BJH Benefits Policies
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1 BJH Benefits Policies 4.0 VACATION, LEAVE, MEALS, LAB COATS, and PARKING: Through the auspices of the GME Consortium and the Hospital, House Officers are provided the following schedule of benefits: 4.1 Vacation and Leave: House Staff have a total of 30 paid workdays off. For purposes of this policy, a workday id defined as Monday through Friday. 15 of those days are defined as vacation. Vacation days should be scheduled in advance and may be taken at any time during the year with the approval of the Program Director. There are no recognized holidays. Duties are assigned by each Program Director House Staff may be paid for up to 15 days of leave in case of their own illness. This leave may also be used for your own medical conditions related to pregnancy and childbirth. In the case of any extended illness or disability, House Staff must use available vacation days after they have exhausted their 15 days of paid leave. Paid time off does not carry over from year to year nor is there a payment for any days that are not sued. For purposes of this policy, the year begins on July 1. Time off will be prorated for House Staff who join Barnes-Jewish throughout the year. Additional unpaid leave may be available in certain circumstances, with the approval of the Program Director. Additional leave may require extension of the training program depending on the guidelines established by the ACGME, Residency review Committee and/or certifying Board for that particular program. Leave must be requested in advance of the actual leave. Additional documentation may be required by your training program to suspend the award and /or accrual of service in order to calculate the time away from the training program. To obtain further information regarding how a leave relates to Board requirements, contact your Program Director. The Leave Policy is intended to provide you with specified paid time off, as well as unpaid leave should the need arise. This leave policy ensures that House Staff have the opportunity to rest and provides financial security in case of illness. It is intended to comply with the federal Family and Medical Leave Act (FMLA) as applicable. 4.2 FMLA: House Officers who are eligible (employed within BJC HealthCare for at least 12 months and worked at least 1,250 hours during the 12 months prior to the commencement of the leave) may request leave for his/her own serious health condition, the care of a new child or the health care of a seriously ill family member. Unpaid leave for a maximum of 12 weeks in a 12 month period of time, which is calculated by looking backward at the amount of leave taken within the 12 month period immediately preceding the commencement of the requested leave, will be granted per FMLA stipulations. Medical certification will be required for leaves due to your or your family member s serious health condition. Conditions and requirements apply; see also BJC Policy 4-8, Family and Medical Leaves of Absence, FMLA.
2 NON-FMLA: For those situations in which you, for any reason, do not qualify for a FMLA leave, you may request a leave from the Program Director. The granting of such leave, as well as the duration thereof, is at the discretion of the Program Director. You may apply for such leave with respect to absences in excess of thirty (30) consecutive calendar days. You must supply such supporting documentation as requested by the Program Director including, for medical leaves, a physician s certification Only the first six weeks of any such leave will be paid, and then only if you have available vacation or paid leave. Any additional leave time shall be unpaid. Additional training after a leave of absence may be needed for successful completion of program requirements and/or for Board certification requirements. The amount of time you must prolong your training program shall be determined by the Program Director and the requirements of the pertinent RRC and/or certifying Board. For more information, see BJC HealthCare Policy 4-9, Non-FMLA Leaves of Absence. 4.3 Meals are available at reduced rates in the cafeteria with the use of a hospital issued identification badge throughout the regular business day and overnight during in-house call periods. Vending machines with nutritious food and other refreshments are also available throughout Barnes-Jewish Hospital on a 24-hour basis. Each House Officer receives two on-call meal vouchers worth $5.00 each per on-call period. An on-call period is defined as restricted to premises for a minimum of six hours after This does not include rotations scheduled after With the move of the Graduate Medical Office to the Barnes-Jewish Center for Outpatient Health in 2012 this process may change. 4.4 On-call quarters are provided in the Hospital for overnight assignments. Problems with call rooms should be reported to the appropriate maintenance, housekeeping or telecommunications office. It is important to provide a thorough description of the problem in the call room, as well as the location of the call room. The Hospital does not provide living quarters for the House Staff or their families during the training year. 4.5 Free parking is provided in the Duncan Taylor Garage and Lot and the Busch Lot. Permits are available in the Security office free of charge. Overflow parking is available in the St. Louis Children's Hospital employee parking garage. The Hospital provides shuttle bus service from the parking areas to the Hospital. Permits and maps will be available for incoming House Staff at orientation. Make/model of your car as well as the license plate number required for a parking permit. 4.6 Lab Coats are provided for you by the hospital. Scrubs are laundered by the Hospital, and should not be regularly worn while off duty. 4.7 The BJC Employee Assistance Program (EAP) helps you deal with problems in life that can affect your job performance and quality of life. The EAP provides professional counseling and work/life referral services to ensure that you and your family receive the help, guidance and support that you need.
3 The EAP offers a variety of short-term problem resolution therapy services in person, by phone and through the Internet. The number of short-term counseling sessions provided under the EAP is based on clinical need. Call or if you are out of the St. Louis area at for EAP service information, to make an appointment or to speak with a professional to talk over your concern. 4.8 Impaired Physicians in Training: The Hospital follows the GME Consortium s Policies and Procedures for Identification and Treatment of Impaired Physicians in Training when performance is affected by mental health problems or substance abuse. The intent of this policy is to facilitate treatment of the impaired House Officer and to ensure the safety of patients, family and significant others. A copy of the policy is provided during orientation and when revisions occur they are posted on the GME website. 4.9 As a member of Graduate Medical Education Training Programs, House Officers are not afforded participation in the Hospital s tuition reimbursement program. 5.0 PROFESSIONAL LIABILITY INSURANCE: Barnes-Jewish Hospital provides professional liability coverage through a self-funded trust to House Staff. Coverage levels for malpractice claims and lawsuits are maintained at a minimum of $1,000,000 per occurrence. Additional, excess coverage is provided through BJC HealthCare. Occurrence type coverage precludes the need for extended reporting ( tail coverage) when you finish your program. Potential claims, patient injury or concerns regarding events arising from your training at Barnes-Jewish Hospital should be directed to BJH Risk Management at or EARLY REPORTING IS ESSENTIAL to manage loss or damage. We encourage verbal or telephone reports to expedite contact with Risk Management. When you rotate to other institutions in the WUMC, the institution where you care for patients at the time of an incident will provide coverage of a similar nature for claims and lawsuits. Please report incidents to the risk management staff at the institution where you are/were on rotation. If you are involved in a potential liability incident, do not provide written information to anyone about the incident (including your attending) without first consulting risk management. Without proper protection, this information can be discoverable in a subsequent lawsuit. The risk management coordinators will help you deal with an incident without creating unnecessary risk of disclosure. As a condition of professional liability coverage and your employment you must participate in the defense of claims against you, your fellow Barnes-Jewish employees and related institutions. For continuation of your coverage, even after completion of your program, continued cooperation is required. Barnes-Jewish Hospital reserves the right to terminate your coverage or otherwise recover resulting losses should you fail to cooperate in the defense of a malpractice claim in which you are involved in any way, even as a fact witness. Your participation may require time for a deposition or trial testimony once you are in private practice or other settings. It also will include time to meet with risk
4 management personnel and defense counsel. Risk Management makes every effort to minimize these impositions on your schedule, but they are essential. Live testimony from House Officers and presence at trial are among the strongest defense tools we have. Your insurance program covers thousands of House Officers and other employees. We do not reimburse for your time involved in the defense process, though we will reimburse for preapproved out of pocket expenses. Risk Management will also provide information concerning your coverage and claims history to any licensing or insuring entities. Inquires should be directed to: Mail Stop Angela R. Standish Director, Claims/Litigation BJC HealthCare 600 Taylor Avenue, Suite 154 St. Louis, MO NOTICE: The benefits described in sections 6.0 through 11.0 are available to Hospital employees and their dependents who meet the eligibility requirements of the corresponding benefit plans. The plan documents provide a full description of the benefits offered, including eligibility, coverage, limitations, and exclusions. The plan documents will always govern if there is a discrepancy between this letter and any of the plan documents. BJC hopes to continue the plans indefinitely, but it reserves the right to end or change any of the plans at any time and for any reason. To obtain a copy of the Summary Plan Description (SPD) for each plan, go to MEDICAL & DENTAL INSURANCE: Enrollment is available for newly benefit eligible House Officers, their spouses and their dependent children up to age 26, same-gender domestic partners of House Officers and children of the House Officer s same-gender domestic partners. They are eligible to participate in medical and dental plans under which the House Officer is enrolled provided enrollment occurs within the first 31 days of employment. Coverage becomes effective the first day of the month following the date you submit completed enrollment paperwork and any required documentation for your dependents as long as you do so within 31 days of your eligibility date. If you are continuing in the training program and were previously enrolled, your coverage will continue until the next fall enrollment period. It is your responsibility to enroll and verify appropriate payroll deductions are being taken for the benefits you have. DEPENDENT ELIGIBILITY VERIFICATION: Please note that if you are enrolling your spouse or dependent children for the first time, your dependents will need to be
5 verified by our eligibility administrator, Secova. If this applies to you, you will receive a verification packet from Secova, and you will be asked to provide appropriate documentation by the deadline indicated in your packet. The packet will contain specific information, but generally, it includes the following: To verify a spouse or same gender domestic partner: marriage certificate and utility bill/bank statement OR a Tax reurn, and To verify a child: birth certificate OR tax return. The deductibles, out-of-pocket maximums, copays, coinsurance, and other amounts noted in Sections 6.1 through 10 below are applicable to the 2011 calendar year. They may change for the 2012 calendar year (as such are not yet determined). 6.1 Medical Insurance: BJC offers a self-funded medical plan, administered by GHP, called the BJC HealthCare Access Plus Plan (P0S). You receive higher benefits when you use an in-network primary care physician, specialists and hospitals. You may also seek care on your own from an out-ofnetwork health care provider, but will receive a lower level of reimbursement. When you use the BJC HealthCare Access Plus Plan in-network providers there is no individual or family deductible. Out-of pocket maximums are $ 1,500(individual) or $3,000 (family) per calendar year (for the 2011 Calendar year). Most office visits will cost you a $15 co-payment. Beginning in 2011, all Preventive care and immunizations are paid at 100% if care is received from an in-network provider. The plan covers 80% of covered expenses for ambulance transportation. Inpatient care for alcoholism, chemical dependency and mental health services are provided at no charge; outpatient care for these services is covered with a $15 member co-payment per visit. The plan requires a $75 co-payment for hospital emergency treatment. The emergency co-payment is waived if you are admitted from the emergency unit. If you seek care from a non-network provider, benefits will be reimbursed at 70% of covered expenses after a $300 (individual) or $900 (family) calendar-year deductible is met. The out-of-pocket maximum per member is $2,000 (individual) or $4,000 (family) per calendar year. The medical plan also provides prescription coverage with a co-payment for each eligible prescription purchased. Generic formulary drugs are $10, brand name formulary drugs are $25, and non-formulary drugs are $40 for up to a 31-day supply when obtained at a participating pharmacy. Dental Insurance: BJC offers a dental plan, administered by Essex Dental Benefits, called the High Option, which lets you choose your provider each time you receive dental care. If you select a PPO network provider, you receive greater benefit than if you use a non-network provider.
6 Coverage is as follows: Annual Deductible (per calendar year 2010 calendar year) Essex Dental Benefits High Option NETWORK $50/Individual $100/Family NON-NETWORK $50/Individual No family limit Preventive Care 100% (no deductible) 80% (no deductible) Basic Care 80% (after deductible) 60% (after deductible) Major Care 60% (after deductible) 40% (after deductible) Orthodontia Care 60% (after deductible) 40% (after deductible) Ortho Life Maximum $ 2,000 $ 1,500 Annual Maximum (per calendar year 2010 calendar year) $ 2,000 $ 1, LIFE AND AD & D INSURANCE: Basic Life and accidental death and dismemberment (AD & D) coverage equal to one times base salary is provided and paid by the Hospital for regular, full-time employees. Coverage is effective the first day of the month following employment for new, full-time employees. Additional coverage may be purchased up to five times the base annual salary. The minimum benefit under the plan is $15,000 and the maximum benefit is $ 1.5 million. If an employee s life insurance coverage is in excess of $50,000 the IRS requires that the cost of coverage over $50,000 be considered taxable income. The cost is calculated according to a table that uses rates established by the IRS based on the employee s age. In addition to life insurance for yourself, you may choose life insurance for your spouse and eligible dependents. If you choose to enroll for dependent life insurance coverage you may elect one of seven levels. Your choices will be (1) No Coverage, (2) Spouse only $20,000, (3) Child only coverage (per child) $5,000, (4) Spouse coverage $20,000, Coverage per child $5,000, (5) Spouse only coverage $50,000, (6) Child only coverage (per child) $10,000, (7) Spouse coverage $50,000, Coverage per child $10,000. If you do not enroll for dependent life insurance within 31 days of the day you and your dependents are first eligible, you will be required to complete evidence of insurability forms. Because of tax laws, you must pay for this dependent life insurance coverage with after-tax dollars. 8.0 LONG-TERM DISABILITY: House Officers are automatically enrolled in Long Term Disability (LTD) upon employment through group coverage insured by The Paul Revere Life Insurance Company, a wholly owned subsidiary of UNUMProvident Corporation. This long-term disability coverage provides a benefit up to 60% of earnings to a program maximum benefit of $3,000 per month after an elimination
7 period of 90 days if you are disable due to an accident or illness. Benefits are integrated with Social Security payments and other listed sources. 9.0 REIMBURSEMENT ACCOUNTS: You will have an opportunity to take advantage of Healthcare and Dependent Care (Child Care) reimbursement accounts. With these accounts, you can set aside money from your paycheck before taxes are withheld to pay for eligible health and dependent daycare expenses during the calendar year. You must use the money set aside in the reimbursement accounts for eligible services. Any money left in the account will be forfeited. Please note that beginning 2011, over the counter drugs without a prescription will no longer qualify for reimbursement under the health care reimbursement account. Refer to your Summary Plan Description and Summary of Material Modifications for more detail RETIREMENT SAVINGS: You will have the opportunity to save for retirement through the BJC 401(k) Plan or the 403(b) Plan (if applicable). You choose the amount you want to save, subject to tax code limits. You can defer current income tax until you receive your money, usually during your retirement years, when you may be in a lower tax bracket LONG TERM CARE INSURANCE: You may choose to purchase Long Term Care Insurance through UNUMProvident Life Insurance. This coverage assists you in protecting against catastrophic costs of long-term care. Please access UNUMProvident Life Insurance web-site for more information. The long term care insurance program is not endorsed, offered or sponsored by the Hospital. This is an entirely voluntary insurance program between you and the insurance company, if you choose to enroll in the program. No contributions are made by the Hospital. All premiums are due from the employee, but the Hospital may permit applicable premiums to be paid through payroll deduction on an after-tax basis. The insurance company is permitted to publicize the programs to the employees. The Hospital does not receive any consideration in the form of cash or otherwise in connection with this insurance program. GMEC Revised/Approved November 14, 2011
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