Manager Checklist for Employee Resignations Your role in the resignation process is very important. How a separation is handled impacts both financial and public relations for the employee and Fairview. With Fairview s attention on recruitment and retention, one goal is to make resigning a smooth process that will encourage former employees to return to Fairview in the future. A returning employee reduces (or eliminates) the cost of new employee training in addition to great public relations on how it s good to be back at Fairview. Paperwork drives the process of resignation. Official processing cannot occur until forms reach Human Resources. Encourage early completion of all forms so the process can run smoothly and we can meet the employee s expectations about final paychecks and notifications. This should all occur prior to the employee s last day of work. Termination notice requirements: Proper notice is defined as two weeks for technical, clerical and entry positions and four weeks for professional and management positions. Paid time off (PTO) cannot be used during the notice period unless pre-approved (before giving notice). If you think special circumstances exist, contact HR. This can impact the employee s final check. Final time sheet: Carefully review the final timesheet for accuracy since this impacts the employee s final paycheck. Questions about final work hours can be difficult to resolve once the employee has left the work area. Form completion requirements: Review the termination check off form with the employee. It is very important for the employee to sign the resignation/termination form due to potential liability (we do not want the manager to sign for the employee unless absolutely necessary). To refill the position, begin the requisition process immediately. Return of Fairview property: Make arrangement to gather ID badge, keys, pagers and any other Fairview owned material from the employee prior to departure on the final day of work. Note: this could impact your budget if monthly charges apply; return items for credit. Rehire options and bridge of service (non-union): Fairview is very interested in rehire possibilities for former employees who leave in good standing. If the employee is rehired within 6 months and was in a benefit status position prior to termination, certain benefits may be reinstated. Contact your HR representative for more details and questions. Exit interview: Please help us gather information that will assist in building employee engagement. Encourage all employees to complete the exit interview either in person or by mail. Human Resources will conduct in person exit interviews. Dual employees: If an employee has multiple positions within Fairview, determine if their resignation is from one or multiple positions. If multiple, have the employee complete a termination/resignation form for each position. Email and voicemail: Check the messages that are being sent to callers through the employee s email/voicemail. If the employee has not recorded appropriate messages, contact the IMS (612-672-6805) for help to override or clear the messages. Transition plan: Make arrangements for transitioning the employee s work/knowledge to others within the department or to yourself. Your working employee file: If there are any potential ramifications regarding the end of situations, your copy of the employee s file should be sent to HR for review and long-term legal retention. DON T DISCARD.
Manager Checklist for Employee Resignations, continued Repayment requirements: If you are aware of any repayment obligations (example: FPP options, bonuses, tuition reimbursement), contact Human Resources as soon as possible so they can handle details prior to the employee s final day of work. Alumni recruiting: It is important for you to assess whether the terminating employee would be a good candidate for future alumni recruiting initiatives. If so, please provide this information to your Human Resource area. Intranet access: Managers MUST complete ASR (Application Service Request) for on the intranet to remove system access for all terminating employees. This can be done by going to the Intranet home page and using the first quick link under office.
Employee Resignation Instructions/ Check off Form As you prepare to leave, please keep in mind that Fairview is always interested in rehire possibilities for former employees who left in good standing. Contact any Human Resource area for more information in this regard. Before you resign: 1. Resignation Notice Requirements: All voluntary resignations require proper notice to your supervisor. Proper notice is defined as two weeks for technical, clerical and entry positions and four weeks for professional and management positions. Lack of proper notice will result in the forfeiture of ½ of your PTO/vacation bank. Paid time off cannot be used during the notice period unless pre-approved. Union employees and physicians should refer to your contract. 2. Resignation Date: The termination effective date is defined as your last actual day of work and cannot be extended by PTO or vacation time. If an employee does not return from an FMLA approved leave of absence, the termination date is the last day of the FMLA leave. 3. Form Completion Requirements: Everyone must complete the Resignation/Termination form included in this packet. It is important that we have your current home address for use in delivering future information (i.e. W2 s, final pay check, pension information). Be sure to complete the Home Address section. 4. Repayment Requirements: Certain situations involve repayment obligations: SOS Loans, Tuition Reimbursement if received in the last 12 months, FPP lump sum/education/time off/tda options if you resign within a year, scholarships/loans or funding requiring a longevity commitment, hiring/retention/referral bonuses requiring a longevity commitment or financial commitments for which you signed a repayment agreement form. When possible, obligations will be deducted from the final paycheck. If the entire funds are not available, you will be billed. 5. Parking: If you have a parking contract, contact the parking office to cancel your contract. This needs to be done by the Wednesday before the start of your final pay period. You must return your parking card to obtain a refund of your deposit. Parking Services phone numbers are: University Campus: 612-273-6674, Riverside/Corporate: 612-672-7275, Southdale: 952-924-5016. 6. Exit Interview: We encourage you to have an in-person exit interview before you leave. Complete the enclosed exit interview form to identify the strengths of your employment experience and our improvement opportunities and bring with you to the in-person interview. If you are unable to complete this prior to leaving, use the postage paid envelope provided. In-person exit interviews are available by contacting Human Resources. 7. Retirement: If your resignation is for retirement and you are in the Fairview Pension Plan, contact the pension area 612-672- 7874. If you are in a union plan, contact the representative listed on the Q & A pension sheet. The process to initiate retirement benefits takes 60 to 90 days so if you have not started this, do so immediately. Also, please complete the enclosed Retirement Form. This form does not initiate the retirement process but is necessary for other reasons. Refer to the retirement information sheets for more details. 8. Resignation from Dual Position (s): If you hold more than one position within Fairview, we ask that you provide detailed information on all other positions currently held (see dual section of form). If you are resigning from more than one of these positions, it is necessary for you to complete a separate Resignation/Termination form for each position. 9. Transition Plan: Please meet with your supervisor to determine a transition plan for any work you have in process, hand over work related items and be sure to clear personal items from your work area. On your last day of work: 10. Final Time Sheet: Complete your time sheet prior to leaving so your final paycheck is accurate. Work with your supervisor.
Employee Resignation Instructions/ Check off Form, continued. 11. Return of Fairview Property: Fairview property must be returned prior to your departure. This includes: keys, ID badge, uniform/lab coats, beepers, cell phones, computers, files/information manuals and parking/purchasing cards. Make all arrangements with your supervisor. Fairview software and information on home computers must be deleted. 12. E-mail and Voice Mail: If you have voice mail and e-mail, please change your messages to indicate your departure, who will be fulfilling your responsibilities and how they can be contacted. Provide your supervisor with your passwords. After you resign: 13. PTO or Vacation Payouts: Terminal PTO or Vacation payouts will occur on your last paycheck only if you have completed the Resignation/Termination form and submitted it following the notice requirements. Taxes are withheld based on your total gross pay including worked hours and terminal PTO/Vacation. Taxation on lump sum payments is governed by taxation laws and cannot be altered by the organization. 14. Insurance Coverage End Dates: Health, dental and life insurance coverage terminates at the end of the month in which your regularly scheduled employment ends. If you are eligible for disability insurance, the coverage end date will be your last day of work as an active employee. If a catch up deduction is required, you will be notified. 15. Insurance Continuation Options: Benefit status employees are eligible to continue health, dental and life insurance coverage past the resignation date through COBRA. You will receive information on this through the mail within 45 days of the processing of your resignation. See COBRA information sheet in the packet. 16. Fairview Pension Fund Options: If you are a participant in a Fairview pension plan, you will receive information on options you have regarding your fund balance. Information will be mailed to your home address within 8 to 10 weeks of the processing of your resignation. See pension Q&A sheet in the packet. 17. Union Sponsored Pension Plans: If you are a participant in a union sponsored pension plan, see pension Q&A sheet for contact numbers. 18. Optional Retirement Programs/Plans: 403(b): If you are a participant in the 403(b) retirement program, refer to pension Q&A sheet for contact information regarding options upon your termination. 401(k): If you are a participant in the 401(k) retirement plan, contact the Pension Area at 612-672-2868 regarding your termination and what options you may have. 19. Deferred Compensation (limited participation): If you are a participant in deferred compensation plans, contact Pension at 612-672-6297 to discuss options. 20. 457(b) Plan Participants (very limited participation): If you are enrolled in this plan, contact pension at 612-672-6297 no later than 2 weeks from your term date. 21. Fairview Employment References: Fairview provides position title and dates of employment as reference information for future employers. 22. Rehire Options and Bridge of Service (Non-Union Employees): As stated earlier, Fairview is very interested in rehire possibilities for former employees who left in good standing. If you are rehired within 6 months and were in a benefit status position prior to your termination, certain benefits may be reinstated. Contact your Human Resource Department for further information and criteria on the Bridge of Service policy. Union employees should refer to the current contract. 23. Final Paycheck: Your last paycheck will follow the normal payday schedule unless there are unique circumstances. Your final check or direct deposit slip will be mailed to your home. 24. Spending Account Participants: Your eligibility to participate in pre-tax spending accounts terminates at the end of the month in which your regularly scheduled employment ends. You will receive fund balance information and instructions in the mail within 4 weeks of the processing of your resignation. See the Medical and Dependent Care Spending Account information sheet for further information.
Employee Resignation Instructions/ Check off Form, continued Employees must meet with their supervisor to review, sign and date this checklist. When the form is complete and signed, the supervisor should return to Human Resources for inclusion in the employees HR file. Employee Signature: Date: Supervisor Signature: Date: Fairview is An Equal Opportunity Employer
Employee Resignation Exit Interview Thank you for taking the time to provide honest and candid feedback regarding the following questions. This information will be helpful as we review both the strengths of your employment experience with us in addition to any opportunity we have for improvement. Please return completed form to Human Resources (either during your personal exit interview or by using the self-addressed stamped envelope provided). 1. Please indicate your one main reason for resigning from Fairview: Relocation Career Advancement Family Reasons Better Pay Dislike Duties Work Environment Health Issues Better Work Hours Better Benefits Retirement Supervisor Issues Return to School Temporary position ended Other: 2. If there were additional reasons for your change, please indicate all that apply: Relocation Career Advancement Family Reasons Better Pay Dislike Duties Work Environment Health Issues Better Work Hours Better Benefits Retirement Supervisor Issues Return to School Temporary position ended Other: 3. Would you recommend employment at Fairview to friends and or relatives: YES NO At my previous work area/unit. YES NO Within the Fairview system at large. 4. What did you like best about your employment here: 5. Is there anything you feel that Fairview could have done to prevent you leaving your current position? NO YES if checked, please explain: 6. Are you aware of any illegal activities occurring at Fairview? If so, please call the Corporate Compliance Hotline at 612-672-2300.
Employee Resignation/Exit Interview, continued 7. For each item presented below, please indicate which response best expresses your feelings as it relates to the job you most recently held. I felt that my performance and contributions were recognized I felt that salaries paid by Fairview were similar to those paid by other organizations for the same jobs I felt that my concerns were heard and responded to I was satisfied with the time off benefits and policies I was satisfied with the insurance benefits I received I was satisfied with the level of supervision I received I felt that I had appropriate information and training in order to do my job well I was satisfied with the manner in which I was supervised I felt that my ideas and suggestions were welcomed I felt that my workload was reasonable I felt that the work environment was adequate and safe I felt informed on subjects I needed to know in order to do my job well Strongly Agree Neutral Disagree Strongly Not Agree Disagree Applicable 8. If you indicated dissatisfaction with any of the items listed above, please indicate what would have increased your satisfaction with those items: 9. Please provide the following information: Approximate number of years worked at Fairview Job Title Department where you worked Entity where you worked Supervisor (optional) Name (optional) Date Thank you for your willingness to provide this very important information!
COBRA Information Sheet (Consolidated Omnibus Budget Reconciliation Act) What is COBRA? The Consolidated Omnibus Budget Reconciliation Act (COBRA) was signed into law in 1986 requiring certain employers who sponsor group health plans to offer their employees and families continuation coverage at group rates that otherwise would have been forfeited under certain situations. Group health plans include health, dental and medical spending accounts. When does the COBRA period start? The COBRA continuation period will start the 1 st of the month after your coverage ends. In the case of resignations/terminations, this will be the 1 st of the month following the month in which your termination was effective. How long does COBRA last? The employee and his/her dependents are entitled to up to 18 month of continuous coverage from the employment termination date. Because domestic partners cannot qualify as spouse under federal law, they are not eligible for COBRA rights. What is the cost of COBRA and who pays for it? When someone elects to continue their insurance coverage under COBRA, they are responsible for the full cost of the coverage. The individual assumes the full premium cost of the plan plus a 2% administrative fee. When does the employee and/or their dependents become disqualified from COBRA coverage? When the premium for coverage is not paid within the designated grace period, as identified in the COBRA letter you will receive. The date the employer terminates group health coverage. When the employee or his/her dependents become covered under another group health plan. The date the employee is entitled to Medicare benefits. At the completion of the 18 month coverage period as described above. When can I expect to receive my COBRA notification? Fairview will send your COBRA notification within 45 days of receiving your termination of employment information. Continuation of Life Insurance: You may continue your life insurance under Minnesota State law for up to 18 months. This information is included in your COBRA letter. After the 18-month extension you may choose to continue the policy with Unum Life Insurance Company directly. Fairview Health Services will mail this information to you two months prior to the end of your 18 months of continuation. Contact Phone Numbers: 612-672-6617
Medical And Dependent Care Spending Accounts Information Sheet What happens to my spending account when I terminate employment with Fairview? Your coverage continues through the last day of the month in which your last day was worked at Fairview. Dates of service beyond the last day of the month will not be reimbursed. In order to be covered for the entire month of your termination, you may have a double deduction for the spending account if you only receive one paycheck in the month that you terminate employment. You will have the deduction turned off for the spending account if your last paycheck is paid in the month following the last day you worked. For example, if your last day worked is the 25 th of the month and your final paycheck is paid on the 3 rd of the following month, your spending account deduction will be turned off on your last paycheck. You will be given the opportunity to continue making contributions to your medical spending account by making after-tax contributions. What is my spending account balance? You will receive a letter at your home from the Benefits department with your spending account balance information. The balance is computed as the total funds deducted less any funds that have been reimbursed thus far. What happens to the money that is left in my account balance once I have submitted all eligible expenses? The disposition of account balances is governed by federal legislation. The employee forfeits any account balances that remain after all eligible reimbursements have been made. Any forfeited funds are used to defray expenses of plan administration. How long do I have to turn in claims to be reimbursed? You have until March 31 st of the following year to submit claims for the current tax year. The dates of services, however, must be when you were a covered participant in the plan (the end of the month in which your last day was worked at Fairview). How will I receive payment for claims since I am no longer receiving a paycheck from Fairview? We will mail a separate check to your home to reimburse you. Where do I call for questions or extra claim forms? You may call the Benefits Service Center at 612-672-5050 or 877-903-5050 with any questions you may have.
Pension Plans/Programs for Terminated Employees Information Sheet If I am a terminated employee and was in the non-contract plan (Fairview Health Services Pension Plan) or Oxboro Union pension plan (Fairview Health Services Pension Plan for union Employees), how do I get my pension? Once your termination date has been entered into the system, we send out monthly information to all pension plan participants who terminated employment in the previous month. We include your vested account balance, vesting percentage and the necessary forms to withdraw the money. What type of payment options do I have in receiving my pension money? You are able to receive your pension money in any of the following ways: Direct rollover to an IRA or new employer s plan; direct pay out of funds to you; combination of both a rollover and payment to you; or, if your balance is over $5,000, you are able to leave the money in the plan. How long does it take to get a pension check after sending in the forms? We forward paperwork to Fidelity once a week. Checks are processed approximately ten business days after paperwork is forwarded to Fidelity. I thought I would have my pension check by now, where is it? Your first contact should be through Fidelity Investments at 1-800-343-0860. If they cannot help you, contact the Fairview pension area at 612-672-7874. I was covered by a union contract while employed by Fairview, so how do I find out if I have accrued union-negotiated pension benefits? For information about your possible pension benefits, contact the administrator of your union pension plans as follows: Twin City Hospital Workers Pension Plan, Local 113 612-331-2131 Twin City Hospitals Pension for Licensed Practical Nurses 651-659-1404 Minnesota Nurses Association Pension Plan ABPA, 651-645-8641 Central Pension Fund of International Union Of Operating Engineers 202-362-1000 If I possibly have benefits from another retirement plan that applies to Fairview who should I call? (Benefits apply only to employees of specific locations): Former St. Mary s Hospital employees still employed At the merger on 1/1/1988 612-672-7463 Milaca Pension Plan (former Milaca employees) Contact American United Life (AUL) 1-800-634-1629 DMH (Deferred Compensation Plan for former DMH employees) 1-800-347-5737
Pension Plans/Programs for Terminated Employees Information Sheet, continued How do I go about getting my TDA (Tax Deferred Annuity) money? To obtain money from TDA accounts, contact the appropriate person from the list below: CitiStreet contracts University Campus 612-624-6620 Southdale 952-924-5262 Riverside Campus 612-672-6669 All other areas 763-549-9122 Fidelity Investments 1-800-343-0860 New England group contracts 612-672-6297 New England individual contracts 651-481-9111 Metropolitan Life contracts 952-797-7484 952-797-7450 Provident Mutual contracts 612-672-6297 Other Miscellaneous TDA contracts: 612-672-6297 Who do I contact if I have general pension questions: The Benefits Service Center can assist you by calling 612-672-5050 or 877-903-5050.
Retirement Information Form Please provide us with the following information if you are retiring: PLEASE NOTE: The completion of this form will NOT initiate retirement benefits. Refer to the checklist form for directions on how to start the process to receive retirement income. Name: Job Classification: Department you last worked in: Entity where you worked: Current supervisor/managers name: Total years of Fairview service: Please return the completed form to your supervisor/manager to forward to Human Resources with your termination paperwork. Thank You