO FAMILY DENTAL CENTER 81 1 S ALVARADO ST (213) 383-3314 F/T I P/T I (SP) Ck LOSANGELES #005901 JAMES BLACK, DDS 3015 CRENSHAW BOULEVARD (323) 731-0801 FIT 5 PIT I (SR KO) & LOSANGELES #041801 RK CHETTY DDS INC 2525 COLORADO BLVD STE A F/3I (S j2885 LOSANGELES #042201 PATRICK CLERK, DDS 1127 WILSHIRE BLVD STE 907 F/T31 4SP)1252 UK( LOSANGELES #044501 WILSHIRE CENTER DENTAL GROUP 3932 WILSHIRE BLVD STE 100 (213) 386-3336 FIT 6 PIT 6 (SP,TA, AR) CL� LOSANGELES #091901 SHAW ADAMS DENTAL GROUP 12714 S AVALON (323) 754-2949 F/T 3 (SP) LOSANGELES #092401 SHAW ADAMS DENTAL GROUP 5220 W WASHINGTON BLVD 103 FIT32 (S )5641 LOSANGELES #OC7201 WILLIAM GINZBURG, DDS 3130 S SEPULVEDA BLVD STE D (310) 268-0646 FIT I (SR FR, RU) GLti LOS ANGELES # 1 10101 THELMA AGONIAS-YOUNG, DDS 3875 WILSHIRE BLVD STE 901 (213) 383-2700 F/T I (SP,TA) LOSANGELES # 1 12101 MARK LASKA, DDS 3460 WILSHIRE BLVD STE 210 P/T33 (SP)3348 LOSANGELES #126501 FARZIN MOUSAVI, DDS 6075 S VERMONT AVENUE (323) 758-3131 F/T I (SP) L LOSANGELES #127601 UNIVERSAL CARE DENTAL I I I I W 6TH STE 120 (213) 895-0009 P/T 5 (SP) CEi LOSANGELES #152101 CALIFORNIA DENTAL CARE 11628 SANTA MONICA BLVD 101 F310 /T I P/T IO60 SP Uk LOSANGELES #173201 CONTINENTAL DENTAL GROUP 600 W MANCHESTER AVE STE 2 (323) 750-1582 `� P/T I (SP) LOSANGELES #175401 SAMI NOUHAD, DDS 7080 HOLLYWOOD BLVD STE 817 F%31 466-3541 T(SR AR, FR) Gk LOSANGELES #183501 WILLIAM FAULKNER, DDS 5870 CRENSHAW BLVD 513 F/T3I (SP-0231 Ck LOSANGELES #184701 FLORENCE COMPTON DENTAL GROUP 7110 S COMPTON AVE F/T33 SRU,SSP 8 Gk LOSANGELES #198001 UNITED FAMILY DENTAL GROUP 5109 E WHITTIER BLVD (323) 265-2222 LOSANGELES # I C6401 NADER RAMZI, DDS 1 125 S BEVERLY DRIVE STE 400 F/TOI (P) 7447 LOSANGELES #211901 CULVER DEL REY DENTAL OFFICE 12202 W WASHINGTON BLVD (310) 915-9797 FIT 4 (FR, SP, TA, VI, GE) Ck LOSANGELES #219901 KENNETH CHANG, DDS 4026 W OLYMPIC BLVD (323) 930-1744 F/T I (SP) LOSANGELES #226701 PINAKIN PARIKH, DDS 5016 YORK BOULEVARD (323) 254-1831 F/T I (SP) LOSANGELES #270101 BRUCE WALKER, DDS 8540 SEPULVEDA BLVD 1212 F%01 645-2886 TP/T I (SP,TA) & LOSANGELES #270601 BYUNG CHUL KIM, DDS 765 N VIRGIL AVE (32 F/T31 (SP, KO)7 LOSANGELES #272501 IMPERIAL FAMILY DENTISTRY 1839 W IMPERIAL HWY F31761 /T2 (SP)& LOSANGELES #320101 NELSON WALKER, DDS 3756 SANTA ROSALIA DR 317 FIT3I (SP-5340 LOSANGELES #328301 WEST COAST DENTAL 2604 S VERMONT AVE STE 109 F/T 4 PIT 13 SP CL% LOSANGELES #328501 WATTS HEALTH FOUNDATION INC 10300 S COMPTON AVE (323) 564-4331 F/T 3 P/T I (SP) 61% LOSANGELES #345501 MANOJ AMIN, DDS 2613 SUNSET BOULEVARD (213) 484-1845 F/T I (Lti LOSANGELES #349001 CHERYL BINGHAM, DDS 11905 S CENTRAL STE 203 (323) 564-7504 FIT I (SP) LOSANGELES #353301 DEVANG GANDHI DENTAL CORP 2500 W FLORENCE AVE (323) 750-2082 F/T I (SP) LOSANGELES #355601 MICHAEL SCHNEIDER & ASSOC 10921 WILSHIRE BLVD STE 809 (310) 208-6813 F/T 2 P/T I (TA, FR, GE) LOSANGELES #356101 PARASTOO FARHOODI, DDS 3169 BARBARA COURT (323) 876-6440 FIT I LOSANGELES #356201 LESLIE LADDARAN, DDS 2105 BEVERLY BLVD STE 101 (213) 484-1288 PIT I (SR CH, TA) 6% LOSANGELES #362101 VERONICA DE GUTA, DMD 907 N VIRGIL AVE (323) 661-8384 F/T I (TA) LOSANGELES #362901 CLARITA OBEJERA, DDS 3827 SUNSET BLVD STE A (323) 953-4980 FIT I (SR TA) 6 LOSANGELES #365501 BENJI BEHROOZAN, DDS 5255 W SUNSET BOULEVARD (323) 463-7262 F/T I (SRAM) LOSANGELES #365601 LA BREA FAMILY DTL PRACTICE 3400 S LA BREA (323) 734-2284 FIT 2 (SR KO, TA) L� LOSANGELES #366001 EMILY LEE, DDS 3756 SANTA ROSALIA DR 200 FIT31 (SP�2994 LOSANGELES #367901 AIRPORT CTR FAMILY DENTAL 5304 W CENTURY BOULEVARD (310) 215-1455 P/T i (SP) Ck LOSANGELES #372901 STEVEN STANLEY, DDS 6221 WILSHIRE BLVD STE 307 (323) 931-1446 FIT I (RU) LOSANGELES #373201 ELEANOR ONGCAPIN, DDS 579 S FAIRFAX AVE (323) 653-4824 FIT 1 (SP, TA) LOSANGELES #375201 HOLLYWOOD SMILE DENTAL CENTER 8182 SUNSET BLVD STE 202 (323) 654-1100 F/T 2 (SR RU, GE) CL� LOSANGELES #375701 DAVID JAMES, DDS 1964 WESTWOOD BLVD STE 145 (310) 474-5575 F/T I PIT I (SR RU) Ck ` - LOSANGELES #375801 VICTOR SAAD, DDS 12427 W WASHINGTON BLVD (310) 390-9581 C� F/T 2 (SR AR) LOSANGELES #382501 ELYSON AND ASSILI 745 S KERN AVE -, P/T 2 (SP) 61 LOSANGELES #389101 LADERA DENTAL GROUP 5814 RODEO ROAD (310) 836-7200 FIT I (SP) Ck LOSANGELES #393301 LUZ CUBILLOS, DDS 12456 VENICE BOULEVARD (310) 390-2423 FIT 2 (SP) LOSANGELES #3C4701 SPARKLE DENTAL SERVICE 2703 1 /2 S VERMONT AVE (323) 735-7223 FIT I C� LOSANGELES #3C7801 CASTLE DENTAL 4251 CRENSHAW BLVD (323) 295-5577 F/T I PIT I CLti LYNWOOD #002089 B.A. DIERMENJIAN, DDS 11337 LONG BEACH BLVD (310) 608-7777 F/T 2 P/T 1 (SP) & LYNWOOD #3C4301 :. UNIVERSAL CARE DENTAL 3680 E IMPERIAL HWY #100 (310) 761-8100 F/T I P/T 2 (SR VT, TA, EI) & MANHATTAN BEACH#001748 BEACH CITIES DENTISTRY 400 S SEPULVEDA BLVD 280 (310) 406-0745 FIT I (SP) (LI MANHATTAN BEACH#2C 1401 MANHATTAN VILLAGE DENTAL GRP 1200 ROSECRANS AVE STE 210 F/TOI (S )0620 MANHATTAN BEACH#2C2701 MANHATTAN BEACH DENTISTRY 500 S SEPULVEDA STE 210 (310) 372-8188 F/T 2 (SP) LOSANGELES #I21001 LOSANGELES #2C4701 LOSANGELES #372501 MARINA DEL REY #1 1 1501 HIGHLAND PARK DENTAL GROUP WILSHIRE DENTAL CARE MEHRDAD MAKHANI, DDS MARINA DENTAL CENTER 5740 1/2 YORK BLVD 6200 WILSHIRE BLVD STE 1508 6200 WILSHIRE BLVD STE 1606 13155 MINDANAO WAY (323) 257-0915 (323) 938-6137 (323) 933-7744 (310) 821-2611 F/T 2 (SP, RU) F/T 3 PIT 2 (SP, RU,TA) CL� 7 FIT I (SR RU) (LI F!T I PIT I (SP) CL� & - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. MARINA DEL REY #173401 MARINA DENTISTRY 4292 LINCOLN BLVD SSP-5000 FIT I () & MAYWOOD #159601 SOUTHEAST DENTAL GROUP 4332 E SLAUSON AVE (323) 588-2141 FIT I P/T 2 (SP, GE) MAYWOOD #168701 DANIEL GAROIAN, DDS 4201 E SLAUSON AVE (323) 560-4658 F/T I (SP) MENIFEE #183201 MENIFEE VALLEY DENTAL GROUP 26910 NEWPORT ROAD STE B (909) 672-9457 F/T I (SP) MEXICALI #351701 DENTICENTER REFORMA AVE 999 STE 14 (619) 247-6884 FIT I (SP) MIRA LOMA #002546 MIRA LOMA DENTAL CENTERS 11058 LIMONITE AVE (909) 737-6005 FIT 1 (SP) MISSION HILLS #355501 PARVIZ KOHANOFF, DDS 11550 INDIAN HILLS RD 281 (818) 361-8777 FIT 1 (SR PE) & MISSION HILLS #366901 ELOISA MARQUEZ, DMD 15531 DEVONSHIRE (818) 894-7979 FIT I (SP, TA) 61 MISSIONVIEIO #001693 LOS ALISOS DENTISTRY 22951 LOS ALISOS BLVD #2 (949) 380-9506 F/T I (RU,) 61 MISSIONVIEIO #001866 MISSION VIEJO DENTAL ASSOC 25522 MARGUERITE PKWAY #100 (949) 586-6200 F/T 2 (SR CH,) MISSIONVIEIO #003205 PACIFIC DENTAL OFFICE 25523 MARGUERITE PKWY STE C (949) 768-1800 FIT I PIT 3 (SP, RU) MISSIONVIEIO #152801 AVALON DENTISTRY 27725 SANTA MARGARITA PKY (949) 9S I -0951 F/T 5 (SP) (k MISSIONVIEIO #271001 FAMILY COSMETIC DENTAL 26302 E LA PAZ STE 211 (949) 586-8110 F/T 2 (SR CH, PE, RU) 61 MISSIONVIEIO #3C0601 MONTGOMERY & KIRIAK DDS 27871 MED CTR RD STE 165 (949) 347-0807 F/T I P/T I (SP, GE) MONROVIA #155501 FOOTHILL DENTAL CENTER 121 S MYRTLE AVE P/T61 M -572SP) 2 MONTCLAIR #199101 JOHNSON FAMILY DENTISTRY 9645 MONTE VISTA STE 305 (909) 621-6002 F/T 2 (SP) MONTCLAIR #3C2501 AMIEL PATEL, DDS 4921 MORENO STREET (909) 625-3865 FIT I (SP) MONTEBELLO #156901 GREENWOOD DENTAL 1214 1/2 S GREENWOOD AVE (323) 728-3272 FIT I (SR FR) (fi MONTEBELLO #210901 DANIEL FARKAS, DDS 3301 W BEVERLY BLVD (323) 722-6766 F/T 3 (SP) MONTEBELLO #239301 DR DAVIDS FAMILY DENTISTRY 210O W BEVERLY BLVD (323) 724-9536 F/T I (SP) Uk MONTEBELLO #363901 SHAHEN GHAZARIAN, DDS 1437 W BEVERLY BLVD F/T3I (AW))2922 is MONTEBELLO #391101 RONALD ARAKAWA, DMD 2059 W WHITTIER BLVD F/T31 7(SP) 9898 MONTEREY PARK #196401 PACIFIC DENTAL GROUP 2016 S ATLANTIC BLVD (323) 725-6797 P/T 2 (SP, AM, IT) & MONTEREY PARK #239601 ISAAC CHEN, DDS 2071 S ATLANTIC BLVD STE F/G (323) 260-7878 FIr 2 (SR CA, CH) CLI MONTEREY PARK #359501 LEELING AND GRANT 616 N GARFIELD AVE STE 404 (626) 280-4122 F/T I (SP) MONTROSE #128201 ARROYO VERDUGO FAMILY DENTAL 3465 N VERDUGO ROAD (818) 249-1819 F/T I P/T I (SP) MORENO VALLEY #000617 CALIFORNIA DENTAL OFFICE 12800 HEACOCK STREET A 1 (909) 247-2688 F/T 3 (SP, CH) MORENO VALLEY #003105 SMILECARE DENTAL GROUP 12125 DAY ST BLDG N STE 211 (909) 222-2000 PIT 2 MORENO VALLEY M#003531 COMMUNITY DENTAL OF DR CHI 11875 PIGEON PASS ROAD B-9 (909) 488-8688 P/T I (SP, CH, KO) MORENO VALLEY #273301 ROBERT SILVOLA, DDS 12810 HEACOCK ST STE B103 (909) 242-3441 FIT 2 (SP) MORENO VALLEY #396301 DTL ASSOC/MORENO VALLEY MALL 22500 TOWN CRCL STE 2074 (909) 697-6800 F/T 4 P/T I (SP) MURRIETA #003165 MURRIETA DENTAL GROUP 25395 MADISON AVE STE #103 (909) 696-5660 F/T I PIT I (SR) MURRIETA #OC2201 MURRIETA DENTAL GROUP 40770 CALIFORNIA OAKS RD (909) 677-3078 PIT I (SP) MURRIETA #2C5901 MADISON SPRINGS DENTAL 25285 MADISON AVE 107 (909) 698-3585 F/T 6 (SP, GE, GR,VI,TA) MURRIETA #3C8601 MURRIETA FAMILY DENTAL GROUP 40643 CALIFORNIA OAKS ROAD (909) 677-7779 FIT I PIT 2 N HOLLYWOOD #000012 MICHAEL KOSDON, DDS 10545 VICTORY BLVD (818) 763-9353 L F/T I P/T I (SP) N HOLLYWOOD #001667 FAMILY DENTISTRY. 11436 VANOWEN STREET (818) 503-9697 FIT I (SR RU) N HOLLYWOOD #001914 IOSEF MAMALIGER, DDS 12450 BURBANK BLVD #L (818) 763-0777 PIT I (RU, HE) N HOLLYWOOD #002797 DANIEL BOUDAIE FAMILY DENTIST 10941 VICTORY BLVD (818) 509-1967 F/T 4 (SP, TA,) & N HOLLYWOOD #002840 PACIFIC DENTAL GROUP 6801 LANKERSHIM BLVD #101 (818) 764-0718 P/T 2 (SR RU, IT) Chi N HOLLYWOOD #003100 BRIGHT SMILE DENTAL 5054 LANKERSHIM BLVD (818) 623-1940 F/T I PIT I (SR TA) N HOLLYWOOD #003546 HAMLIN DENTAL GROUP 12509 OXNARD ST STE 201 (818) 285-5757 F/T I (SR AM) N HOLLYWOOD #209401 ALAN BRODY, DDS 12520 MAGNOLIA BLVD STE 202 (818) 762-2682 `� F/T I (SP) N HOLLYWOOD #305301 LAUREL CHANDLER DENTAL 5451 LAUREL CNYN BLVD STE100 (818) 508-2250 FIT 2 P/T I (SP) N HOLLYWOOD #349801 JULIAN GERSHFELD, DDS 5160 VINELAND AVE STE 105 (818) 761-8899 P/T I (S NATIONAL CITY #181201 THOMAS TOMA, DMD 3460 HIGHLAND AVE STE D (619) 420-1100 F/T 2 (SP, AR, TA) NATIONAL CITY #321901 ERNEST TAUB, DDS 936 HIGHLAND AVE (619) 474-6200 F/T 2 P/T I (TA, SP) NATIONAL CITY #35S 101 RICHARD CERVANTES, DDS 1919 HIGHLAND AVE (619) 477-3770 F/T I (SR TA) NEWBURY PARK #171201 STEVEN DESTLER, DDS 587 N VENTU PARK RD # C (805) 499-1253 F/T I PIT I (SP) 61 NEWHALL #001217 ELITE DENTAL 23206 LYONS AVE #203 (661) 255-7338 FIT I P/T I (SP,) NEWPORT BEACH #125801 NEWPORT BEACH DENTAL 1501 SUPERIOR AVE STE 100 (949) 650-6772 FIT 2 & NEWPORT BEACH #146701 JEFFREY LYSDALE, DDS 355 PLACENTIA AVE STE 205 (949) 646-0818 F/T I NORCO #142201 NORCO FAMILY DENTAL 2031 RIVER ROAD (909) 372-9094 P/T 2 (PE, SP) NORCO #190201 CHARLES RODGERS, DDS 1260 HAMNER STE C & D (909) 279-5200 FIT I (SP) NORTH HILLS #000195 DENTAL SOLUTION GROUP 9146-A SEPULVEDA BLVD (818) 830-7000 FIT 2 (SP) 61 NORTH HILLS #002753 HOMA SHAHRIARI DDS INC 15206 PARTHENIA ST (818) 892-0714 F/T I (SP) NORTHRIDGE #002307 AT -EASE DENTISTRY 1 1 155 TAMPA AVE F/T I (67) 3382 CFi NORTHRIDGE #026401 LAWRANCE LEVINE, DDS 8363 RESEDA BLVD STE 202 (818) 885-0536 F/T I & NORTHRIDGE #106101 RICHARD ROTHSTEIN, DDS 9145 RESEDA BOULEVARD (818) 886-9920 F/T I P/T I NORTHRIDGE #176401 HAMLIN DENTAL GROUP 8349 RESEDA BLVD STE F (818) 701-6667 FIT I P/T I (SP) MONTCLAIR # 179501 MORENO VALLEY #346201 NATIONAL CITY #OC2301 NORTHRIDGE #365901 CENTRAL FAMILY DENTISTRY JAMES DICKEY, DDS TOWN AND COUNTRY DENTAL BHARATI DESAI, DDS 9197 CENTRAL AVE STE C 24266 POSTALAVE STE 100 1536 SWEETWATER RD STE E 8954 RESEDA BLVD STE 100 (909) 398-1107 (909) 242-2600 (619) 477-4945 (818) 701-3010 F/T I (CH, SP) FIT 1 FIT I (SP, TA) F/T 1 (SP) 8 ck The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. NORTHRIDGE #378801 BABAK KOHANOFF, DDS 18250 ROSCOE BLVD STE 225 (818) 349-9151 F/T I (SP) NORTHRIDGE #3C7201 ALL FAMILY DENTAL CARE 8864 CORBIN AVENUE (818) 700-7980 F/T I (SP) NORWALK #002720 NORWALK FAMILY DENTISTRY 15617 STUDEBAKER RD STE 5 (562) 484-3936 F/T I (TA, SP) (Fi NORWALK #003204 NORWALK FAMILY DENTAL 12319 E IMPERIAL HWY F28-7955 IT2 SP & NORWALK #121901 PADDISON DENTAL GROUP 12501 S NORWALK BLVD (562) 929-0880 F/T I (SP) NORWALK #364001 CHAN LEE, DDS 11780 FIRESTONE BLVD (562) 868-9897 F/T I (SR CH) C OCEANSIDE #002321 DENTISTRY 2000 3529 CANNON ROAD SUITE 2G (760) 945-7000 F/T I OCEANSIDE #002510 A+ GENTAL DENTAL OF OCEANSIDE 2216 EL CAMINO REAL STE 121 (760) 439-7800 F/T I (RU, GE, SP) OCEANSIDE #OC6001 NORTH COUNTY FAMILY DENTAL 3837 PLAZA DR STE 805 F/T 2 630-(SP)6354 OCEANSIDE #125701 COLLEGE DENTAL GROUP 467 COLLEGE BLVD 2 (760) 631-3060 FIT 2 (SR IT, FR,VI,TA, GE) ONTARIO #000194 FAMILY DENTISTRY 628-C WEST HOLT BLVD (90 F/T91 (SP, FR) 4 61 ONTARIO #001601 WILLIAM STANLEY, DDS 211 N EUCLID AVE (909) 983-9639 F/T 4 P/T I (SP) ONTARIO #OC2401 ARCHIBALD RANCH DENTAL 3065 B ARCHIBALD AVE F92 (S)3640 /TCFi ONTARIO #357001 KYUNG CHUNG, DDS 941 W MISSION BLVD STE H F90 IT91 (SR KO)3 ONTARIO #367201 JASWANT SUTHAR, DDS 2242 S MOUNTAIN AVE FQI 1549 /T(SP)Ck ORANGE #001875 ST CATHERINE DENTAL CENTER 235 EAST KATELLA AVENUE (714) 633-3336 PIT 2 (SP, VI) C ORANGE #002242 SMILECARE DENTAL GROUP 179 N TUSTIN AVE P41 35 (SR PE /T& ORANGE #IC5301 COMFORT SMILE 1920 E KATELLA STREET STE J (714) 997-4133 F/T I (SP) ORANGE #280401 TUSTIN PLAZA DENTAL 1872 N TUSTIN AVE (714) 637-8662 FIT 3 P/T 2 (SP, JA) ORANGE #282401 ORANGE HILL DENTAL 3138 E CHAPMAN AVE FIT41 (SP)2703 ORANGE #367801 TOWN & COUNTRY DENTAL I I I I TOWN & COUNTRY RD 33 (714) 285-0505 F/T 3 P/T I (SR CH) (1i ORANGE #388601 DENTAL GROUP OF ORANGE 1502 E COLLINS FIT I (SP) 8464 (k OXNARD #002325 PACIFIC DENTAL GROUP 2150 N ROSE AVE (805) 604-0449 `� P/T I (SP) OXNARD #002328 BEACH CITIES DENTAL GROUP 1801 SOLAR DR STE 290 (805) 278-6887 FIT 2 (� OXNARD #002749 FREMONT SQUARE FMLY DENTISTRY 712 N VENTURA RD FIT I (S8-4540 `1k OXNARD #002823 ISLAND PLAZA DENTAL GROUP 2500 SAVIERS ROAD (805) 486-4896 FIT I P/T 2 (SP) & OXNARD #002857 IRAJ MOVAHHEDI, DDS 4225 SAVIERS ROAD #9 (805) 982-8283 FIT I (SP) OXNARD #OC290I OXNARD DENTAL PRACTICE 2411 SAVIERS ROAD FIT 3 �Pj0487 61 OXNARD #IC3601 DENTAL CARE OF OXNARD 1350 W GONZALES RD 2ND FLOOR PIT 2988-5888 (SP,AM, TA) Ck OXNARD #395501 ABAJIAN & RHAYEM DDS 1901 N SOLAR DRIVE SUITE 205 (805) 988-2250 FIT 2 (SR FKAR) C� PACOIMA #148401 KISHORE SHAH, DDS 13279 VAN NUYS BLVD (818) 899-2505 F/T 1 (SP, TA) PALM DESERT #2C3701 DESERT CROSSING DENTAL GROUP 72333 HWY I I I STE B (760) 674-9666 FIT I (SP) PALM SPRINGS #199801 DESERT DENTAL GROUP I I I I TAHQUITZ CYN WAY 210 (760) 327-1125 F/T I (SP) PALMDALE #000997 ANDRE KANARKI, DDS 1543 E PALMDALE BLVD:B (661) 274-1866 F/T I PALMDALE #001507 SMILECARE DENTAL GROUP 38745 TIERRA SUBIDA AVE #ISO (661) 272-9091 FIT 3 P1T 2 6% PALMDALE #001732 HI -DESERT DENTAL CENTER 2205 E PALMDALE BLVD (661) 273-1333 F/T I P/T 2 (RU, SP, TA, KO, AR) (;. PALMDALE #IC0801 PREMIER DENTAL CARE 3005 E PALMDALE BLVD STE 22 (661) 273-5221 &F/T I (SP, AM, AR) PALMDALE #375601 Y SIANI, DMD 2270 E PALMDALE BLVD STE E F/T 11 (SP) 6782 & PANORAMA CITY #002803 VAN NUYS PANORAMA DENTAL CTR 8227 VAN NUYS BL (818) 989-3074 F/T 2 (SR AM, RU, AR, FR) (1i PANORAMA CITY #0031 16 BRIGHTER SMILE DENTAL 9501 VAN NUYS BLVD STE #115 P81 1782 (SP,) /TCILI PANORAMA CITY #188301 HAMLET DAVARI, DDS 8121 VAN NUYS BLVD STE 310 . (818) 782-8120 P/T I (SP) PANORAMA CITY #341801 DAN ROSEN/SR NOURIAN DDS 8424 VAN NUYS BLVD (818) 893-4222 F/T I PIT 2 (SP, KO) 6. PANORAMA CITY #3S7201 GARY KARSH, DDS 8614 VAN NUYS BOULEVARD P8I BSPI , RU /TC� PANORAMA CITY #3C4801 GENTLE DENTAL CENTER 14526 ROSCOE BLVD (818) 893-7858 FIT I P/T 1 (SP, RU) PARAMOUNT #355901 WEST COAST DENTAL 14525 LAKEWOOD BLVD STE A (562) 272-0000 FIT i P/T I (SP) PASADENA #001746 LAKE ORANGE DENTAL 720 N LAKE AVE 7 (626) 808-9797 &P/T I (ARRU) PASADENA #001902 PASADENA FAMILY DENTAL CENTER 950 E COLORADO BLVD STE 201 (626) 431-2930 `�. P/T I (SP, FR) PASADENA #002781 PASADENA DENTAL CENTER 766 N LAKE AVE P6I B7 SP,AM /TG� PASADENA #002786 SUNNY KIM, DDS 826 E UNION STREET F61 683 (KO) /T PASADENA #038601 LEON ROISMAN, DMD 310 S LAKE LOWER LEVEL F658 PIT 6 /TSP Chi. PASADENA #148701 SHAUN MALEK, DDS 465 NORTH LAKE AVE F61 41445 /TSP 6% PASADENA # I C8201 WASHINGTON DENTAL GROUP 2554 E WASHINGTON BLVD 056 F61 P/T 0 /T(SP,AR,AM) CFi PASADENA #272401 PASADENA DENTAL ASSOCIATES 1302 N ALTADENA DRIVE F/T 2 (SP) 6778 PASADENA #316601 DAVID WYNDHAMSMITH, DDS 1092 E GREEN STREET (626) 795-9328 F/T I P/T 2 (SP, IT, GE, CH, JA,VI)(k PASADENA #359301 GREEN STREET DENTAL 1 175 E GREEN STREET (626) 578-1687 F/T I (Fi PASADENA #387501 DAVID LAWSON, DDS 700 E WALNUT STREET STE 1 (626) 793-6175 F/T 3 P/T I (SP) PASADENA #3C2601 FAIR OAKS DENTAL 301 S FAIR OAKS STE 208 (626) 431-2654 F/T I (SP) PERRIS #IC5501 INLAND DENTAL GROUP OF PERRIS 2560 N PERRIS BLVD STE F I (909) 657-6466 F/T I (SP) PICO RIVERA #000013 FAMILY DENTISTRY 4400 ROSEMEAD BLVD #2 (562) 695-5251 FIT I (SP, IN, FR, CH,VT) C1i PICO RIVERA #143901 RIVERA FAMILY DENTAL 9050 WHITTIER BOULEVARD (562) 942-8900 FIT 2 P/T I (SR AM, RU) (ilk ORANGE #001750 PACOIMA #002092 PARAMOUNT #370701 PICO RIVIE #320601 PETER SUMARSONO, DDS URIZAR DENTAL CLINIC PARAMOUNT FAMILY DENTAL CTR ASHOKKUMAR MEHTA, DDS 1042 N TUSTIN STREET 13215 VAN NUYS BLVD 8131 ROSECRANS AVE STE 101 9514 WHITTIER BOULEVARD (714) 771-0058 (818) 890-6442 (562) 634-2984 (562) 942-2345 F/T I (SR) FIT I (SR) 9 FIT I (SP, EI) 61% FIT I (SP) Ok (,k. - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. PICO RIVERA #367501 DANNY MUDITAJAYA, DDS 8308 ROSEMEAD BOULEVARD (562) 949-0177 FIT 4 (SP, TA) Ok PLACENTIA #001674 ROSE LINDA DENTAL 1203 E YORBA LINDA BLVD (714) 528-2833 FIT I (SR GE,) C� REDLANDS #002339 JOHN CESARIO, DDS 233 CAJON STREET SUITE #8 (909) 798-7228 FIT I REDLANDS #155201 BROOKSIDE DENTAL ASSOCIATES 720 BROOKSIDE AVE STE 100 (909) 798-7111 FIT 2 (SP) RIALTO #19390! NEELA GHATNEKAR, DDS 1786 N RIVERSIDE AVE STE 5 FIT 2 (SP) 0323 Ok RIVERSIDE #000161 ALLAN ETEMADI, DDS 6071 MAGNOLIA AVENUE (909) 680-1777 FIT 2 (SP, FR) RIVERSIDE #2CO201 ARLINGTON DENTAL 3297 ARLINGTON AVE STE 101 FI92 (Sp)6055 RIVERSIDE #2C9201 CENTRAL RIVERSIDE DTL PRAC 3630 CENTRAL AVE STE 6 (909) 682-1720 FIT 4 PLACENTIA #003050 REDLANDS #301601 RIVERSIDE #000612 RIVERSIDE #320S01 THE DENTAL GROUP OF PLACENTIA DRS LOW & LI JAMES LUCAS, DDS M K MANSOUR, DDS 1858 N PLACENTIA AVE 229 CAJON AVE 6339 BROCKTON AVE 7776 LIMONITE AVE (714) 577-9070 (909) 792-9217 (909) 369-3597 (909) 360-0696 PIT I (AR, KO, SR IT, GE, FR) FIT 2 FIT I (SR RU, AR) FIT 3 (SR FR, AR) PLACENTIA #394701 IMPERIAL ROSE FMLY DENTISTRY 1061 E IMPERIAL HIGHWAY FIT42 (SR KO)5 & POMONA #000292 FAMILY DENTAL CLINIC 2280 S GAREY AVE (909) 364-0633 FIT I (SP) POMONA #001718 BELLA MANCHANDIA, DDS 551 HOLT BLVD (909) 622-8600 FIT I (SP) POMONA #002031 TOOTH TOWNE DENTAL OFFICE 2127 N TOWNE AVENUE FIT91 (SR)4442 OK POMONA #002509 SAHARA DENTAL 676 FAIRPLEX DR (909) 623-9590 FIT I (SR AR, FR) & POMONA #198201 POMONA FAMILY DENTAL OFFICE 175 W LA VERNE STE A FITI (59) 59j5515 O POMONA #210101 DENTAL ASSOCIATES OF POMONA 180 EMISSION BOULEVARD (909) 623-5278 FIT I (SR CH) POMONA #308201 HARPREET GILL, DDS 722 EARROW HIGHWAY (909) 621-9177 FIT I PIT I (SP,TA) & POMONA #318801 KI SUN CHOI, DDS 956 N GAREY AVE (909) 629-9741 FIT I (SP, KO) POMONA #357101 POMONA DENTAL GROUP 850 N INDIAN HILL BOULEVARD (909) 626-3541 FIT I PIT I (SR KO, CH) PORT HUENEME #222901 ANA HERNANDEZ CARR, DDS 2480 VICTORIA AVE 204 (805) 985-1159 FIT I (SP) REDLANDS #356801 UNITED DENTAL GROUP 434 CAJON ST STE 101 (90 PIT91 (AR, SP)793-8793 ARSP)3 & REDONDO BEACH #001672 RAMIN ABDO, DDS 220 VISTA DEL MAR ST D (310) 316-2611 FIT I REDONDO BEACH #002783 DENTAL CTR OF REDONDO BEACH 1959 KINGSDALE AVE (310) 921-3938 PIT I (SP,) (� REDONDO BEACH #126601 GALLERIA DENTAL CARE 1505 HAWTHORNE BLVD (310) 370-1586 FIT I PIT I (IT, FR, SP) REDONDO BEACH #27000I BARRY KASHFIAN DENTAL GROUP 1917 S CATALINA AVE B (310) 375-0787 FIT 3 (TA, SP) RESEDA #001668 CANBY DENTAL 18440 SHERMAN WAY (81 PIT81PE)(SP, P4 O� RESEDA #002754 JOHN FOROUTAN, DDS 18308 SHERMAN WAY #1 (818) 881-0404 FIT I (SP) 61 RESEDA #092901 HARVEY DLUGATCH, DDS 18909 SHERMAN WAY (818) 345-1343 FIT I (SP) RESEDA #325401 LINDA KAPGAN, DDS 19301 D SATICOY ST (818) 772-4222 PIT I (RU, SP) & RESEDA #382301 ROBERT FREEMAN, DDS 19231 VICTORY BLVD STE 216 (818) 344-0257 FIT I PIT I CILI RIALTO #000131 DR AHUJAS DENTAL OFFICE 1130 N RIVERSIDE AVE (909) 873-0277 PIT I (EA, SP) Ck RIVERSIDE #000734 NEWPORT DENTAL GROUP 3560 ARLINGTON AVE (909) 680-1200 FIT I (SP) RIVERSIDE #000767 NEWPORT DENTAL GROUP 3724 LA SIERRA , SUITE FI (909) 688-2400 FIT I (SP) RIVERSIDE #001823 RIVERSIDE DENTAL OFFICE 1485 UNIVERSITY AVE (909) 784-4441 PIT I (SP) RIVERSIDE ® #003520 COMMUNITY DENTAL OF DR CHI 4595 LA SIERRA AVE. (909) 688-6000 FIT I (SP, KO, CH) RIVERSIDE #008201 DONALD PEARSON, DDS 6900 BROCKTON AVE STE 2 (909) 682-2245 FIT 2 (SR KO) RIVERSIDE #080601 LOW FAMILY DENTISTRY 6862 PALM AVE (909) 683-5490 FIT 2 (SP) RIVERSIDE #121101 RIVERSIDE DENTISTRY 1857 UNIVERSITY AVE (909) 781-3021 FIT 2 (VI, SP) RIVERSIDE #152301 LA SIERRA FAMILY DENTISTRY 3410 LA SIERRA AVE STE D (909) 354-9550 FIT I (SR JA, KO) & RIVERSIDE #172501 VIVIAN KWON, DDS 2955 VAN BURAN BLVD STE H4 (909) 689-8S44 FIT I (SP, KO) RIVERSIDE #174701 RIVERSIDE FAMILY DTL OFFICE 10286 INDIANA AVE (909) 352-9747 PIT I (SP, KO) RIVERSIDE #IC0701 UNIVERSAL CARE DENTAL 4381 BROCKTON AVE (909) 784-0636 FIT I PIT 2 (SP) RIVERSIDE #388201 SNUAP DENTAL GROUP 5515 VAN BUREN BLVD (909) 352-5838 FIT I (SP) RNCHO CUCAMONGA#053101 ANTHONY KAVORINOS, DDS 10630TOWN CENTER DR STE 131 643 F91 PIT 6 IT(SP) & RNCHO CUCAMONGA# 117701 STAR DENTAL GROUP 12729 FOOTHILL BLVD STE A (909) 899-8757 FIT 3 (SP) RNCHO CUCAMONGA#IC7401 RANIA REFAAT, DDS 7388 CARNELIAN ST STE C (909) 989-1758 FIT 2 (SP, AR) Ck RNCHO CUCAMONGA#IC8301 KRISHAN MITTAL, DDS 10064ARROW ROUTE (909) 987-5522 FIT I (SR IN) CLi RNCHO CUCAMONGA#390301 RANCHO CUCAMONGA DENTAL CARE 10470 FOOTHILL BLVD STE 126 FIT9I (SP-7888 O RNCHO CUCAMONGA#3C7001 GHAZAL DENTAL CORPORATION 10797 FOOTHILL BLVD (909) 581-0888 FIT I RNCHO SANTA MAR#3C650I RANCHO DENTAL GROUP 30592 SANTA MARGARITA PKWY (949) 766-5740 FIT I PIT I (SR) ROLLING HILLS ##3C3801 PENINSULA DENTAL ARTS 927 DEEP VALLEY DR 125 (310) 377-9575 PIT 3 (CA, SP) ROSEMEAD #001705 MIN LWIN, DDS 8115 E GARREYAVE (626) 571-7000 PIT 3 (SR CH, CA,) Gk ROSEMEAD ##002496 STEVEN HOU, DDS 3163 SAN GABRIEL BLVD #106 F62 IT61 (CH, SP)7 6% POWAY #001867 RIALTO #117501 RIVERSIDE #207301 ROSEMEAD #003133 FARAJZADEH & BAKER PRO DENTAL FAMILY DENTISTRY M J SAVANT, DDS SETHI FAMILY DENTAL CENTER 13422 POMERADO RD # 201 51 1 S RIVERSIDE AVE 4080 TYLER AVE STE D 21 1 1 N SAN GABRIEL BLVD #1 (858) 679-4949 (909) 820-2274 (909) 359-0149 (626) 280-4976 PIT I (SR RU, TA) Ok FIT I PIT 2 (SP) FIT I FIT I (SP,) CL. POWAY #051001 RIALTO #166001 RIVERSIDE #267501 ROSEMEAD ® #003513 E DENNIS FINK, DDS DENTAL CARE OF RIALTO DENTAL ASSOC OF RIVERSIDE SMILECARE DENTAL GROUP 12620 MONTE VISTA RD STE D 1727 N RIVERSIDE AVE 3487 CENTRAL AVE 4100 ROSEMEAD BLVD 485-8800 (909) 873-03SS (909) 369-1001 (626) 575-1161 F858) FIT 4 (SR CH) 10FIT 3 PIT 3 (SP) FIT 2 PIT 2 (CA,TA, VI, SP) & - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. ROSEMEAD #306001 BORIS ZAK, DDS 8951 GLENDON WAY (626) 288-7667 FIT 2 (SR RU, AM) Ok ROWLAND HEIGHTS#002543 STAR DENTAL PRACTICE 18750 COLIMA RD STE A-1 F62 IT61 PIT 3521 SP & ROWLAND HEIGHTS#268501 PLAZA DENTAL GROUP 18156 E COLIMA ROAD FIT 3 96(SP0971 c ROWLAND HEIGHTS#3 72 101 MICHAEL CHAN, DDS 1725 S NOGALES AVE STE 107 (626) 913-0222 FIT 2 (SR CH) & SAN BERNARDINO #000129 SAN BERNARDINO DENTAL GROUP 575 W 5TH ST (909) 888-6581 FIT 2 (SR KO) SAN BERNARDINO #000132 DR AHUJAS DENTAL OFFICE 654 4TH ST #A (909) 386-3650 FIT I (SR EI) SAN BERNARDINO #000142 DR AHUJAS DENTAL OFFICE 1584 W BASELINE STE 103 (909) 885-3100 FIT I (SP. CH. EI) SAN BERNARDINO #000217 LUIS VARGAS, DDS 965 SOUTH E STREET STE N (909) 885-6262 FIT 3 (CH, SP) SAN BERNARDINO #000220 SOUTHLAND DENTAL GROUP 399 E HIGHLAND STE 120 (909) 881-0645 FIT I (SR AR) SAN BERNARDINO #093201 WALTER ANDERSON, DDS 1879 N WESTERN AVE (909) 887-1212 FIT I (SP) SAN BERNARDINO #160101 JAMES CHO, DDS 2130 N ARROWHEAD AVE STE 201 (909) 882-7211 FIT I (SP, KO) SAN BERNARDINO #193501 BRENDA EVANS-LOUKA, DDS 1113S EST (909) 885-0969 FIT I (AR, SP) SAN BERNARDINO #193801 CITRUS DENTAL 2015 DINERS COURT FIT I (P90)0050 & SAN BERNARDINO #IC7601 INLAND DENTAL CENTER 599 INLAND CENTER DRIVE 116 (909) 384-1111 FIT 6 PIT I & SAN BERNARDINO #212801 AMERICAN FAMILY DENTAL ,CARE 695 W HIGHLAND AVE (9,09) 881-2545 FIT I (VI, KO, SP, FR) (LI SAN BERNARDINO #284301 D STREET DENTAL GROUP 1579-1581 NORTH D ST (909) 889-1977 FIT I (SR KO) SAN CLEMENTE #OC2701 OCEANVIEW PLAZA DENTISTRY 638 CAMINO DE LOS MARES C140 F94 500 (AR) /T SAN DIEGO #000076 PREFERRED DENTAL 3330 THIRD AVE STE 400 (619) 291-8750 FIT 1 PIT I (CH, SP) SAN DIEGO #000648 TIERRASANTA FAMILY DENTAL GRP 10645 TIERRASANTA BLVD STE B (858) 277-6080 FIT 4 (SR TA, FR) SAN DIEGO #001895 PACIFIC DENTAL 9330 B MIRA MESA BLVD (858) 695-3177 FIT I PIT I (TA,VI) SAN DIEGO #00241 1 SMILECARE DENTAL GROUP 1333 CAMINO DEL RIO STE 20 (619) 260-4990 FIT I PIT 3 (SP) SAN DIEGO #002413 SMILECARE DENTAL GROUP 10788 BLACK MOUNTAIN ROAD (858) 536-5550 FIT 2 PIT 5 SAN DIEGO #002539 SMILECARE DENTAL GROUP 3820 CONVOY STREET (858) 569-1100 FIT I PIT 2 (SR TA) SAN DIEGO #002826 NASER OSTAD, DDS 12330 CARMEL MOUNTAIN RD #C4 (858) 485-0555 FIT I (SP) SAN DIEGO #003121 PREMIER FAMILY DENTAL 4230 30TH STREET (619) 282-1007 FIT I (SR) SAN DIEGO #008 10 1 RICHARD KATNIK, DDS 7319 CLAIRMONT MESA BLVD (858) 569-96SI FIT 3 (SP,TA, IT) SAN DIEGO #030501 MISSION VALLEY DENTAL GROUP 2650 CAMINO DELRIO N STE 102 (619) 298-0521 FIT I PIT 2 (SP, TA) SAN DIEGO #OC 1601 SORRENTO VALLEY DENTAL 11230 SORRENTO VALLEY RD 130 (858) 458-9126 FIT I SAN DIEGO #252901 STEPHEN BARAL, DDS 3651 4TH AVE STE 300 (619) 298-2942 FIT 2 (SP) SAN DIEGO #2C6501 JEROME BANNISTER, DDS 4370 PALM AVENUE SUITE C (619) 428-8682 FIT I (SP, TA) SAN DIEGO #2C9601 STADIUM DENTAL CARE 8590 RIO SAN DIEGO DR 110 (619) 299-1122 FIT I PIT 2 (SR RU,TA) SAN DIEGO #377901 MARK RIEDLER, DDS 4167 OHIO ST (619) 281-6635 FIT I (SP, GE) SAN DIEGO #385601 BERNARDO DENTAL OFFICE 16466 BERNARDO CTR DR STE185 FIT81 (SP)1845 SAN DIEGO #393701 CARMEL PLAZA DENTAL CENTER 11738 CARMEL MOUNTAIN ROAD (858) 675-1180 F/T 2 PIT I (SP, FR) SAN DIEGO #3C0001 MESA FAMILY DENTAL 5450 CLAIREMONT MESA C (858) 503-6789 FIT I (SR PE) SAN DIEGO #3C0401 APPLE DENTAL I S40 FERN STREET (619) 236-9549 PIT I (SR CH) SAN DIEGO #3C8101 DR SHIH AND ASSOCIATES 12112 SCRIPPS SUMMIT DR #C (858) 689-6088 FIT 2 (SP,TA) SAN DIMAS #199901 PLAZA DENTAL OFFICE 1 120 VIA VERDE (909) 599-2444 FIT 2 (SR FR, GE) Ok SAN DIMAS #3C6601 BOUZ DENTAL CORPORATION 639 E FOOTHILL BLVD #A (909) 599-2029 FIT I (SR AR, RU) SAN FERNANDO #002380 TOOTH FAIRY DENTAL 556 SOUTH BRAND BLVD (818) 365-3004 FIT I (SR) SAN GABRIEL #001457 DR. M LWIN 1739 SAN GABRIEL BOULEVARD (626) 288-5777 PIT 3 (SR CH, CA) SAN GABRIEL #001807 SAN GABRIEL FAMILY DENTISTRY 531 W LAS TUNAS DR STE B F6I 1628 IT(SP)(k SAN GABRIEL #001909 BHANUMATI TOPRANI, DDS 5204 N ROSEMEAD BLVD (626) 286-2111 PIT I (SP) (� SAN GABRIEL 9002378 HONG SUN, DDS 6951 N ROSEMEAD BLVD (626) 292-5865 FIT I PIT I (CA, CH) (� SAN GABRIEL #OC3501 THOMAS WU, DDS 1103 S SAN GABRIEL BLVD .A FIT 6I286-7000 PIT I (CH, SR CA) & SAN GABRIEL #176601 SUN DENTAL 1720 S SAN GABRIEL BLVD 101 (626) 288-9055 FIT I (SR CH) SAN GABRIEL #371901 LAS TUNAS FAMILY DENTAL 1 107 E LAS TUNAS DRIVE (626) 285-0031 FIT 2 (VI, CA) 611 SAN WAN CAPIST #001924 CAPISTRANO DENTAL GROUP 31878 DEL OBISPO ST STE #105 P9I -3273 IT(SP, & SAN JUAN CAPIST #0C9701 MEHRVARZI MEHRDOKHT DTL CORP 31952 CAMINO CAPISTRANO (949) 240-6888 FIT 1 (SP) SAN LUIS OBISPO #130901 CAMPUS DENTAL 21 SANTA ROSA RD STE 50 FIT52 547-(SP) 7010 L� SAN MARCOS ® #003532 MISSION FAMILY DENTAL 1344 EAST MISSION RD STE C (760) 740-0070 FIT I (SR FR, RU) SAN PEDRO #227301 SAN PEDRO FAMILY DENTAL CTR 204 N PACIFIC AVE (310) 832-0291 FIT I (SP) 6% SAN DIEGO #OC2001 SAN FERNANDO #066801 SAN PEDRO SUNSHINE DENTAL OFFICE JERRY MALLEUS, DDS MILENA TASIC, DDS 9888 B CARMEL MOUNTAIN RD 125 S BRAND BLVD 601 W 6TH STREET (858) 780-8870 (818) 365-6321 (310) 831-1211 FIT I (SP) FIT I (SP, PE) FIT I (GE) SAN DIEGO #189501 RANCHO DENTAL GROUP 1442 UNIVERSITY AVE (619) 297-6104 FIT I SAN DIEGO #192201 MORAGA FAMILY DENTAL 3737 MORAGA AVE STE 13311 (8S8) 490-4281 FIT i SAN FERNANDO #325301 SAN FERNANDO DENTAL CARE 1315 SAN FERNANDO ROAD (818) 365-7107 FIT I (SP, CH) SAN FERNANDO #373401 MIGUEL MONTES, DDS 11273 LAUREL CANYON BLVD (818) 365-7191 FIT I (SP) SAN DIEGO #231301 SAN GABRIEL #001455 GENE MOORE, DDS DEL MAR FAMILY DENTAL 286 EUCUD AVE STE 201 702 S DELMAR AVE F91 6(SP, VI, TA) IT 6F61 287-9781 ITPIT (SR CH, AR) & #396501 Ck SAN PEDRO #3C8301 HAMID COHEN-KHERADYAR, DDS 400 S GAFFEY STREET (310) 548-1665 FIT I SANTA ANA #002491 AMISTAD DENTAL OFFICE 1028 W FIRST STREET STE E FIT4I (SP-542i C� SANTA ANA #003168 DENTAL 4 102 E 4TH STREET 2ND FLOOR (714) 558-1464 FIT 3 (SP) c, - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. SANTA ANA #005201 LOUIS COHEN, DDS 1913 E 17TH ST 113 FIT4I (P) 9751 SANTA ANA #160501 BAY DENTAL 3620 S BRISTOL AVE STE 307 (714) 540-2836 FIT I (SR GE) C SANTA ANA # I CO201 UNIVERSAL CARE DENTAL 1400 N MAIN (714) 480-0434 F/T I PIT I (SP,TA,VI) Ck SANTA AN #305801 BRISTOL FAMILY DENTISTRY 2707 N BRISTOL STE FI (714) 569-0021 &FIT I P/T I (SP) SANTA ANA #32780I JOSEPH DI CAPRIO, DDS I SOON GRAND AVE STE 102 (714) 667-5945 FIT I (SP) SANTA ANA #377101 IRA) EBRAMI, DDS 1 125 E 17TH ST STE E227 (714) 543-7770 PIT I (GE, PE) SANTA BARBARA #OC6701 SEA BREEZE DENTAL/DR ZAK 5I68 HOLLISTER AVE SUITE A (805) 683-5300 C� SANTA BARBARA #199701 MISSION DENTAL PRACTICE 330 STATE STREET SUITE A (805) 963-1533 F/T I (SP) SANTA BARBARA #2C2201 LA CUMBRE DENTAL CARE 200 N LA CUMBRE ROAD STE H - (805) 687-6767 FIT I (SR RU, HU) & SANTA BARBARA #2C4001 DENNIS DIERENFIELLD, DDS 16 W MISSION STE A (805) 569-2338 F/T 2 (SP) SANTA FE SPRING #000227 GENTLE DENTAL CARE 10805 ORR AND DAY ROAD (562) 929-8399 F/T I PIT I (SP) SANTA FE SPRING #002239 SANTA FE DENTAL 10009 ORR & DAY RD (562) 484-0808 FIT I (SP, TA) SANTA MONICA #002304 PARKSIDE DENTAL GROUP 2428 SANTA MONICA BLVD #403 (310) 453-7737 P/T I (SP, PE) O SANTA MONICA #004701 DOUGLAS OSWELL, DDS 3231 PICO BOULEVARD (310) 828-7429 FIT 6 (SP) SANTA MONICA #OC9801 SANTA MONICA DENTAL 1244 7TH ST STE 101 (310) 393-0743 FIT 2 (SP) SANTA MONICA #200401 EUGENE AND VICTORIA FIELD 2825 SANTA MONICA BLVD 101 (310) 453-5436 F/T 2 (SP,AR,TA, PE) (� SANTEE #219501 EDWARD REIDY, DDS 9280 MAST BOULEVARD (619) 449-8530 FIT I SANTEE #3S4201 SANTEE COTTONWOOD DENTAL 9715 MISSION GORGE RD (619) 448-7444 F/T I PIT 2 (SP,TA) SAUGUS #203401 GOLDEN TRIANGLE DENTAL 21700 GOLDEN TRIANGLE RD 201 (661) 259-5540 F/T 3 PIT I (SP, TA) SEAL BEACH . #000056 MAGED ZAKY NESSIM DDS INC 1058 BOLSA AVENUE (562) 594-4885 P/T I (SP,VI) SEAL BEACH #144701 GILBERT UNATIN, DDS 1900-A ST ANDREWS (562) 430-1054 FIT I P/T I SHERMAN OAKS #316701 HEIDI CHIN, DDS 13732 VENTURA BOULEVARD (818) 907-9533 F/T 3 (CH, SP) Ck SHERMAN OAKS #3C5101 KAREN ARAKELIAN, DDS 4940VAN NUYS BLVD #102 (818) 995-3377 F/T I (SR RU, AM) SIMIVALLEY #002379 ANIT NATT, DDS 1420 E LOS ANGELES AVE #D (805) 581-1191 FIT I SIMIVALLEY #176101 DENTAL CARE OF SIMI VALLEY 1687 ERRINGER RD STE 201 (805) 527-3534 F/T I (SP, PE,AM) (� SIMIVALLEY #253401 RALPH MAIELLO DDS, INC 495 E LOS ANGELES AVENUE (805) 584-2228 F/T 4 P/T 3 (SP) SIMIVALLEY #333101 BORIS ZAK, DDS 4537 ALAMO STREET STE A (805) 520-1100 F/T 1 (1. SOLANA BEACH ■#003478 DEL MAR DENTAL GROUP 512 VIA DEL LA VALLE #101 (858) 755-4221 P/T I (SP, IT) SOUTH EL MONTE #003135 DURFEE DENTAL OFFICE 1723 DURFEE AVE (626) 443-3915 F/T I PIT 2 (SP) SOUTH EL MONTE #3C7601 ROBERT PHAM, DDS 10050 GARVEY AVE #105 (626) 444-4220 F/T I (SP,VI) SOUTH GATE N #003543 YOUNG CHIL KIM DDS 8200 LONG BEACH BLVD STE E (323) 581-0707 FIT I (SP, KO) CK SOUTH GATE #013201 CASTLE DENTAL 4433 TWEEDY BLVD (323) 567-1227 F/T 2 PIT I (� SOUTH GATE #1 14601 ADULT & CHILDRENS DENTAL GRP 4444 TWEEDY BOULEVARD (323) 564-2444 F/T 14 PIT 3 (SP,TA, CH, PE) (, SOUTH GATE #285201 WEST COAST DENTAL 4149 TWEEDY BLVD STE G F/T35 567-(SP)3333 Ck SOUTH GATE #373001 KAPIL FAMILY DENTISTRY 2639 SANTA ANA STREET FIT31 (SP) 1481 C SPRINGVALLEY #396601 CHARLIE CARMICHAEL, DDS 8300 PARADISE VLY RD STE 122 (619) 479-9143 F/T I (SP, TA) STANTON #001892 SMILE ACADEMY 12793 BEACH BLVD P42 )63 (SP,VI IT Ck STANTON #003203 JEFFREY CHU, DDS 7025 KATELLA AVE (714) 229-1234 FIT I P/T I (CH, SP) & SUN VALLEY # 1 28001 UNIVERSAL CARE DENTAL 9375 SAN FERNANDO RD STE 602 (818) 504-9876 P/T 6 (FR, IT, SP, CH) SUNVALLEY #2C7901 FRESH SMILE DENTAL 8215 SUNLAND BOULEVARD (818) 252-7222 FIT I (SP, PE, AM) Ck SUNVALLEY #379901 FAMILY DENTISTRY 8805 SUNLAND BOULEVARD (818) 767-5243 FIT I PIT I (SP,TA) Ck SUNLAND #00312S SUNLAND FAMILY DENTISTRY 8522 FOOTHILL BLVD (818) 352-8888 F/T 2 Gk SUNLAND #134101 SUNLAND DENTAL CARE 7902 FOOTHILL BLVD (818) 353-5520 FIT I P/T I (SP) CFi SYLMAR #001456 ALI SAEGHI, DDS 13203 GLADSTONE AVE (818) 833-0444 F/T I (SP, PE) 61 SYLMAR #160301 CALIFORNIA DENTAL ASSOCIATES 2040 GLENOAKS BLVD STE F (818) 361-3889 F/T I (SP) TARZANA #356401 FARA SALEHI, DDS 1874O VENTURA BLVD STE 105 (818) 344-3357 F/T I TEHACHAPI #2C8901 VALLEY FAMILY DENTISTRY 20300 VALLEY BLVD SUITE A (661) 822-1134 F/T 2 TEMECULA #001605 SHAILESH PATEL, DDS 40335 WINCHESTER RD STE G (909) 296-9063 P/T I (SP) TEMECULA #2S3101 TEMECULA DENTAL GROUP 41593 WINCHESTER RD STE 211 (909) 296-3366 FIT I P/T 6 (SP) TEMECULA #364901 PALM PLAZA DENTAL 26475 YNEZ ROAD (909) 296-9661 FIT 3 P/T I (SP) TEMECULA #3C7101 LYNDA WATANABE DTL CORP 27487 YNEZ ROAD (909) 699-2144 F/T I P/T I (SP) TEMPLE CITY #001722 FRIENDLY DENTAL CARE 10455 LOWER AZUSA (626) 444-3744 F/T I (SR AR) THOUSAND OAKS #147501 PETER SABOLCH, DDS 1459 THOUSAND OAKS BLVD D (805) 379-5222 FIT 3 (SP) THOUSAND OAKS #244501 LOMBARD DENTAL GROUP 245 LOMBARD STREET (805) 495-2431 FIT 4 PIT I (SR AR, GE) THOUSAND OAKS #363301 MOJGAN HASHEMI, DDS 313 S MOORPARK ROAD (805) 449-9952 F/T I TIIUANA #322301 DENTICENTER AVE PASEO TIJUANA 8903202 (619) 428-0690 FIT I (SP) TOLUCA LAKE #OC4401 ESTEBAN BONILLA, DDS 10745 RIVERSIDE DRIVE STE B (81 FIT81 (SP, CH)7 Ck TOLUCA LAKE #3C3001 TINA GHOTANIAN, DDS 10916 RIVERSIDE DRIVE (818) 762-9966 F/T 2 (SR AM) TORRANCE #001370 ALL SMILES FAMILY DNTL GROUP 18506 HAWTHORNE BLVD (310) 370-7500 FIT I P/T I (SR CA) (� TORRANCE #001810 JOSHUA C H CHILI DDS INC 21320 HAWTHORNE BLVD 212 F01 (CH, A ITCk SANTA MONICA #1 1 1301 SOUTH GATE 9002544 TARZANA #002101 TORRANCE #001812 BENJI BEHROOZAN, DDS DR R SALWAN INC W A STOMEL, DDS DENTAL GROUP OF TORRANCE 2221 LINCOLN BLVD STE 200 8536 B LONG BEACH BLVD 19525 VENTURA BLVD 21229 HAWTHORNE BLVD 9 FIT33 581-0754 F/T I (SP, TA) & & F/T82 (SR RU) PIT 2 (SP)C� 12 c� The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. TORRANCE #OC8701 TORRANCE DENTAL ARTS 23325 HAWTHORNE BLVD STE 190 F/T02 PIT 3209 SP & TORRANCE #127901 UNIVERSAL CARE DENTAL 21840 S NORMANDIE STE 400 (310) 618-1522 P/T 7 (SP, IT, FR, CH) & TORRANCE #159701 ALL CARE DENTAL 19019 HAWTHORNE BLVD 10011 FIT i P/T 01 SP Ck TORRANCE #288501 DAVID SCHINNERER, DDS 2055 TORRANCE BOULEVARD (310) 320-0707 F/T I P/T I (SP,TA) Ck TORRANCE #2C4201 VILLAGE FAMILY DENTAL 1235 WEST SEPULVEDA BLVD F/T 2 P/T 26(SP,TA) (Ii TORRANCE #347301 TORRANCE DENTAL ASSOCIATES 17305 CRENSHAW BLVD 310 F/T I (SP) I66 & TORRANCE #356001 WEST COAST DENTAL 1730 W SEPULVEDA STE 1 (310) 325-8888 F/T I P/T I (SR CH) C� TORRANCE #361101 CABRILLO DENTAL GROUP 1509 CABRILLO AVE (310) 783-6644 F/T I (SP) C % TUSTIN #000188 NADIA REZAIAMIRI, DDS 13372 NEWPORT AVENUE STE F (714) 665-0898 F/T I TUSTIN #002827 A.A. FAMILY DENTISTRY 18102 IRVINE BLVD STE 205 F42 7SP 5656 /T61 TUSTIN #003200 ELVIS BAQUERO, DDS 14122 REDHILL AVE (714) 665-1554 FIT 2 (SP) & TUSTIN #IC6201 TUSTIN DENTAL OFFICE 13721 NEWPORT AVE STE 1 F714) 368-1400 IT I P/T I (SP) 61 UPLAND #000232 ERIC CHIANG, DDS 1273 WEST 7TH STREET (909) 920-9543 F/T I (SP, CH) & UPLAND 0 #003588 JANE CHERN, DDS 288 S MOUNTAIN AVE F90 IT91 (SP, CH)2 Ck UPLAND #017301 DOUGLAS JOHNSON, DDS 2345 W FOOTHILL BLVD 10 13 F1 91 (SR KO) /T61 UPLAND #367301 YUEN SIANG HUNG, DDS 1268 W FOOTHILL BLVD F9-4111 /T2 (SP) Ck VALENCIA #000215 VISTA VILLAGE DENTAL GROUP 25864 TOURNAMENT RD. STE F FIT I (SP) CFi VALENCIA ae #003542 NILDA WOOLARD, DMD 23369 LYONS (661) 259-7702 (SP, TA) VALENCIA #121701 VALENCIA DENTAL CARE 23838 VALENCIA BLVD STE 301 F/T 11 P/T 1412 SP & VALENCIA #131101 ZAK DENTAL CARE 26324 BOUQUET CANYON ROAD (661) 253-4000 F/T I P/T I (SRAM, RU) Ck VALLEYVILLAGE #388101 FAMILY DENTISTRY 12037 RIVERSIDE DRIVE (818) 762-8393 F/T 2 (SR TA) VAN NUYS #002327 PLAZA DENTAL CLINIC 7028 1/2 VAN NUYS BLVD (818) 780-8555 F/T I VAN NUYS #002492 GEORGIA FERREIRA, DDS 14100 VICTORY BLVD (818) 908-9199 FIT I (SP) Ok VAN NUYS #002747 SHERMAN WAY DENTAL ASSOCIATES 15333 SHERMAN WAY STE O (818) 909-0200 F/T I (AM, SP, RU, FR) 611 VAN NUYS #002801 HAMLIN DENTAL GROUP 14401 HAMLIN STREET SUITE D (818) 782-6919 F/T 2 P/T I (SP,TA,) VAN NUYS #072401 RICHARD KRATOCHVIL DDS INC 7136 HASKELL AVE STE 217 (818) 787-6060 F/T 1 & VAN NUYS # 127701 UNIVERSAL CARE DENTAL 14600 SHERMAN WAY STE 100 (818) 909-9277 F/T I P/T 6 (FR, IT. SR CH) Gk VAN NUYS # I C8001 SHERMAN WAY DENTAL GROUP 7120 HAYVENHURST AVE 205 (818) 988-1641 F/T I (AR,AM) VAN NUYS #394601 THE DENTAL CARE CENTER 7068 SEPULVEDA BOULEVARD (818) 781-1533 FIT 2 (SP, TA) VAN NUYS #3C0301 FIROUZEH BANKI, DDS 15243 VAN OWEN ST 411 (818) 781-4260 F/T I P/T I (SP) VENTURA #002338 DENTAL CARE OF VENTURA 178 S VICTORIA AVE #A (805) 677-5900 FIT I (SR TA) VENTURA #199601 VENTURA DENTAL GROUP 1001 PARTRIDGE ROAD STE 210 F/T53 644-(SP) 9501 VENTURA #285301 MARVIN BROWN DDS'MSD INC 3037 MARTHA DRIVE F/T51 6(SP) 6911 VENTURA #2C5201 AMERIDENT GROUP 6555 ETELEPHONE ROAD 8 F53 27.90 IT(AR) & VENTURA #2C9701 MISSION DENTAL GROUP 26 S GARDEN STREET STE 1 (805) 648-1090 F/T 2 (SR FR,VI) & VICTORVILLE #193401 VICTOR VALLEY DENTAL PLAZA 15165 7TH ST STE 1 (760) 245-1015 F/T I (SP, KO) VICTORVILLE #222501 FREDERICK MEYERS & ASSOCIATES 15366 11 TH ST STE E (760) 245-8616 F/T 3 (SP, FR) VICTORVILLE #306401 S M BHATT, DDS 14495 SEVENTH STREET SUITE A (760) 245-7800 FIT I P/T 3 (SP) VICTORVILLE #390901 DESERT VALLEY DENTAL GROUP 13622 BEAR VALLEY RD STE 10 (760) 245-2010 FIT 3 (SP,VI,TA) & VISTA #002708 BREEZ HILL FAMILY DENTAL CARE 610 S MELROSE DRIVE (760) 941-9000 F/T I P/T I (SP,) VISTA #003104 SMILECARE DENTAL GROUP 1010 E VISTA WAY STE A AND B (760) 940-8811 F/T I P/T 2 (SP) VISTA #IC6301 PALOMAR PARK DENTAL 3211 BUSINESS PARK DR (760) 598-8881 F/T 2 (SP) VISTA #275901 DONALD FELLARS, DDS 1000 EAST VISTA WAY (760) 940-4266 F/T 2 P/T I (SP) VISTA ##389301 MATTHEW DI MATTED, DDS 319 ESCONDIDO AVE (760) 630-6527 F/T I W LOSANGELES #120201 DAVID DANESHRAD, DDS 11850 WILSHIRE BLVD STE 101 (310) 477-8766 F/T I (TA, SP) UPLAND #317501 VENICE #267701 W LOS ANGELES #393401 INLAND EMPIRE DENTAL CASTLE DENTAL CENTER SAEID SOELMANIAN, DDS 1049 W FOOTHILL BOULEVARD 1440 LINCOLN BOULEVARD 1620 WESTWOOD BOULEVARD F/T91 (SR PE) 61 FIT01 P/T 2 (SP,TA) FIT 1475-5598 WALNUT #000652 WALNUT HILLS FAMILY DENTISTRY''- 18758 E AMAR ROAD (626) 912-5599 F/T I (SR FR) WALNUT #364401. TEIN CHUN WANG, DDS 18800AMAR ROAD STE BI6 (626) 912-9590 FIT I (SR CH, TA, PE, CA) WEST COVINA #002091 DENTAL CARE BY BLANCO 1031 AMAR ROAD F6I 3SP, 6655 /T61 WEST COVINA #00271 1 KULDIP HANJAN, DDS 906 S SUNSET AVE STE 105 F/T6I (SP-5243 WEST COVINA ®® #003510 NEWPORT DENTAL GROUP 151 N AZUSA AVE (626) 331-0076 F/T 2 (SP) WEST COVINA 0 #003512 SMILECARE DENTAL GROUP 1215 W COVINA PKWY 911 F63 B P/T /T(SP,VI) 6% WEST COVINA #160201 WEST COVINA FAMILY DENTISTRY 450 S GLENDORA AVE STE 106 (626) 856-3317 P/T I & WEST COVINA #221001 RANK YANNI, DDS 2365 S AZUSA AVE (626) 913-1421 FIT 2 (SPAR) WEST COVINA #232501 AMERICAN DENTAL GROUP 436 N SUNSET AVE (626) 337-7271 F/T 3 (SP) WEST COVINA #314801 MANINDER SINGH, DDS 1312 W FRANCISQUITO AVE D4 (626) 918-0171 F/T I (SP, IN) WEST COVINA #329601 QUEENS DENTAL GROUP 910 S SUNSET AVE STE 4 (626) 337-6166 FIT I P/T I (TA, SP) WEST COVINA #355001 SOUTHERN CALIF DTL SER 1014 S GLENDORA AVE (626) 918-2886 F/T I (SP,VI, CH) WEST COVINA #370301 ILDEFONSO ALCANTRARA, DMD 358 N AZUSA AVE (626) 966-4514 F/T I (TA) WEST 14OLLYWOOD#393001 EVA DLOOMY, DDS 9201 SUNSET BLVD STE 501 (310) 278-9121 F/T I (SR HE, FR,AR) C WESTCHESTER #002782 BENJAMIN ROSENBERG, DDS 8540 SEPULVEDA BLVD STE 1000 (310) 649-2430 F/T I (SP) C� . WESTCHESTER #161001 WESTCHESTER DENTAL CARE 8930 S SEPULVEDA BLVD STET 17 (310) 641-8890 F/T 2 (SP, TA) 13 ck The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. WESTCHESTER #3C5401 KREST FAMILY DENTAL 8740 S SEPULVEDA BLVD #130 (310) 410-9494 FIT I (SP, TA, EI) Cfi WHITTIER #002501 SO CAL FAMILY DENTISTRY 14412 E WHITTIER BLVD F/T 2 N3 SP) 8 WILMINGTON #002867 WILMINGTON FAMILY DENTISTRY 851 W PACIFIC COAST HWY F/T I (SP, KO) Ck WESTLAKEVLG #001508 WHITTIER #251801 WILMINGTON #388401 GHOTANIAN DDS PC DARREL DAGDIGIAN, DDS LARRY ROBINSON, DDS 870 HAMPSHIRE RD # C 16406 E WHITTIER BOULEVARD 207 W G STREET 549-2400 FIT 2 (AM, SP) Ck F/T(805) 497-226022 P/T I (SP) 61 F/T 96 3 P/T I (SP) WESTMINSTER #001916 HEATHER DANG, DMD 14022 SPRINGDALE ST STE E&F (714) 799-2803 FIT I (SP,VI, CA,) Uk WESTMINSTER #115401 THANH NGOC NGUYEN DMD INC 15355 BROOKHURST ST STE 101 P�42531-5175 C (V) WESTMINSTER #203001 CHRISTOPHER WONG, DDS 9900 MCFADDEN AVE STE 102 (714) 531-1131 F/T I (Ei WHITTIER #000026 RODOLPHO BURQUEZ, DDS 10420 WHITTIER BLVD F2I -3838 IT(SP) & WHITTIER #283501 WHITTIER DENTAL CENTER 14564 E WHITTIER BLVD (562) 693-8202 F/T 3 P/T I (SPAR) WHITTIER #363601 WHITTIER DENTAL OFFICE 8317 S PAINTER AVE STE 4 (562) 693-8790 F/T 2 (TA) & WHITTIER #396701 FRIENDLY HILLS FMLY DENTISTRY 14544 E WHITTIER BLVD F22 6SP, EI) /TCk WILDOMAR #003115 CLINTON KEITH DENTAL GROUP 23905 CLINTON KEITH RD #108 PfT I (S j9700 WINCHESTER #IC5101 WINCHESTER DENTAL CENTER 33040 SIMPSON ROAD (909) 926-2489 F/T I (KO, SP) WINNETKA #002853 WINNETKA PLAZA DENTAL 7616 WINNETKA AVE #1 F/T 81772-6222 (SRAM) Ck WOODLAND HILLS#0C8001 PIVNICK AND ROSEN DDS 6325 TOPANGA CNYN BLVD 518 (818) 346-8840 PIT 1 61 WOODLAND HILLS #134301 THOMAS BARTLE, DMD 22554 VENTURA BLVD STE 117 FIT82 224-(SP)2095 WOODLAND HLS #002829 NADER AHDOUT, DDS 22116 VENTURA BLVD (818) 340-3062 F/T I (SP,) YORBA LINDA #160401 YORBA LINDA DENTAL CENTER 21560 YORBA LINDA BLVD STE C (714) 779-7675 F/T 2 (SP, CH) YORBA LINDA ##304701 KISHORI MODI, DDS 19831 YORBA LINDA BLVD STE A (714) 693-0990 FIT 2 6% YUCAIPA #000925 IMPERIAL DENTAL PRACTICE 34880 YUCAIPA BOULEVARD (909) 797-1136 F/T 3 (SP) YUCAIPA #157601 YUCAIPA FAMILY DENTISTRY 34488 YUCAIPA BLVD STE F (909) 797-0303 FIT I (KO, SP, JA) YUCCA VALLEY ## I C4901 YUCCA FAMILY DENTAL CARE 54663 29 PALMS HWY (760) 365-2351 F/T I 14 & - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. Southern California - Closed Offices Theseo feces are presently serving members, but are closed to further enrollment at this time. These offices may open to new enrollment in the future if office capacity permits. ALHAM13 #376401 COSTA MESA #187301 GRANADA HILLS #128101 LA HABRA #355701 ERWIN LEE, DDS TURQUOISE DENTAL GROUP CATHERINE ALFONSO, DDS JULIET CHUA, DDS 1430 S ATLANTIC BLVD 2969 HARBOR BLVD 16917 DEVONSHIRE STREET 1441 W WHITTIER BLVD (626) 576-7797 (714) 424-9393 (818) 360-0957 (562) 691-7438 FIT 2 (CA) FIT I FIT I (TA, SP) 61 FIT I (SP TA, CH) t ALISO VIEIO #271701 ROBERT MURRAY, DDS 24541 PACIFIC PK DR STE 240 (949) 831-4655 FIT I (RU, GE, SP) ANAHEIM #021501 DERRICK BROWN, DDS 853 N HARBOR BLVD (714) 535-2487 FIT I ANAHEIM #360301 JANNA TRAN, DDS 250 W LINCOLN AVE (714) 535-3254 FIT I PIT I (SPVI) 6% ANAHEIM #364201 DAE HUR, DDS 40 E ORANGETHORPE (714) 870-6611 FIT I (KO) ANAHEIM HILLS #183301 DTL ARTISTRY IN ANAHEIM HILLS 145 CHAPARRAL COURT STE 201 998-1646 FIT 41 (SP, AM) (Ei ARROYO GRANDE #286501 JEFFREY WILLIAMS, DDS 236 S HALCYON (805) 489-1495 FIT I (ilk BAKERSFIELD #IC5601 G STREET FAMILY DENTAL 2611 G ST (661) 859-0192 FIT I BAKERSFIELD #308901 STEWART DENTAL CORPORATION 1518 NILES STREET (661) 326-0766 FIT 2 (SP) & BAKERSFIELD #373501 GREGORY HANFORD, DDS 3130 UNION AVENUE (661) 327-8473 FIT 1 61 BELLFLOWER #354901 BENJAMIN WOO, DDS 17802 S CLARK (562) 925-3715 FIT 2 (SP, CH) BEVERLY HILLS #25S201 STEVEN GOLDY AND ASSOC DDS 416 N BEDFORD DR STE 409 (310) 550-1511 FIT 2 (SP,TA) BREA #032401 VAUGHN G STEWART DDS INC 2500 E IMPERIAL STE 166 F4I (SP5920 IT ) & BURBANK #005301 CASTLE DENTAL CENTER 140 N VICTORY BLVD STE 101 (818) 841-1634 FIT 2 PIT I (SP TA) BURBANK #236001 JOHN YEKIKIAN, DDS 2601 W ALAMEDA AVE STE 406 (818) 843-7841 FIT 1 (AM, SP) COSTA MESA #274401 CALIFORNIA DENTAL GROUP 1755 ORANGE AVE STE D (949) 646-9671 FIT I PIT I (SP) COVINA #111401 JOHN F MACK DDS INC 558 W BADILLO (626) 331-0506 FIT I PIT I (SP) CULVER CITY #041701 DRS BILLENS AND KAUFMAN 10760 WASHINGTON BLVD (310) 838-7780 FIT 3 CULVER CITY #381601 STEVEN SELDON, DDS 10310 CULVER BLVD (310) 204-0700 FIT I DELANO #IC0501 CAJIMAT DENTAL OFFICE 416 1ITHAVE (66 PITII (TA,SP)6 DIAMOND BAR #198101 GRAND AVENUE DENTISTRY I I I I S GRAND AVE STE G (909) 396-7474 FIT I (SP) DOWNEY #354801 THOMAS DILLON, DDS 11411 BROOKSHIRE AVE STE 406 (562) 861-6737 FIT 2 (SP) L� DUARTE #366801 SALEH KHOLAKI, DDS 1230 E HUNTINGTON DR STE 5 (626) 301-4220 FIT I (SPAR) EL CAJON #369501 DR KOREL FAMILY DENTISTRY 1265 AVOCADO BLVD STE 102 (619) 444-3393 FIT I (SR AR) FULLERTON #174601 FAMILY DENTAL 2442 E CHAPMAN AVE (71 FIT41 (AR S )8 & GLENDALE #091401 WILLIAM FONG, DDS 3532 OCEAN VIEW BLVD (818) 957-7711 FIT 1 61 GLENDALE #162301 BROADWAY DENTAL OFFICE 727 E BROADWAY (818) 240-5888 FIT I (SP) 6% GLENDALE #235901 JOHN YEKIKIAN, DDS 1128 N BRAND BOULEVARD (818) 242-4703 FIT I (AR, SP) GLENDORA #380201 369 DENTAL CENTER 505 EARROW HIGHWAY (626) 335-2899 FIT 2 (SRTA) HACIENDA HGTS #201401 ANDREW KING WONG, DDS 15534 E GALE AVE (626) 330-7705 FIT I (SP) HACIENDAHGTS #230201 VALLEY DENTAL CENTER 1607 1 /2 S AZUSA AVE (626) 964-830S FIT I PIT I (SP, CH, TA) L� HACIENDAHGTS #324801 RONALD NICHOLS, DDS 1850 S AZUZA AVE STE 108 (626) 912-9394 FIT I (SP) & HACIENDAHGTS #361501 APPLE DENTAL CENTER 2219 S HACIENDA BLVD STE 102 (626) 369-5225 FIT 2 (SP, CH, FR) & HAWTHORNE #122601 HAWTHORNE DENTAL CARE 4477 W 118TH STREET STE 500 (3I0) 970-92SS FIT 2 PIT I (SP) (k HAWTHORNE #286801 BURTON SCHNIEROW, DDS 13450 S HAWTHORNE BOULEVARD (310) 679-0106 FIT 4 (SP, CHAR, FR,TA) & HEMET #368001 LARRY GRIMALDI, DDS 1600 E FLORIDA AVE STE 311 (909) 658-7251 FIT I (SP, GE) HUNTINGTON BCH #091601 THOMPSON AND CHRISTENSEN DDS 6968 WARNER AVE (714) 842-5593 FIT 2 PIT I (SP) HUNTINGTON BCH #I 51801 GABRIEL CAPDEVILA, DDS 6082 EDINGER AVE STE A (714) 846-2895 FIT I (SP) HUNTINGTON BCH #305601 ARTHUR CABRERA, DDS 18542 BEACH BLVD (714) 965-6025 FIT I (SP) 61% HUNTINGTON BCH #315101 GOLDEN WEST DENTAL 16900 GOLDENWEST ST STE A (714) 375-7700 `� FIT I PIT I (CH) INGLEWOOD #375501 RAYMONT JOHNSON JR, DDS 808 E MANCHESTER BOULEVARD FIT 110) 6SP 1234 Gk IRVINE #304501 JEFFEREY KIM, DDS 4902 IRVINE CTR DRIVE 200 (949) 733-8011 FIT I (KO) LA CANADA #152001 DOUGLAS LANGELL, DDS 1370 FOOTHILL BLVD STE 101 (818) 952-6193 FIT I (SP) LA MIRADA #080301 VICTOR ISRAEL, DDS 12675 LA MIRADA BLVD STE 315 (714) 521-2881 FIT 3 PIT 2 (SP) & LA PALM A #347501 LICAUCO-TAN DENTAL CORP 30 CENTERPOINTE DRIVE STE 10 (714) 994-0888 FIT 2 PIT 1 6% LEMON GROVE #193001 E GARNEL MARTIN, DDS 7040 BROADWAY (619) 667-1088 FIT I (SP) LOMITA #042101 ROBERT JONES DDS INC 25124 NARBONNE AVE STE 202 (310) 530-3260 FIT I (SP) LOMPOC #234701 VINCENT SIEFE, DDS 1201 EAST OCEAN AVE STE G (805) 735-2702 FIT 1 6% LONG BEACH #046101 DRS GANZ & BATEMAN 2618 LOS COYOTES DIAGONAL (562) 425-1196 FIT I (SP) LONG BEACH #084001 VILLAGE DENTAL CENTER BLDG 4200 LAKEWOOD BLVD (562) 420-1701 FIT 4 (SP) (LI LONG BEACH #185201 WILLARD HANKINS, DDS 5509 E SPRING ST (562) 421-8206 FIT 1 (SP) LONG BEACH #242401 GARY TROMBATORE, DDS 3840 WOODRUFF AVE STE 104 (562) 421-7177 FIT I PIT I LONG BEACH #359201 MARK COCCHI, DDS 2865 ATLANTIC AVE STE 119 (562) 426-0778 FIT I (GE, IT) LOSANGELES #000634 GEORGE TAY FAMILY DENTISTRY 4607 N HUNTINGTON DRIVE (323) 227-9885 FIT I (SP, CH) & LOSANGELES #360901 JONI FORGE, DDS 231 W VERNON AVE STE 107 (323) 233-5906 FIT I (SP) LOSANGELES #372601 FRANDSEN MAXWELL, DDS 6713 LA TIJERA BOULEVARD FIT I (SP) 0971 Ok LOSANGELES #374401 GARY WIRTSCHAFTER, DDS 11965 VENICE BLVD STE 209 (310) 397-1206 FIT I (SP, FR) & 15 & - The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. LOSANGELES #374501 DAVID YORK, DDS 2472 OVERLAND AVE (310) 838-0844 C� FIT I (SR PE) LOS OSOS #180901 MICHAEL JANICH, DDS 1205 4TH ST F�5) 528-1695 6% MISSION HILLS #147901 ANTHONY HOLCOMB, DDS 15501SAN FERNANDO MISSION104 F�8) 365-8600 (Ei MONTEBELLO #383101 GREGORY ROBINS FMLY DNSTRY 1400 W WHITTIER BOULEVARD F/T 3 (SP, TA) 9 Gk MORENO VALLEY #202601 WILLIAM KOHL, DDS 24270 SUNNYMEAD BLVD (909) 924-9831 F/T I MORENO VALLEY #2C4301 INLAND DENTAL OF MORENO VLY 24655 SUNNYMEAD BLVD (909) 924-2999 F/T I NEWHALL #002901 MARVIN SAGERMAN, DDS 25061 PEACHLAND AVE (661) 255-7530 F/T I (CH, SP) NEWPORT BEACH #317701 NEWPORT CENTER DENTAL GROUP 1401 AVOCADO AVE STE 404 (949) 640-1122 FIT I P/T 5 (SP) NORTHRIDGE #000501 W LOLLI, DDS 17022 DEVONSHIRE STREET (818) 363-7469 FIT I P/T I NORWALK #283601 RALPH NICASSIO, DDS 11936 E IMPERIAL HWY STE A/B (562) 868-7768 F/T 3 (TA, SP) & PALM DESERT #12920I DESERT DENTAL CARE 44139 MONTEREY AVE STE E (760) 340-4494 F/T 2 (SP,VI) & PALOS VERDES #340001 SOUTH BAY FAMILY DENTAL GROUP 927 DEEP VALLEY DR STE 220 (310) 377-5566 F/T 2 P/T I (SP, RU,TA) PARAMOUNT #002713 KAIS CHEBBI DENTAL OFFICE 16260 PARAMOUNT BLVD STE G (562) 633-5070 F/T I (FR, SR AR) 6% PASADENA #002785 BELEN GUERRERO, DMD 1650-B E WALNUT STREET F61 51739 ITTA & PASADENA #230501 WILLIAM KATES, DDS 903 E DEL MAR BOULEVARD (626) 792-6195 F/T 2 (SR TA) PASO ROBLES #000940 DAVID KRILL, DDS 1920 CRESTON ROAD #B (805) 239-2146 FIT I & POMONA #348001 DONALD HODSON, DDS 1956 INDIAN HILL BOULEVARD F9T9) 621(SP-5848 REDLANDS #114501 ORANGE PLAZA DENTISTRY 470 ORANGE ST (909) 793-4585 F/T I (SP, CH) 6% REDLANDS #259801 REDLANDS DENTAL ASSOC 860 REDLANDS BLVD STE 105 (909) 793-5270 F/T 2 P/T I (SR GE) RESEDA #356301 GREGORY TURK. DDS 19231 VICTORY BLVD STE 215 (818) 705-6600 F/T 1 6% RIALTO #111801 JOSEPH/SUSANE LEE-HONG DDS 1734 N RIVERSIDE AVE STE 3 (909) 875-1279 F/T I PIT I (KO) RIALTO #386601 DOUGLAS DUNN, DDS 1590 N RIVERSIDE F91 2050 (SP) IT & RIVERSIDE #153101 NAT SHAIN, DDS 4151 BROCKTON AVE (909) 788-4500 FIT I RIVERSIDE #268601 CLAYTON CHING, DDS 6086 BROCKTON AVE STE 1 F9) 684-5191 SAN BERNARDINO #356901 DENTAL CARE OF SAN BERNARDINO 322 N H ST (909) 888-1301 F/T 2 (SP) SAN BERNARDINO #396401 WATERMAN DENTAL CENTER 1428 N WATERMAN STE A FIT91 8SP 111I ok SAN DIEGO #171301 CLAIREMONT FAMILY DENTAL 3670 CLAIREMONT DRIVE STE 14 (858) 273-0540 F/T I SAN DIEGO #181601 GREG MCELROY, DDS 4352 ORANGE AVE (619) 280-4861 FIT 2 This list is subject to change without notice. Additional Dental Offices will be added as required. You may call the DeltaCare Customer Relations Department at (800) 422-4234 for updates to the provider list, or to obtain information regarding a particular provider, including if they are accepting new patients. If any office is closed to further enrollment, PMI reserves the right to assign you another dental office as close to your home as possible. All members of your family must be treated at the same facility. I SAN DIEGO #231701 RONALD PETRILLO, DDS 7440 BEAGLE STREET (858) 560-S222 FIT I SAN DIEGO #2C3401 RGB DENTAL 16471 BERNARDO CENTER DRIVE (858) 673-9200 F/T I (FR, SP, IT) SAN DIEGO #3C6901 MISSION BAY DENTAL 4295 GESNER ST STE 2B (619) 275-2750 FIT I (SP) SAN DIMAS #023401 SAN DIMAS DENTAL GROUP I I I I COVINA BOULEVARD 200 (626) 966-1671 FIT 2 (k SAN IACINTO #390101 CRAIG SMITH, DDS 182 S RAMONA BLVD (909) 654-7393 F/T I (SP) SAN WAN CAPIST #285601 KIRK HOBOCK, DDS 32382 DEL OBISPO STE C2 (949) 493-6006 F/T I (SP) (k SAN MARCOS #268801 MICHAEL NELSON, DDS 365 S RNCHO SANTA FE RD 105 (760) 471-9560 FIT 2 (SP) SANTA ANA #202101 CECILIA GROVER, DDS 2200 E FRUIT STREET STE 206 F41 SSP 7379 /TLLI SANTA MAR#286701 ROBERT EVANS, DDS 2151 S COLLEGE DRIVE #103 (805) 928-5871 FIT I ok SANTA MONICA #060401 ALAN RUBENSTEIN, DDS 1260 15TH ST STE 703 (310) 393-8284 F/T I PIT I (SP,TA) SHERMAN OAKS #366301 STEVEN BLEIER, DDS 4910 VAN NUYS BLVD STE 107 (818) 501-6000 FIT I L� SHERMAN OAKS #391701 GUS HUERTA, DDS 4910 VAN NUYS BLVD STE 204 (818) 995-8484 F/T I (SP) ok SIMIVALLEY #002463 TED CHAFFEE, DDS 2950 SYCAMORE DR STE 103 ' F5I (S j6400 /T& TOLUCA LAKE # 120301 NAJARIAN AND NAJARIAN DDS 10724 RIVERSIDE DRIVE (818) 769-1111 F/T I P/T I (SP) TORRANCE #177501 CAROLYN DOHERTY, DDS 23451 MADISON ST STE 260 F01 7743 (SP) /TChi WEST COVINA #002401 EDISON DER, DDS 148 N GRAND AVE F/T61 (SP)3305 G� WEST COVINA #066401 JOHN THOMPSON, DDS 126 S GLENDORA AVE (626) 918-8513 FIT I P/T I (SP,VI) WEST COVINA #370401 KATHERINE FORBES, DDS 415 S GLENDORA AVE STE A (626) 919-0135 FIT I (SP) WEST COVINA #383201 GREGORY ROBINS FMLY DNSTRY 1 129 S GLENDORA AVE (626) 919-7707 F/T 2 P/T 2 (SP,TA, GE) & WEST HILLS #369301 RICHARD MCKEE, DDS 7325 MEDICAL CENTER DR 207 F81 76315 ITSP & WESTMINSTER #357801 BOYD JOYER JR, DDS 15310 GOLDENWEST STREET (714) 893-2411 `� WHITTIER #037701 KC PRASAD DDS INC 1 1610 SLAUSON AVE F21 1330 /T(SP)& WOODLAND HILLS #395901 VIKEN TOUTOUNJIAN, DDS 6325 TOPANGA CANYON BLVD 204 (818) 348-3801 F/T I (SR AR) (� Visit us at our website: www.deltadentaica.org/pmi NOTE:The "01" listed at the end of each provider number shown is for internal use only. The provider selection will be honored whether OR NOT the "01" is noted on the enrollment form. OM - New Offices Foreign languages spoken in the dental office are listed by code in (). Below is a key to the foreign language codes. AM - Armenian FR - French IT - Italian RU - Russian AR -Arabic GE - German )A -Japanese SP - Spanish CA - Cantonese GR - Greek KO - Korean TA -Tagalog CH - Chinese HE - Hebrew PE - Persian V I -Vietnamese EI - East Indian IN -1—Ii— on _ D, Ni k 6%- The wheelchair symbol indicates functional accessibility for individuals with limited mobility. Information regarding dental office 09/ 19/02 accessibility for patients with mobility impairments is available by calling PMI's Customer Relations department at (800) 422-4234. PLCASOU 1. Prophylaxis is limited to one treatment each six-month period (in- cludes periodontal maintenance following active therapy); 2. Full maxillary and/or mandibular dentures including immediate den- tures are not to exceed one each in any five year period from initial placement; 3. Partial dentures are not to be replaced within any five-year period from initial placement, unless necessary due to natural tooth loss where the addition or replacement of teeth to the existing partial is not feasible; 4. Crown(s) and bridges are not to be replaced within any five-year period from initial placement; 5. Denture relines are limited to one per denture during any 1'2 con- secutive months; 6. Periodontal treatments (root planing/subgingival curettage) are lim- ited to four quadrants during any 12 consecutive months; 7. Full mouth debridement (gross scale) is limited to one treatment dur- ing any 12 consecutive month period; 8. Bitewing x-rays are limited to not more than one series of four films in any six-month period; 9. Full mouth x-rays are limited to one set every 24 consecutive months; 10. Sealant benefits include the application of sealants only to permanent first and second molars with no decay, with no restorations and with the occlusal surface intact, for first molars up to age nine and second molars up to age fourteen. Sealant benefits do not include the repair or replacement of a sealant on any tooth within three years of its application. • Exclusions The following services are not covered benefits of this program: 1. General anesthesia and the services of a special anesthesiologist; 2. Cosmetic dental care; 3. Dental conditions arising out of and due to enrollee's employment or for which Workers' Compensation is payable. Services which are provided to the enrollee by State government or agency thereof or are provided without cost to the enrollee by any municipality, county or other subdivision, except as provided in Section 1373(a) of the Cali- fornia Health and Safety Code; 4. Treatment required by reason of war; 5. Dental services performed in a hospital and related hospital fees; 6. Treatment of fractures and dislocations; 7. Loss or theft of fixed and removable prosthetics (crowns, bridges, full or partial dentures); 8. Dental expenses incurred in connection with any dental procedures started after termination of eligibility for coverage; 9. Any service that is not specifically listed as a covered expense; 10. Dental expenses incurred in connection with any dental procedure started prior to enrollee's eligibility with the DeltaCare program. Ex- ample: teeth prepared for crowns, root canals in progress, orthodon- tic treatment; 11. Congenital malformations (e.g., congenitally missing teeth, supernumerary); 12. Cysts and malignancies; 13. Dispensing of drugs not normally supplied in a dental office; 14. Accidental injury. Accidental injury is defined as damage to the hard and soft tissues of the oral cavity resulting from forces external to the mouth. Damages to the hard and soft tissues of the oral cavity from normal masticatory (chewing) function will be covered at the normal schedule of benefits; 15. Cases which, in the professional judgment of the attending dentist, a satisfactory result cannot be obtained, or where the prognosis is poor or guarded; 16. Dental services received from any dental office other than the assigned DeltaCare office, unless expressly authorized in writing by DeltaCare or as cited under "Provisions for Emergency Care "; 17. Prophylactic removal of impactions (asymptomatic/nonpathological); 18. "Specialist consultations"for noncovered benefits; 19. Implant placement or removal, appliances placed on or services associated with implants, including but not limited to prophylaxis and . periodontal treatment. 20. Crown lengthening procedures. • Summary of Orthodontic Limitations and Exclusions The program provides coverage for orthodontic treatment plans provided through DeltaCare Network orthodontists. The start-up fees and the cost to the enrollee for the treatment plan are listed in the Description of Benefits and Copayments, subject to the following: 1. Orthodontic treatment must be provided by a DeltaCare orthodontist. 2. Plan benefits cover 24 months of usual and customary orthodontic treatment. 3. Should an enrollee's coverage be canceled or terminated for any reason, and atthetime of cancellation ortermination be receiving any. orthodontic treatment, the enrollee and not DeltaCare will be responsible for payment of balance due for treatment provided after cancellation or termination. In such a case the enrollee's payment shall be based on a maximum of $2,300for dependent children to age 19 and $2,500 for covered full time students and adults. The amount will be prorated over the number of months to completion of the treatment and, will be payable by the enrollee on such terms and conditions as are arranged between the enrollee and the orthodontist. Start-up fees are included in these amounts. 4. Start-upfeescoverthe initial examination, diagnosis, consultationand the retention phase of treatment of up to two years maximum.. This includes initial construction, placement and adjustments to retainers and office visits for a maximum period of two years. The following services are not covered, 1. Pre, mid- and post- treatment records which include cephalometric x- rays, tracings, photographs and study models; 2. Lost, stolen or broken orthodontic appliances, functional appliances, headgear, retainers and expansion appliances; 3. Retreatment of orthodontic cases; 4. Treatment that extends morethan24monthsfromthepointofbanding dentition will be subject to an office visit charge at orthodontist's usual, customary and reasonable fee; 5. Treatment in progress at inception of eligibility; 6. Transfer after banding has been initiated. GETTING TO KNOW YOUR DeltaCare PROGRAM 0 What is PMI? PMI is a dental HMO that has administered DeltaCare programs for nearly 30 years. PMI contracts with network dentists, works with your group to design your benefits program and handles all customer service inquiries. Today, more than a million enrollees are covered by DeltaCare programs. 0 What is the difference between PMI and Delta? PMI administers DeltaCare dental HMO programs and is an affiliate of Delta Dental Plan of California. 0 How do I know if my dentist is a PMI dentist? When you enroll in DeltaCare, you select a primary care dentist from the list of DeltaCare network dentists. With more than 2,500 general and specialist dentists, the DeltaCare network is one of the largest in California. 0 My dentist is a Delta dentist but is not on the list of DeltaCare network dentists. Can I still receive treatment from this dentist? No, you must receive treatment from your selected DeltaCare network dentist. Please note that Delta dentists are not necessarily DeltaCare dentists. 0 How do I know DeltaCare dentists provide quality care? DeltaCare dentists are reviewed for quality, availability and safety before joining the network. PMI maintains quality standards by visiting each network dental office every three months. 0 Do my family members receive treatment from the same DeltaCare network dentist? Yes, you and all eligible dependents receive care from the same primary care network dentist. DENTAL HEALTH PLAN An Amraic of Dcha Dental Plan If you have any questions or need additional information, call or write to: PMI Dental Health Plan 12898 Towne Center Drive Cerritos, CA 90703-8579 (800) 422-4234 or visit our website at www.deltadentalca.org/pmi Note: THIS IS ONLY A BRIEF SUMMARY OF THE PLAN. The Group Dental Service Contract must be consulted to determine the exact terms and conditions of coverage. An Evidence of Coverage will be sent to you upon enrollment. If you wish to review an Evidence of Coverage prior to enrollment, you may request a copy by calling PMI's Customer Relations Department at (800) 422-4234. 0 How long does it take to get an appointment with a DeltaCare dentist? Two to four weeks is a reasonable amount of time to wait for a routine, non -urgent appointment. If you require a specific time, you may have to wait longer. In addition, most DeltaCare dentists are in private group practices, which means greater appointment availability and extended office hours. 0 1 have a pre-existing dental condition. Can I still join DeltaCare? Yes, treatment for pre-existing conditions such as extracted teeth is not excluded under the DeltaCare program. However, benefits are not provided for any dental treatment started before joining the program (that is, work in progress, such as preparations for crowns, root canals, impressions for dentures and orthodontic treatment). 0 How does the DeltaCare program encourage preventive care? Your DeltaCare program is designed to encourage regular visits to the dentist by having no copayments (fees you pay to the network dentist) on most diagnostic and preventive services. See the enclosed "Description of Benefits and Copayments." 0 Does my DeltaCare program cover specialists'services? Yes. Your primary care network dentist will coordinate your specialty care needs with an approved network specialist. There is no additional charge to you for receiving care from a specialist. If there's no network specialist within your service area, PMI will authorize a referral to an out -of -network specialist at no extra cost, other than the applicable copayment. If you or your dependent is assigned to a dental school clinic for specialty services, those services may be provided by a dentist, a dental student, a clinician or a dental instructor. 0 Can I change my primary care network dentist? Yes. You may change network dentists by notifying PMI either by phone or in writing, or by visiting our website (www.deltadentalca.org/pmi). If you contact us by the 21 st of the month, the change will become effective the first of the following month. 0 What if I have questions about my DeltaCare program? Call PMI Customer Relations at (800) 422-4234. We have multilingual representatives available from 5 a.m. to 6 p.m., Monday through Friday. Our Customer Relations representatives have worked in dental offices and can answer benefits questions, as well as arrange office transfers and urgent care referrals. 09/01 SCCA700 BENEFIT HIGHLIGHTS FOR CITY OF HUNTINGTON BEACH GROUP NO.4729 PRINCIPAL BENEFITS AND COVERED SERVICES* WHO'S COVERED Primary enrollee and spouse as well as dependent children to age 19 and full- time students to age 25. DEDUCTIBLES AND $25 per person, $75 per family per BENEFITS MAXIMUM calendar year. The maximum benefit paid per calendar year is $1000 per person. DIAGNOSTIC AND PREVENTIVE 85% of Delta dentist's fee BENEFITS* —oral examinations, cleanings, x-rays, examinations of tissue biopsy, fluoride treatment, space maintainers, specialist consultations BASIC BENEFITS* —oral surgery 85% of Delta dentist's fee (extractions), tissue removal (biopsy), fillings, root canals, periodontic (gum) treatment, sealants CROWNS, JACKETS AND OTHER CAST 85% of Delta dentist's fee RESTORATIONS* PROSTHODONTIC BENEFITS* — 60% of Delta dentist's fee (denture bridges, partial dentures, full dentures subject to a maximum allowance) ORTHODONTIC BENEFITS* —for adults 60% of Delta dentist's fee (subject to a and eligible dependent children $3000 lifetime maximum per person) DENTAL ACIDENT BENEFITS* 100% of Delta dentist's fee . *Please refer to your Evidence of Coverage for limitations on these benefits. Some examples of limitations on services are the number of cleanings and oral exams covered in a calendar year, and time limitations on filling and crown replacements. SERVICES THAT ARE NOT COVERED Although your plan covers many of the most commonly needed services, some services are not covered. If you are unsure whether a particular procedure is covered, or how much of it Is paid for by your plan, check with Delta before proceeding. The following are not covered by the plan: ♦ Services for injuries or conditions covered under Workers' Compensation or Employer's Liability Laws ♦ Cosmetic surgery or dentistry or services to correct congenital malformation ♦ Experimental procedures o Therapeutic drugs, premedication or pain relievers ♦ Hospital costs or extra charges for hospital treatment o Anesthesia (except for general anesthesia for oral surgery) ♦ Extra -oral grafts, implants and implant removal ♦ Treatment related to the temporomandibular joint (TMJ) The preceding information is not intended for use as a summary plan description, nor is it designed to serve as an Evidence of Coverage for the plan. This DeltaPremier plan is administered by Delta Dental Plan of California. If you have specific questions regarding benefit structure, limitations or exclusions, consult the Evidence of Coverage or contact Delta's Customer and Member Service department. d DELTA ®ENTAL6 Delta Dental Plan of California P.O. Box 7736 San Francisco, California 94120 For customer service and eligibility/benefits information: (888) DELTA CS (888-335-8227) or cros@delta.org For online or faxed eligibility/benefits information: www.deltadentalca.org or (888) DELTA CS (888-335-8227) and press 1 For a list of Delta dentists: (800) 4-AREA-DR (800-427-3237) or www.deltadentalca.org (Group 4729 - 9/01 ap) (Master Rc . 6/01) 4 BENEFIT HIGHLIGHTS FOR CITY OF HUNTINGTON BEACH DELTAPREMIER® Managed Fee -for -Service Program ABOUT DELTAPREMIER The DeltaPremier plan allows you to: ♦ Visit any licensed dentist of your choice ♦ Change dentists at any time ♦ Go to a dental specialist of your choice ♦ Receive dental care anywhere in the world Under the DeltaPremier plan, you may visit any licensed dentist you wish. Nearly 22,000 dental offices in California — 92% of all dentists statewide — are Delta dentists. There are several advantages to choosing a Delta dentist: DELTA DENTIST NON -DELTA DENTIST Claim forms are completed and You may have to complete and submitted for you at no charge. submit your own claim forms or pay a service fee. Your dentist's fees have been certified by Delta as usual, customary and reasonable — you're responsible only for the patient share." Delta has not certified the dentist's fees — you are responsible for the difference if your dentist charges more than Delta's preapproved fees. You may be charged only the patient I You may have to pay the entire bill share" at the time of treatment, not at the time of treatment and wait for Delta's portion. reimbursement. "Patient share" is the copayment, any deductible and any amount over the annual maximum. Some services may not be covered; please refer to your Evidence of Coverage. Some examples of services not covered are cosmetic dentistry, experimental procedures and services to correct congenital malformations. GROUP NO. 4729 DELTAPREMIER IS EASY 7b USE DeltaPremier is a fee -for -service plan with freedom to choose any licensed dentist. The program pays a percentage for covered services; you may be charged only what Delta determines is the "patient share." To use the plan, just call the dental office of your choice and make an appointment. During your first appointment, give your dentist your group number, which is at the top of this page, and the primary enrollee's social security number. For a list of Delta dentists in your area, search the dentist directory on our web site at www.deltadentalca.org or call our toll -free automated telephone service at (800) 4-AREA-DR (800-427-3237). You can also check with your benefits administrator, who has a complete list of Delta dentists. You can also view your eligibility and benefits information on our web site, including remaining deductible and maximum amounts for you and your family. Or, you can have the information faxed to you by calling toll -free (888) DELTA __CS (888-335-8227). --- -- - - - - - -- - - Delta Dental Plan of California offers you what no other dental plan can —The Delta Difference' Here's what makes us unique: ♦ We prenegotiate dentists' fees. Delta dentists agree to charge you the lowest fees usually charged in their office. ♦ Copayments are guaranteed. Delta dentists charge you only what Delta determines to be your share of the treatment cost. If your share is 20 percent, you pay 20 percent of the Delta -approved fee — and no more. ♦ We require professional treatment standards. Delta dentists must meet professional standards for hygiene, radiation safety and other areas related to quality care. These are just a few of the reasons that one in three Californians counts on Delta for dental care benefits. DELTA DENTAV Delta Dental Plan of California For Employees of CITY OF HUNTINGTON BEACH Group Number 4729 Combined Evidence of Coverage and Disclosure Form USING THIS BOOKLET This booklet has been written with you in mind. It is designed to help you make the most of your Delta dental program. This combined Evidence of Coverage/Disclosure form discloses the terms and conditions of your coverage. The Combined Evidence of Coverage\Disclosure form should be read completely and carefully and individuals with special health care needs should read carefully,those; sections that apply to them (see CHOOSING YOUR DENTIST section). You have a right to review it prior to your enrollment. Please read the "DEFINITIONS" section. It will explain to you any words which have special or technical meanings under your group Contract. A copy of the Contract will be furnished upon request. Please read this summary of your dental Benefits carefully. Keep in mind that YOU means the ENROLLEES whom Delta covers. WE, US and OUR always refers to Delta Dental Plan of California (Delta). If you have any questions about your coverage that are not answered here, please check with your personnel office, or with Delta. DELTA DENTAL PLAN OF CALIFORNIA P.O. Box 7736 San Francisco, California 94120 For claims, eligibility and benefits inquiries, or additional information, call Delta's Customer and Member Service Department toll -free at: 1-888-335-8227. Or contact us on the Internet at: e-mail: cros@delta.org web site: www.deltadentaica.org A STATEMENT DESCRIBING OUR POLICIES AND PROCEDURES FOR PRESERVING THE CONFIDENTIALITY OF MEDICAL RECORDS IS AVAILABLE AND WILL BE FURNISHED TO YOU UPON REQUEST. This Combined Evidence of Coverage and Disclosure Form constitutes only a summary of the dental plan. The dental Contract must be consulted, to determine the exact terms and conditions of coverage. TABLE OF CONTENTS DEFINITIONS.........................................................3 WHO IS COVERED?..............................................3 WHO ARE YOUR ELIGIBLE DEPENDENTS?......................................................4 ENROLLING YOUR DEPENDENTS....................4 COVERAGE COSTS..............................................4 WHEN YOU ARE NO LONGER COVERED..............................................................5 CANCELING THIS PROGRAM ...........................5 YOUR BENEFITS..................................................5 LIMITATIONS........................................................6 EXCLUSIONS/SERVICES WE DO NOTCOVER..........................................................8 DEDUCTIBLES......................................................9 COVERED FEES....................................................9 CHOOSING YOUR DENTIST...............................9 CONTINUITY OF CARE.....................................10 PUBLIC POLICY PARTICIPATION BYENROLLEES..................................................10 SAVING MONEY ON YOUR DENTAL BILLS...................................................10 YOUR FIRST APPOINTMENT ...........................10 PREDETERMINATIONS.....................................11 PAYMENT............................................................11 IF YOU HAVE QUESTIONS ABOUT SERVICES FROM A DELTA DENTIST.............12 SECOND OPINIONS............................................12 ORGAN AND TISSUE DONATION...................12 COMPLAINT PROCEDURE, CLAIMS APPEAL AND ARBITRATION ...........................12 IF YOU HAVE ADDITIONAL COVERAGE..........................................................13 OPTIONAL CONTINUATION OFCOVERAGE ......................................... :.......... 14 2 DEFINITIONS Certain words that you will see in this booklet have specific meanings. These definitions should make your dental program easier to understand. Attending Dentist's Statement - a form used by your dentist to request payment for dental treatment or predetermination for proposed dental treatment. Benefits - those dental services available under the Contract and which are described in this booklet. Contract - the written agreement between your employer or sponsoring group and Delta to provide dental Benefits. The Contract, together with this booklet, forms the terms and conditions of the Benefits you are provided. Covered Services - those dental services to which Delta will apply Benefit payments, according to the Contract. Delta Dentist - a Dentist who has a signed agreement with Delta or a Participating Plan, agreeing to provide services under the terms and conditions established by Delta or the Participating Plan. Dependent - a Primary Enrollee's Dependent who is eligible to enroll for Benefits in accordance with the conditions of eligibility outlined in this booklet. Effective Date - the date this program starts. Enrollee - a Primary Enrollee or Dependent enrolled to receive Benefits or a person who chooses to pay for OPTIONAL CONTINUATION OF COVERAGE. Maximum - the greatest dollar amount Delta will pay for covered procedures in any calendar year and lifetime for Orthodontic Benefits. Premiums - the money paid to Delta each month for you and your Dependents' dental coverage. Participating Plan — Delta and any other member of the Delta Dental Plans Association with whom Delta contracts for assistance in administering your Benefits. Primary Enrollee - any group member or employee who is eligible to enroll for Benefits in accordance with the conditions of eligibility outlined in this booklet. Single Procedure - a dental procedure to which Delta has assigned a separate procedure number; for example, a three -surface amalgam restoration of one permanent tooth (procedure 02160) or a complete upper denture, including adjustments for a six- month period following installation (procedure 05110). Usual, Customary and Reasonable (UCR) - A Usual fee is the amount which an individual dentist regularly charges and receives for a given service or the fee actually charged, whichever is less. A Customary fee is within the range of Usual fees charged and received for a particular service by dentists of similar training in the same geographic area. A Reasonable fee schedule is reasonable if it is Usual and Customary. Additionally, a specific fee to a specific patient is Reasonable if it is justifiable considering special circumstances, or extraordinary difficulty, of the case in question. WHO IS COVERED? All present and future regular employees are required to enroll and will become eligible to receive Benefits on the first day of the month following 30 days of continuous employment. New Dependents should be enrolled as soon as they become Dependents, and they will then immediately be covered for dental Benefits. You are not eligible if you are not reporting to work on a regular basis and are not actively employed. Coverage resumes on the first day of the month after you return to active employment, report to work regularly and amounts due to Delta for coverage have been paid. But, coverage can continue without interruption if your employer continues to report you as a Primary Enrollee and amounts due Delta for your coverage continue to be paid. Family and Medical Leave Act of 1993 You can continue your coverage if you take a leave governed by the Family and Medical Leave Act of 1993. If you do not continue your coverage during the governed leave, it will be reinstated at the same Benefit level you received before your leave. Uniformed Services Employment and Re- employment Rights Act of 1994 You can continue coverage for up to 18 months, if you take a leave governed by the Uniformed Services Employment and Re-employment Rights Act of 1994. If you make this election, you must submit any Premiums necessary, which may include administrative costs, to your employer. If you do not continue your coverage during a military leave, it will be reinstated at the same Benefit level you received before your leave. WHO ARE YOUR ELIGIBLE DEPENDENTS? • Your legal spouse; Your unmarried dependent children until their 19th birthday; Your unmarried dependent children until their 23rd birthday if enrolled full-time in an accredited school, college or university, or live at home and are dependent upon parent(s) for at least 50% of their support; • An unmarried dependent child aged 19 or older who is incapable of self-support because of a physical or mental handicap that occurred before he or she turned 19, if the child is mostly dependent on you for support. Proof of this handicap must be given to Delta or your employer within 31 days, if it is requested. Proof will not be required more than once a year after the child has reached age 21. "Dependent children" also means stepchildren, adopted children, children placed for adoption and foster children, provided that they are dependent upon you for support and maintenance. Dependent coverage is also extended to any child who is recognized under a Qualified Medical Child Support Order (QMCSO). No Dependent in the military service is eligible. ENROLLING YOUR DEPENDENTS A payroll deduction is required for your enrolled Dependents. Your group can only provide coverage for your Dependents if at least half of the Primary Enrollees who have Dependents enroll all of them in this program. Your Dependents must be enrolled when you first become eligible or on the first day of the month after they become Dependents. However, Dependents who are covered under another group dental program are not required to enroll under this Delta program. If the other coverage ends, the Dependents may enroll under this program within 30 days of the loss of the other coverage. Proof of prior coverage is required. Dependent children up to four years of age may be enrolled at the beginning of any Contract year including the Contract year immediately following their fourth birthday. If you drop coverage for your Dependents, you may not re -enroll them in this program. COVERAGE COSTS ' Your employer pays Delta monthly Premiums for coverage of you and your enrolled Dependents. You do not pay for your own coverage but a payroll deduction is made for monthly Premiums required for your Dependent's coverage. The amount of Premiums may change at each renewal of the Contract between your employer and Delta. Premiums will not increase during the contract year unless new taxes or tax rates are imposed upon Delta for this program or unless there is an agreement between your employer and Delta to change the Premiums rate. WHEN YOU ARE NO LONGER COVERED 1. If you stop working for your employer, your dental coverage will end on the last day of the month in which you stop working, unless you qualify for and pay for OPTIONAL CONTINUATION OF COVERAGE. Your Dependents' coverage ends when yours does, or as soon as they are no longer Dependents, unless they choose to pay for OPTIONAL CONTINUATION OF COVERAGE. 2. When the Contract between Delta and your employer is discontinued or canceled, your coverage ends immediately. CANCELING THIS PROGRAM Delta may cancel this program only on an anniversary date (period after the program first takes effect or at the end of each renewal period thereafter), or any time your group does not make payment as required by the Contract. If you believe that this program has been terminated or not renewed due to your health status or requirements for health care services (or that of your Dependents), you may request a review by the California Director of the Department of Managed Health Care. If the Contract is terminated for any cause, Delta is not required to predetermine services beyond the termination date or to pay for services provided after the termination date, except for Single Procedures begun while the Contract was in effect which are otherwise Benefits under the Contract. If this program is canceled, you and your Dependents have no right to renewal or reinstatement of your Benefits. YOUR BENEFITS Your dental program covers several categories of Benefits, when the services are provided by a licensed dentist, and when they are necessary and customary under the generally accepted standards of dental practice. After you have satisfied any deductible requirements, Delta will provide payment for these services at the percentage indicated up to a Maximum of $1,000 for each Enrollee in each calendar year. Payment for Orthodontic Benefits for Enrollee is limited to a lifetime Maximum of $3,000. An agreement between your employer and Delta is required to change Benefits during the term of the contract. The following Benefits are limited to the applicable percentages of dentist's fees or allowances specified below. You are required to pay the balance of any such fee or allowance, known as the "patient copayment." If the dentist discounts, waives or rebates any portion of the patient copayment to the Enrollee, Delta only provides as Benefits the applicable allowances reduced by the amount that such fees or allowances are discounted, waived or rebated. I. DIAGNOSTIC AND PREVENTIVE BENEFITS - 85% Diagnostic - oral examinations (including initial examinations, periodic examinations and emergency examinations); x-rays; diagnostic casts; examination of biopsied tissue; palliative (emergency) treatment of dental pain; specialist consultation Preventive - prophylaxis (cleaning); fluoride treatment; space maintainers II. IV. BASIC BENEFITS - 85% Oral surgery - extractions and certain other surgical procedures, including pre- and post- operative care ky Restorative - amalgam, silicate or composite VI (resin) restorations (fillings) for treatment of carious lesions (visible destruction of hard tooth structure resulting from the process of dental decay) Endodontic - treatment of the tooth pulp Periodontic - treatment of gums and bones that support the teeth Sealants - topically applied acrylic, plastic or composite material used to seal developmental grooves and pits in teeth for the purpose of preventing dental decay Adjunctive General Services - general anesthesia; office visit for observation; office visit after regularly scheduled hours; therapeutic drug injection; treatment of post- surgical complications (unusual circumstances); limited occlusal adjustment CROWNS, JACKETS, INLAYS, ONLAYS AND CAST RESTORATION BENEFITS - 85% Crowns, Jackets, Inlays, Onlays and Cast Restorations are Benefits only if they are provided to treat cavities which cannot be restored with amalgam, silicate or direct composite (resin) restorations. PROSTHODONTIC BENEFITS - 60% Construction or repair of fixed bridges, partial dentures and complete dentures are Benefits if provided to replace missing, natural teeth. ORTHODONTIC BENEFITS - 60% Procedures using appliances or surgery to straighten or realign teeth, which otherwise would not function properly. DENTAL ACCIDENT BENEFITS - 100% Any services which would be covered under other Benefit categories (subject to the same limitations and exclusions) are covered instead by your dental accident coverage when they are provided for conditions caused directly by external, violent and accidental means. LIMITATIONS Only the first two oral examinations, including office visits for observation and specialist consultations, or combination thereof, in a calendar year are Benefits while you are eligible under any Delta program. Oral examinations provided by a California dentist are Benefits only when the dentist is a Delta Dentist with an accepted fee on file with Delta. 2. Full -mouth x-rays are a Benefit once in a five-year period while you are eligible under any Delta program. 3. Bitewing x-rays are provided on request by the dentist, but no more than twice in any calendar year for children to age 18 or once in any calendar year for adults age 18 and over, while you are eligible under any Delta program. 4. Diagnostic casts are a Benefit only when made in connection with subsequent orthodontic treatment covered under this program. 5. Only the first two cleanings, fluoride 10. Delta will pay its percentage of the dentist's treatments, or Single Procedures which fee for a standard partial or complete denture include cleaning, or combination thereof, in up to a maximum fee allowance. This fee a calendar year are Benefits while you are allowance is the fee that would satisfy the eligible under any Delta program. majority of Delta's Dentists. A standard partial or complete denture is one made from 6. Sealant Benefits include the application of accepted materials and by conventional sealants only to permanent first molars up to methods. The maximum fee allowance is age nine and second molars up to age 14 if revised periodically, as dental fees change. they are without caries (decay), or If your dentist's accepted fee on file with restoration on the occlusal surface. Sealant Delta for a partial or complete denture is Benefits do not include the repair or higher than this maximum allowance, you replacement of a sealant on any tooth within must pay that portion of his or her fee that three years of its application. exceeds Delta's allowance in addition to your portion of the allowance. 7. Direct composite (resin) restorations are Benefits on anterior teeth and the facial 11. Implants (appliances inserted into bone or surface of bicuspids. Any other posterior soft tissue in the jaw, usually to anchor a direct composite (resin) restorations are denture) are not covered by your program. optional services and Delta's payment is However, if implants are provided along limited to the cost of the equivalent with a covered prosthodontic appliance, amalgam restorations. Delta will allow the cost of a standard partial or complete denture toward the cost of the 8. Crowns, Jackets, Inlays, Onlays and Cast implants and the prosthodontic appliances Restorations are Benefits on the same tooth when the prosthetic appliance is completed. only once every five years, while you are If Delta makes such an allowance, we will eligible under any Delta program, unless not pay for any replacement for five years Delta determines that replacement is following the completion of the service. required because the restoration is unsatisfactory as a result or poor quality of 12. If you select a more expensive plan of care, or because the tooth involved has treatment than is customarily provided, or experienced extensive loss or changes to specialized techniques, an allowance will be tooth structure or supporting tissues since made for the least expensive, professionally the replacement of the restoration. acceptable, alternative treatment plan. Delta will pay the applicable percentage of the 9. Prosthodontic appliances are Benefits only lesser fee for the customary or standard once every five years, while you are eligible treatment and you are responsible for the under any Delta program, unless Delta remainder of the dentist's fee. determines that there has been such an extensive loss of remaining teeth or a change For example: a crown where a silver filling in supporting tissues that the existing would restore the tooth; or a precision appliance cannot be made satisfactory. denture where a standard denture would Replacement of a prosthodontic appliance suffice. not provided under a Delta program will be made if it is unsatisfactory and cannot be made satisfactory. ` 13. If orthodontic treatment is begun before you 3. become eligible for coverage, Delta's payments will begin with the first payment due to the dentist following your eligibility date. 14. Delta's orthodontics payments will stop Services for cosmetic purposes or for conditions that are a result of hereditary or developmental defects, such as cleft palate, upper and lower jaw malformations, congenitally missing teeth and teeth that are discolored or lacking enamel. when the first payment is due to the dentist 4. Services for restoring tooth structure lost following either a loss of eligibility, or if from wear (abrasion, erosion, attrition, or treatment is ended for any reason before it is abfraction), for rebuilding or maintaining completed. chewing surfaces due to teeth out of 15. X-rays and extractions that might be necessary for orthodontic treatment are not covered by Orthodontic Benefits, but may be covered under Diagnostic and Preventive or 5 Basic Benefits. 16. Delta will pay Dental Accident Benefits when services are provided within 180 days following the date of accident and shall not include any services for conditions caused by an accident occurring before your eligibility date. EXCLUSIONS/SERVICES WE DO NOT COVER. Delta covers a wide variety of dental care expenses, but there are some services for which we do not provide Benefits. It is important for you to know what these services are before you visit your dentist. Delta does not provide benefits for: Services for injuries covered by Workers' Compensation or Employer's Liability Laws. 2. Services which are provided to the Enrollee by any Federal or State Governmental Agency or are provided without cost to the Enrollee by any municipality, county or other political subdivision, except Medi-Cal benefits. R 7. a 10 alignment or, occlusion, or for stabilizing the teeth. Examples of such treatment are equilibration and periodontal splinting. Any Single Procedure, bridge, denture or other prosthodontic service which was started before the Enrollee was covered by this program. Prescribed drugs, or applied therapeutic drugs, premedication or analgesia. Experimental procedures. Charges by any hospital or other surgical or treatment facility and any additional fees charged by the Dentist for treatment in any such facility. Anesthesia, except for general anesthesia given by a dentist for covered oral surgery procedures. Grafting tissues from outside the mouth to tissues inside the mouth ("extraoral grafts") 11. Implants (materials implanted into or on bone or soft tissue) or the repair or removal of implants, except as provided under LIMITATIONS. 12. Diagnosis or treatment by any method of any condition related to the temporomandibular (jaw) joints or associated muscles, nerves or tissues. 13. Replacement of existing restoration for any purpose other than active tooth decay. 14. Intravenous sedation, occlusal guards and complete occlusal adjustment. 15. Charges for replacement or repair of an orthodontic appliance paid in part or in full by this program. DEDUCTIBLES You must pay the first $25 of Covered Services for each Enrollee in your family in each calendar year, up to a limit of $75 per family. COVERED FEES It is to your advantage to select a dentist who is a Delta Dentist, since a lower percentage of the dentist's fees may be covered by this program if you select a dentist who is not a Delta Dentist. A list of Delta Dentists (see DEFINITIONS) is available in a directory at your group benefits office, or by calling 1-800-427-3237. Payment to a Delta Dentist will be based on the applicable percentage of the lesser of the Fee Actually Charged, or the accepted Usual, Customary and Reasonable Fee that the dentist has on file with Delta. Payment to a dentist located outside the United States will be based on the applicable percentage of the lesser of the Fee Actually Charged, or the fee which satisfies the majority of Delta's dentists. Payment to a dentist outside of California who agrees to be bound by Delta's rules in the administration of the program will be based on the applicable percentage of the lesser of the Fee Actually Charged or the Customary Fee for corresponding services for Delta Dentists in California. Payment to a California dentist, or an out-of-state dentist, who is not a Delta Dentist will be based on the applicable percentage of the lesser of the Fee Actually Charged, or the fee which satisfies the majority of Delta's Dentists. CHOOSING YOUR DENTIST PLEASE READ THE FOLLOWING INFORMATION SO YOU WILL KNOW FROM WHOM OR WHAT GROUP OF PROVIDERS HEALTH CARE MAY BE OBTAINED. More than 18,000 dentists in active practice in California are Delta Dentists. You are free to choose any dentist for treatment, but it is to your advantage to choose a Delta Dentist. This is because his or her fees are approved in advance by Delta. Delta Dentists have treatment forms on hand and will complete and submit the forms to Delta free of charge. If you go to a non -Delta Dentist, Delta cannot assure you what percentage of the charged fee may be covered. Claims for services from non -Delta Dentists may be submitted to Delta at the address listed on page 1. Dentists located outside the United States are not Delta Dentists. Claims submitted by out -of -country dentists are translated by Delta staff and the currency is converted to U.S. dollars. Claims submitted by out -of -country dentists for patients residing in California are referred to Delta's Quality Review department for processing Delta may require a clinical examination to determine the quality of the services provided, and Delta may decline to reimburse you for Benefits if the services are found to be unsatisfactory. A list of Delta Dentists can be obtained by calling 1-800-427-3237. This list will identify those dentists who can provide care for individuals who have mobility impairments or have special health care needs. You can obtain specific information about Delta Dentists by using our web site — www.deltadentalca.org or calling the Delta Customer and Member Service Department at the number shown on page 1. A printed list of the Delta Dentists in your area is also available by calling 1-800-427-3237. Services may be obtained from any licensed dentist during normal office hours. Emergency services are available in most cases through an emergency telephone exchange maintained by the local dental society which is listed in the local telephone directory. Services from dental school clinics may be provided by students of dentistry or instructors who are not licensed by the state of California. Delta shares the public and professional concern about the possible spread of HIV and other infectious diseases in the dental office. However, Delta cannot ensure your dentist's use of precautions against the spread of such diseases, or compel your dentist to be tested for HIV or to disclose test results to Delta, or to you. Delta informs its panel dentists about the need for clinical precautions as recommended by recognized health authorities on this issue. If you should have questions about your dentist's health status or use of recommended clinical precautions, you should discuss them with your dentist. CONTINUITY OF CARE If you are undergoing a course of treatment and your dentist no longer is a Delta Dentist, you may continue to receive treatment from that dentist. PUBLIC POLICY PARTICIPATION BY ENROLLEES Delta's Board of Directors includes Enrollees who participate in establishing Delta's public policy regarding Enrollees through periodic review of Delta's Quality Assessment program reports and communication from Enrollees. Enrollees may submit any suggestions regarding Delta's public policy in writing to: Delta Dental Plan of California, Customer and Member Service Department, P. O. Box 7736, San Francisco, CA 94120. SAVING MONEY ON YOUR DENTAL BILLS You can keep your dental expenses down by practicing the following: Comparing the fees of different dentists; 2. Using a Delta Dentist; 3. Having your dentist obtain predetermination from Delta for any treatment over $300; 4. Visiting your dentist regularly for checkups; 5. Following your dentist's advice about regular brushing and flossing; 6. Avoiding putting off treatment until you have a major problem; and 7. By learning the facts about overbilling. Under this program, you must pay the dentist your copayment share (see YOUR BENEFITS). You may hear of some dentists who offer to accept insurance payments as "full payment." You should know that these dentists may do so by overcharging your program and may do more work than you need, thereby increasing program costs. You can help keep your dental Benefits intact by avoiding such schemes. YOUR FIRST APPOINTMENT During your first appointment, be sure to give your dentist the following information: 1. Your Delta group number (on the front of this booklet); 2. The employer's name; 10 3. Primary Enrollee's social security number (which must also be used by Dependents); 4. Primary Enrollee's date of birth; 5. Any other dental coverage you may have. PREDETERMINATIONS After an examination, your dentist will talk to you about treatment you may need. The cost of treatment is something you may want to consider. If the service is extensive and involves crowns or bridges, or if the service will cost more than $300, we encourage you to ask your dentist to request a predetermination. A predetermination sloes not guarantee payment. It is an estimate of the amount Delta will pay if you are eligible and meet all the requirements of your program at the time the treatment you have planned is completed. In order to receive predetermination, your dentist must send an Attending Dentist's Statement to us listing the proposed treatment. Delta will send your dentist a Notice of Predetermination which estimates how much you will have to pay. After you review the estimate with your dentist and decide to go ahead with the treatment plan, your dentist returns the statement to us for payment when treatment has been completed. Computations are estimates only and are based on what would be payable on the date the Notice of Predetermination is issued if the patient is eligible. Payment will depend on the patient's eligibility and the remaining annual Maximum when completed services are submitted to Delta. Predetermining treatment helps prevent any misunderstanding about your financial responsibilities. If you have any concerns about the predetermination, let us know before treatment begins so your questions can be answered before you incur any charges. PAYMENT Delta will pay Delta Dentists directly. Our agreement with our Delta Dentists makes sure that you will not be responsible to the dentist for any money we owe. However, if for any reason we fail to pay a dentist who is not a Delta Dentist, you may be liable for that portion of the cost. If you have selected a non -Delta Dentist, Delta will pay you. Payments made to you are not assignable (in other words, we will not grant requests to pay non -Delta Dentists directly). Delta does not pay Delta Dentists any incentive as an inducement to deny, reduce, limit or delay any appropriate service. If you wish to know more about the method of reimbursement to Delta Dentists, you may call Delta's Customer and Member Service Department for more information. Payment for claims exceeding $500 for services provided by dentists located outside the United States may, at Delta's option, be conditioned upon a clinical evaluation at Delta's request (see Second Opinions). Delta will not pay Benefits for such services if they are found to be unsatisfactory. Payment for any Single Procedure which is a Covered Service will only be made upon completion of that procedure. Delta does not make or prorate payments for treatment in progress or incomplete procedures. The date the procedure is completed governs the calculation of any Deductible (and determines when a charge is made against any Maximum) under your program. If there is a difference between what your dentist is charging you and what Delta says your portion should be, or if you are not satisfied with the dental work you have received, contact Delta's Customer and Member Service Department. We may be able to help you resolve the situation. Delta may deny payment of any Attending Dentist's Statement for services submitted more than six months after the date the services were provided. If a claim is denied due to a Delta Dentist's failure to make a timely submission, you shall not be liable to 11 that dentist for the amount which would have been payable by Delta (unless you failed to advise the dentist of your eligibility at the time of treatment). The process Delta uses to determine or deny payment for services are distributed to all Delta Dentists. They describe in detail the dental procedures covered as Benefits, the conditions under which coverage is provided, and the limitations and exclusions applicable to the program. Claims are reviewed for eligibility and are paid according to these processing policies. Those claims which require additional review are evaluated by Delta's dentist consultants. If any claims are not covered, or if limitations or exclusions apply to services you have received from a Delta Dentist, you will be notified by an adjustment notice on the Notice of Payment or Action. You may contact Delta's Customer and Member Service Department for more information regarding Delta's processing policies. IF YOU HAVE QUESTIONS ABOUT SERVICES FROM A DELTA DENTIST If you have questions about the services you receive from a Delta Dentist, we recommend that you first discuss the matter with your dentist. If you continue to have concerns, call our Quality Review Department at 1-888-335-8227. If appropriate, Delta can arrange for you to be examined by one of our consulting dentists in your area. If the consultant recommends the work be replaced or corrected, Delta will intervene with the original dentist to either have the services replaced or corrected at no additional cost to you or obtain a refund. In the latter case, you are free to choose another dentist to receive your full Benefit. SECOND OPINIONS Delta obtains second opinions through Regional Consultant members of its Quality Review Committee who conduct clinical examinations, prepare objective reports of dental conditions, and evaluate treatment that is proposed or has been provided. Delta will authorize such an examination prior to treatment when necessary to make a Benefits determination in response to a request for a Predetermination of treatment cost by a dentist. Delta will also authorize a second opinion after treatment if an Enrollee has a complaint regarding the quality of care provided. Delta will notify the Enrollee and the treating dentist when a second opinion is necessary and appropriate, and direct the Enrollee to the Regional Consultant selected by Delta to perform the clinical examination. When Delta authorizes a second opinion through a Regional Consultant, we will pay for all charges. Enrollees may otherwise obtain second opinions about treatment from any dentist they choose, and claims for the examination or consultant may be submitted to Delta for payment. Delta will pay such claims in accordance with the Benefits of the program. This is only a summary of Delta's policy on second opinions. A copy of Delta's formal policy is available from Delta's Customer and Member Service Department upon request. ORGAN AND TISSUE DONATION Donating organ and tissue provides many societal benefits. Organ and tissue donation allows recipients of transplants to go on to lead fuller and more meaningful lives. Currently, the need for organ transplants far exceeds availability. If you are interested in organ donation, please speak to your physician. Organ donation begins at the hospital when a patient is pronounced brain dead and identified as a potential organ donor. An organ procurement organization will become involved to coordinate the activities. COMPLAINT PROCEDURE, CLAIMS APPEAL. AND ARBITRATION If you have any questions about the services you receive from a Delta Dentist, we recommend that you first discuss the matter with your dentist. If you continue to have concerns, call our Quality Review Department at 1-888-335-8227. 12 We will provide notification if any dental services or claims are denied, in whole or in part, stating the specific reason or reasons for denial. If you have a question or complaint regarding eligibility, the denial of dental services or claims, the policies, procedures and operations of Delta, or the quality of dental services performed by a Delta Dentist, you may contact us at the telephone number shown on page 1. You have 60 days after you receive notice of denial to appeal. If you write, you must include the name of the patient, the group name and number, the Primary Enrollee's name and social security number or identification number and your telephone number on all correspondence. You should also include a copy of the treatment form, Notice of Payment and any other relevant information. Clearly explain your complaint and send it to us at the address shown on page 1. We will review your complaint and will resolve the matter within 30 days of receipt or inform you of the pending status of the complaint if more information or time is needed to resolve the matter. We will respond within three days of receipt to complaints involving severe pain and imminent and serious threat to a patient's health. The California Department of Managed Health Care is responsible for regulating health care service plans. The department has a toll -free number 1-888-HMO-2219 to receive complaints regarding health plans. The hearing and speech impaired may use the California Relay Service's toll -free telephone numbers 1-800-735-2929 (TTY) or 1-888-877-5378 (TTY) to contact the department. The department's Internet web site (http://www.hmohelp.ca.gov) has complaint forms and instructions online. If you have a grievance against the plan, you should first telephone the plan at 1-888-335-8227 and use the plan's grievance process before contacting the department. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by the plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. The plan's grievance process and the department's complaint review process are in addition to any other dispute resolution procedures that may be available to you, and your failure to use these processes does not preclude your use of, any other remedy provided by law. Disputes relating to your plan, including claim denials, may be settled by arbitration if they cannot be settled by this complaint process. Arbitration will follow the Commercial Rules of the American Arbitration Association (AAA). You can begin this process by giving written notice to each party (for example, Delta and your dentist) with whom you want to arbitrate, explaining the dispute and the amount involved, if any, and the solution you wish. You must then file two copies of the notice with the Association's regional office in Los Angeles or San Francisco, along with the fee required by the Association. In the event of extreme hardship on the part of an Enrollee or subscriber, and upon an application for relief presented to the AAA, Delta shall assume all or a portion of the arbitration fees and expenses as determined by the AAA in accordance with procedures established and administered by the AAA. IF YOU HAVE ADDITIONAL COVERAGE It is to your advantage to let your dentist and Delta know if you have dental coverage in addition to this Delta program. Most dental carriers cooperate with one another to avoid duplicate payments, but still allow you to make use of both programs - sometimes paying 100% of your dental bill. For example, you might have some fillings which cost $100. If the primary carrier usually pays 80% for these services, it would pay $80. The secondary carrier might usually pay 50% for this service. In this case, since payment is not to exceed the entire fee charged, the secondary carrier pays the remaining $20 only. Since this method pays 100% of the bill, you have no out-of-pocket expense. Be sure to advise your dentist of all programs under which you have dental coverage and have him or her complete the dual coverage portion of the Attending Dentist's Statement, so that you will 13 receive all benefits to which you are entitled. For further information, contact the Delta Customer and Member Service Department at the number in the USING THIS BOOKLET section. OPTIONAL CONTINUATION OF COVERAGE (COBRA OR CAL -COBRA) The federal Consolidated Omnibus Budget Reconciliation Act (or COBRA, pertaining to certain employers having 20 or more employees) and the California Continuation Benefits Replacement Act (or Cal -COBRA, pertaining to employers with 2-19 employees), both required continued health care coverage be made available to "Qualified Beneficiaries" who lose health care coverage under the group plan as a result of a "Qualifying Event". You or your Dependents may be entitled to continue coverage under this program, at the Qualified Beneficiary's expense, if certain conditions are met. The period of continued coverage depends on the Qualifying Event. DEFINITIONS The meaning of key terms used in this section are shown below. Qualified Beneficiary means: 1. you and/or your Dependents who are enrolled in the Delta plan on the day before the Qualifying Event, or 2. a child who is born to or placed for adoption with you during the period of continued coverage, provided such child is enrolled within 30 days of birth or placement for adoption. Qualifying Event means any of the following events which, except for the election of this continued coverage, would result in a loss of coverage under the dental plan: Event 1. the termination of employment (other than termination for gross misconduct), or the reduction in work hours, by your employer; Event 2. your death; Event 3. your divorce or legal separation from your spouse; Event 4. your Dependents' loss of dependent status under the plan, and Event 5. as to your Dependents only, your entitlement to Medicare. You means the Primary Enrollee. PERIODS OF CONTINUED COVERAGE Qualified Beneficiaries may continue coverage for 18 months following the month in which Qualifying Event 1 occurs. This 18 month period can be extended for a total of 29 months, provided: a determination is made under Title II or Title XVI of the Social Security Act that an individual is disabled on the date of the Qualifying Event or becomes disabled at any time during the first 60 days of continued coverage; and 2. notice of the determination is given to the employer during the initial 18 months of continued coverage and within 60 days of the date of the determination. This period of coverage will end on the first day of the month that begins more than 30 days after the date of the final determination that the disabled individual is no longer disabled. You must notify the employer within 30 days of any such determination. If, during the 18 months continuation period resulting from Qualifying Event 1, your Dependents, who are Qualified Beneficiaries, experience Qualifying Events 2, 3, 4, or 5, they may 14 choose to extend coverage for up to a total of 36 months (inclusive of the period continued under Qualifying Event 1). Your Dependents, who are Qualified Beneficiaries, may continue coverage for 36 months following the occurrence of Qualifying Events 2, 3, 4 or 5. Under federal COBRA law only, when an employer has filed for bankruptcy under Title II, United States Code, benefits may be substantially reduced or eliminated for retired employees and their Dependents, or the surviving spouse of a deceased retired employee. If this benefit reduction or elimination occurs within one year before or one year after the filing, it is considered a Qualifying Event. If you are the retiree, and you have lost coverage because of this Qualifying Event, you may choose to continue coverage until your death. Your Dependents who have lost coverage because of this Qualifying Event may choose to continue coverage for up to 36 months following your death. ELECTION OF CONTINUED COVERAGE Your employer will notify Delta in writing within 30 days of Qualifying Event 1. A Qualified Beneficiary must notify Delta in writing within 60 days of Qualifying Events 2, 3, 4, or 5 or within 60 days of receiving the election notice from the employer. Otherwise, the option of continued coverage will be lost. Within 14 days of receiving notice of a Qualified Event, Delta will provide a Qualified Beneficiary with the necessary benefits information, monthly Premiums charge, enrollment forms, and instructions to allow election of continued coverage. A Qualified Beneficiary will than have 60 days to give Delta written notice of the election to continue coverage. Failure to provide this written notice of election to Delta within 60 days will result in the loss of the right to continue coverage. A Qualified Beneficiary has 45 days from the written election of continued coverage to pay the initial Premiums to Delta, which includes the Premiums for each month since the loss of coverage. Failure to pay the required Premiums within the 45 days will result in the loss of the right to continue coverage, any Premiums received after that will be returned to the Qualified Beneficiary. CONTINUED COVERAGE BENEFITS The Benefits under the continued coverage will be the same as those provided to active employees and their Dependents who are still enrolled in the dental plan. If the employer changes the coverage for active employees, the continued coverage will change as well. Premiums will be adjusted to reflect the changes made. TERMINATION OF CONTINUED COVERAGE A Qualified Beneficiary's coverage will terminate at the end of the month in which any of the following events first occurs: 1. the allowable number of consecutive months of continued coverage is reached; 2. failure to pay the required Premiums in a timely manner; 3. the employer ceases to provide any group dental plan to its employees; 4. the individual first obtains coverage for dental Benefits, after the date of the election of continued coverage, under another group health plan (as an employee or Dependent) which does not contain or apply any exclusion or limitation with respect to any pre-existing condition of such a person, if that pre-existing condition is covered under this program; 5. entitlement to Medicare; or 6. the individual becomes eligible for coverage under the federal COBRA law. The employer shall notify Delta within 30 days 15 of the date when a Qualified Beneficiary becomes so eligible. Once continued coverage ends, it cannot be reinstated. TERMINATION OF THE EMPLOYER'S DENTAL CONTRACT If the dental Contract between the employer and Delta terminates prior to the time that the continuation coverage would otherwise terminate,,, the employer shall notify a Qualified Beneficiary under Cal -COBRA either 30 days prior to the termination or when all Enrollees are notified, whichever is later, of the ability to elect continuation coverage under the employer's subsequent dental plan, if any. The continuation coverage will be provided only for the balance of the period that a Qualified Beneficiary would have remained covered under the Delta program had such program with the former employer not terminated. The employer shall notify the successor plan in writing of the Qualified Beneficiaries receiving continuation coverage so they may be notified of how to continue coverage. The continuation coverage will terminate if a Qualified Beneficiary fails to comply with the requirements pertaining to enrollment in, and payment of Premiums to the new group benefit plan. OPEN ENROLLMENT CHANGE OF COVERAGE A Qualified Beneficiary under Cal -COBRA may elect to change continuation coverage during any subsequent open enrollment period, if the employer has contracted with another plan to provide coverage to its active employees. The continuation coverage under the other plan will be provided only for the balance of the period that a Qualified Beneficiary would have remained covered under the Delta program. 16 1,218 08/01 HSM How To Use Your Benefits 1. Call your VSP doctor and make an appointment. 2. When you call, tell the doctor you are a VSP member and give the following information: • Your name and date of birth • The name of the group that provides your VSP coverage (This may be your or your spouse's employer, organization, health plan, trust fund, etc.) • Covered member's VSP identification number (usually the Social Security number)* * The covered member is the person whose group provides your VSP coverage. If it's not your group that provides you with VSP, then it's probably your spouse or a parent. 3. After you make an appointment, your doctor and VSP will handle the rest. The doctor will check your eligibility for services and plan coverage. During your doctor visit, ask whether the services and materials — such as eyewear — that you want are covered by your VSP plan. Tints, special lenses and scratch -resistant coatings are some of the cosmetic options that may be covered under your plan or available to you at discounted prices. Pay your doctor for any copayments and other costs not covered by your VSP plan. VSP pays the doctor for services and materials covered by your VSP plan. If you have problems with your eligibility, contact the VSP Customer Service phone number listed in this brochure. For More Information This information is a summary of your VSP benefit. Note: In the event of a conflict between this brochure and your group or health plan's contract with VSP, the terms of the contract will prevail. For more information, call the VSP Customer Service phone number, or log on to our Web site at www.vsp.com, and click on the Information for Members button. VSP Customer Service, 24-hour, toll -free phone number: 1-800-877-7195 T.D.D. for the hearing impaired: 1-800-428-4833 Web site address: www.vsp.com Vision Service Plan is an Equal Opportunity and Affirmative Action Employer. Help Prevent Insurance Fraud VSP's Fraud Watch Hotline 1-800-877-7236 VIVS A MERI'CA%S'.FI-R'ST CHOICE '.EOR EY'I:CA'RE 14 V'IVSPI AMERIC .CA'S FIRST CHOIE. FOR EYEC .using your vision besnpefit Welcome to the Nation's Premier Eyecare Health Plan! As a Vision Service Plan member, you have: Great access to doctors We have the nation's largest eyecare doctor network, with thousands of doctors located in metropolitan as well as rural areas. Excellent health protection All of our plans provide a thorough eye examination, which is important to your overall health. Eye examinations can detect and diagnose numerous medical problems, including diabetes, glaucoma, high blood pressure and certain cancers. High quality We were one of the first eyecare health plans to use stringent National Committee for Quality Assurance guidelines to credential all of our doctors. These guidelines are increasingly becoming the national benchmark for evaluating the quality of health plans. Your VSP Benefits at a Glance VSP benefits are designed to protect your visual wellness. Consequently, you may have to pay extra if you choose certain cosmetic or elective eyewear options. Before selecting your eyewear, ask your doctor what is fully covered by your VSP plan. The following summarizes the main benefits of your plan. BENEFIT FREQUENCY CO -PAY FROM VSP DOCTOR FROM OUT -OF -NETWORK PROVIDER Examination 12 months' Covered Covered up to $40 Lensesz 12 months' Covered Covered up to $40/single vision Covered up to $60/bifocal $10 for Covered up to $80/trifocal covered benefit Covered up to $125/lenticular (services & materials) A wide selection of Frame 12 months' attractive frames are covered in full Covered up to $45 Contact Lenses3, 4 Medically Necessary' 12 months' Covered Covered up to $210 Elective 12 months' None Covered up to $105 Covered up to $105 1 Based on your last date of service. 2 Your plan provides a 20 percent discount on non -covered complete pairs of prescription glasses when provided by a VSP doctor. 3 Patients choosing contacts use their eligibility for a frame and lenses. 4 Your plan includes a 15 percent discount off of the VSP doctor's professional services when buying contact lenses. Materials are provided at the customary fees. 5 Medically necessary contact lenses must be prescribed by a VSP doctor for certain conditions. Your VSP doctor must get prior approval from VSP for medically necessary contact lenses. Finding a VSP Doctor You can easily find a VSP doctor by: • Asking your organization's benefits representative • Calling the VSP Customer Service phone number • Logging on to the VSP Web site at www.vsp.com, and using the Doctor Directory Services From an Out -of -Network Provider Typically, more than 90 percent of our patients receive care from VSP doctors. If you wish to see an out -of -network provider, VSP will reimburse you up to the amount allowed under your plan's out -of -network provider reimbursement rate. Be aware that your out -of -network provider reimbursement rate does not guarantee full payment, and VSP cannot guarantee patient satisfaction when services are received from an out -of -network provider. If your plan allows such reimbursements, pay the entire bill when you see the out -of -network provider and gather the following information: • The provider's bill, including a detailed list of the services you received • The covered member's VSP member identification number (usually the Social Security number) • The covered member's name, phone number and address • The name of the organization that provides your VSP coverage • Your name, date of birth, phone number and address • Your relationship to the covered VSP member (such as "self," "spouse," "child," etc.) Claims must be filed with VSP within six months after seeing the provider. Please keep a copy of the information for your records and send the originals to: Vision Service Plan Attn.: Out -of -Network Provider Claims P.O. Box 997100 Sacramento, CA 95899-7100 City of Huntington Beach 00105162 #40404 6/99 .man, M.D. .................. 3737 Moraga Ave., Ste. A105, (85J) 273-0200 O.D................. 5450 Clairemont Mesa Blvd., Ste. D, (858) 292-1700, ard, O.D........................... 7841 Balboa Ave., Ste. 201, (858), 278-3937 kg, O.D................................ 5222 Balboa Ave., Ste. 42, (858) 650-6800 ni, M.D. ................... :..3737 Moraga Ave., Ste. A105, (858) 273-0200 ;ler, O.D . ........... 7420 Clairemont Mesa BI, Ste. 109, (858) 560-8581 ), O.D..............................3670 Clairemont Dr., Ste. 1, (858) 274-2020 D...................................... 4310 Genesee Ave., Ste. 101, (858) 560-5181 O.D.............................................. 2354 Ulric St., Ste. B, (858) 495-0592 ase, O.D......... 7061 Clairmont Mesa Blvd., Ste. 205, (858) 571-2081 i Kirk, O.D.................... 5604 Balboa Ave., Ste. B104, (858) 541-7088 ).D.................................. 4310 Genesee Ave., Ste. 101, (858) 560-5181 D.D......................... 7330 Clairemont Mesa, Ste. 105, (858) 292-4498 n, O.D................................................. 4096 Park Blvd., (619) 291-5505 .nson, O.D.......................................287 Horton Plaza, (619) 239-1716 nson, O.D......................................... 55 Horton Plaza, (619) 544-9000 Area ren, O.D......................... 4844 University Ave., Ste. A, (619) 284-3937 n, O.D............................ 4748 University Ave., Ste. C, (619) 516-1730 lung, O.D.................................. 4236 University Ave., (619) 281-3422 - College Area O.D.................................. 4616 El Cajon Blvd., Ste. 10, (619) 280-0664 n, O.D........................ 6760 University Ave., Ste. 130, (619) 583-4295 an, O.D............................................ 3408 College Ave., (619) 583-5744 YI.D................................ 5555 Reservoir Dr., Ste. 300, (619) 286-3711 , M.D........................................... 6945 El Cajon Blvd., (619) 697-4600 i, O.D............................. 4185 Fairmount Ave., Ste. E., (619) 508-5678 d.D................................. 5555 Reservoir Dr., Ste. 300, (619) 286-9077 11M.D..... .............................................. ... 3939 3rd Ave., (619) 296-8525 >oper, M.D............................................... 233 Lewis St., (619) 299-1100 ris, M.D.................................................. 3730 3rd Ave., (619) 291-6191 horst, M.D............................................. 3720 3rd Ave., (619) 298-7221 :;ualtieri, M.D....................................... 2558 4th Ave., (619) 239-3349 dler, M.D................................ 3900 5th Ave., Ste. 270, (619) 298-1000 hin, M.D................................. 3900 5th Ave., Ste. 270, (619) 298-1000 n, O.D........................................................ 907 6th Ave., (619) 231-5799 berger, O.D.............................................. 907 6th Ave., (619) 231-5799 D.D................... ........................................3945 1st Ave, (619) 295-4194 O.D........................................................ 3666 4th Ave., (619) 297-4331 nas, Jr., M.D............................ 3900 5th Ave., Ste. 270, (619) 298-1000 1, M.D...................................................... 3720 3rd Ave., (619) 298-7221 San Carlos Area O.D.......................... 8312 Lake Murray Blvd., Ste. C, (619) 464-2076 r, O.D........................... 9460 Mira Mesa Blvd., Ste. A, (858) 566-1756 iang, O.D...................... 8230 Mira Mesa Blvd., Ste. B, (858) 566-6670 n, O.D............... 11230 Sorrento Valley Rd., Ste. 115, (858) 535-9835 3to, O.D................................... 9186 Mira Mesa Blvd., (858) 566-6262 nes,O.D................. 9580 Black Mountain Rd., Ste. G, (858) 536-8952 ura, O.D. : .......................... 9186 Mira Mesa Blvd., (858) 566-6262 lung,O.D ............................... 9880 Hibert'St.; Ste. El, (858) 693-9044 ck, O.D......................... 9460 Mira Mesa Blvd., Ste. A, (858) 566-1756 onds, O.D................ 6755 Mira Mesa Blvd., Ste. 141, (858) 535-8282 i, M.D.................................... 9855 Erma Rd., Ste. 130,(858) 578-5220 ian, O.D...:..................... 9450 Scranton Rd., Ste. 111, (858) 558-0606 Center Area o, O.D.................................. 7007 Friars Rd., Ste. 371, (619) 295-0537 ar, O.D.................................. 7007 Friars Rd., Ste. 371, (619) 295-0537 t, O.D................... 591 Camino De La Reina, Ste. 427, (619) 298-1137 p O.D................... 591 Camino De La Reina, Ste. 427, (619) 298-1137 ner, O.D......................... 5624 Mission Ctr. Rd., Ste. B, (619) 297-6881 ias, O.D...................... 7610 Hazard Ctr. Dr., Ste. 517, (619) 291-7712 In Kearney Mesa ).D......................................:..... 5075 Ruffin Rd., Ste. B, (858) 278-4720 ea D.................................................... 3094 El Cajon Blvd., (619) 280-1277 r, O.D............................................ 2404 Madison Ave., (619) 291-3836 -cker, O.D..................................... 1947 Fern St., Ste. 3, (619) 233-6183 n, O.D....................................... 3068 University Ave., (619) 298-5524 ).D.............................................3068 University Ave., (619) 298-5524 el, O.D...........................................:......... 3950 30th St., (619) 296-6361 O.D............................................... 4822 Newport Ave., (619) 222-0559 Pacific Beach - Christy Chu Park, O.D.............................................. 1939 Grand Ave., (858) 272-2211 Lisa M. Galstian, O.D..............................................1330 Garnet Ave., (858) 272-6414 John E'. Gartner, O.D..................................................1330 Garnet Ave., (858) 272-6414 Kristie M. Homuth, O.D ............................... 2168 Balboa Ave., Ste. 1, "(858) 274-3777 Robert M. Homuth, O.D................................ 2168 Balboa Ave., Ste. 1, (858) 274-3777 Stephen A. Luskin, O.D............................................. 1018 Grand Ave., (858) 272-6843 David C. Park, O.D.................................................... 1939 Grand Ave., (858) 272-2211 Point Loam Michael A. Goldsmid, O.D.............. 3750 Sports Arena Blvd., Ste. 9, (619) 224-2879 Robert M. Homuth, O.D................................3445 Midway Dr., Ste. I, (619) 224-2973 Stanley S. Mestman, O.D........................... 3555 Kenyon St., Ste. 101, (619) 221-9560 Rancho Bernardo Gregory J. Hayes, O.D...................16840 Bernardo Ctr. Dr., Ste. 150, (858) 487-5504 Steven T. Klein, O.D.......................16840 Bernardo Ctr. Dr., Ste. 150, (858) 487-5504 Suzanne P. Lee, O.D................................... 11944 Bernardo Plaza Dr., (858) 451-1250 Bruce D. Rasmussen, M.D..................................16950 Via Tazon Rd., (858) 521-2301 Gary R. Saks, O.D................................ 17631 W. Bernardo Dr., Ste. A, (858) 487-7900 Charles W. Tornatore, O.D................................16950 Via Tazon Rd., (858) 521-2301 Rancho Penasquitos Barbara H. Bytomski, O.D. ........ 9320 Carmel Mountain Rd., Ste. E., (858) 484-1500 Brian Chou, O.D..........................9320 Carmel Mountain Rd., Ste. E., (858) 484-1500 Joel L. Cook, O.D.......................... 9320 Carmel Mountain Rd., Ste. E., (858) 484-1500 Glenn M. Demlinger, O.D...,........ 13223 Black Mountain Rd., Ste. 6, (858) 484-5155 Kevin M. Reeder, O.D................. 9320 Carmel Mountain Rd., Ste. E., (858) 484-1500 Robert A. Ring, O.D....................... 13223 Black Mountain Rd., Ste. 6, (858) 484-5155 Robert C. Rosa, O.D...............11495 Carmel Mountain Rd., Ste: 102, (858) 675-0485 David N. Sherman, O.D . ...... 12070 Carmel Mountain Rd., Ste. 292, (858) 676-3926 Mitchell S. Shulkin, O.D... 11835 Carmel Mountain Rd., Ste. 1313, (858) 674-1276 Scripps Ranch Cyrus N. Rad, O.D........................ 10549 Scripps Poway Pky., Ste. G, (858) 530-2800 Keith M. Wan, O.D....................... 10549 Scripps Poway Pky., Ste. G, (858) 530-2800 South San Diego Area Christine M. Davis, O.D........................................... 2935 Bever Blvd., (619) 428-2121 Tierrasanta Gregory J. Hayes, O.D....................................... 6020 Santo Rd., Ste. B, (858) 571-8835 Steven T. Klein, O.D........................................... 6020 Santo Rd., Ste. B, (858) 571-8835 Kimberly B. Plattner, O.D................................. 6020 Santo Rd., Ste. B, (858) 571-8835 University City Area John E. Gartner, O.D...................................7770 Regents Rd., Ste. 104, (858) 546-1940 David I. Geffen, O.D......................... Gordon Binder Vision Institute, (858) 455-6800 Robert M. Heller, O.D............................. 8650 Genesee Ave., Ste. 220, (858) 452-7374 Lori L. Johnson, O.D............................................... 4009 Governor Dr., (858) 453-0444 Dale W. Kimball, O.D................................. 4575 La Jolla Village Dr., (858) 455-5795 Steven P Tayman, O.D............................ 8650 Genesee Ave., Ste. 220, (858) 452-7374 Patrick Van Hoose, O.D ............................... 4575 La Jolla Village Dr., (858) 455-5795 San Marcos Richard G. Clarke, O.D........................... 181 S. Rancho Santa Fe Rd., (760) 744-3002 Denton L. Kimball, O.D........................... 1 Civic Center Dr., Ste. 130, (760) 744-2611 Richard M. Skay, O.D................1903 W. San Marcos Blvd., Ste. 130, (760) 727-2211 Santee Robert L. Grazian, O.D ............................... 9727 Mission Gorge Rd., (619) 562-5220 Ernest J. Grosso, O.D.................................. 9025 Carlton Hills Blvd., (619) 449-5252 Ronald W. Schisler, O.D . .......... 9621 Mission Gorge Rd., Ste. 105A, (619) 449-2000 Solana Beach Michael A. Foyle, O.D................................ 437 S. Hwy. 101, Ste. 163, (858) 481-7262 loana M. Staniciu, O.D. . ............. 124 Lomas Santa Fe Dr., Ste. 203A, (858) 793-1550 Spring Valley James W. Cummins, Jr., O.D ......................10225 Austin Dr., Ste. 206, (619) 670-0300 John C. Fleming, O.D...................................... 9628 Campo Rd., Ste. C, (619) 463-9318 Donald N. Freeman, O.D....................................687 Sweetwater Rd., (619) 466-9444 Joan Keddington, O.D.........................................687 Sweetwater Rd., (619) 466-9444 Vista Gary L. Barnes O.D............................................. 931 Anza Ave., Ste. B 7 60 758-3944 Stephen Chinn,O.D ............................... 640 Escondido Ave., Ste. 114, (760) 726-2400 K. P. Oscar Chung, O.D ............................... 217 Escondido Ave., Ste. 1, (760) 941-0857 Glenn M. Demlinger, O.D.........................770 Sycamore Ave., Ste: G, (760) 727-1844 John P. Fitzpatrick, O.D........................ 110 Escondido Ave., Ste_ . 101, (760) 724-2119 Bruce D. George, O.D.................................................. 931B Anza Ave., (760) 758-2340 Bradley W. Greider, M.D........................ 2067 W. Vista Way, Ste. 120, (760) 758-2020 Nicoletta Stefanidis, O.D....................... 2067 W. Vista Way, Ste. 120, (760) 758-2020 Randy L. Stone, O.D................................. 2067 W. Vista Way, Ste. 120, (760) 758-2020 Ronald C. Stout, O.D ............................... 2067 W. Vista Way, Ste. 120, (760) 758-2020 Victor Wechter, M.D................................................. 1020 E. Vista Way, (760) 940-1700 PLEASE NOTE By acceptance and use of this VSP doctor list, recipient recognizes and agrees that the information contained herein is protected proprietary information and publication or dissemination of the information contained herein for any purpose other than the normal and necessary implementation of the VSP vision care plan is prohibited. All VSP doctors accept new patients. The VSP doctors contained in this list were VSP doctors at the time the list was created. However, this list is subject to change without notice. Please check with the VSP doctor of your choice when making your appointment to ensure he or she is currently participating with VSP and provides the services you require. 01005 Southern California Except Los Angeles VSP LIST OF PARTICIPATING DOCTORS Counties: Imperial Orange Riverside San Diego This list is also available on our, Web site at www.vsp.Com and is updated weekly. ® y VSP 3333 Quality Drive Rancho, Cordova, CA 95670 (800) 877-7195 . . 09/02 Imperial County Brawley Donald L. Barniske, O.D.................................................. 260 Main St, (760) 351-2020 George K. Ching, M.D.................................................116 N. Plaza St., (760) 344-4330 David W. Gayle, O.D: . . ....... .......... ... .- 537 Main St., (760) 344-1293 Calexico Bill G. Bell, M.D."..................... ........:.. 2451- Rockwood Ave., Ste. 114„ (760) 357-4200 David R. Boniface, O.D.............................:... `" .". 329 W. 2nd St., (760) 357-2712 ................ El Centro George K. Ching, M.D.'....:...............................:..:...:......:. 444 S. Sth St., (760) 336-3980 David P. Espinosa, O.D....................................... 828 N Imperial Ave., (760) 352-7460 William F. Middleton, Jr., O.D........................................ 496 Main St., (760) 353-1190 Narendra J. Patel, M.D................................................... 1461 State St., (760) 352-6234 Janina Soto, O.D..........................................................2151 Ross Ave., (760) 352-3505 Christopher M. Wright, O.D............................................ 534 S. 8th St., (760) 352-4361 Orange County Aliso Viejo Michael T. Bywater, O.D............... 27792 Aliso Creek Rd., Ste. B124, (949) 362-3500 Laura Giampiccolo, O.D................ 27001 Moulton Pky., Ste. A204, (949) 362-6552 Peter L. Rich, O.D................................... 26611 Aliso Creek Rd., Ste. B, (949) 362-2200 Anaheim Daniel W. Berry, O.D...............................1092 N. State College Blvd., (714) 635-8671 David B. Ciminski, O.D......................................2091 W. Lincoln Ave., (714) 533-0960 Suzanne M. Day, O.D.......................1211 W. La Palma Ave., Ste. 201, (714) 533-3126 Robert Everakes, M.D........................3055 W. Orange Ave., Ste. 104, (714) 826-6480 Carlos E. Green, O.D........ ................ .._....... ........ 2117 E. Lincoln Ave., (714) 776-8770 Paul E. Habener, O D.............................................. 220 W. Cypress St., (714) 774-3890 Tony K. Huynh, O.D.................................1105 N. State College Blvd., (714) 998-3535 Stanley T. Kawai, O.D................................. 10502 Katella Ave., (714) 776-2020 Eric J. Kawata, O.D................................ 101 E. Lincoln Ave., Ste. 103, (714) 535-7515 Lulu Y. Kim, O.D................................ 1150 N. Harbor Blvd., Ste. 118, (714) 758-0185 Ian M. Lane, O.D.......................................................... 731 N. Euclid St., (714) 533-8240 A. J. Marchin, O.D........................................... 2571 W. La Palma Ave., (714) 821-4666 Milton M. Nakano, O.D......................... 2795 W. Lincoln Ave., Ste. L, (714) 527-5060 Bao-Thu Nguyen, M.D.....................1211 W. La Palma Ave., Ste. 201, (714) 533-3126 Nelson N. Noguchi, M.D..., ............ ; 3055 W. Orange Ave., Ste. 203, (714) 527-9347 Joseph R. Occhipinti, O.D . ........... ........... ... 10502 Katella Ave., (714) 776-2020 RobertA. Reynolds, O.D................. 330 N. State College Bl, Ste. 205, (714) 535-6777 Robert S. Ross, O.D......................7........................ 10502 Katella Ave., (714) 776-2020 Rodman F. Sandoval, 01) ................................... 2174 E. Lincoln Ave., (714) 772-1300 Steven A Schmidt, M.D..................1211 W. La Palma Ave., Ste. 201, (714) 533-3126 David M. Shigekuni, O.D...................................2378 W. Lincoln Ave., (714) 635-6680 Theo D. Tran, M.D............................................. 1739 W. Romneya Dr., (714) 502-9393 Patricia Uyekawa, O.D. ............. 2571 W. La Palma Ave., (714) 821-4666 Garrett S. Wada, O.D.................................................. 2933 W. Ball Rd., (714) 827-9780 Hershel B. Welton, O.D......................... 303 W. Lincoln Ave., Ste. 120, (714) 535-8404 Timothy H Welton, O.D...................... 303 W. Lincoln Ave., Ste. 120, (714) 535-8404 Anaheim Hills Arthur D. Charap, M.D.............................. 500 S. Anaheim Hills Rd., (714) 921-0232 Harry J. Charm, O.D. - ..................... 6200 Canyon Rim Rd., Ste. 101, (714) 998-2020 Robert E. Downs, O.D........... 5701 E. Santa Ana Canyon Rd., Ste. H, (714) 998-8710 Ronald LaCroix, O.D.................... .............. :... 5753 E. La Palma Ave., (714) 779-2596 Gary M. Lovcik, O.D.............. 5701 E. Santa Ana Canyon Rd., Ste. H, (714) 637-1640 Rebecca M. Maravilla, O.D . ......... 781 S. Weir Canyon Rd., Ste. 195, (714) 282-2888 Kari V. Nguyen, O.D.............................. 1081 N. Tustin Ave., Ste. 113, (714) 632-1616 Artesia Ken Imoto, O.D......................................... 11436 Artesia Blvd., Ste. D, (562) 860-1717 Thomas C. Kang, O.D............................ ............. 17617 Pioneer Blvd., (562) 924-6271 Cheng-Hong J. Lee, O.D....................................... 18371 Pioneer Blvd , (562) 865-4190 Alvin Y. Quan, O.D............................................. 18107 Pioneer Blvd., (562) 865-6017 Brea David G. Kirschen, O.D. ......................... ............... - 428 S. Brea Blvd., (714) 529-8228 Edgar A. Lucidi, M.D... ................ ........ 410 W. Central Ave., Ste. 101, (714) 256-9170 Jan S. Lukac, M.D............. :............ :........ 410 W. Central Ave., Ste. 109, (714) 529-9563 Benjamin K. Marumoto, O.D: .......... ........................ 526 S. Brea Blvd., (714) 529-1676 Stanley M. Matsuoka, O.D......................... :............. 2170 Brea Mall, (714) 990-9311 Mark J. Piekarski, O.D........................ 255 E. Imperial Hwy., Ste. Dl, (714) 990-2782 Laurie B. Stern, O.D.................................. 2500 E Imperial Hwy. 108, (714) 257-0599 Nhan T. Tran, O.D.................... :....................... 110 W. Birch St. Unit 3, (714) 529-9907 Buena Park James S. Cohen, O.D................................................ 5811 Beach Blvd., (714) 521-7582 Osamu Ikeda, O.D............................................... 8751 Valley View St., (714) 827-7191 Sally 1. Kim, M.D........................................ 5730 Beach Blvd., Ste. 201, (714) 562-5857 Robert A. Latent, O.D................................. 7960 Orangethorpe Ave., (714) 521-3002 - John J. Monteleone, O.D.................................. 8288 Buena Park Mall, (714) 828-7373 Jane A. MWnroe, O.D.............................. . . 7960 Orangethorpe Ave., (714) 521-3002 K. Leo Uyeda, O.D.................................................... 5426 Beach Blvd., (714) 522-6703 Helen I,. Yoon, O.D..................................................... 5319 Beach Blvd., (714) 523-8109 Cerritos Justin T. Abe, O.D.........................................................11420 South St., (562) 860-1339 Thomas L. Blake, O.D................................................. 11847 South St., (562) 865-6119 Darlyne H. Fujimoto, O.D........................... ............... 11420 South St., (562) 860-1339 Helena Kim, O.D......................................... 11900 South St., Ste. 121, (562) 809-4041 Jenny Y. Kim, O.D...........:............ ............................ .... 11420 South St., (562) 860-1339 Larissa A. Murakami, O.D........................................11420 South St., (562) 860-1339 Sheldon B. Pitluk, O.D............................................... 11243 183rd St., (562) 924-0950 David B. Rosenblum, O.D ............................... 326 Los Cerritos Mall, (562) 860-4475 Seymour A. Rosenblum, O.D......................... 326 Los Cerritos Mall, (562) 860-4475 Costa Mesa Jeffrey H. Brown, O.D. .- ................................ 1175 Baker St., Ste. E16, (714) 979-1811 Ronald V. Craig, O.D...................................... 234 E. 17th St., Ste. 110, (949) 548-1631 Melina Friedman, O.D ............................... 2706 Harbor Blvd., Ste. B, (714) 545-9162 Robert S. Glass, O.D................................1696 Newport Blvd., Ste. D, (949) 574-0200 Steven S. Grant, O.D....................................................... 3140 Bear St., (714) 557-2020 Bohan A. Joseph, M.D..................................... 3033 Bristol St., Ste. E., (714) 957-2704 Bob Kamkar, O.D.................................................1796 Newport Blvd., (949) 642-2020 Dan E. Quon, O.D................................ S. Coast Plaza Mall, Ste. 1872, (714) 540-2020 Jack C. Shea, O.D...................................2200 Harbor Blvd., Ste. D130, (949) 642-7882 Alissa S. Wald, O.D.................................... 2706 Harbor Blvd., Ste. B, (714) 545-9162 Cypress Ralph E Flutter, O.D......................................................... 4049 Ball Rd., (714) 828-0600 Noemi D. Larragoiti, O.D ............................... 10145 Valley View St., (714) 229-1986 Joy T. Nakabayashi, O.D................................................ 4049 Ball Rd., (714) 828-0600 C. Gene Wilkins, O.D....................................................... 5021 Ball Rd., (714) 995-4571 Dana Point Thomas C. Kopan, O.D. ................ 32585 Golden Lantern St., Ste. H, (949) 493-1600 William L. Petersen, O.D . .......... 34179 Golden Lantern St., Ste. 201, (949) 661-1181 Diana K. Them, O.D.......................................24692 Del Trade, Ste. B, (949) 661-8884 Bruce T. Wagner, O.D..................... 24040 Camino Del Avion, Ste. E., (949) 443-9110 Fountain Valley Del F. Barrett, O.D................................................ 16341 Harbor Blvd., (714) 839-2021 Dan B. Carver, O.D................................. 10900 Warner Ave., Ste. 119, (714) 963-3664 James L. Cooperman, O.D. ............... --. 18449 Brookhurst St., Ste. 6, (714) 963-2111 Tina U. Dan, O.D.................................. 16027 Brookhurst St., Ste. E., (714) 210-2393 Deep R. Dudeja, M.D.............................. ............... 9940 Talbert Ave., (714) 964-3700 Barbara B. Fineberg, O.D. .- .................. 18449 Brookhurst St., Ste. 6, (714) 963-2111 Harvey R. Goldstone, O.D.................................. 9107 Garfield Ave., (714) 963-2020 Nina H. Ha, O.D........................ ...... .18430 Brookhurst St., Ste. 100, (714) 968-9121 Sanford Koyama, O.D ...................... 18430 Brookhurst St., Ste. 100, (714) 968-9121 Ronald F. Kuykendall, O.D.............................18120 Brookhurst St., (714) 963-8349 Van T.Ly,O.D ...... ....................................... .._.....16341 Harbor Blvd., (714) 839-2024 Lincoln Manzi, Jr., M.D......................... 11100 Warner Ave., Ste. 214, (714) 546-2020 Debra McLaurin, O.D............................................ 9940 Talbert Ave., (714) 964-3700 Anh-Lmh T. Nguyen, O.D.................................... 16125 Harbor Blvd., (714) 531-9900 Trung M. Nguyen, M.D......................... 11180 Warner Ave., Ste. 151, (714) 444-0303 Lee H. Novick, M.D............................ 18837 Brookhurst St., Ste. 110, (714) 378-0333 Gordon K. Ota, O.D..................................... 10130 Warner Ave., Ste. J, (714) 965-5130 Harriet G. Stallings, O.D........................... 10130 Warner Ave., Ste. J, (714) 965-5130 S. Eugene Terada, O.D................................ 10130 Warner Ave., Ste. J, (714) 965-5130 Brittany A. To, O.D................................................ 10968 Warner Ave., (714) 962-1794 Yvonne V To, O.D................................................... 10968 Warner Ave., (714) 962-1794 Hoai T. Tran, O.D............................................ 15972 Euclid St., Ste. G, (714) 531-7626 Fullerton V Sanford Agarth, O.D......... 1912 W. Commonwealth Ave., Ste. D, (714) 526-1513 Christopher G. Albaugh, O.D . ......... 1321 N. Harbor Blvd., Ste. 300, (714) 871-2570 Christopher T. Allred, O.D............................1342 E. Chapman Ave., (714) 526-5515 Alvin M. Arellano, O.D.................................. 1909 W. Malvern Ave., (714) 992-8020 J. Nickolas Berbos, M.D. .................. 1321 N. Harbor Blvd., Ste. 300, (714) 879-0020 Steven). Chiana, O.D........................... 1839 W. Orangethorpe Ave., (714) 879-2020 Southern CA College of OptES ................. 2575 E. Yorba Linda Blvd., (714) 449-7401 John E. Esser, O.D............................ 301 W. Bastanchury Rd., Ste. 10, (714) 879-7372 Carleton S. Fong, O.D...... .............................. 2001 E Chapman Ave., (714) 738-6902 NgocYenHoang,O.D........................................... 501 N. Cornell Ave., (714) 525-3350 Sung S. Kim, O.D.................................................1028 Rosecrans Ave., (714) 738-5864 Clyde K. Kitchen, M.D.......................1321 N. Harbor Blvd., Ste. 300, (714) 879-0623 Nathan Kvetny, O.D......................................... 2001 E. Chapman Ave., (714) 738-6902 Thomas B. Law, O.D ...........................1321 N. Harbor Blvd., Ste. 300, (714) 871-2570 Maryanne Marcolivio, O.D.................. 270 W. Laguna Rd., Ste. 100, (714) 525-2375 William D. Mosier, M.D................... 1321 N. Harbor Blvd., Ste. 300, (714) 871-2570 Connie M.' Park, O.D........................................ ... .... 1425 S. Euclid St., (714) 680-5000 William H. Peloquin, M.D ...........301 W. Bastanchury Rd, Ste. 115, (714) 525-2251 Robert T. Rice, O.D...........................................1342 E. Chapman Ave., (714) 526-5515 George P. Saleen, O.D........................................ 612 E. Chapman Ave., (714) ,525-5727 Ramin Tayani, M.D................................ 270 W. Laguna Rd., Ste. 100, (714) 525-2375 Clifford M. Terry, M.D........................... 270 W. Laguna Rd., Ste. 100, (714) 525-2375 John D. Zdral, M.D.......................... 301 W. Bastanchury Rd., Ste. 10, (714) 879-7372 Garden Grove James D. Boyce, M.D. ....................12665 Garden Grove BI, Ste. 401, (714) 534-8373 Robert H. Collier, M.D.................. 12665 Garden Grove BI, Ste. 401, (714) 534-8373 Donald W. Cook, O.D............................. 12902 Brookhurst St., Ste. A, (714) 530-5050 Sally IT Dang, O.D........................12302 Garden Grove Blvd., Ste. 6, (714) 590-2020 Michael P. De Carlo, O.D. ......................... 10931 Chapman Ave., (714) 741-3937 Carmen Jan, O.D. ..................................... 12620 Brookhurst St., Ste. 1, (714) 530-5720 Stanley S: Kim, M.D.................................. 8736 Garden Grove Blvd., (714) 534-8100 Sheryn S. Lee, O.D............................ 9636 Garden Grove Blvd., Ste. 5, (714) 537-1313 Soo J. Lee, O.D................................... 9520 Garden Grove Blvd., Ste. 3, (714) 530-2557 Norman H. Liu, M.D.....................12665. Garden Grove Bl, Ste. 401, (714) 534-8373 Joel K. Marutani, O.D....................................... 12432 Brookhurst St., (714) 539-0100 Terry Metsovas, O.D...................................... 10931 Chapman Ave., (714) 741-3937 Dawn M. Miller, O.D.............................. 12620 Brookhurst St., Ste. 1, (714) 530-5720 - Mai-Huong T. Nguyen, O.D ............................... 13192 Ilarbor Blvd., (714) 534-3100 Mai-HuongT. Nguyen, O.D . .......................9191 Westminster Ave, (714) 698-8100 Ngoc-Thuy T. Nguyen, O.D........ 10872 Westminster Ave., Ste 112, (714) 636-9585 Richard L. Nguyen, M.D................ 9746 _Westminster Ave., Ste. A, (714) 638-4433 Thao P. Nguyen, O.D .......................................... 14322 Brookhurst St., (714) 839-9996 Ladan Nilforoushan, O.D .......... 8942 Garden Grove Blvd , Ste. 104, (714) 638-0852 HuongT.Pham,O.D........ ........................ 14251 Euclid St., Ste. F101, (714) 265-2197 Thao T. Pham, O.D...................... 10872 Westminster Ave., Ste. 112, (714) 636-9585 Tiffany T. Pham, O.D.......................................... 13192 Harbor Blvd, (714) 534-3100 Tiffany T. Pham, O.D..................................... 9191 Westminster Ave., (714) 698-8100 Charles R. Soltes, O.D..................12302 Garden Grove Blvd., Ste. 6, (714) 590-2020 Murray Taubman, O.D................................... 12568 Valley View St., (714) 894-3353 Dieu Nga T. Truong, O.D......................... 14251 Euclid St., Ste. F101, (714) 265-2197 Steven S. Yoo, O.D........................9042 Garden Grove Blvd., Ste. 110, (714) 53076611 Hawaiian Gardens Richard R. Ambrose; O.D. ...................... I .......... _... 12525 Carson St., (562) 860-1255 Huntington Beach Linda Arboleda, O.D............................................ 10041 Adams Ave., (714) 962-9377 L'esheC. Bender, O.D ..........................20932 Brookhurst St., Ste. 205, (714) 962-3371 Roberti Blau,M.D.................................17742 Beach Blvd., Ste. 305, (714) 842-0651 Paul A. Blaze, O.D.................................................... 5092 Warner Ave., (714) 846-2897 Byron M. Fennema, O.D....................... 16152 Beach Blvd., Ste. 173E, (714) 841-5051 Kevin J. Germundsen, O.D.................................. 10041 Adams Ave., (714) 962-9377 Kenneth W. Hardy, O.D............................ ........:19030 Brookhurst St., (714) 962-6601 Carmen Jan, O.D.'...... '_ ....164.50 Bolsa Chica St., (714) 840-1366 Timothy C. Jankowski, O.D. ........................... 16450 Bolsa Chica St., (714) 840-1366 Masami Jitosho, O.D. ..................................... 18685 Main St., Ste. E., (714) 847-1271 Michael I. Jones, O.D........................................ 15786 Springdale St., (714) 892-2987 Michael R. Kaplan, M.D.........................17742 Beach Blvd., Ste. 305, (714) 842-0651 Vicken H. Karageozian, M.D.................17742 Beach Blvd., Ste. 305, (714) 842-0651 Joy E. Kataoka, O.D..........................................19030 Brookhurst St., (714) 962-6601 Richard D. Klotz, M.D. ......... : ... .................. 18800 Main St., Ste. 101, (714) 847-5900 George Kusztyk, O D........................................ 19066 Magnolia St., (714) 593-9900 Khanhtrang T. Le, O.D..................... 19051 Goldenwest St., Ste. 102, (714) 698-2626 Timothy,S. Liegler, O.D.........................19582 Beach Blvd., Ste. 322, (714) 965-9696 Cleve S. MacKenzie, M.D.......................19582 Beach Blvd., Ste. 322, (714) 965-9696 J. Harvey Marklinger, O.D . ......................... 18800 Main St., Ste. 108, (714)-842-5537 Dru Ann J. McCluskey, M.D................. 19582 Beach Blvd., Ste. 322, (714) 965-9696 Donald M. McMillan, M.D....., .......................... 19066 Magnolia St., (714) 593-9900 Hironobu Mori, O D.....................................18700 Main St., Ste. 105, (714) 596-1210 Ngoc-Thuy T. Nguyen, O.D.- 19051 Goldenwest St., Ste. 102, (714) 698-2626 Dennis K. Noda, O.D.............................................. 8931 Atlanta Ave., (714) 960-4330 Alpa J. Patel, O.D.......................................... 7251 Warner Ave., Ste. H, (714) 596-2258 Joseph S. Powell, O.D.......... .................... .-........... 19746 Beach Blvd., (714) 964-3811 Glenda B. Secor, O.D...............................17742 Beach Blvd., Ste. 305, (714) 842-0651 Michael H. Sigband, M.D......................... 7677 Center Ave., Ste. 204, (714) 893-7576 Deric C. Simmons, O.D......................... 8907 Warner Ave., Ste. 125, (714) 962-6400 David N. Stein, O.D..................................... 7251 Warner Ave., Ste IT, (714) 596-2258 S. Victor Stella, O.D.................. ...................... 15057 Goldenwest St., (714) 894-5556 Douglas R. Williams, O.D...................................... 6042 Warner Ave., (714) 847-6059 Norman K. Wong, O.D................................ 7251 Warner Ave., Ste. IT, (714) 596-2258 Irvine . Shahla Abedi, M.D................... 16300 Sand Canyon Ave., Ste. 602, (949) 753-8880 Mohsen Ahnaghian, O.D.............................18124 Culver Dr., Ste. C, (949) 857-8213 Larry Bowes, M.D......................... 4330 Barranca Prkwy, Ste. 232, (949) 451-0035 Lena B. Chang, O D....................................15333 Culver Dr., Ste 690, (949) 552-4271 Li -Li S. Chia, M.D........................ 16300 Sand Canyon Ave., Ste. 604, (949) 753-1163 David N Cler, O.D..................................... 17885 Sky Park Cn., Ste. F, (949) 250-1415 Michael D. Cook, O.D ............................... 17885 Sky Park Cir., Ste. F, (949) 250-1415 Arthur B. Corish, O.D.......................... 4950 Barranca Pky., Ste. 301, (949) 559-5905 Kelly H. Qinh,O.D...................................4255 Campus Dr., Ste. 11 Eran Duzman, M.D..... ........................ ............. 27 Mauchley, Ste. 201 Eran Duzman, M.D............................. 4605 Barranca Pky., Stc,10 Keith A. Farson, O.D.................................4940 Irvine Blvd., Ste. 10 Dan W. Gilbert, O.D.................................. 4940 Irvine Blvd., Ste. 10 Raymond Z. Huang, O.D..........)........:' ..... 4250 Barranca Pky.,.Ste. Christopher P Likens, O.D............:...... 4040 Barranca Pky., Ste. IL Michael B. Lipman, Q.D................................ 2030 Main St, Ste. 11 Mark A. Robin, O.D........................................14210 Culver Dr., Ste.. Julie B. Ryan, O.D................................... 4950 Barranca Pky., Ste. 31 Richard A. Sarlitt, O.D....................................... 5327 University Di Michael N. Spitzer, O.D............................ 2646 DuPont Dr., Ste. 24 Zen-Ni Su, O.D.- ........................................ 14785 Jeffrey Rd., Ste. 10 Ruth Tang, O.D..................... ................ 17585 Harvard Ave., Ste. I Karen K. Toki, O.D.... ...... ..................... 4040 Barranca Pky., Ste. 11 Billy L. Tran, O.D...................................... 2967 Michelson Dr., Ste. D Terry Y. Tsang, O.D.............................. 4950 Barranca Pky, Ste. 31 UC Irvine School of Opth ................ - Gottschalk Medical Plazz David Wakabayashi, O.D.......................4200 Trabuco Rd., Ste. 17 John M. Walcott, M.D........................... 4950 Barranca Pky, Ste. 30 Nancy L. Wilson, O.D........................... 4040 Barranca Pky., Ste. 11 Pamela Wu, O.D.......................................... 5414 Walnut Ave., Ste. La Habra Mary E. Anagnost, O.D..................................1009 E. La Habra Blv, Lawrence Fromm, O.D....................... 601 E. Whittier Blvd., Ste. 1C Joseph C. Peters, M.D ............................481 E. Whittier Blvd. Suite Lisa M. Shimada, O.D.............:.......... 601 E. Whittier Blvd., Ste 1C Cynthia Tjahjadi, O.D................................... 1339 W. Whittier Blv( Bennett A. Weiner, OD....................................1339 W. Whittier Blvc La Mirada Mark Forman, O.D......................................... 15066 Rosecrans Ave Daniel Kimura, O.D........................................ 15066 Rosecrans Avc Lynne D. Louie, O.D........................12675 La Mirada Blvd., Ste. 3C David E. Mont, O.D........................................... 15076 Imperial Hw) Stephen P. Sokol, O.D................................... 12819 Valley View Ave Jeffrey V Winston, M.D..................12675 La Mirada Blvd., Ste. 3C La Palma Michael S. Bold, O.D............................................ 5422 La Palma Av Yadavinder Dang, M.D......................... 5451 La Palma Ave., Ste. 1 Ilan Hartstein, M.D................................ 5451 La Palma Ave., Ste. 5 Laguna Beach David N. Cler, O.D...................................................... 265 Laguna Av, Michael D. Cook, O.D............................................... 265 Laguna Avi William D. Harrison, O.D...................... 540 S. Coast Hwy., Ste. 2( Susan M. Hartley, O.D....................................... 330 Park Ave., Ste. Andrew Henrick, M.D........................ 31852 S. Coast Hwy., Ste. 1C Laguna Hills Shahla Abedi, M.D............................................ 15 Mareblu, Ste. 26 Randall R. Alessi, O.D................................ 25401 Alicia Pky., Ste. 1 Scott T. Anderson, O.D.............. 24351 Ave. De La Carlota, Ste. NI Terra J. Barnes, 01) .... . ......... :.......:........24361 El Toro Rd., Ste. 1E Terra J. Barnes, O.D........................ .... :.... 24902 Moulton Pky. 2nd 1 James R Brinkley, Jr., M.D................ 23961 Calle De La Magdalen Richard N. Frieder, O.D.............................25252 McIntyre St., Ste. Michael M. Goldman, O.D..... 24155 Laguna Hills Mall, Ste. 164 John A. Hovanesian, M.D . ......... 24401 Calle De La Louisa, Ste. 3( Thuy-Uyen D. Hua, O.D ..................................23161 Moulton Pk, Edward W. Kim, M.D.................24401 Calle De La Louisa, Ste. 3( Mark J. Levy, O.D......................... 24953 Pasco De Valencia, Ste 17 Charles C. Manger, I11, M.D................................23161 Moulton, Pky William L. McCarthy, Jr., M.D......... 24411 Health Ctr. Dr., Ste. 3� Bert L. McCoy, O.D...................................... 24191 Pasco De Valenci Rebecca Ng, O.D............................ 24022 Calle De La Plata, Ste. 3( HiepNguyen,O.D...............................................23161 Moulton Pk, Roger V. Ohanesian, M.D . ........ . 24401 Calle De La Louisa, Ste. 3( Norman D. Peterson, M.D........... 24022 Calle De La Plata, Ste. 3( Paul L- Prendiville, M.D................. 23961 Calle De La Magdalen Robyn S. Rakov, O.D.................................. 25301 Cabot Rd., Ste. 11 Aaron M. Sake, O.D................................25252 McIntyre St., Ste Mary Sciarra, O.D...............................................23161 Moulton Pk, Nicoletta Stefanidis, O.D... ..-...24401 Calle De La Louisa, Ste 3( Wendy U. Tran, O.D.............................. 22972 Moulton Pky., Ste. 1( John M. Walcott, M.D....... ............ 23961 Calle De La Magdeler Jean J. Yoo, O.D........................................ 25252 McIntyre St., Ste. Laguna Niguel Patrick A. Griffin, O.D...................... 30100 Town Center Dr., Ste. T. Powers Griffin, Jr., O.D.................. 30100 Town Center Dr., Ste. any Arcemont, O.D . ........... 24400 Jackson Ave., Ste. A, (909) 677-5144, tch, O.D............... 40680 California Oaks Rd., Ste. 1A, (909) 600-9226 teller, O.D............ 25460 Medical Center Dr., Ste. 103, (909) 698-4575 i, O.D................................... 24400 Jackson Ave., Ste. A, (909) 677-5144 rmid, O.D......................25405 Hancock Ave., Ste. 105, (909) 696-5388 )le, O.D......................39872 Los Alamos Rd., Ste. All, (909) 698-4185 enson, M.D.................... 25405 Hancock Ave., Ste. 105, (909) 696-5388 v, Jr., O.D........................... 1700 Hamner Ave., Ste. 102, (909) 735-7122 Lick, O.D..... ......................... 3179 Hamner Ave., Ste. 1, (909) 734-4802 eman, O.D................. 73111 Country Club Dr., Ste. B3, (760) 340-5292 , O.D...................... 44250 Town Center Way, Ste. CIO, (760) 674-8806 sen, O.D.......................... 44139 Monterey Ave., Ste. A, (760) 773-3099 ller, O.D.....................74000 Country Club Dr., Ste. B2, (760) 341-7373 D............................. Palm Desert Town Ctr. Lower Lev, (760) 776-9767 Matson, O.D........ ...... 73211 Fred Waring Dr., Ste. 102, (760) 346-1136 s s, O.D.............................................. 139 S. Palm Canyon, (760) 325-6326 libel, O.D.......... :........... 2367 E. Tahquitz Canyon Way, (760) 327-8528 Idban, M.D..... 1180 N. Indian Canyon Dr., Ste. W100, (760) 320-8497 ;, M.D........................1180 N. Indian Canyon, Ste. 130, (760) 320-7051 ;kinson, M.D............... 1700 E. Tahquitz Canyon Way, (760) 320-2133 er, M.D.....................1180 N. Indian Canyon, Ste. 130, (760) 320-7051 ius, O.D ............................... 1546 N. Palm Canyon Dr., (760) 320-4441 iing, M.D..................1180 N. Indian Canyon, Ste. 130, (760) 320-7051 LD............................................ 700 N. Palm Canyon Dr., (760) 320-2333 )per, O.D..................................................... 350 E. 4th St., (909) 657-4900 , O.D.................................. 136 W. Nuevo Rd., Ste. E & F, (909) 943-4949 ge ;, O.D ............................... 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 wes, O.D........................ 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 rock, O.D...................................... 42390 Bob Hope Dr., (760) 340-4524 .D.................................... 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 ter, M.D.......................... 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 M.D.............................. 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 e, M.D............................ 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 uskas, M.D.................... 39700 Bob Hope Dr., Ste. 109, (760) 340-3937 aerer, O.D................................................ 2 W. Fern Ave ,.(909) 793-3311 ushon, O.D.........................1478 Industrial Park Ave., (909) 793-2106 o, O.D.................................................... 568 Orange St., (909) 335-0300 ner, M.D.................................................. 2 W. Fern Ave., (909) 793-3311 n, O.D................................1478 Industrial Park Ave., (909) 793-2106 imine, O.D....................... 4515 Central Ave., Ste. 101, (909) 784-2420 M.D.............................. 4500 Brockton Ave., Ste. 107, (909) 686-4911 ier, O.D................................................ 4037 Market St., (909) 684-9700 per, O.D........................... 1345 University Ave., Ste. B, (909) 682-8190 1, O.D........................................................ 6405 Day St., (909) 697-5480 itt, O.D......................... 6377 Riverside Ave., Ste. 190, (909) 684-7822 O.D..........................5225 Canyon Crest Dr., Ste. 201, (909) 788-2020 O.D.............................2955 Van Buren Blvd., Ste. H2, (909) 785-1212 , nge, M.D...................... 4500 Brockton Ave., Ste. 107, (909) 686-4911 P. Ha, O.D..................... 4500 Brockton Ave., Ste. 107, (909) 686-4911 iley, O.D.................................................. 4000 Tyler St., (909) 687-7100 en, O.D..........................I.......................1 4000 Tyler St., (909) 687-7100 O.D......................................... 17675 Van Buren Blvd:, (909) 780-0270 in, O.D.....................5051 Canyon Crest Dr., Ste. 102, (909) 686-3937 D.......................................5300 Arlington Ave., Ste. C, (909) 689-9180 ian, O.D...................... 9496 Magnolia Ave., Ste.101, (909) 687-5312 r, M.D ............................... 6780 Indiana Ave., Ste. 110, (909) 782-3091 M.D.................................6780 Indiana Ave., Ste. 110, (909)782-3091 !r, M.D................................... 8990 Garfield St., Ste. 1, (909) 785-5421 O.D.............................. 6377 Riverside Ave., Ste. 190, (909) 684-7822 Nguyen, O.D................. 9939 Magnolia Ave., Ste. A, (909) 785-0250 . son, O.D.......................... 6780 Indiana Ave., Ste. 110, (909) 782-3091 ;dale, O.D.................. 285 E. Alessandro Blvd., Ste. F, (909) 780-5151 " ar, O.D....................... 19530 Van Buren Blvd., Ste. G8, (909) 656-0500 ,es, M.D....................... 4440 Brockton Ave., Ste. 130, (909) 682-4353 D.D.................................... 7900 Limonite Ave., Ste. H, (909) 681-4125 nberg, M.D....................6780 Indiana Ave., Ste. 110, (909) 782-3091 ury, O.D........................ 1450 University Ave., Ste. D, (909) 788-8650 Minn, O.D............................. 17675 Van Buren Blvd., (909) 780-0270 1.D............................................2296 Galleria at Tyler, (909) 689-4500 Carol J. Tillman, O.D.............................. 6780 Indiana Ave., Ste. 110, (909) 782-3091 Anthony J. Worth, O.D.......................................... 3824 La Sierra Ave., (909) 359-3377 Sun City William P. Blase, M.D............................ 28125 Bradley Rd., Ste. 180, (909) 301-8888 John S. Hersh, O.D............. ..................................... 27830 Bradley Rd., (909) 672-4971 Kenneth James, O.D................................ 28125 Bradley Rd., Ste. 180, (909) 301-8888 Satpal S. Multani, O.D...........................................28083 Bradley Rd., (909) 672-2010 Reggie L. Ragsdale, O.D............................ 27994 Bradley Rd., Ste. A, (909) 679-0545 Peter Shaw -McMinn, O.D....................................27830 Bradley Rd., (909) 672-4971 Temecula Julie R. Anthony Arcemont, O.D............ ......... 31685 US Hwy. 79 S., (909) 302-5580 Bret F. Argenbright, O.D...................... 41540 Winchester Rd., Ste. B, (909) 296-1822 Donny R. Broyles, O.D..................................... 40705 Winchester Rd., (909) 296-2228 Markus Buri, O.D.......................................28551 Old Town Front St., (909) 676-4211 K. P. Oscar Chung, O.D. ............................. 27403 Ynez Rd., Ste. 101, (909) 676-4121 Steven A. Cory, O.D.............................. 31950 US Hwy. 79 S., Ste. B7, (909) 303-0575 Mark A. Jury, O.D............................................ 27580 Ynez Rd., Ste. A, (909) 676-1955 ToddA.Kelseh,O.D............................ 41540 Winchester Rd., Ste. B, (909) 296-1822 Kevin J. Lane, O.D................................................ 31685 US Hwy.' 79 S., (909) 302-5580 Douglas F. Larsen, O.D.................... 41238 Margarita Rd., Ste. 105, (909) 699-1111 Scott A. Lewis, O.D................................. ........ 31685 US Hwy. 79 S., (909) 302-5580 Thomas D. Lobue, M.D ............................... 40945 Winchester Road, (909) 719-1670 David S. McCleary, O.D........................ 31950 US Hwy. 79 S., Ste. B7, (909) 303-0575 Tamela A. Monteleone, M.D ............. 27720 Jefferson Ave., Ste. 100, (909) 693-4600 Eric J. Ramos, O.D. ........................... 40945 Winchester Road, (909) 719-1670 W. Berwyn Smith, M.D...... ................. 41540 Winchester Rd., Ste. B, (909) 296-1822 Patrick W. Utnehmer, O.D ............................... 27580 Ynez Rd., Ste. A, (909) 676-1955 Alan M. Winkelstem, O.D..... 30520 Rancho California, Ste. A106, (909) 676-9465 Wildomar Mark A'. Jury, 0.D.......................... 23905 Clinton Keith Rd., Ste. 115, (909) 304-9733 Yucaipa Lewis E. Kemmerer, O.D.................................... 13391 California St., (909) 795-9747 Norman*Robert Miller, O.D ......... .................. 34806 Yucaipa Blvd., (909) 797-0134 Steven A. Miller, O.D.......................................... 34806 Yucaipa Blvd., (909) 797-0134 Brian E. Van Dusen, O.D. ..................... 34590 County Line Rd., Ste. 1, (909) 795-2416 San Diego County Bonita Timothy A Giles, O.D.............................................. 4370 Bonita Rd., (619) 267-5901 Edward K. Harver, O.D............................................. 4502 Bonita Rd., (619) 479-7334 Carlsbad Jeffrey R. Anshel, O.D..................... 7130 Avenida Encinas, Ste. 103, (760) 931-1390 Bill G. Bell, M.D................................ 7130 Avenida Encinas, Ste. 103, (760) 931-0099 David A. Bloch, O.D.................................. 2910 Jefferson St., Ste. 101, (760) 730-3733 George A. Bradford, O.D.................. 2525 El Camino Real, Ste. 165, (760) 434-3308 Susan L. Daniel, O.D.............................. 2624 El Camino Real, Ste. A, (760) 434-3314 Christopher Davis, O.D....................... 2624 El Camino Real, Ste. A, (760) 434-3314 John P. Fitzpatrick, O.D............................................ 3044 Harding St., (760) 729-5921 ;-Toward J. Levy, O.D........................................ 6949El Camino Real, (760) 438-2020 Douglas M. Osborne, O.D..... _............... 2910 Jefferson St., Ste. 101, (760) 729-4327 John J. Riggs, O.D...................................... 7750 El Camino Real, Ste. P, (760) 942-3937 David W. Stemley, O.D..................................... 2540 El Camino Real, (760) 729-9353 Chula Vista Kim E. Admire, O.D................................................ 320 3rd Ave., Ste. B, (619) 498-0730 Kim E. Admire, O.D.......................................... 555 Chula Vista Mall, (619) 427-6253 Beverly P. Bianes, O.D. .: .......... ......................... 374 E. H St., Ste. 1708, (619) 425-7990 Marilyn A. Carter, O.D.............................................. 353 H St. Suite C, (619) 420-3010 Christine M. Davis, O.D......................... 299 Landis Ave., Ste. 101 A, (619) 425-5555 Robert L. Evans, O.D..................................... 330 Oxford St., Ste. 206, (619) 422-5361 Robert L. Evans, O.D................................................... 353 H St. Suite C, (619) 420-3010 Stephen E. Fry, O.D.................................................... 11 3rd Ave., Ste. B, (619) 420-5681 W. Joseph Garvin, O.D............................. 531 Telegraph Canyon Rd., (619) 482-2020 Peter D. Huang, O.D .................................... ...........................557 H St., (619) 422-0139 Gary M. Jacobs, M.D.........................................................681 3rd Ave., (619) 420-2111 Lucinda Y. Li, O.D............................................................... 681 3rd Ave., (619) 420-2111 Efrain Mascarene, O.D.......................................... 340 4th Ave., Ste. 9, (619) 427-2020 Daniel L. Mason, O.D........................................... 746 Otay Lakes Rd., (619) 656-1081 Anita R. Niederberger, O.D................................. 1400 E. Palomar St., (619) 397-3088 John C. Pack, O.D................................................ 374 E. H St., Ste. 1708, (619) 425-7990 Robert Penner, M.D............................................. ................ 681 3rd Ave., (619) 420-2111 Debra A. Quick, O.D........................................... 1400 E. Palomar St., (619) 397-3088 Barry M. Scher, M.D........................................................... 681 3rd Ave., (619) 420-2111 Gene R. Sieben, O D........................................................565 Broadway, (619) 420-8011 Robert E. Thomas, O.D............................................................ 545 H St., (619) 427-5177 Floyd L. Wergeland, M.D................................................ 681 3rd Ave., (619) 420-2111 Elizabeth Yanagitani, O.D...........................................565 Broadway, (619) 420-8011 Coronado Gerald J.'Easton, O.D.......................................................... 1010 8th St., (619) 435-6221, C. William Harpur, O.D..................................................... 1010 8th St., (619) 435-6221 John E. Kohler, O.D..................................................1021 Isabella Ave., (619) 437-4461 Blake R. Shaw, M.D.........................................1317 Ynez Place, Ste. A, (619) 435-8800 Del Mar Gregory J. Graham, O.D................................. 1349 Camino Del Mar, (858) 755-5484 El Cajon Kim J. Butler, O.D......................................................... 1273 Broadway, (619), 579-2345 Richard H. Carlson, O.D....................................... 2508 Fletcher Pky., (619) 463-9975 Marilyn A. Carter, O.D.....................................510 S. Magnolia Ave., (619) 444-9012 Randall E. Conrad, O.D................................................ 303 E. Main St., (619) 444-1153 Franklin Crystal, M.D........................... 225 W. Madison Ave., Ste. 1, (619) 442-0844 Michael J. Guarnotta, O.D ............................... 277 N. Magnolia Ave., (619) 442-1186 Jay Kovtun, O.D................................................ 277 N. Magnolia Ave., (619) 442-1186 Richard N. Learn, M.D.......................... 225 W. Madison Ave., Ste. 1, (619) 442-0844 Rex A. Werner, O.D............................... ....2650 Jamacha Rd., Ste. 141, (619) 670-6296 Greg K Woodworth, O.D........................................ 575 Fletcher Pky., (619) 447-5555 Encinitas Janie M. Bodman, O.D.................. 477 N. El Camino Real, Ste. C202, (760) 631-3500 Victor L. Copeland, O.D..................................... 1279 Encinitas Blvd., (760) 436-1877 Bessie B. Floyd, M.D......................... 317 N. El Camino Real, Ste. 206, (760) 479-0977 Deborah S. Haug, O.D................................................ 893 Santa Fe Dr., (760) 753-3500 Michael J. Haug, O.D.................................................. 893 Santa Fe Dr., (760) 753-3500 Ray A. Hutchinson, O.D....................... 681 Encinitas Blvd., Ste. 302, (760) 753-6336 Richard A. Kramb, O.D..................................... 1279 Encinitas Blvd., (760) 436-1877 Jeffrey B. Morris, M.D.................. 477 N. El Camino Real, Ste: C202, (760) 631-3500 Barry R Mozlin, O.D...........................165 S. El Camino Real, Ste. A, (760) 944-9601 Ronald M. Rosa, O.D...........................272 N. El Camino Real, Ste. A, (760) 634-1957 Frank A. Scotti, M.D................................... 320 Santa Fe Dr., Ste. 104, (760) 943-7141 Jeffrey P. Winick, M.D..................... 317 N. El Camino Real, Ste. 402, (760) 942-1488 John P. Zack, M.D.............................. 317 N. El Camino Real, Ste. 402, (760) 942-1488 Escondido John E. Bokosky, M.D........................................... 700 W. El Norte Pky., (760) 738-7800 Michael J. Cooper, O.D.................................................. 251 E. 4th Ave., (760) 745-5412 Christine M Davis, O.D........................ 330 W. Felicita Ave., Ste. El, (760) 741-5519 Daniel R. Delgado, O.D........................................... 613 E. Grand Ave., (760) 743-4616 David A: Edwards, M.D...............................225 E. 2nd Ave., Ste. 310, (760) 738-9985 Bruce G. Frimtzis, O.D ............................... 1320 E. Valley Pky., Ste. D, (760) 432-6331 W. Joseph Garvin, O.D........................................... 147 E. Grand Ave., (760) 743-2020 Gina M. Grasso, O.D.................................................. 810 E. Ohio Ave., (760) 746-3937 Dale W. Kimball, O.D.............................................201 W. Valley Pky., (760) 489-5100 Howard L Krausz, M.D.............................................810 E. Ohio Ave., (760) 746-3937 Kenneth R. Manell, O.D....................................... :........ 251 E. 4th Ave., (760) 745-5412 Jeffery L. McDonald, O.D..............................................280 E. 3rd Ave., (760) 747-2010 Erwin M. Omens, M.D................................................ 810 E. Ohio Ave., (760) 745-9500 Matt T. Pham, O.D.................................................... 968 W. Valley Pky., (760) 743-5872 David R. Plotner, M.D.............................................201 W. Valley Pky., (760) 489-5100 Norman A. Rose, O.D.................... 1299 E. Pennsylvania Ave., Ste. B, (760) 743-6540 Basanti Shaw, O.D.......................................... 255 N. Elm St., Ste. 105, (760) 743-1994 Garrick T. Sit, O.D. . ................................................... 324 S. Kalmia St., (760) 741-7497 Oliver F. Smith, O.D................................................201 W. Valley Pky., (760) 489-5100 Marty C. Tornatore, O.D..............................225 E. 2nd Ave., Ste. 310, (760) 738-9985 Fallbrook Gary L. Barnes, O.D::...................................................... 131 N. Vine St., (760) 723-8417 Douglas H. Clements, M.D........................... 521 E. Elder St., Ste. 102, (760) 728-5728 John E. Cutler, M.D......................................... 521 E. Elder St., Ste. 102, (760) 728-5728 Robert H. Davison, O.D. ..:_ .............................. 645 E. Elder St., Ste. D, (760) 728-9440 Eric J. Ramos, O.D.............................................. 645 E. Elder St., Ste. D,'(760) 72879440 Imperial Beach Helfon Hanono, O.D........................................... 894 Palm Ave.; Ste. B, (619) 424-9333 Paul J. Lavin, O.D............................................ 655 Saturn Blvd., Ste. H, (619) 425-9001 Angelica M. Villa, O.D....... :.......................... 655 Saturn Blvd., Ste. H, (619) 425-9001 Jamul Kim J: Butler, O.D................................ 13910 Lyons Valley Rd., Ste. G, (619) 669-6414 La Jolla` Colin R. Bernstein, O.D........................... 9834 Genesee Ave., Ste. 428, (858) 457-1200 Daniel J. Coden; M.D.............................. 9850 Genesee Ave., Ste. 316, (858) 457-3010 Victor L. Copeland, O.D......................... 9850 Genesee Ave., Ste. 310, (858) 457-3010 Michael S. Cypress, O.D........................ 9850 Genesee Ave., Ste. 310, (858) 457-3010 Matthew W. Gentile, O.D.............. 4150 Regents Park Row, Ste. 160, (858) 450-9400 Franklin W. Lusby, M.D................................. 7825 Fay Ave., Ste. 140, (858) 459-6200 David S. Michelson; M.D....................... 9834 Genesee Ave., Ste. 200, (858) 457-3050 Paul E. Michelson, M.D.......................... 9834 Genesee Ave., Ste. 200; (858) 457-3050 Forrest P. Murphy, M.D.......................... 9834 Genesee Ave., Ste. 209, (858) 457-2220 Padma Nanduri, M.D............................. 9834 Genesee Ave., Ste. 406, (858) 450-1010 Arthur C. Perry, M.D.............................. 9850 Genesee Ave., Ste. 310, (858) 457-3010 Steven G. Pratt, M.D ............................... 9850 Genesee Ave., Ste. 310, (858) 457-3010 Mary Terlaak-Smith, M.D.................... 9834 Genesee Ave., Ste. 209, (858) 457-2220 Richard Trainer, O.D................................................930 Silverado St., (858) 454-0191 UCSD Shiley Eye Center ............................... 9415 Campus Point Dr., (858) 534-6290 Gordon G. Wong, O.D..................................... 7825 Fay Ave., Ste. 140, (858) 454-4699 La Mesa Caroline Guerrero Cauchi, O.D .....................8235 University Ave., (619) 461-4913 Gary R. Funk, O.D................................................. 7862 El Cajon Blvd., (619) 644-6405 Bruce T. Haight, M.D........................ 5565 Grossmont Ctr. Dr., Ste. 3, (619) 463-0331 Thomas M. Hixson, O.D...................................... 8007 La Mesa Blvd., (619) 466-5665 David M. Kasanoff, O.D........................... 7339 El Cajon Blvd., Ste. G, (619) 465-7900 Phillip A. Levy, O.D.................................... 5020 Baltimore Dr., Ste. B, (619) 464-8303 David M. Newman, O.D............................. 5642 Lake Murray Blvd., (619) 589-6263 Michael A. Nyberg, M.D..................................... 7862 El Cajon Blvd., (619) 644-6405 Steven G. Peterson, O.D................................................... 7090 Pky. Dr., (619) 286-2810 Donald M: Rasmussen, O.D........................................... 7090 Pky. Dr., (619) 286-2810 Lawrence S. Rice, M.D................. 5565 Grossmont Ctr. Dr., Ste. 551, (619) 465-2020 Kevin M. Riggs, O.D:................... 5500 Grossmont Ctr. Dr., Ste. 215, (619) 469-0131 Martin Rothschild, O.D....................................... 7862 El Cajon Blvd., (619) 644-6405 J. Michael Vidal, O.D....................................................... 7090 Pky. Dr., (619) 460-2020 Jeffrey P. Wasserstrom, M.D....... 5565 Grossmont Ctr. Dr., Ste. 551, (619) 698-1088 Ronald M. Watson, O.D............................:......... 3653 Avocado' Blvd., (619) 660-6000 Lakeside John C. Fleming, O.D.................. 9710 Winter Gardens Blvd., Ste. A, (619) 443-1075 Lemon Grove Carl G. Hillier, O.D..................................................... 7898 Broadway, (619) 464-7713 Melissa C. Hillier, O.D............................................... 7898 Broadway, (619) 464-7713 Robert H. Meisel, O.D................................................ 7850 Broadway, (619) 697-2020 James M. Officer, O.D.................................................... 3048 Main St., (619) 469-9668 National City Sheryl A. Andrews, O.D....................... 1615 E. Plaza Blvd., Ste. 101, (619) 477-2159 Donald N. Freeman, O.D...................... 1615 E. Plaza Blvd., Ste. 101, (619) 477-2159 Joan Keddington, O.D........................... 1615 E. Plaza Blvd., Ste. 101, (619) 477-2159 Greg L. Marlay, O.D ............................... 1132 E. Plaza Blvd., Ste. 201,, (619) 477-4166 Gordon J. Montgomery, M.D......................610 Euclid Ave., Ste. 302, (619) 472-1010 Richard K. Simonds, O.D......................................2411 E. Plaza Blvd., (619) 475-2184 Ronald M. Watson, O.D...................................... 1033 Highland Ave., (619) 477-2771 Oceanside Janie M. Bodman, O.D...................................3909 Waring Rd., Ste. B, (760) 631-3501 Thomas L. Curtin, M.D.................................3231 Waring Rd., Ste. S., (760) 724-1800 Matthew W. Gentile, O.D........................... 3915 Mission Ave., Ste. 2, (760) 757-8771 Frederick W. Knapp, Jr., D.O........................... 3998 Vista Way, Ste. D, (760) 941-7300 Kurt A. Lundquist, O.D.............................. 3915 Mission Ave., Ste. 2, (760) 757-8771 Jeffrey B. Morris, M.D....................................3909 Waring Rd., Ste. B, (760) 631-3501 Donald E. Pearcy, O.D. ...: ...................... 4065 Oceanside Blvd., Ste. C, (760) 945-2020 Edward A. Richards, O.D..................... 4065 Oceanside Blvd., Ste. C, (760) 945-2020 Robert A. Ring, O.D.........................................3231 Waring Rd., Ste. B, (760) 726-9383 Ronald M. Rosa, O.D........................................ 2174 Vista Way, Ste. B, (760) 433-9449 David N. Sherman, O.D................................3809 Plaza Dr., Ste. 103, (760) 945-0222 Jeffrey P. Winick, M.D..................................3231 Waring Rd., Ste. M, (760) 758-2550 Poway Randall E. Conrad, O.D:........................ 13029 Pomerado Rd., Ste. A, (858) 748-6210 Marianne R. Decker, O.D........................................ 13373 Poway Rd., (858) 748-0171 David A. Edwards, M.D......................15525 Pomerado Rd., Ste. Cl, (858) 485-5600 Donald J. Janiuk, O.D............................ 13029 Pomerado Rd., Ste. A, (858) 748-6210 Douglas A. Morse, O.D........................15525 Pomerado Rd., Ste. Cl, (858) 485,-5600 Robert J. Okamura, O.D.......................................... 13373 Poway Rd., (858) 748-0171 James R. Smith, O.D................................................. 13569 Poway Rd., (858) 486-2630 Marty C. Tornatore, O.D.....................15525 Pomerado Rd., Ste. Cl, (858) 485-5600 Ramona Susan D. Homesley, O.D................................ 1516 Main St., Ste. 102, (760) 789-0950 Kenny F. Lane, O.D........................................... 220 Rotanzi St., Ste. A, (760) 788-0088 Gary B. Myers, O.D........................................................ 1419 Main St., (760) 789-1191 Rancho Santa Fe Elizabeth A. Christensen, O.D ............................... 6037 La Granada, (858) 756-3210 San Diego Allied Gardens - Del Cerro Darrel D. Fullbright, O.D............................. I.......... 10433 Friars Rd., (619) 283-6056 John C. Urey, O.D....................................................... 5175 Waring Rd., (619) 583-1000 Carmel Valley Kim E. Admire, O.D..............12750 Carmel Country Rd., Ste.'A110, (858) 350-1302 Carlton L. Chan, O.D. ._ ................... 12857 El Camino Real, Ste. N3, (858) 755-5503 Dale M. Koers, O.D.......................... 3830 Valley Centre Dr., Ste. 703, (858) 350-4980 Clairernont Area Archie Ackroyd,'O.D............... 7307 Clairemont Mesa Blvd., Ste. A, (858) 292-7460 Carl A. Boeck, O.D...................... 7420 Clairemont Mesa Bl, Ste. 109, (858) 560-8581 :k, O.D.................................. 27451 La Paz Rd., Ste B, (949) 643-2020 D.D.................................. 30001 Crown Valley Pky., (949) 495-1610 ).D............................ 30231 Golden Lantern, Ste. E., (949) 495-9336 mvecchio, O.D................ :. 23635 El Toro Rd., Ste. J2, (949) 951-8391 ;tensen, O D....... . 22681 Lake Forest Dr., Ste. A2, (949) 837-2121 ullinane, O.D............. 22741 Lambert St., Ste. 1601, (949) 581-6880 O.D................................. 22421 El Toro Rd., Ste. H, (949) 951-1424 er, O.D................................... 23002 Lake Center Dr., (949) 454-1064 , O.D........................... 22741 Lambert St., Ste. 1601, (949) 581-6880 O.D................................23811 Bridger Rd., Ste. 110, (949) 830-7400 D............................. 23632 Rockfield Blvd., Ste. 103, (949) 206-1560 1, O D........... ...... ......... 23635 EI Toro Rd., Ste. J2, (949) 951-8391 O.D......................................... 23002 Lake Center Dr., (949) 454-1064 ).D...................................... 22421 El Toro Rd., Ste H, (949) 770-5514 Is, O.D.............................. 23700 El Toro Rd., Ste. Al, (949) 859-3180 , O.D................................ 10861 Cherry St., Ste. 204, (562) 598-3160 in; O.D.............................. 10861 Cherry St., Ste. 204, (562) 598-3160 an, M.D. .....................10861 Cherry Ave., Ste. 204, (562) 799-2020 se, M.D........................... 10861 Cherry St., Ste. 204, (562) 598-3160 i, M.D.............. .........- 3801 Katella Ave., Ste. 414, (562) 598-7728 ,n, O.D.............. 10900 Los Alamitos Blvd., Ste. 102, (562) 431-1301 D.................................... 3801 Katella Ave., Ste. 414, (562) 598-7728 .D.................................... 3502 Katella Ave., Ste. 101, (562) 430-6161 ano, M.D...................... 10861 Cherry St., Ste. 204, (562) 598-3160 �.D.....................10900 Los Alamitos Blvd., Ste. 102, (562) 431-1301 D..................................... 10771 Los Alamitos Blvd., (562) 430-7515 elli, O.D ........- ....... ...................4281 Katella Ave., (714) 252-1135 ka, O.D..........................................4230 Katella Ave., (562) 795-6111 , M.D ............................... 26701 Crown Valley Pky, (949) 582-5009 ............. I .................. 28601 Marguerite Pky., Ste. 3, (949) 364-0891 D.D .......................602 The Shops at Mission Viejo, (949) 582-2020 ier, O.D..................... 28601 Marguerite Pky., Ste. 3, (949) 364-0891 M.D.............. ...... 27871 Medical Ctr. Rd., Ste. 120, (949) 364-6688 ).D....................... :............. 27652 Crown Valley Pky., (949) 347-9646 O.D........... _ ....... ..... 27724 Santa Margarita Pky., (949) 583-0422 D........................................ 24000 Alicia Pky., Ste. 11, (949) 768-0331 h, M.D......... .. ........ ....... 26701 Crown Valley Pky., (949) 582-5009 O.D............... :.................. 26701 Crown Valley Pky., (949) 582-5009 O.D.....................27723 Santa Margarita, Ste. 131, (949) 770-8505 Sian, M.D.............. 27800 Medical Ctr. Rd., Ste. 130, (949) 364-0225 )............................. 27800 Medical Cit. Rd., Ste. 130, (949) 364-0225 g, O.D........................... 26701 Crown Valley Pky., (949) 582-5009 D........................................... 26902 Oso Pky., Ste. 120, (949) 582-7776 -ay, O.D.......................27724 Santa Margarita Pky., (949) 583-0422 g, M.D................... 27871 Medical Ctr. Rd., Ste. 120, (949) 364-6688 ).D.......... .....:......... .......25270 Marguerite Pky., (949) 581-1040 ...........................23166 Los Alisos Blvd., Ste. 112B, (949) 707-1181 M.D....................... 27800 Medical Ctr. Rd., Ste. 130, (949) 364-0225 ).D.......................................26902 Oso Pky., Ste. 120, (949) 582-7776 g, O.D............................. 26701 Crown Valley Pky, (949) 582-5009 ,, Jr., M.D...................... 1525 Superior Ave., Ste. 101, (949) 645-2250 , O D.........................................833 Dover Dr., Ste. 9, (949) 642-0292 O.D................... 400 Newport Center Dr., Ste. 404, (949) 640-2023 O.D............. ........................... 2628 San Miguel Dr., (949) 644-0165 M.D........................... 1525 Superior Ave., Ste. 101, (949) 645-2250 M.D. ................. 400 Newport Center Dr., Ste. 404, (949) 640-2023 .D..............................................833 Dover Dr., Ste. 9, (949) 642-0292 ).D............... ........ I....................1725 Westcliff Dr., (949) 642-0720 man, M.D...................... 320 Superior Ave., Ste. 350, (949) 631-4780 son,M.D......................1441 Avocado Ave., Ste. 206, (949) 760-9007 lholm, M.D................... 320 Superior Ave., Ste. 350, (949) 631-4780' in, M.D......................... 1401 Avocado Ave., Ste. 402, (949) 760-3003 4.1) ..................................................1901 Westcliff Dr., (949) 646-2471 <, O.D. .._ ..................... 1525 Superior Ave., Ste. 101, (949) 645-2250 :k, O.D.................................. 1280 Bison Ave., Ste. B7, (949) 720-0204 , O.D................ '....... ....... 522 Old Newport Blvd., (949) 650-9060 rson, O.D. ....... ....... ..... : . ...... ...... 1907 N. Tustin St., (714) 974-4400 O.D...... ..................... ............. I City Blvd. W., Ste. 111, (714) 634-0033 O.D.......................... ..... 101 City Dr. S. Pavillion 2, (714) 704-3990 O.D......................................1 City Blvd. W., Ste. 111, (714) 634-0033 O.D. ................. ........ 101 City Dr. S. Pavillion 2, (714) 704-3990 ................................................... 130 S. Main St, Ste. P, (714) 939-9202 O.D. ......................... 1201 W. La Veta Ave., Ste. 406, (714) 558-8666 Gregory G. Char, O D............................. 850 E. Chapman Ave., Ste. B, (714) 538-1434 Thinh D. Do, O.D.................................. 3533 E. Chapman Ave., Ste. H, (714) 516-9090 Byron M. Fennema, O.D................1234 W. Chapman Ave., Ste. 201, (714) 997-1091 George H. Garcia, M.D.......................1201 W. La Veta Ave., Ste. 406, (714) 558-8666 Ronald L. Hankins, O.D. ................... I .......... . 4703 E. Chapman Ave, (714) 538-4803 Charles E. Keller, M.D......................... 1201 W. La Vela Ave., Ste. 408, (714) 633-5696 Christopher Lyon, M.D.......................1201 W. La Veta Ave, Ste. 300, (714) 771-1144 Joel K. Marutani, O.D........... ........1234 W. Chapman Ave., Ste. 201, (714) 997-1091 Byron Y. Newman, O.D................... 2501 E. Chapman Ave., Ste. 105, (714) 288-8282 Cynthia T. Nguyen, O.D.......................................... 1964 N. Tustin St., (714) 282-0111 Adrian V Pop, O.D........................... 2501 E. Chapman Ave., Ste. 105, (714) 288-8282 Herman L. Rundle, M.D. ...... ....... .1201 W. La Veta Ave., Ste. 406, (714) 558-8666 Keith V. Rundle, M.D ...........................1201 W. La Veta Ave., Ste. 406, (714) 558-8666 Robert F. Roper, M.D............................................... 436 S. Glassell St., (714) 633-6060 H. Michael Shack, O.D.....................................2198 N. Orange Mall, (714) 637-4500 Kauser Sharieff, O.D...................................... Inside Block at Orange, (714) 937-3937 Sandra L. Stevens, O.D .... ... .......... 1234 W. Chapman Ave., Ste. 201, (714) 997-1091 Joseph Vansuch, O.D................................... 128 E. Katella Ave., Ste 5, (714) 997-3535 Frank H. Yoon, O.D........................... ......... 311 N. Tustin St., Ste. B, (714) 997-7500 Placentia Jeffrey R. Dougal, O.D ............................... 1201 N Rose Dr., Ste. 100, (714) 528-2566 Jerry T. Lin, O.D............................................................. 630 N. Rose Dr., (714) 524-6688 John S: Marshburn, M.D............................ 1275 N. Rose Dr., Ste. 112, (714) 792-1199 Michael Swearingen, O.D.........................1201 N. Rose Dr., Ste. 100, (714) 528-2566 Robert J. Thomas, O.D ............................... 1201 N. Rose Dr., Ste. 100, (714) 528-2566 Richard L. Vermillion, O.D............................1428 N. Kraemer Blvd., (714) 996-1136 Rancho Santa Margarita Kathleen M. Andersen, O.D............ 22461 Antonio Pky., Ste. A130, (949) 589-6171 Steven D. Smith, O.D....................................... 29851 Aventura, Ste. I, (949) 589-0900 San Clemente Gabriel Dery, O.D..................638 Camino De Los Mares, Ste. A120, (949) 493-2269 Patrick A. Griffin, O.D.......................... ....:.... 140 Avenida Del Mar, (949) 492-1853 Stephen R. Griffin, O.D......................................140 Avenida Del Mar, (949) 492-1853' T. Powers Griffin, Jr., 0.1) .................................. 140 Avenida Del Mar, (949) 492-1853 Diana H. Kersten, M.D............. 665 Camino De Los Mares, Ste. 102, (949) 493-5411 David J. Nota, O.D.................................. 224 Avenida Del Mar, Ste. A„ (949) 492-2029 Roger V. Ohanesian, M.D......... 665 Camino De Los Mares, Ste. 102, (949) 493-5411 Traci L. Paul, O.D................................................140 Avenida Del Mar, (949) 492-1853 Nicoletta Stefanidis, O.D ......... 665 Camino De Los Mares, Ste. 102, (949) 493-5411 San Juan Capistrano Rick A. Abelson, O.D......................... 31878 Del Obispo St., Ste. 122, (949) 248-2590 Joseph G. Heinrich, O.D....... 32241 Camino Capistrano, Ste. A101, (949) 661-3669 Ryan K. Onishi, O.D..................... 32282 Camino Capistrano, Ste. B, (949) 496-0552 Charles M Roberts, O.D............. 32282 Camino Capistrano, Ste. B, (949) 496-0552 Santa Ana Patricia A. Atie, O.D............................ 2414 S. Fairview St., Ste. 103,(714) 557-9492 William M. Berke, 0.1) ....................... 3301 S. Harbor Blvd., Ste. 104, (714) 979-2021 M. Alexander Bonakdar, O.D................. 801 N. Tustin Ave., Ste. 404, (714) 558-1182 Paul A. Brarlsford, M.D..................... :.... 801 N. Tustin Ave.,,Ste. 303, (714) 547-2200 Luis A. Chanes, M.D................................. 2621 S. Bristol St., Ste. 205, (714) 557-5777 James S_ Cohen, O.D................................... :............. 1023 N. Bristol St., (714) 569-1023 Neville S. Cohen, O.D.............................................3696 S. Bristol St., (714) 549-4343 Mary A. Cote, M.D.............. :..................... 2621 S. Bristol St., Ste. 205, (714) 557-5777 Alberto De La Pena, M.D................................... . 1520 N. Grand Ave., (714) 558-1385 Nina T. Do, O.D.............................................. 1601 W. 17th St. Unit Bl, (714) 953-4393 Jeffrey S. Fimreite, O.D.: ............. 2414 S. Fairview St., Ste. 103, (714) 557-9492 Gary Fishberg, O.D....... :................... :........................... 1223 E. 17th St., (714) 972-4888 Robert P. Gonzales, O.D..........................................1415 N. Bristol St., (714) 543-9022 Larry J. Gottlieb, O.D....................................... 268 Main Place Mall, (714) 973-2020 Bruce F. Grant, O.D......................................... 800 N. Tustin Ave., Ste. J, (714) '835-2424 Melvin H. Honda, O.D......................................1730 E. 17th St., Ste. G, (714) 543-9489 Jon H. Kendall, O.D.........:.......................... 1125 E. 17th St., Ste. 455N, (714) 835-0141 Charles C. Luu, O.D ...............................................748 S. Harbor Blvd., (714) 839-7534 Sheldon L. Marshall, O.D............................ 2860 S. Bristol St., Ste. D, (714) 540-3993 Rick K. Nakasone, O.D.............................. 2390 N. Tustin Ave., Ste. B, (714) 543-3167 Xavier P Ordonez, O.D............................3940 S. Bristol St., Ste. 111, (714) 557-7373 Firooz R. Oskooi, M.D.............................2621 S. Bristol St., Ste. 205, (714) 557-5777 Remy Park, O.D................................................. 268 Main Place Mall, (714) 973-2020 Herman L. Rundle, M.D......... ..................... 1125 E. 17th St., Ste. 204E, (714) 558-2822 Keith V Rundle, M.D.................................. 1125 E. 17th St., Ste. E204, (714) 558-2822 Darcy C. Ryan, O.D. _..........................3301 S. Harbor Blvd., Ste. 104, (714) 979-2021 David B. Sacks, M.D................................. 999 N. Tustin Ave., Ste. 122, (714) 542-3961 Rodman F. Sandoval, O.D................................... 431 E. 1st St., Ste. 4B, (714) 547-6819 Michael C. Satterlee, O.D........................ .............3696 S. Bristol St., (714) 549.4343 Jimmy K. So, O.D................................................ 400 Main Place Mall, (714) 543 3333 Tony D. Vu, O.D.................................................... 1520 N. Grand Ave., (714) 558-1385 James J. Weyrich, O.D...................................................2018 E. 17th St., (714) 564-0222 Seal Beach Wm Randolph Hill, O.D. _ ....................... 1029 Pacific Coast Hwy., (562) 431-2031' Scott E. Nelsen, 0.1) ...... ................. ...........1029 Pacific Coast Hwy., (562) 431-2031 Stanton Stacey Q. T. Le, O.D.................................................. 7038 Katella Ave., (714) 895-4899 Trabuco Canyon S. Nelson Jun, O.D . ........................... 21612 Plano Trabuco Rd., Ste. C, (949) 459-5687 Tustin Amy L. Booth, O.D.................................................... 1102 Irvine Blvd., (714) 838-3210 Lowell J. Booth, O.D ............................ ....._......... 1102 Irvine Blvd., (714) 838-3210 Cindy K. Broady, O.D....................................17300 E. 17th St., Ste. M, (714) 838-9664 Walter E Combs, O.D.............................13372 Newport Ave., Ste. D, (714) 544-4810 Rebecca L. Kammer, O.D.............................17300 E. 17th St., Ste M, (714) 838-9664 Joshua Kaye, O.D............................................17602 17th St., Ste. 103, (714) 832-1288 Robert f. Klemberg, O D.........................2923 Tustin Market Place, (714) 731-0215 Robert J. Moeser, O.D......................... 13011 Newport Ave., Ste. 101, (714) 544-5282 Todd J Silverberg, O.D ..... .......................... 13257 Jamboree Rd., (714) 832-7575 William B. Stanford, O.D.................................... 190 El Camino Real, (714) 669-1121 Joseph Vansuch, O.D. ............................. 17842 Irvine Blvd., Ste. 104, (714) 832-5335 Villa Park James P. Furcolow, O.D................................... 17829 Santiago Blvd., (714) 998-6610 Westminster Eric J. Bass, O.D................................................. 15068 Goldenwest St., (714) 898-5631 Robert J. Bravo, O.D......................................... 15068 Goldenwest St., (714) 898-5631 Michael L. Byrne, O.D......................................... 16481 Magnolia St., (714) 848-0028 Sally H. Dang, O.D ................ .........._............. 9600 Bolsa Ave., Ste. C. (714) 775-7045 Viet V. Dang, M.D.......................................10301 Bolsa Ave., Ste. 104, (714) 775-0898 Linh V. Dinh, O.D....................................................... 10161 Bolsa Ave., (714) 775-0019 Lmh V. Dinh, 01) .................................... 9131, Bolsa Ave., Ste 202, (714) 896-0788 Cuong Dung Trong Do, M.D....................... 9061 Bolsa Ave., Ste. 105, (714) 899-5670 Robert S. Glass, O.D............................................... 16498 Beach Blvd.,, (714) 848-3937 Dennis A. Ho, O.D....................................................... 9078 Bolsa Ave., (714) 899-8991 Ngoc Yen Hoang, O.D ....................... ........_...... ...... 9022 Bolsa Ave., (714) 892-3636 Peter M. Horvath, O.D............................................ 16498 Beach Blvd., (714) 848-3937 Tracy Bich -Tram Le, O.D.- .............I........... 9200 Bolsa Ave., Ste 131, (714) 903-7858 Tracy Bich -Tram Le, O.D. ....................... :....... 9393 Balsa Ave., Ste. C, (714) 839-8581 Loretta M. Li, O.D........................................................ 9022 Bolsa Ave., (714) 892-3636 Arthur C. Lu, M.D..................................14571 Magnolia St., Ste. 205, (714) 894-4599 Charles C.Luu,O.D ............ .......................... 9191 Bolsa Ave., Ste. 116, (714) 892-4171 Chan P. Nguyen, O.D.............................14072 Magnolia St., Ste. 105, (714) 379-1214 Diem D. Nguyen, O.D................................................. 9567 Bolsa Ave., (714) 775-8080 Kim-Anh T. Nguyen, O D...............................15626 Brookhmst St., (714) 775-4553 Lethuy T. Nguyen, O.D .................................9842 Bolsa Ave., Ste. 104, (714) 775-3237 Melody T. Nguyen, O.D .................. ......_... 9131 Bolsa Ave., Ste. 202, (714) 896-0788 Triet M. Nguyen, M.D................................................ 9286 Bolsa Ave., (714) 899-0054 Thanh-Lan T. Quan, M.D......................... 10362 Bolsa Ave., Ste 201, (714) 531-4804 Charles R. Soltes, O.D..................................... 9600 Bolsa Ave., Ste. C, (714) 775-7045 Frank B. Sue, O.D......................... 6731 Westminster Blvd., Ste. 102, (714) 379-5495 Carolyn A. Takaesu, O.D.....................14571 Magnolia St., Ste. 205, (714) 894-4599 Yvonne V. To, O.D........................... 6731 Westminster Blvd., Ste. 102, (714) 379-5495 Khanh K. Tong, O.D........................................ 9651 Bolsa Ave., Ste. A, (714) 839-9915 Kieutien P. Tonnu, O.D.............................................. 10161 Bolsa Ave., (714) 775-0019 Thao T. Tran, O.D.......................................... 2069 Westminster Mall, (714) 898-3464 Michael T. Vu, M.D......................................... 8860 Bolsa Ave., Ste. B2, (714) 373-8555 Whittier Aaron D. Adame, O.D.................................... 6537 S. Greenleaf Ave., (562) 698-9583 Harold H. Crum, O.D.................................13313 E. Telegraph Rd., (562) 944-9881 Marie E. Cuadra, M.D............................. 9209 Colima Rd., Ste. 3600, (562) 698-1208 Suzanne M. Fabrizio, O.D...................................... 7749 Painter Ave., (562) 945-6391 Douglas F. Floc O.D. .......................................... 15925 Whittier Blvd., (562) 947-8681 Mark A. Galvan, O.D..:.................................._ 6711 Comstock Ave., (562) 698-0027 David B. Golden, O.D......................11245 Washington Blvd., Ste. E., (562) 692-1208 Sheldon M. Golden, 0 D.. .............11245 Washington Blvd., Ste. E., (562) 692-1208 Guy K. Kato, O.D.................................................6309 Greenleaf Ave., (562) 698-3279 John A. Katzaroff, O.D...................................... 15925 Whittier Blvd., (562) 947-8681 Nicholas Kokorrs, M.D.......................................... 7749 Painter Ave., (562) 945-6391 Barbara T. Konishi, O.D................................13313 E. Telegraph Rd., (562) 944-9881 David E. Marshburn, D.O................................. 15925 Whittier Blvd., (562) 947-8681 William N. May, M.D............................. 9209 Colima Rd., Ste. 2000, (562) 69813776 Marc A. Mintz, D.O........................................... 15925 Whittier Blvd., (562) 947-8681 Joy T Nakabayashi, O.D..................................6309 Greenleaf Ave., (562) 698-9907 Sam M. Otsuji, O.D...................... '................... 13313 E. Telegraph Rd., (562) 944-9881 William E. Overman, O.D............ ....... ............... 7247 Painter Ave., (562) 945-3589 Frederick M. Raymond, M.D................................. 7247 Painter Ave., (562) 945-3589 Derek R.Rice, O.D...................... .....................16414 Whittier Blvd., (562) 947-0391 Robert Rosenberg, O.D.................................... 16414 Whittier Blvd., (562) 947-0391 Dennis J. Spiro, O.D ..................... 11311 La Mirada Blvd., Ste. B, (562) 946-3311 Nhan T. Tran, O.D............................................... 15925 Whittier Blvd , (562) 947-8681 Yorba Linda Lisa A. Benham, O.D........................ 21520 Yorba Linda Blvd., Ste. B, (714) 777-7867 Seth Bernstein, O.D. _................... 21520 Yorba Linda Blvd., Ste. B, (714) 777-7867 Charles F. Bittel, O.D................................... 20399 Yorba Linda Blvd., (714) 779-8521 Christine A. Matson, O.D................................ 18291 Imperial Hwy., (714) 777-1770 Stephanie S. Ripley, O.D..................... 4945 Yorba Ranch Rd., Ste. E., (714) 692-2063 Kauser Sharieff, O.D.................................. 17524 Yorba Linda Blvd., (714) 996-6210 John C. Spaeth, O.D.............................. 4945 Yorba Ranch Rd., Ste. E., (714) 692-2063 Dieter Steimann, O.D....................................... 18282 Imperial Hwy., (714) 777-3969 Riverside County Anza Mark A. Gillispie, O.D......................... 39 100 Contreras Rd., Ste. D, (909) 763-2020 Banning Lewis E. Kemmerer, O.D...................................... 6109 W. Ramsey St., (909) 845-0313 Brian E. Van Dusen, O.D.........................3559 W. Ramsey St., Ste. D6, (909) 849-2020 Beaumont Blair M Ball, O.D................................................ 1659 E. 6th St., Ste. A, (909) 845-0272 Dennis T: Hamamura, O.D .. ........ .................. 1130 Beaumont Ave., (909) 845-1555 Blythe Daniel M. Judd, O.D......'........................................ 600 E. Hobson Way, (760) 922-0284 Timothy R. Port, O.D............................................. 836 E. Hobson Way, (760) 922-39,91 Canyon Lake Richard T. Blowers, O.D . ........... 31740 Railroad Canyon Rd., Ste. 4, (909) 244-4444 Corona Thomas L. Adams, O D.......................... 2205 Vesper Cir., Ste 104, (909) 520-1212 Gary R. Bell, 01) .........................................807 W. Grand Blvd., Ste A, (909) 735-1002 Lisa A. Benham, O.D ..................... 2791 Green River Rd., Ste. 106, (909) 736-2020 Seth Bernstein, O.D ............................2791 Green River Rd., Ste. 106, (909) 736-2020 James L. Davidian, M D................_....1820 Fullerton Ave., Ste. 310, (909) 734-8600 Becky Fartash, O.D.'.................................................... 730 N Main St., (909) 737-2020 Morton P. Israel, M.D............................ 802 Magnolia Ave., Ste. 205, (909) 734-9750 Paul H. Kim, O.0......................... .......... 1400 W. 6th St, Ste. 101, (909) 734-2001 Kenneth M. McKenzie, O.D...................... 1124 S. Main St., Ste. 101, (909) 737-2280 Dena M. Mintz, O.D.. .....................:... 800 Magnolia Ave., Ste. 113, (909) 737-7820 Douglas T. Munroe, O.D..................... :.................... 464 Corona Mall, (909) 737-3881 William M. Rogoway, 0.1) ... _..........._......... ....... 730 N. Main St., (909) 737-2020 Mark E. Schneider, M.D............................................. 1124 S. Nlam St., (909) 737-6363 Francis M. Terranova, O.D . .... I............ 370 W. Grand Blvd., Ste. 110, (909) 737-0477 Desert Hot Springs Steven A. Miller, 0.1) .................................................. 13 108 Palm Dr., (760) 329-5569 Hemet William P. Blase, M.D........................ 2390 E. Florida Ave., Ste. 207, (909) 652-6100 Markus Buri, O.D.................................................. 731 E. Florida Ave., (909) 766-8587 David N. Chrisman, O.D...................................1302 W. Florida Ave., (909) 925-7641 R. Michael Duffm, M.D...: .. ...... ............... ...... 361 N. San Jacinto St., (909) 652-4343 Arthur L Jacobson, M.D...................... 2390 E. Florida Ave., Ste. 207, (909) 652-6100 Dean E. King, O.D........................................... 900 E. Morton Place, (909) 658-9409 Steven R. Kleen, O.D................................................. 999 E. Morton PL, (909) 929-2746 Kevin J. Lane, O.D...................... ......... 2390 E. Florida Ave., Ste. 207, (909) 652-6100 David S. McCleary, O.D....................................361 N. San Jacinto St., (909) 652-4343 Daniel Navarro, O D....................................... :........ 999 E. Morton Pl., (909) 929-2746 Barratt L. Phillips, M.D........................ :............ 361 N. San Jacinto St., (909) 652-4343 Gayle A. Reis, O.D...................................... 627 E. Florida Ave., Ste. A, (909) 766-0599 Thomas R. Scruggs, O.D. ................................ .. - 41705 Florida Ave., (909) 652-2020 Steve J. Simpson, O.D..........:' ................................ 41705 Florida Ave., (909) 652-2020 Robert C. Sorenson, M.D..................................361 N. San Jacinto St, (909) 652-4343 Indian Wells Vincent V. De Francisco, O.D ........................... 74927 US Hwy 111, (760) 568-2340 Indio Mark A. Gillispie, O.D............... 82227 US Hwy. 111, Ste. 10, (760) 347-6636 Norman S. Seto, O.D..................................................... 45655 Oasis St., (760) 347-5191 La Quinta Winston H. Alwes, O.D......................:......:........ 78-560 US Hwy. 111, (760) 564-3887 Lake Elsinore Richard-T. Blowers, O.D ...... :::.i..:...:....'32245 Mission Trail, Ste. D4, (909) 674-1561 Stephen G. Schroeder, O.D...................32245 Mission Trail, Ste D4, (909) 674-1561 Moreno Valley Williarn K. Dorrance, O.D.....................................24250 Postal Ave., (909) 242-2020 Eric Fennema, O.D.................................... 12968 Frederick St., Ste. A, (909) 924-1877 Francisco J: Pabalan, M.D.........: ............. 12980 Frederick St., Ste. G, (909) 243-2266 Mark A. Rosa, O.D.......................... 11875 Pigeon Pass Rd., Ste. B10; (909) 242-3937 Clinton K. Wong, O.D........................... 12810 Heacock St., Ste. B104, (909) 924-2020 Paul R. Yang, O.D ............ ..... ...... ... . ... 12980 Frederick St., Ste. G, (909) 243-2266 VISION SERVICE PLAN Benefit Summaryfor CITY OF HUNTINGTON BEACH BENEFITS: COPAYMENT: Examination Single Vision Lenses Bifocal Lenses Trifocal Lenses Lenticular Lenses Frame(2) Tint Contact Lenses (3) Necessary Elective Examination Lenses Frame Examination and/or Materials Services from a VSP Participating Provider e> Paid -in -Full Paid -in -Full Paid -in -Full Paid -in -Full Paid -in -Full VSP fully covers a wide selection of attractive frames. Paid -in -Full 7N'M"6 tCA S Fkt�S 1' CMQInI F'F{1R"`E4t 1•,I.F>'; Once every 12 months Once every 12 months Once every 12 months $10.00 Services from a Non -Participating Provider up to $ 40.00 up to $ 40.00 up to $ 60.00 up to $ 80.00 up to $125.00 up to $ 45.00 up to $ 5.00 (Instead of a complete pair of prescription glasses) Paid -in -Full less copayment up to $210.00 up to $ 105.00 up to $105.00 Obtaining services from a VSP doctor: When you want to obtain vision care services, call a VSP doctor to make an appointment. For details on how you locate a VSP doctor, contact your benefits representative or call VSP at 800-877-7195 to request a VSP doctor listing. Make sure you identify yourself as aVSP member, and be prepared to provide the covered member's social security number. The VSP doctor will contact VSP to verify your eligibility and plan coverage, and will also obtain authorization for services and materials. If you are not currently eligible for services, the VSP doctor is responsible for communicating this to you. VSP will pay the doctor directly for covered services and materials. Obtaining services from an out -of network provider: Services and materials obtained from an out -of -network provider will be reimbursed up to amounts on the above schedule less any copayments. For out -of -network reimbursement, pay the entire bill when you receive services, then send your itemized receipts and full patient and member information to VSP. Claims must be submitted to VSP within six months from your date of service. Please keep a copy of the information for your records and send the originals to the following address: Vision Service Plan, Out - of -Network Provider Claims, P.O. Box 997105, Sacramento, CA 95899-7105. ADDITIONAL BENEFITS: Laser Vision Correction: VSP's Laser VisionCare"' program is also available to those covered under this VSP WellVision® Plan. It is designed to provide members with a discount off laser surgery when obtained through VSP contracted doctors, surgeons and laser centers. This program includes the two most common laser vision correction procedures, laser -assisted in -situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Call your VSP doctor to check if he or she is participating in the program. Doctors can also be located on VSP's Web site at www.vsi).com or by calling 888-354-4434. 1 When an exam and/or materials are received from a VSP doctor, the patient will have no out-of-pocket expense other than the copayment, unless optional items are selected. Optional items include, but are not limited to, oversize lenses (61 mm or larger), coated lenses, no -line multifocal lenses, treatments for cosmetic reasons or a frame that exceeds the plan allowance. VSP doctors offer valuable savings including a 20 percent discount on non -covered pairs of prescription glasses (lenses and frame). Services must be received within 12 months from the same VSP doctor who provided your last covered eye exam. You can also save 15 percent off the cost of your contact lens exam when you receive contact lens services from VSP. (This discount does not apply to the contact lens materials.) Your VSP benefit provides guaranteed savings whether you choose a frame that is covered in full or one that exceeds the plan allowance. If you choose a frame valued at more than the plan's allowance, the difference you'll pay is based on VSP's low, discounted member pricing. Have your doctor help you choose the best frame for you based on your VSP coverage. The allowance is in addition to the 15 percent discount on the contact lens exam. The allowance is applied to both the contact lens exam (fitting and evaluation) and the contact lenses. Any costs exceeding this allowance are the patient's responsibility. The contact lens exam is a special exam for ensuring proper fit of your contacts and evaluating your vision with the contacts. Medically necessary contact lenses must be prescribed by your doctor (as required for certain medical conditions) and approved by VSP. THIS IS ONLY A SUMMARY FOR FURTHER INFORMATION, SEE YOUR EMPLOYER'S BENEFIT REPRESENTATIVE S US ER SERVICE (800) 877-7195 ?4 �A MO Uaw a sit ttp://WWW.vsp.com I A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon 97204-1282 (503) 321-7000 People. Not Just Policies. CERTIFICATE: GROUP LONG TERM DISABILITY INSURANCE Policyowner: City of Huntington Beach Policy Number: 332175MM-LTD Effective Date: February 1, 1995 A Group Policy has been issued to the Policyowner. We certify that you will be insured as provided by the terms of the Group Policy. If your coverage is changed by an amendment to the Group Policy, we will provide the Policyowner with a revised Certificate or other notice to be given to you. Possession of this Certificate does not necessarily mean you are insured. You are insured only if you meet the requirements set out in this Certificate. "We", "us" and "our" mean Standard Insurance Company. "You" and "your" mean the Member. All other defined terms appear with the initial letter capitalized. Section headings, and references to them, appear in boldface type. GC190-LTD President %OPrinted on recycled paper A MOU - EXHIBIT 4 CALIFORNIA LIFE AND HEALTH INSURANCE GUARANTEE ASSOCIATION ACT SUMMARY DOCUMENT AND DISCLAIMER Residents of California who purchase life and health insurance and annuities should know that the insurance companies licensed in this state to write these types of insurance are members of the California Life and Health Insurance Guarantee Association ("CLHIGA"). The purpose of this Association is to assure that policyholders will be protected, within limits, in the unlikely event that a member insurer becomes financially unable to meet its obligations. If this should happen, the Guarantee Association will assess its other member insurance companies for the money to pay the claims of the insured persons who live in this state and, in some cases, to keep coverage in force. The valuable extra protection provided by these insurers through the Guarantee Association is not unlimited, however, as noted below, and is not a substitute for consumers' care in selecting insurers. The California Life and Health Insurance Guarantee Association may not provide coverage for this policy. If coverage is provided, it may be subject to substantial limitations or exclusions, and require continued residency in California. You should not rely on coverage by the Association in selecting an insurance company or in selecting an insurance policy. Coverage is NOT provided for your policy or any portion of it that is not guaranteed by the insurer or for which you have assumed the risk, such as a variable contract sold by prospectus. Insurance companies or their agents are required by law to give or send you this notice. However, insurance companies and their agents are prohibited by law from using the existence of the guarantee association to induce you to purchase any kind of insurance policy. Policyholders with additional questions should first contact their insurer or agent or may then contact: The California Life and Health Insurance Guarantee Association PO Box 17319 Beverly Hills CA 90209-3319 OR Consumer Services Division California Department of Insurance 300 S Spring St, 14th Fl Los Angeles CA 90013 The state law that provides for this safety -net coverage is called the California Life and Health Guarantee Association Act. Below is a brief summary of this law's coverages, exclusions and limits. This summary does not cover all provisions of the law; nor does it in any way change anyone's rights or obligations under the Act or the rights or obligations of the Association. COVERAGE Generally, individuals will be protected by the California Life and Health Insurance Guarantee Association if they live in this state and hold a life or health insurance contract, or an annuity, or if they are insured under a group insurance contract, issued by a member insurer. The beneficiaries, payees or assignees of insured persons are protected as well, even if they live in another state. EXCLUSIONS FROM COVERAGE However, persons holding such policies are not protected by this Guarantee Association if: Their insurer was not authorized to do business in this state when it issued the policy or contract; Their policy was issued by a health care service plan (HMO, Blue Cross, Blue Shield), a charitable organization, a fraternal benefit society, a mandatory state pooling plan, a mutual assessment company, an insurance exchange, or a grants and annuities society; They are eligible for protection under the laws of another state. This may occur when the insolvent insurer was incorporated in another state whose guaranty association protects insureds who live outside that state. The Guarantee Association also does not provide coverage for: Unallocated annuity contracts; that is, contracts which are not issued to and owned by an individual and which guarantee rights to group contract holders, not individuals; Employer or association plans, to the extent they are self -funded or uninsured; Any policy or portion of a policy which is not guaranteed by the insurer or for which the individual has assumed the risk, such as a variable contract sold by prospectus; Any policy of reinsurance unless an assumption certificate was issued; Interest rate yields that exceed an average rate; Any portion of a contract that provides dividends or experience rating credits. LIMITS ON AMOUNT OF COVERAGE The Act limits the Association to pay benefits as follows: LIFE AND ANNUITY BENEFITS 80% of what the insurance company would owe under a policy or contract up to $100,000 in cash surrender values, $100,000 in present value of annuities, or $250,000 in life insurance death benefits. A maximum of $250,000 for any one insured life no matter how many policies and contracts there were with the same company, even if the policies provided different types of coverages. HEALTH BENEFITS A maximum of $200,000 of the contractual obligations that the health insurance company would owe were it not insolvent. The maximum may increase or decrease annually based upon changes in the health care cost component of the consumer price index. PREMIUM SURCHARGE Member insurers are required to recoup assessments paid to the Association by way of a surcharge on premiums charged for health insurance policies to which the Act applies. CALIFORNIA NOVICE OF COMPLAINT PROCEDURE Should any dispute arise about your premium or about a claim that you have filed, write to the company that issued the group policy. If the problem is not resolved, you may also write to the State of California, Department of Insurance, Consumer Services Division, 300 S. Spring Street, 14th FL, Los Angeles, CA 90013, or call toll -free 1-800-927-IiELP (4357). This notice of complaint procedure is for information only and does not become a part or condition of this group policy/certificate. Table of Contents COVERAGE FEATURES GENERAL POLICY INFORMATION 1 BECOMING INSURED PREMIUM CONTRIBUTIONS SCHEDULE OF INSURANCE DISABILITY PROVISIONS EXCLUSIONS AND LIMITATIONS DEDUCTIBLE INCOME OTHER PROVISIONS INSURING CLAUSE DEFINITION OF DISABILITY RETURN TO WORK INCENTIVE................................................................................... REASONABLE ACCOMMODATION E XPENSE BENEFIT 5 TEMPORARY RECOVERY WHEN LTD BENEFITS END PREDISABILITY EARNINGS DEDUCTIBLE INCOME EXCEPTIONS TO DEDUCTIBLE INCOME RULES FOR DEDUCTIBLE INCOME SURVIVORS BENEFIT WAIVER OF PREMIUM 10 BENEFITS AFTER INSURANCE ENDS OR IS CHANGED 10 EFFECT OF NEW DISABILITY......................................................................................110 EXCLUSIONS ...................................................................................................................1 LIMITATIONS CLAIMS ALLOCATION OF AUTHORITY TIME LIMITS ON LEGAL ACTIONS .............................................. 13 INCONTESTABILITY PROVISIONS 13 CONTINUITY OF COVERAGE14 WHEN YOUR INSURANCE BECOMES EFFECTIVE 14 ACTIVE WORK PROVISIONS 15 WHEN YOUR INSURANCE ENDS 15 REINSTATEMENT OF INSURANCE DEFINITIONS................................................................................................................... 16 Index of Defined Terms The page number shown below is where the term is defined. For terms defined by an entire section, the page number below is the page on which that section begins. Active Work, Actively At Work, 15 Allowable Period, 5 Any Occupation Definition of Disability, 4 Any Occupation Income Level, 2 Any Occupation Period, 2 Benefit Waiting Period, 2, 16 Class Definition, 1 Contributory, 16 CPI-W, 16 Deductible Income, 7 Disability,4 Disabled, 4 Eligibility Waiting Period, 17 Employer(s), 1 Evidence of Insurability, 17 Exclusion Period, 2 Group Policy, 17 Group Policy Effective Date, 1 Group Policy Number, 1 Hospital, 11 Indexed Predisability Earnings, 17 Injury, 17 Leave of Absence Provision, 3 LTD Benefit, 17 Material Duties, 4 Maximum Benefit Period, 2, 17 Maximum LTD Benefit, 2 Member, 1 Mental Disorder, 11 Minimum LTD Benefit, 2 Noncontributory, 17 Own Occupation, 4 Own Occupation Definition Of Disability, 4 Own Occupation Income Level, 2 Own Occupation Period, 2 Partial Disability, 4 Physical Disease, 17 Physician, 17 Policyowner, 1 Predisability Earnings, 6 Preexisting Condition, 10 Preexisting Condition Period, 2 Pregnancy, 17 Prior Plan, 17 Proof Of Loss, 12 Reasonable Accommodation Expense Benefit, 3, 5 Return To Work Incentive, 5 Salary Continuation Offset, 3 Temporary Recovery, 5 War, 10 Work Earnings, 5 C COVERAGE FEATURES This section contains many of the features of your long term disability (LTD) insurance. Other provisions, including exclusions, limitations, and Deductible Income, appear in other sections. Please refer to the text of each section for full details. The Table of Contents and the Index of Defined Terms help locate sections and definitions. Group Policy Number: Policyowner: Employer(s): Group Policy Effective Date: GENERAL POLICY INFORMATION 332175MM-LTD City of Huntington Beach City of Huntington Beach February 1, 1995 Policy Issued In: California BECOMING INSURED To become insured you must: (a) Be a Member; (b) Complete your Eligibility Waiting Period; and (c) Meet the requirements in Active Work Provisions and When Your Insurance Becomes Effective. Definition of Member: You are a Member if you are: 1. An active employee of the Employer, who is in a class represented by the Municipal Employees Association; 2. Regularly working at least 20 hours each week, and 3. A citizen or resident of the United States or Canada. You are not a Member if you are: 1. A temporary or seasonal employee; or 2. A full time member of the armed forces of any country. Class Definition: None Eligibility Waiting Period: You are eligible on the first day as a Member. Evidence of Insurability Required: a. For late application for Contributory insurance. b. For reinstatements if required. c. For Members eligible but not insured under the Prior Plan. d. For becoming insured for any amount greater than the amount for which you were insured under the Prior Plan, if your insurance under the Prior Plan was limited because you did not provide evidence of insurability or because your evidence of insurability was not approved. Printed 10/24/01 1 332175MM-LTD Insurance is: PREMIUM CONTRIBUTIONS Noncontributory SCHEDULE OF INSURANCE LTD Benefit: 60% of the first $20,833 of your Predisability Earnings, reduced by Deductible Income. Maximum: $12,500 before reduction by Deductible Income. Minimum: $50 Benefit Waiting Period: The longer of. (a) 60 days or (b) the sum of the period for which you receive injured -on -duty pay and the period for which you choose to receive sick leave benefits under the Employer's sick leave plan. Maximum Benefit Period: Age Maximum Benefit Period 61 or younger .................................................. To age 65, or 3 years 6 months, if longer. 62................. ........ ...... ....... 3 years 6 months 63...................................................................... 3 years 64................................................................... 2 years 6 months 65...................................................................... 2 years 66...................................................................... 1 year 9 months 67...................................................................... 1 year 6 months 68...................................................................... 1 year 3 months 69 or older ........................................................ 1 year DISABILITY PROVISIONS Own Occupation Period: The first 24 months for which LTD Benefits are paid. Any Occupation Period: From the end of the Own Occupation Period to the end of the Maximum Benefit Period. Partial Disability: Covered Own Occupation Income Level: 80% of your Indexed Predisability Earnings. Any Occupation Income Level: 60% of your Indexed Predisability Earnings. See Definition of Disability for more information. EXCLUSIONS AND LIMITATIONS Preexisting Condition Exclusion: Yes Preexisting Condition Period: The 90 day period just before your insurance becomes effective. Exclusion Period: 12 months See Exclusions and Limitations for this and other exclusions and limitations. Printed 10/24/01 2 332175MM-LTD r I DEDUCTIBLE INCOME Social Security Offset: Full offset Salary Continuation Offset: Sick Pay or other salary continuation paid to you by your Employer, but not including vacation pay. See Deductible Income for this and other Deductible Income. OTHER PROVISIONS Survivors Benefit Amount: A lump sum equal to 3 times your monthly LTD Benefit without reduction by Deductible Income. Estate Payment Allowed: No Leave of Absence Provision: 30 days or less. Continuity of Coverage: Yes Reasonable Accommodation Expense Benefit: The expenses incurred for the reasonable accommodation or $500, whichever is less. Predisability Earnings based on: Earnings in effect on your last full day of Active Work. Printed 10/24/01 3 332175MM-LTD INSURING CLAUSE If you become Disabled while insured under the Group Policy, we will pay LTD Benefits according to the terms of the Group Policy after we receive satisfactory Proof Of Loss. LT.IC.01 DEFINITION OF DISABILITY You are Disabled if you meet one of the following definitions during the period it applies: A. Own Occupation Definition of Disability; B. Any Occupation Definition of Disability; or C. Partial Disability Definition. Own Occupation means any employment, business, trade, profession, calling or vocation that involves Material Duties of the same general character as your regular and ordinary employment with the Employer. Your Own Occupation is not limited to your job with your Employer. Material Duties means the essential tasks, functions and operations, and the skills, abilities, knowledge, training and experience, generally required by employers from those engaged in a particular occupation. A. Own Occupation Definition Of Disability During the Benefit Waiting Period and the Own Occupation Period you are required to be Disabled only from your own occupation. You are Disabled from your Own Occupation if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, you are unable to perform with reasonable continuity the Material Duties of your Own Occupation. B. Any Occupation Definition Of Disability During the Any Occupation Period you are required to be Disabled from all occupations. You are Disabled from all occupations if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, you are unable to perform with reasonable continuity the Material Duties of any gainful occupation for which you are reasonably fitted by education, training and experience. C. Partial Disability Definition 1. During the Benefit Waiting Period and the Own Occupation Period, you are Partially Disabled when you work in your Own Occupation but, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, you are unable to earn more than the Own Occupation Income Level. 2. During the Any Occupation Period, you are Partially Disabled when you work in an occupation but, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, you are unable to earn more than the Any Occupation Income Level in that occupation and in all other occupations for which you are reasonably fitted under the Any Occupation Definition of Disability. You may work in another occupation while you meet the Own Occupation Definition of Disability. If you are Disabled from your own occupation, there is no limit on your Work Earnings in another occupation. Your Work Earnings may be Deductible Income. See Return To Work Incentive and Deductible Income. Your Any Occupation Period, Any Occupation Income Level, Own Occupation Period, and Own Occupation Income Level are shown in the Coverage Features. Printed 10/24/01 4 332175MM-LTD LT.DD.01 X 11DOIIt11tlZ0IMa"fl7`t63DIZ00 A. During The Benefit Waiting Period You may serve your Benefit Waiting Period while working, if you meet either the Own Occupation Definition of Disability or the Partial Disability Definition. B. After The Benefit Waiting Period You are eligible for the Return To Work Incentive on the first day you work after the Benefit Waiting Period if LTD Benefits are payable on that date. The Return To Work Incentive changes 12 months after that date, as follows: 1. During the first 12 months, your Work Earnings will be Deductible Income as determined below: a. Determine the amount of your LTD Benefit as if there were no Deductible Income, and add your Work Earnings to that amount. b. Determine 100% of your Indexed Predisability Earnings. c. If a. is greater than b., the difference will be Deductible Income. 2. After those first 12 months, one half of your Work Earnings will be Deductible Income. Work Earnings means your gross monthly earnings from work you perform while Disabled, including earnings from your Employer, any other employer, or self-employment. Work Earnings will not include any renewal commissions, overwriting renewal commissions, or service fees received on business sold before you become Disabled. LTAW.09 REASONABLE ACCOMMODATION EXPENSE BENEFIT If you are Disabled and return to work in any occupation for any employer, not including self employment, as a result of a reasonable accommodation made by such employer, we will pay that employer a Reasonable Accommodation Expense Benefit as shown in the Coverage Features. The Reasonable Accommodation Expense Benefit is payable only if the reasonable accommodation is approved by us in writing prior to its implementation. LT.RA01 TEMPORARY RECOVERY You may temporarily recover from your Disability, and then become Disabled again from the same cause or causes, without having to serve a new Benefit Waiting Period. Temporary Recovery means you cease to be Disabled for no longer than the applicable Allowable Period. A. Allowable Periods 1. During the Benefit Waiting Period: a total of 30 days of recovery. 2. During the Maximum Benefit Period: 180 days for each period of recovery. B. Effect Of Temporary Recovery If your Temporary Recovery does not exceed the Allowable Periods, 1 through 5 below will apply. Printed 10/24/01 5 332175MM-LTD k 1. The Predisability Earnings used to determine your LTD Benefit will not change. 2. The period of Temporary Recovery will not count toward your Benefit Waiting Period, your Maximum Benefit Period or your Own Occupation Period. 3. No LTD Benefits will be payable for the period of Temporary Recovery. 4. No LTD Benefits will be payable after benefits become payable to you under any other group long term disability insurance policy under which you become insured during your period of Temporary Recovery. 5. Except as stated above, the provisions of the Group Policy will be applied as if there had been no interruption of your Disability. LT.TR.08 WHEN LTD BENEFITS END Your LTD Benefits end automatically on the earliest of 1 through 4 below. 1. The date you are no longer Disabled. 2. The date your Maximum Benefit Period ends. 3. The date you die. 4. The date benefits become payable under any other group long term disability insurance policy under which you become insured during a period of Temporary Recovery. LT.BE.01 PREDISABILITY EARNINGS Your Predisability Earnings will be based on your earnings in effect on your last full day of Active Work unless a different date applies (see the Coverage Features). Any subsequent change in your earnings will not affect your Predisability Earnings. Predisability Earnings means your monthly rate of earnings from your Employer, including: 1. Contributions you make through a salary reduction agreement with your Employer to: a. An Internal Revenue Code (IRC) Section 401(k), 403(b), 408(k), or 457 deferred compensation arrangement; or b. An executive nonqualified deferred compensation arrangement. 2. Shift differential pay. 3. Amounts contributed to your fringe benefits according to a salary reduction agreement under an IRC Section 125 plan. Predisability Earnings does not include: 1. Bonuses. 2. Commissions. 3. Overtime pay. 4. Your Employer's contributions on your behalf to any deferred compensation arrangement or pension plan. Printed 10/24/01 6 332175MM-LTD 5. Any renewal commissions, overwriting renewal commissions, or service fees. 6. Any other extra compensation. If you are paid on an annual contract basis, your monthly rate of earnings is one -twelfth (1/12th) of your annual contract salary. If you are paid hourly, your monthly rate of earnings is based on your hourly pay rate multiplied by the number of hours you are regularly scheduled to work per month, but not more than 173 hours. If you do not have regular work hours, your monthly rate of earnings is based on the average number of hours you worked per month during the preceding 12 calendar months (or during your period of employment if less than 12 months), but not more than 173 hours. LT. PD.24 DEDUCTIBLE INCOME Subject to Exceptions To Deductible Incommne, Deductible Income means: 1. Sick pay or other salary continuation as shown in the Coverage Features. 2. Your Work Earnings, as described in the Return To Work Incentive. 3. Any amount you receive or are eligible to receive because of your disability under any workers' compensation law or similar law, including amounts for partial or total disability, whether permanent, temporary, or vocational. 4. Any amount you, your spouse, or your children under age 18 receive or are eligible to receive because of your disability or retirement under: a. The Federal Social Security Act; b. The Canada Pension Plan; c. The Quebec Pension Plan; or d. Any similar plan, act, or law. Benefits your spouse or children receive or are eligible to receive because of your disability are Deductible Income regardless of marital status, custody, or place of residence. The Coverage Features states which one of the following options applies to your Social Security benefits. a. Full offset: Both the primary benefit (the benefit awarded to you) and dependents benefits are Deductible Income. b. Primary offset: Primary benefits are Deductible Income, but dependents benefits are not. c. Partial dependents offset: Primary benefits are Deductible Income. Dependents benefits are Deductible Income as determined below: (1) Determine the amount of your LTD Benefit as if there were no Deductible Income, and add your dependents benefits to that amount. (2) Multiply your Predisability Earnings by the dependents limit. (3) If (1) is greater than (2), the difference will be Deductible Income. Printed 10/24/01 7 332175MM-LTD 4 5. Any amount you receive or are eligible to receive because of your disability under any state disability income benefit law or similar law. 6. Any amount you receive or are eligible to receive because of your disability under any other group insurance coverage. 7. Any disability or retirement benefits you receive or are eligible to receive under your Employer's retirement plan, including a public employee retirement system, a state teacher retirement system, and a plan arranged and maintained by a union or employee association for the benefit of its members. If any of these plans has two or more payment options, the option which comes closest to providing you a monthly income for life with no survivors benefit will be Deductible Income, even if you choose a different option. 8. Any amount you receive by compromise, settlement, or other method as a result of a claim for any of the above, whether disputed or undisputed. LT.D1.02 EXCEPTIONS TO DEDUCTIBLE INCOME Deductible Income does not include: 1. Any cost of living increase in any Deductible Income other than Work Earnings, if the increase becomes effective while you are Disabled and while you are eligible for the Deductible Income. 2. Reimbursement for hospital, medical, or surgical expense. 3. Reasonable attorneys fees incurred in connection with a claim for Deductible Income. 4. Benefits from any individual disability insurance policy. 5. California Workers' Compensation benefits for permanent total or permanent partial disability. 6. Early retirement benefits under the Federal Social Security Act which are not actually received. 7. Group credit or mortgage disability insurance benefits. 8. Accelerated death benefits paid under a life insurance policy. 9. Benefits from a through h below: a. Profit sharing plan. b. Thrift or savings plan. c. Deferred compensation plan. d. Plan under IRC Section 401(k), 408(k), or 457. e. Individual Retirement Account (IRA). f Tax Sheltered Annuity (TSA) under IRC Section 403(b). g. Stock ownership plan. h. Keogh (HR-10) plan. LT.ED.06 Printed 10/24/01 8 332175MM-LTD RULES FOR DEDUCTIBLE INCOME A. Monthly Equivalents Each month we will determine your LTD Benefit using the Deductible Income for the same monthly period, even if you actually receive the Deductible Income in another month. If you are paid Deductible Income in a lump sum or by a method other than monthly, we will determine your LTD Benefit using a prorated amount. We will use the period of time to which the Deductible Income applies. If no period of time is stated, we will use a reasonable one. B. Your Duty To Pursue Deductible Income You must pursue Deductible Income for which you may be eligible. We may ask for written documentation of your pursuit of Deductible Income. You must provide it within 60 days after we mail you our request. Otherwise, we may reduce your LTD Benefits by the amount we estimate you would be eligible to receive upon proper pursuit of the Deductible Income. C. Pending Deductible Income We will not deduct pending Deductible Income until it becomes payable. You must notify us of the amount of the Deductible Income when it is approved. You must repay us for the resulting overpayment of your claim. D. Overpayment Of Claim We will notify you of the amount of any overpayment of your claim under any group disability insurance policy issued by us. You must immediately repay us. You will not receive any LTD Benefits until we have been repaid in full. In the meantime, any LTD Benefits paid, including the Minimum LTD Benefit, will be applied to reduce the amount of the overpayment. We may charge you interest at the legal rate for any overpayment which is not repaid within 30 days after we first mail you notice of the amount of the overpayment. LT.RU.01 SURVIVORS BENEFIT If you die while LTD Benefits are payable, we will pay a Survivors Benefit according to 1 through 4 below. 1. The amount of the Survivors Benefit is shown in the Coverage Features. 2. The Survivors Benefit will first be applied to reduce any overpayment of your claim. 3. The Survivors Benefit will be paid at our option to any one or more of the following: a. Your surviving spouse; b. Your surviving unmarried children under age 25; or c. Any person providing the care and support of any of them. 4. If you are not survived by a spouse or an unmarried child under age 25, no Survivors Benefit will be paid unless payment to your estate is allowed as stated in the Coverage Features. LT.SB.01 Printed 10/24/01 9 332175MM-LTD WAIVER OF PREMIUM Your insurance will continue without payment of premiums while LTD Benefits are payable. LT. WP.01 BENEFITS AFTER INSURANCE ENDS OR IS CHANGED Your right to receive LTD Benefits for a period of Disability which begins while you are insured will not be affected by: 1. Termination of the Group Policy after you become Disabled; 2. Termination of your insurance while the Group Policy remains in force; or 3. Any amendment to the Group Policy approved after the date you become Disabled. LT.BA.01 EFFECT OF NEW DISABILITY If a period of Disability is extended by a new cause while LTD Benefits are payable, LTD Benefits will continue while you remain Disabled. However, 1 and 2 apply. 1. LTD Benefits will not continue beyond the end of the original Maximum Benefit Period. 2. All provisions of the Group Policy, including the Exclusions and Limitations sections, will apply to the new cause of Disability. LT.ND.01 EXCLUSIONS A. War You are not covered for a Disability caused or contributed to by War or any act of War. War means declared or undeclared war, whether civil or international, and any substantial armed conflict between organized forces of a military nature. B. Intentionally Self -Inflicted Injury You are not covered for a Disability caused or contributed to by an intentionally self-inflicted Injury, while sane or insane. C. Preexisting Condition 1. Definition Preexisting Condition means a mental or physical condition for which you have done any of the following at any time during the Preexisting Condition Period shown in the Coverage Features: a. Consulted a Physician; b. Received medical treatment or services; or c. Taken prescribed drugs or medications. Printed 10/24/01 10 332175MM-LTD 2. Exclusion You are not covered for a Disability caused or contributed to by a Preexisting Condition or medical or surgical treatment of a Preexisting Condition unless, on the date you become Disabled, you: a. Have been continuously insured under the Group Policy for the entire Exclusion Period shown in . the Coverage Features; and b. Have been Actively At Work for at least one full day after the end of the Exclusion Period. LIMITATIONS A. Care Of A Physician LT.EX.01 You must be under the ongoing care of a Physician during the Benefit Waiting Period. No LTD Benefits will be paid for any period of Disability when you are not under the ongoing care of a Physician. B. Mental Disorder Payment of LTD Benefits is limited to 24 months for each period of continuous Disability caused or contributed to by a Mental Disorder. However, if you are confined in a Hospital at the end of the 24 months, this limitation will not apply while you are continuously confined. Mental Disorder means any mental, emotional, behavioral, psychological, personality, cognitive, mood or stress- related abnormality, disorder, disturbance, dysfunction or syndrome, regardless of cause, including any biological or biochemical disorder or imbalance of the brain. Mental Disorder includes, but is not limited to, bipolar affective disorder, organic brain syndrome, schizophrenia, psychotic illness, manic depressive illness, depression and depressive disorders, or anxiety and anxiety disorders. Hospital means a legally operated hospital providing full- time medical care and treatment under the direction of a full-time staff of licensed Physicians. Rest homes, nursing homes, convalescent homes, homes for the aged, and facilities primarily affording custodial, educational, or rehabilitative care are not Hospitals. C. Alcohol Use, Alcoholism Or Drug Use Payment of LTD Benefits is limited to 24 months during your entire lifetime for a Disability caused or contributed to by your use of alcohol, alcoholism, use of any drug, including hallucinogens, or drug addiction. LT.LM.08X A. Filing A Claim Claims should be filed on our forms. If you do not receive our forms within 15 days after you ask for them, you may submit your claim in a letter to us. The letter should include the date disability began, and the cause and nature of the disability. B. Time Limits On Filing Proof Of Loss You must give us Proof Of Loss within 90 days after the end of the Benefit Waiting Period. If you cannot do so, you must give it to us as soon as reasonably possible, but not later than one year after that 90 day period. If Proof Of Loss is filed outside these time limits, your claim will be denied. These limits will not apply while you lack legal capacity. Printed 10/24/01 11 332175MM-LTD C. Proof Of Loss Proof Of Loss means written proof that you are Disabled and entitled to LTD Benefits. Proof Of Loss must be provided at your expense. D. Documentation At your expense, you must submit completed claims statements, your signed authorization for us to obtain information, and any other items we may reasonably require in support of your claim. If you do not provide the documentation within 60 days after we mail you our request, your claim may be denied. E. Investigation Of Claim We may investigate your claim at any time. At our expense, we may have you examined at reasonable intervals by specialists of our choice. We may deny or suspend LTD Benefits if you fail to attend an examination or cooperate with the examiner. F. Time Of Payment We will pay LTD Benefits within 60 days after you satisfy Proof Of Loss. LTD Benefits will be paid to you at the end of each month you qualify for them. LTD Benefits remaining unpaid at your death will be paid to the person(s) receiving the Survivor Benefit. If no Survivor Benefit is paid, the unpaid LTD Benefits will be paid to your estate. G. Notice Of Decision On Claim You will receive a written decision on your claim within a reasonable time after we receive your claim. If you do not receive our decision within 90 days after we receive your claim, you will have an immediate right to request a review as if your claim had been denied. If we deny any part of your claim, you will receive a written notice of denial containing: 1. The reasons for our decision; 2. Reference to the parts of the Group Policy on which our decision is based; 3. A description of any additional information needed to support your claim; and 4. Information concerning your right to a review of our decision. H. Review Procedure You must request in writing a review of a denial of all or part of your claim within 60 days after you receive notice of the denial. When you request a review, you may send us written comments or other items to support your claim. You may review any non -privileged information that relates to your request for review. We will review your claim promptly after we receive your request. We will send you a notice of our decision within 60 days after we receive your request, or within 120 days if special circumstances require an extension. We will state the reasons for our decision and refer you to the relevant parts of the Group Policy. I. Assignment The rights and benefits under the Group Policy are not assignable. LT.CL01 Printed 10/24/01 12 332175MM-LTD r ALLOCATION OF AUTHORITY Except for those functions which the Group Policy specifically reserves to the Policyowner, we have full and exclusive authority to control and manage the Group Policy, to administer claims, and to interpret the Group Policy and resolve all questions arising in the administration, interpretation, and application of the Group Policy. Our authority includes, but is not limited to: 1. The right to resolve all matters when a review has been requested; 2. The right to establish and enforce rules and procedures for the administration of the Group Policy and any claim under it; 3. The right to determine: a. Eligibility for insurance; b. Entitlement to benefits; c. Amount of benefits payable; d. Sufficiency and the amount of information we may reasonably require to determine a., b., or c., above. Subject to the review procedures of the Group Policy, any decision we make in the exercise of our authority is conclusive and binding. LT.AL.01 TIME LEWITS ON LEGAL ACTIONS No action at law or in equity may be brought until 60 days after you have given us Proof Of Loss. No such action may be brought more than three years after the earlier of 1. The date we receive Proof Of Loss; and 2. The end of the period within which Proof Of Loss is required to be given. LT.TL.01 INCONTESTABILITY PROVISIONS A. Incontestability Of Member's Insurance Any statement you make to obtain insurance is a representation and not a warranty. No misrepresentation by you will be used to reduce or deny your claim or contest the validity of your insurance unless: 1. Your insurance would not have been approved if we had known the truth; and 2. We have given you a copy of a written instrument signed by you which contains your misrepresentation. After your insurance has been in effect for two years, we will not use a misrepresentation by you to reduce or deny your claim, unless it was a fraudulent misrepresentation. Printed 10/24/01 13 332175MM-LTD B. Incontestability Of Group Policy Any statement made by the Policyowner or Employer to obtain the Group Policy is a representation and not a warranty. No misrepresentation by the Policyowner or Employer will be used to deny a claim or to deny the validity of the Group Policy unless: 1. The Group Policy would not have been issued if we had known the truth; and 2. We have given the Policyowner or Employer a copy of a written instrument signed by the Policyowner or Employer which contains the misrepresentation. The validity of the Group Policy will not be contested after it has been in force for two years, except for nonpayment of premiums or fraudulent misrepresentations. LT.IN.01 CONTINUITY OF COVERAGE If your Disability is subject to the Preexisting Condition Exclusion, LTD Benefits will be payable if- 1. You were insured under the Prior Plan on the day before the effective date of your Employer's coverage under the Group Policy; 2. You became insured under the Group Policy when your insurance under the Prior Plan ceased; 3. You were continuously insured under the Group Policy from the effective date of your insurance under the Group Policy through the date you became Disabled from the Preexisting Condition; and 4. Benefits would have been payable under the Prior Plan if it had remained in force, taking into account the preexisting condition exclusion, if any, of the Prior Plan. Payment of your LTD Benefit will be under the terms of the Prior Plan or the Group Policy, whichever pays less. LT.CC.09 WHEN YOUR INSURANCE BECOMES EFFECTIVE The Coverage Features states whether your insurance is Contributory or Noncontributory. A. Noncontributory Insurance Subject to the Active Work Provisions, your Noncontributory insurance becomes effective on the date you become eligible. B. Contributory Insurance You must apply in writing for Contributory insurance and agree to pay premiums. Subject to the Active Work Provisions, your insurance becomes effective on: 1. The date you become eligible, if you apply on or before that date; 2. The date you apply, if you apply within 31 days after you become eligible; or 3. The date we approve your Evidence Of Insurability, if you apply more than 31 days after you become eligible (late application). Printed 10/24/01 14 332175MM-LTD It C. Insurance Subject To Evidence Of Insurability Subject to the Active Work Provisions, insurance subject to Evidence Of Insurability becomes effective on the date we approve Evidence Of Insurability. D. Takeover Provisions 1. If you were insured under the Prior Plan on the day before the effective date of your Employer's coverage under the Group Policy, your Eligibility Waiting Period is waived on the effective date of your Employer's coverage under the Group Policy. 2. You must submit satisfactory Evidence Of Insurability to become insured for insurance if you were eligible for insurance under the Prior Plan for more than 31 days but were not insured. ACTIVE WORK PROVISIONS A. Active Work Requirement LT.EF.03 If you are incapable of Active Work because of Physical Disease, Injury, Pregnancy or Mental Disorder on the day before the scheduled effective date of your insurance, your insurance will not become effective until the day after you complete one full day of Active Work as an eligible Member. Active Work and Actively At Work mean performing the Material Duties of your Own Occupation at your Employer's usual place of business. You will also meet the Active Work requirement if: 1. You were absent from Active Work because of a regularly scheduled day off, holiday, or vacation day; 2. You were Actively At Work on your last scheduled work day before the date of your absence; and 3. You were capable of Active Work on the day before the scheduled effective date of your insurance. B. Changes In Insurance This Active Work requirement also applies to any increase in your insurance. However, if you return to Active Work during a period of Disability or Temporary Recovery (see Temporary Recovery), you will not qualify for any change in insurance caused by a change in: 1. Your status as a member of a class; 2. The rate of earnings used to determine your Predisability Earnings; or 3. The terms of the Group Policy. WHEN YOUR, INSURANCE ENDS Your insurance ends automatically on the earliest of: LT.AW.05 Printed 10/24/01 15 332175MM-LTD 1. The date the last period ends for which you made a premium contribution, if your insurance is Contributory. 2. The date the Group Policy terminates. 3. The date your employment terminates. 4. The date you cease to be a Member. However, if you cease to be a Member because you are not working the required minimum number of hours, your insurance will be continued during the following periods, unless it ends under 1 through 3 above. a. While your Employer is paying you at least the same Predisability Earnings paid to you immediately before you ceased to be a Member. b. During the Benefit Waiting Period and while LTD Benefits are payable. c. During a leave of absence if continuation of your insurance under the Group Policy is required by a state -mandated family or medical leave act or law. d. During any other leave of absence approved by your Employer in advance and in writing and scheduled to last the Leave Of Absence Period shown in the Coverage )Features. LT.EN.28 REINSTATEMENT OF INSURANCE If your insurance ends, you may become insured again as a new Member. However, the following will apply. 1. If your insurance ends because you cease to be a Member, and if you become a Member again within 90 days, the Eligibility Waiting Period will be waived. 2. If your insurance ends because you fail to make a required premium contribution, you must provide Evidence Of Insurability to become insured again. 3. If your insurance ends because you are on a federal or state mandated family or medical leave of absence, and you become a Member again immediately following the period allowed, your insurance will be reinstated pursuant to the federal or state mandated family or medical leave act or law. 4. The Preexisting Conditions Exclusion will be applied as if there had been no break in coverage in the following instances: a. If you become insured again within 90 days. b. If required by federal or state mandated family or medical leave act or law and you become insured again immediately following the period allowed under the family or medical leave act or law. LT.RE.01 DEFINITIONS Benefit Waiting Period means the period you must be continuously Disabled before LTD Benefits become payable. No LTD Benefits are payable for the Benefit Waiting Period. See Coverage Features. Contributory means you pay all or part of the premium for your insurance. CPI-W means the Consumer Price Index for Urban Wage Earners and Clerical Workers published by the United States Department of Labor. If the CPI-W is discontinued or changed, we may use a comparable index. Where required, we will obtain prior state approval of the new index. Printed 10/24/01 16 332175MM-LTD Eligibility Waiting Period means the period you must be a Member before you become eligible for insurance. See Coverage Features. Providing Evidence Of Insurability means you must: 1. Complete and sign our medical history statement; 2. Sign our form authorizing us to obtain information about your health; 3. Undergo a physical examination, if required by us, which may include blood testing; and 4. At your expense, provide any additional information about your insurability that we may reasonably require. Group Policy means the group long term disability insurance policy issued by us to the Policyowner and identified by the Group Policy Number. Indexed Predisability Earnings means your Predisability Earnings adjusted by the rate of increase in the CPI-W. During your first year of Disability, your Indexed Predisability Earnings are the same as your Predisability Earnings. Thereafter, your Indexed Predisability Earnings are determined on each anniversary of your Disability by increasing the previous year's Indexed Predisability Earnings by the rate of increase in the CPI-W for the prior calendar year. The maximum adjustment in any year is 10%. Your Indexed Predisability Earnings will not decrease, even if the CPI-W decreases. Injury means an injury to your body. LTD Benefit means the monthly benefit payable to you under the terms of the Group Policy. Maximum Benefit Period means the longest period for which LTD Benefits are payable for any one period of continuous Disability, whether from one or more causes. It begins at the end of the Benefit Waiting Period. No LTD Benefits are payable after the end of the Maximum Benefit Period, even if you are still Disabled. See Coverage Features. Noncontributory means the Policyowner or Employer pays the entire premium for your insurance. Physical Disease means a physical disease entity or process that produces structural or functional changes in your body as diagnosed by a Physician. Physician means a licensed medical professional, other than yourself, acting within the scope of the license. Pregnancy means your pregnancy, childbirth, or related medical conditions, including complications of pregnancy. Prior Plan means your Employer's group long term disability insurance plan in effect on the day before the effective date of your Employer's coverage under the Group Policy and which is replaced by the Group Policy. LT.DF.06 Printed 10/24/01 17 332175MM-LTD NOTICE OF PLAN CHANGE WE Members insured under Group Policy 332175MM-LTD issued to City of Huntington Beach as Policyowner. Effective March 30, 2002, and subject to the Active Work Provisions, the Schedule of Insurance portion of the Coverage Features has been amended to provide the following for you: Benefit Waiting Period: The longer of: a) 30 days or b) the sum of the period for which you receive injured -on -duty pay and the period for which you choose to receive sick leave benefits under the Employer's sick leave plan. Please attach this notice to your certificate. STANDARD INSURANCE COMPANY CITY OF HUNTINGTON BEACH INTER -DEPARTMENT COMMUNICATION HUNTINGTON BEACH Connie Brockway, City Clerk Office of the City Clerk Liz Ehring, Deputy City Clerk 11 To: Date:IW/;L 16 2 Meeting Date: Proposed City Council Agenda Items: The City Clerk's Office/City Administrator's Office must return your agenda item due to the following requirements that have not been met. When your Agenda Item is ready to resubmit, please return to: Elaine Kuhnke, Management Assistant, Administration 1. Signature(s) Needed A On RCA B On Agreement C Other 2. Attachments A Missing B Not identified C Other 3. Exhibits A Missing r' B Not identified C Other 4. Insurance Certificate (Proof Of Insurance) A Not attached B Not approved by City Attorney's Office C Signed form notifying City Clerk that department will be responsible r obtaining insurance certificate on this item. (See form attached) 5. Wording On Request For Council Action (RCA) Unc!,wSr A Recommended Action on RCA not complete B Clarification needed on RCA C Other 6. City Attorney Approval Required 7. Agreement Needs To Be Changpd A Page No. 8. Other. 9_. 4 2--� Tom. _ G: agenda/m isdreaform INITIATING DEPARTMENT: ADMINISTARTIVE SERVICES SUBJECT: APPROVAL OF MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY AND THE HUNTINGTON BEACH MUNICIPAL EMPLOYEES' ASSOCIATION COUNCIL MEETING DATE: December 16, 2003 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached Tract Map, Location Map and/or other Exhibits Not Applicable Contract/Agreement (w/exhibits if applicable) Signed in full by the City Attorney Not Applicable Subleases, Third Party Agreements, etc. Approved as to form by City Attome Not Applicable Certificates of Insurance (Approved by the City Attorney) Not Applicable Financial Impact Statement (Unbudget, over $5,000) Not Applicable Bonds (If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial Not Applicable -' 1 11W0', -1 11 1 1, Mi-RIH REVIEWED RETURNED FORWARDED Administrative Staff Assistant City Administrator Initial City Administrator Initial City Clerk ( ) EXPLANATION FOR RETURNO; RCA Author: William McReynolds