January 2009
Retirement Planning
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2009
Everett Public Schools
Human Resources & Payroll
3715 Oakes Avenue
Everett, WA 98201
January 2009
Human Resources and Payroll Contacts
Mandy Benson
Supervisor/Analyst Certificated Staff
425.385.4129
René Boswell
Benefits Tech/Classified Staff/COBRA
425.385.4116
Linda Bundy
Payroll Tech/Retirement
425.385.4164
Lynn Evans
Executive Director of Human Resources
425.385.4101
Bev Rogers
Payroll Manager
425.385.4160
Randi Seaberg
HR Director/Certificated Staff
425.385.4104
Carol Stolz
HR Director/Classified Staff
425.385.4106
Arlene Vollema-Rich
Benefits Tech/Certificated Staff/COBRA
425.385.4115
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Outside Agency Contacts
Department of Retirement Systems (DRS)
www.drs.wa.gov
800.547.6657
ICMA Retirement Corporation
www.icmarc.org/plan3
888.711.8773
Internal Revenue Service (IRS)
www.irs.gov
800.829.1040
Public Employees Benefits Board (PEBB)
www.pebb.hca.wa.gov
800.200.1004
Social Security/Medicare
www.ssa.gov
800.772.1213
January 2009
TABLE OF CONTENTS
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Human Resources & Payroll Contacts
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Outside Agency Contacts
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Retirement Application Process
Retirement Application Process --------------------------------------------------------1
Final Pay Projection Letter --------------------------------------------------------------3
Medical and Other Trust-Provided Benefits-----------------------------------------3
Dues and Voluntary Reductions-------------------------------------------------------4
Other Important Reminders-------------------------------------------------------------5
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Insurance Options
Insurance Summary-----------------------------------------------------------------------6
PEBB Plan------------------------------------------------------------------------------------7
COBRA Plan/Rates ------------------------------------------------------------------------8
Other Optional Insurance ----------------------------------------------------------------9
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Additional Information
DRS Seminar Dates---------------------------------------------------------------------- 10
Working After Retirement--------------------------------------------------------------- 10
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Forms
Resignation/Retirement Form
Sick Leave Cash-Out Application
TRS Plan 1 Personal Day Cash-Out Form
Flexible Spending Participants Termination of Employee Form
January 2009
January 2009
Retirement
Application Process
January 2009
January 2009
1
Retirement Application Process
o Six months prior to retirement, call DRS for a retirement packet and a written
estimate. Use the DRS online account access to check the accuracy of service
credit and to create benefit estimates based on your actual member data. To use
the self-estimate worksheet, visit the DRS online at http://www.drs.wa.gov/ and
select Benefit Estimators under “Quick Clicks.”
o Complete and return retirement application and other forms to the Department
of Retirement Systems (DRS). They recommend sending in paperwork at least 30
to 90 days prior to your retirement date to avoid unnecessary delays in
processing.
Note: Careful attention should be given to selecting the appropriate benefit
option for yourself and for your beneficiaries.
o Complete and sign the Resignation/Retirement Notice (see Forms Section or
office manager) and submit to Human Resources as soon as possible to facilitate
transition.
Note: To avoid unnecessary pay delays, submit additional hours on a time sheet
to the Payroll Office prior to retirement date.
Certificated employees with supplemental/extended work year contracts should
submit verification form to the Payroll Office prior to retirement date
.
o Complete Sick Leave Cash-Out Application (see Forms Section or the office
manager) and return to Payroll prior to retirement date. A Sick Leave Cash-Out
Application is required in order to receive reimbursement for unused sick leave.
The cash-out will be included in your final pay warrant.
Note: Sick leave cash-out will be on the basis of one day paid for each four days
cashed out and is not included as earnable compensation for any retirement
system.
Washington State law allows employees to cash out a maximum of 180 days of
accumulated sick leave.
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2
The following bargaining groups have elected to adopt VEBA for Sick Leave Cash-
Out upon retirement or separation from employment:
Everett Association of Educational Office Personnel
Everett Association of School Administrators
Everett Education Association
Everett Licensed Nurses Association
Everett Professional & Technical Employees – Steps F, G & H
Everett School District Cabinet
Payroll will include information regarding VEBA with your final pay projection
letter.
Review the description of plan benefits for the VEBA Health
Reimbursement Plan prior to completing the enrollment form. Send the
completed enrollment form to the Payroll Office. If you are a member of one of
the bargaining units listed above there will be a penalty imposed if you choose
not to participate. If you have questions, call Linda Bundy in Payroll at
425.385.4164.
o Complete and return the Personal Day Cash-Out Form to Payroll by June 30 if
you are a TRS Plan 1 EEA employee and want to receive compensation for
unused personal days.
NOTE: Personal day cash-out will occur automatically for the EEA certificated
TRS Plan 2 and TRS Plan 3 employees who elect to receive their final payroll
warrant in June. For TRS Plan 2 and TRS Plan 3 EEA certificated employees
who elect to receive their final payroll warrant in August, the personal day cash
out will automatically occur on the July warrant as per the collective bargaining
agreement.
o Evaluate your health insurance options available through the Public Employees
Benefits Board (PEBB) within 60 days before you retire.
NOTE: You must enroll in or defer health coverage within 60 days after the date
your active employer or continuous Consolidated Omnibus Budget Reconciliation
Act (COBRA) coverage ends. If you fail to do so, you will not be able to enroll in
any health plan through PEBB.
o Contact the Social Security Office three months prior to your Social Security
eligibility date, if you qualify for Social Security benefits.
o Notify Human Resources in writing or via e-mail of any address changes so that
the W-2 Form and other important information will reach you in a timely
manner.
o If you wish to have your retirement or Social Security checks automatically
deposited, contact Social Security, DRS and your financial institution to make
the proper arrangements.
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3
NOTE: If you are on direct deposit, your final pay will be deposited to your
financial institution unless Payroll is otherwise instructed. If you are
not
on
direct deposit, your final pay warrant from the District will be mailed to your
home.
Final Pay Projection Letter
After sending your retirement notification to Human Resources, you will receive a
final pay projection letter from Payroll. For employees retiring at the end of the
school year, the final pay projection letter will be received in May.
The purpose of the final pay projection letter is to provide information regarding
final pay and to coordinate final federal income tax withholding payment.
School-term employees who have completed their contract may elect to receive their
final pay in the month of either June or August. The final pay projection letter will
allow you the option to choose.
The letter also includes the following final payment amounts as it relates to your job
assignment: Basic Pay, Personal Day, TRI Amount, Vacation Cash Out,
Supplemental Pay, Projected Gross Pay, Sick Leave Cash Out
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Medical and Other Trust-Provided Benefits
Medical Insurance
For school-term employees, monthly premiums for medical insurance will be paid
through August. This will provide health coverage through the month of September.
For year-round employees, medical insurance premiums will provide coverage
through the following month after receiving your final pay.
Dental Coverage
For school-term employees, dental premiums will be paid through August providing
dental coverage through September.
For year-round employees, dental premiums will provide coverage through the
following month after receiving your final pay.
NOTE: Continuation of medical and dental coverage is not automatic (refer to the
Insurance Options section of this handbook). One option is to select one of the
PEBB (Public Employees Benefit Board) plans sponsored by the state. You must
submit the PEBB application form to Washington State Health Care Authority
within 60 days after the date your active employer or continuous COBRA coverage
ends. It is highly recommended that you request the packet 60 days prior to your
retirement date. When you complete your forms and enroll in or defer coverage
January 2009
4
prior to your retirement date or when COBRA ends, you will reduce the risk of
having a break in coverage
.
If you do not enroll in or defer PEBB coverage within 60 days after your active
employer or continuous COBRA coverage ends, you will not have another chance to
enroll into PEBB.
Long-Term Disability (Standard)
Long-term disability coverage will end the month you select for your final pay.
Basic Life Insurance (MetLife)
Basic life insurance coverage will end the month you select for your final pay. You
may convert this coverage to an individual policy, if you choose. Human Resources
will send a conversion form with your COBRA information.
Dues and Voluntary Reductions
Union Dues
For EEA certificated employees, the last dues payment will be deducted in the
month of August. If you select June as your final pay month, the union dues will be
deducted in triplicate.
Classified employees’ union dues are based on a percentage up to a maximum
allowable amount according to the bargaining agreement.
Credit Union
Your last credit union payment will be deducted the month you select for your final
pay. Coordinate with your credit union to set up future loan payments.
Tax Sheltered Annuity (TSA)
For school-term employees, the last TSA contribution will be deducted in August. If
you select June as your final pay month, the TSA amount will be deducted in
triplicate.
For year-round employees, the last TSA contribution will be deducted on the final
payroll warrant. Contact your TSA representative directly to select an option for
receiving annuity payments. In some cases delay in selecting an option limits your
choices.
Deferred Compensation Program (DCP)
Your last DCP contribution will be deducted in the month you choose to receive
your final pay. You may change your deduction by calling the DCP Information Line
(888.327.5596) or by accessing your DRS account online at www.drs.wa.gov/dcp.
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5
Optional Life Insurance (MetLife)
Your optional voluntary life insurance coverage will end the month you select for
your final pay. You may convert this coverage to an individual policy if you choose.
You will receive further information from Human Resources.
United Way
Your last United Way contribution will be deducted the month you select for your
final pay.
UNUM Long-Term Care
Your long-term care coverage will end the month you select for your final pay. Your
coverage can be converted by making arrangements through UNUM at
800.421.0344.
Flexible Spending Account (Flex-Plan Services, Inc.)
Complete the Termination of Employment Form included in the Forms Section of
this handbook and return it to Payroll. If you elect not to continue participation in
health care, your participation will cease in the month you choose to receive your
final pay. For instance, if your final contribution is deducted in June, you may
submit claims only for expenses incurred prior to July 1. However, if you choose to
pay the remaining contributions for the current plan year, we will deduct the total
remaining plan balance from your final payroll check. Your last contribution will be
deducted in the month you choose to receive your final pay for dependent care.
Short-Term Disability (Standard)
Your supplemental short-term disability coverage will end the month you select for
your final pay.
Savings Bonds
Your last savings bond payment will be deducted the month you select for your final
pay
Other Important Reminders
Federal Withholding Tax
Your final federal withholding tax projections are based on the withholding selection
that you are currently claiming. The final payroll projection letter will display the
projected wages subject to withholding and the projected withholding tax deduction.
If you want to make a change to the withholding amount displayed on the final
payroll projection letter, complete and return a new W-4 Form to Payroll. If you
have questions or need assistance filling out the W-4 Form, contact Linda Bundy in
Payroll at 425.385.4164.
January 2009
January 2009
Insurance Options
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Insurance Summary
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PEBB Plan
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COBRA Plan
Individual Plans
Other/Optional Insurance
January 2009
January 2009
6
Insurance Summary
PEBB
(Public Employees Benefits Board)
•
Medical, dental and vision coverage is available
•
Monthly premium is state subsidized
•
Submit an application to enroll or defer medical coverage no later than
60
days
after active employer or COBRA coverage ends
•
Contact the Health Care Authority at 800.200.1004 for more information or
access their Web site: www.pebb.hca.wa.gov
COBRA
(Consolidated Omnibus Reconciliation Act)
•
Medical and dental coverage available
•
Premium receives no state subsidy
•
18-month maximum continuation period
•
Medicare enrollment must meet certain guidelines
•
Contact Benefits in Human Resources for more information
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Individual Medical and Dental Plans
•
Premiums receive no state subsidy
•
None available for PEBB plan enrollment
•
Contact your insurance provider for more information
•
Lose the right to enroll in PEBB coverage
Contact your medical provider for eligibility, enrollment and coverage information.
Human Resources does not have information regarding individual plan coverage.
PacifiCare
800.932.3004
Group Health Cooperative
888.901.4636
PPO Plans (HMA)
888.486.7927
Washington Dental
800.342.8355
Willamette Dental
800.360.1909
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7
PEBB PLAN - Public Employees Benefits Board
Administration
Retiring public school employees have access to comprehensive health insurance
coverage sponsored by the Public Employees Benefits Board (PEBB). Administration
is through Washington State Health Care Authority (HCA).
Not all medical or dental plans are available in every county. In most cases, you
must live in the plan’s service area to enroll in the plan. Service area restrictions do
not apply to the Uniform Medical Plan or the Uniform Dental Plan.
Medical/Vision Coverage
The Washington State Health Care Authority offers up to four medical plans
depending on where you reside. Medicare-eligible retirees have the additional option
of selecting from Medicare managed-care plans and Medicare supplement plans.
If you are entitled to Medicare, you are required to enroll in Medicare Parts A and B.
You may also enroll in Supplement Plans E and Plan J.
Benefit limitations, annual deductibles, co-payments, and out-of-pocket maximums
may vary from plan to plan. A comparison of plans can be found in the 2009 PEBB
packet.
Questions to consider when selecting a PEBB medical plan:
1. Do I live within the plan service area?
2. What are my health care needs?
3. What benefits are available through the PEBB plans?
4. What choice of providers will I have?
5. What are the out-of-pocket costs of the plan(s) I have to consider?
Dental Coverage
Three dental plans are offered by the HCA. The three plans have the same basic
level of benefits. The Uniform Dental Plan (preferred provider) allows you the
freedom to choose any dentist but gives you the opportunity to receive a higher level
of reimbursement if your dentist is in the Washington Dental Service.
The other two plans are managed dental plans. Clinics/dentists are not available in
all counties.
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Rates
Current PEBB rate schedules are located in the packet.
Payment Methods
Automatic Deduction: PEBB plan premiums will be deducted automatically from
your retirement pay unless you make other arrangements with HCA.
Self-Pay: Make special arrangements with the HCA’s self-pay department if you do
not wish to have premiums automatically deducted from your pension check.
VEBA Systematic Payment Plan: A reimbursement plan using leave cash outs to
pay for medical, dental, Medicare Part B and other supplemental plans after
retirement. Premium payments may be sent automatically from your VEBA account
directly to the HCA. Alternatively, if you choose to self-pay or have automatic
deduction, VEBA payments may be sent directly to you or your financial institution
in order to reimburse your premium payment expenses. Payroll will provide you
with a VEBA Membership Enrollment Form. Forms are available at www.veba.org.
COBRA Plan
Eligibility
You and/or your eligible dependents may continue your current medical and dental
coverage with a COBRA continuation plan. Continuation coverage begins
immediately following the ending date of your medical coverage and can last up to
18 months. (An extension to the initial 18 months of coverage is available with
certain qualifying events.)
If you are entitled to Medicare coverage
before
the date of your COBRA election, you
can continue your medical coverage under COBRA. However, if you become
Medicare entitled
after
you have made your COBRA selection, COBRA coverage will
terminate; however, your covered dependents are eligible for a COBRA extension.
Enrollment
You have 60 days to elect COBRA continuation coverage from the date your
employer-sponsored coverage ends. COBRA notification and enrollment information
will be sent to you prior to your coverage ending date.
A VEBA account may be used to make systematic COBRA payments to the District.
Contact the VEBA administrator at 800.832.2102.
Coverage
Coverage under a COBRA continuation plan does not differ from your active
coverage provided by the Trust. Refer to your plan benefits booklet for a detailed
description of the actual terms and conditions of your medical insurance contract.
While continuing coverage through COBRA, any change in Trust-provided coverage
or benefits for active employees will also apply to you.
January 2009
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Rates
Rates are subject to change effective January 1 each year. You will be notified by
the Benefit Trust of any rate changes during the annual open enrollment period.
Payment
Premium payment for coverage under a COBRA continuation plan must be made
directly to the Everett School Employee Benefit Trust (ESEBT). COBRA payments
cannot be automatically deducted from your pension check.
A COBRA notice,
election form and rate sheet will be sent to you prior to termination of your
coverage.
Conversion
When COBRA coverage ends, you are eligible to continue coverage through a
conversion plan available from your plan.
Additional Information
Please contact Benefits at 425.385.4115 or 425.385.4116 if you have any questions
regarding COBRA continuation coverage.
Other Optional Insurance
MetLife Group Life and AD&D Insurance
You may convert your group life insurance (basic and optional) which includes
accidental death or dismemberment policy through Metropolitan Life (MetLife). Your
group life insurance will end the month you select for your final pay. For more
information, call 800.638.5433.
Short-Term and Long-Term Disability
No conversion or continuation options are available for these plans. Your coverage
will end the month you select your final pay.
January 2009
Additional Information
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DRS Seminar Dates
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Working After Retirement
January 2009
January 2009
10
Check the DRS Web site often for updates!
www.drs.wa.gov
Register for a seminar
•
Using online registration at DRS retirement planning
•
By e-mail, register@drs.wa.gov
•
By phone at 1-888.711.6676 or 360.664.7300 in the Olympia area. If you are
hearing impaired, please call the TDD line toll-free at 1.866.377.8895 or 360.
586.5450 in the Olympia area.
•
By mail, send your information to:
Department of Retirement Systems
Education and Outreach Program
PO Box 48380
Olympia, WA 98504-8380
These are group presentations - individual appointments are available by contacting
a Retirement Services Analyst by e-mail or by calling 1.800.547.6657 or
360.664.7000 in the Olympia area.
Please select the city and date you wish to attend and complete the registration
information on the website:
https://fortress.wa.gov/drs/retirementplanning/main.asp
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Working After Retirement
Many retirees want to continue working in some capacity after retiring from Everett
Public Schools. We strongly encourage staff to consider applying to substitute in
the district. Some of our best substitutes are former employees. If you are
considering returning to work, there are some specific rules you need to be aware of
related to your retirement system and plan. You will also be required to submit a
new employment application and resubmit your direct deposit paperwork. All
employment applications are required to be completed on-line at
www.everett.k12.wa.us.
School Board Policy 5131 Regarding Hiring of Retired School Employees
The District shall recruit, select and employ the best-qualified individuals as
employees. The District may employ persons retired from the Teachers’ Retirement
System (TRS), the School Employees’ Retirement System (SERS) or the Public
Employees’ Retirement System (PERS). A retired employee shall only be rehired
January 2009
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pursuant to this District policy.
Retirees are required to have a break in service
before returning to active employment. The maximum number of hours that
retirees are allowed to work before affecting their retirement benefit is
determined by the Department of Retirement Systems (DRS).
Plan 2 and Plan 3 Retirees
All retirees, including substitutes, of TRS or SERS may work an annual threshold of
867 hours per year while receiving retirement benefits. The annual threshold for
Plan 2 and Plan 3 is calculated per calendar year. Qualified hours are determined
by whether the retiree works in an eligible position as defined by the Department of
Retirement Systems (DRS).
Plan 1 Retiree Waiting Periods
Plan 1 retirees may work beyond the 867 hours per work year up to a total of 1,500
hours per year while receiving retirement benefits, subject to limitations established
by DRS. TRS Plan 1 retirees, retired on or after July 22, 2007, must remain
unemployed for at least 45 calendar days after their effective retirement date. The
annual threshold for TRS Plan 1 retirees is calculated per fiscal year. PERS Plan 1
retirees, retired on or after August 1, 2003, must remain unemployed for at least 90
calendar days after their effective retirement date to work beyond the 867 hours per
calendar year. PERS Plan 1 retirees, retired before August 1, 2003, must remain
unemployed for a least one calendar month after their effective retirement date to
work up to 1,500 hours per calendar year.
The District shall abide by the following process when considering a retiree for
employment:
A. The District’s employee recruitment and selection process will include
information about rehiring retirees.
B. There shall be no prearranged employment agreement or commitment to rehire
an employee after retirement. Mere inquiries about post-retirement employment
do not constitute an agreement.
C. Employment shall be limited annually to a maximum of a one-year, non-
continuing contract or appointment.
D. The District shall make contributions to the appropriate Washington state
retirement system when any TRS, SERS or PERS retiree works more than 867
hours per year.
E. The District shall maintain records of the hiring process followed in seeking
qualified candidates and the justifiable need that resulted in the hiring of the
retiree.
F. The Board of Directors shall approve the hiring of all employees.
G. The District shall provide the retiree with the same terms and conditions of
employment as other appointees or employees in comparable positions with the
exception of sick-leave cash-out.
H. The District shall report the number of hours worked by the retiree to DRS. The
following conditions of employment shall apply to retirees returning to work:
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12
A. Retired applicants shall disclose to the District whether they are
retired from a Washington state retirement system.
B. Employees must satisfy the DRS requirement for separation and
retirement from service prior to accepting a retire/rehire position
with the District.
C. Retirees are responsible for tracking service hours during post-
retirement employment among multiple employers.
Additional Information
The Washington State Department of Retirement Systems (DRS) has an excellent
brochure titled Thinking About Working After Retirement? on their Web site
(www.drs.wa.gov) that explains all the different rules employees need to be aware of
if they are considering returning to work for a school district or other DRS covered
business.
Plan-specific information regarding retire/rehire employees can be accessed from
the following Web sites:
TRS Plan 1 members
www.drs.wa.gov/Member/Publications/TRS/trs1returntowork.htm
TRS Plans 2 and 3 members
www.drs.wa.gov/Member/Publications/TRS/trsreturntowork.htm
PERS Plan 1 members
www.drs.wa.gov/Member/Publications/PERS/pers1returntowork.htm
SERS Plan 2 & 3 members
www.drs.wa.gov/Member/Publications/p23returntowork.htm
January 2009
January 2009
Forms
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Resignation/Retirement Form
Required to initiate the retirement process. Send to Human Resources
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Sick Leave Cash-out Form
Required to process sick leave cash-out. Send to Payroll
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Personal Day Cash-out Form
To be completed by TRS Plan 1 Members
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Flexible Spending Employment Termination Form
To be completed by flexible spending subscribers only
January 2009
EVERETT PUBLIC SCHOOLS
HUMAN RESOURCES
RESIGNATION/RETIREMENT NOTICE
TO:
The Executive Director of Human Resources
FROM:
(employee)
POSITION:
WORK LOCATION:
This is an official notification to Everett Public Schools that I will be
(select one)
:
o
RESIGNING
Last Work Day:__________
Effective Date of Resignation:__________
o
RETIRING
I am retiring from public school
OPTION 1
employment and will begin receiving
my retirement lifetime pension
(defined benefit) immediately
upon separation.
Effective Date of Retirement:___________
o
RETIRING
I am retiring from public school
OPTION 2
employment and am deferring the
effective date for receiving my retirement
lifetime pension (defined benefit)
until approximately:______________ Last Work Day: __________________
My mailing address and telephone number for any future correspondence is as follows.
Note:
If this is a new address, please provide the effective date of the address
Address:
Telephone Number:
Effective Date:
Additional Information or Comments:
Name:
(please print)
Signature
Date
______________________________________________________________________________
Approved:
FOR OFFICE USE ONLY
Molly Ringo
Date
Executive Director of Human Resources
Date Hired
__________________
Position
__________________
Location
__________________
Board Meeting
__________________
Copy:
HR Certificated
HR Benefits
HR Classified
Payroll
April 2007
HR Director
January 2009
January 2009
Everett Public Schools
SICK LEAVE CASH-OUT APPLICATION
I am eligible to cash out my unused sick leave because (mark one):
I have notified Human Resources in writing of my intention to retire; and upon separation from employment
with Everett Public Schools, I will be granted a retirement allowance under the laws governing the
Teachers’ Retirement System or the Public Employees’ Retirement System or the School Employees’
Retirement System.
If the reason you are entitled to these funds is due to your retirement from TRS, PERS or SERS,
please attach a copy of the confirmation letter that you would have received from DRS after your
retirement application was filed.
At the time of separation from employment, I will be at least age 55 and have 15 years of service in the
Teachers Retirement System Plan 2 or 15 years of service in the School Employees’ Retirement System
Plan 2.
At the time of separation from employment, I will be at least age 55 and have 10 years of service in the
Teachers’ Retirement System Plan 3 or 10 years of service in the School Employees’ Retirement System
Plan 3.
I am the executor or personal representative of the estate of a former employee eligible for cash out. In the
event of an employee’s death, a certified copy of the death certificate must be forwarded to Human
Resources.
RETURN COMPLETED FORM AT LEAST 30 DAYS PRIOR TO
YOUR FINAL PAYDATE TO:
Everett Public Schools
Payroll Department
PO Box 2098
Everett WA 98213
The sick leave cash out will be processed
(and your VEBA deposit mailed to the administrator if applicable)
on your final pay date.
If you have any questions, please contact Linda Bundy at (425) 385-4164.
PLEASE TYPE OR PRINT
_________________________________ ________________
______________________________
Employee Name
Social Security No.
Date of Employment Separation or Death
_____________________________________________ _____________________ _____ ______
Mailing Address (for year-end W-2)
City
State
Zip
_____________________________________________ _____________________
Employee or Executor Signature
Today’s Date
January 2009
January 2009
Due date: 06/30/09
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PERSONAL DAY CASH-OUT FORM
FOR EEA CERTIFICATED EMPLOYEES WHO ARE MEMBERS OF TRS PLAN 1
Certificated employees who are members
2008
of the Teachers’
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-2009
Retirement System Plan I program and
who wish to cash out their unused personal days, must document four (4) hours of additional work
beyond their assigned workday for each day of cash out. The cash out will be made at a fixed rate
of
$145 per day per FTE
. (See Section 7.02B of Collective Bargaining Agreement)
Date ____ | Hours
| Activity Description
___________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
__________ |____________|______________________________________________________|
Total Hours _____________
I certify that the above is an accurate record of time worked.
Employee’s Signature
ID#
Date
________________________________
(Print) Employee Name
Verified By:
Supervisor’s Signature
Date
To cash out unused personal days, complete and return this form to Payroll by June 30, 2009.
This payment will be included in your July 31 pay check. Unused personal days will be forfeited
if they are not cashed out by using this form.
January 2009
January 2009
FLEXIBLE SPENDING PARTICIPANTS
TERMINATION OF EMPLOYMENT
Upon termination or retirement of employment, the IRS allows for the following options to
Section 125 participants:
Health Care Flexible Spending Account (HCFSA):
1) If the Participant does not elect to continue participation in the Health Care Flexible Spending Account for
the remainder of the Plan Year in which such termination occurs, the Participant’s participation in the Plan
shall cease and no further salary redirection or contributions shall be made. The participant may submit
claims
only for expenses incurred PRIOR to his /her termination date
. All claims must be submitted
prior to the end of the Plan Year grace period.
2) If the Participant elects to continue participation in the Health Care Flexible Spending Account for the
remainder of the Plan Year in which such termination occurs, the Participant may elect to continue
participation in the Health Care Flexible Spending Account through “ACCELERATION”. The Participant shall
be required to make an accelerated contribution (amount owed for remainder of the Plan Year) to the fund
out of their last paycheck issued, equal to the difference between contributions to date and the annual
election amount.
(This means if you wish to continue in the Plan at the time of termination, you can have the difference between
contributions year-to-date and your annual election amount deducted from your last paycheck. You will then be
able to incur expenses at any time throughout the Plan Year and claim reimbursement for all expenses incurred
throughout the Plan Year.)
you must elect one of the following and return to Payroll
o
YES
, I elect to continue participation in the Plan.
Signature
Date
Please Print Name
Social Security No.
o
NO
, I decline to continue to participate in the Plan.
Signature
Termination Date
Please Print Name
Social Security No.
Depende nt Care Flexible Spending Account (DCFSA):
Upon termination, the Participant’s participation in the Plan shall cease and no further salary redirection or
contributions shall be made to this Account. However, such Participant may incur expenses and submit claims
for expenses incurred during the plan year. Claims must be filed during the plan year or prior to the expiration of
the grace day period.
January 2009
January 2009
Thank you for supporting and
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doing the world’s most
important work with Everett
students and community
.
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Best wishes on
planning a great
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retirement!
January 2009
2009 Schedule
Cascade High School Library
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Session I – Monday, January 26 (4 - 6 pm)
Welcome and Overview of Seminar Series
How to use your VEBA Plan
District Procedures
PEBB (Public Employees Benefit Board)
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Session II – Wednesday, February 4 (4 – 6 pm)
Sno-Isle Retired Teachers Association
Social Security / Medicare
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Session III – Wednesday, February 11 (4 – 5:30 pm)
Presented by DRS
For Plan 1 Members (TRS and PERS)
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Session IV – Wednesday, February 18 (4 – 5:30 pm)
Presented by DRS
For Plan 2 Members (TRS and SERS)
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Session V – Monday, February 23 (4 – 5:30 pm)
Presented by ICMA
For Plan 3 Members (TRS and SERS)
Special thanks to:
•
Larry Cade, Health Care Authority
•
Christy Cowen, Social Security Administration
•
Mike Smolko, VEBA
•
Jim Mendoza, DRS
•
Stephanie Dutton, ICMA
•
Bruce Engebretsen, School Employees Credit Union
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