|State & Federally Mandated Benefits|
The District pays the cost of unemployment insurance on your behalf. Should you become unemployed for any reason, you may apply for unemployment insurance at your local office of the state's Employment Development Department (EDD). This department will determine if you are eligible to receive unemployment compensation. For more information, please call your local EDD office.
If you have a job-related illness or injury that requires medical care (beyond first aid) and/or it requires you to take time off from work, you may file a claim for Workers' Compensation benefits. You may obtain an Employee's Claim for Workers' Compensation benefits form from your supervisor or the time reporter at your work site.
If you are off work because of a job-related illness or injury, you may continue to receive your full salary for up to 60 days. The salary continuation you receive from the District while out on an industrial illness or injury leave will reflect on your paycheck as an amount equal to the temporary disability payments authorized by the Workers' Compensation administrator and the amount paid by the District. The total of these amounts will equal your usual full salary. After 60 days of salary continuation, if you are still unable to work as a result of an industrial illness or injury, the difference between the temporary disability payment authorized by the Workers' Compensation administrator and your regular salary will be deducted from your accumulated illness pay benefits. If you have no illness or vacation balance remaining, the Workers' Compensation administrator will send disability payments directly to you.
Your District-sponsored health care benefits will continue for as long as you continue to receive any part of your salary from the district. If you do not receive any salary from the District for an entire pay period, your District-sponsored benefits will end and you will receive a notice to pay premiums under COBRA if you want to continue your health care coverage.
Please note this rule applies even if you are still receiving temporary disability payments under Workers' Compensation.
For more information, please call the District's Workers' Compensation Section at (213) 241-3138.
Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a normal vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending physician, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, health plan providers may not require that a provider obtain authorization for prescribing a hospital length of stay of less than 48 hours (or 96 hours).
Federal law requires group health plans to provide coverage for the following services to an individual receiving plan benefits in connection with a mastectomy:
Each group health plan must determine the manner of coverage in consultation with the attending physician and patient. Benefits for breast reconstruction and related services must be consistent with the deductibles and coinsurance amounts that apply to other similar services covered under the plan.
The District is committed to providing equal employment opportunities for individuals with disabilities and does not discriminate on the basis of a disability in the admission, access, treatment or employment in its programs or activities. The District has established a return to work program (Stay at Work) to assist injured and/or ill employees in continuing gainful, productive and rewarding employment. Paticipation in the program is mandatory for both the District and its employees. For additional information about reasonable accomodations or early return to work, please contact the Division of Risk Management and Insurance Services, Integrated Disability Management Unit at 213-241-3974.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), apply to health information created or maintained by health care providers who engage in certain electronic transactions, health plans, and health care clearinghouses to protect the privacy of personal health information. For more information, click here to visit the The Department of Health and Human Services (HHS) web site.
Qualified Medical Child Support Order
A Qualified Medical Child Support Order (QMCSO) is an order of judgment from a court or administrative body directing the Plan to cover a child of a participant under the group health plan. Federal law provides that a medical child support order must meet certain form and content requirements in order to be QMCSO. When an order is received each affected participant and each child (or child's representative) covered by the order will be given notice of the receipt of the order and a copy of the Plan's procedures for determining if the order is valid. Coverage under the Plan pursuant to a QMCSO will not become effective until the Plan Administrator determines that the order is a QMCSO. If you have any questions about the procedure for determining if the order is valid, please contact Benefit Administration.