G-639 - 08/10/1999 - PERSONNEL RULES & REGS - Ordinances ORDINANCE 99-PL-EXI-G-639
AN ORDINANCE ADOPTING A COMPREHENSIVE AMENDMENT
TO THE PERSONNEL RULES AND REGULATIONS
OF THE VILLAGE OF OAK BROOK
WHEREAS, at the recommendation of the Village Manager and staff, the Board of Trustees of the
Village of Oak Brook wish to adopt a comprehensive amendment to the Village's Personnel Rules and
Regulations; and
WHEREAS, the Village's Personnel Rules and Regulations are currently appended to the Code of
Ordinances of the Village of Oak Brook as Appendix D; and
WHEREAS, in an effort to make the Village's Personnel Rules and Regulations more accessible
to employees and others in the Village, the Village wishes to publish the Personnel Rules and Regulations
in pamphlet form and discontinue appending the Rules and Regulations to the Code of Ordinances; and
WHEREAS, it is in the best interest of the Village of Oak Brook that the attached Comprehensive
Amendment to the Personnel Rules and Regulations be adopted;
NOW, THEREFORE, BE IT ORDAINED BY THE PRESIDENT AND BOARD OF TRUSTEES OF
THE VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS as follows:
Section • That the provisions of the preamble hereinabove set forth are hereby adopted as
though fully set forth herein.
Section 2: That the comprehensive amendment to the Personnel Rules and Regulations which is
entitled, "Village of Oak Brook Personnel Manual", a copy of which is attached hereto and incorporated
herein as Exhibit A, is hereby approved and adopted in its entirety.
Section • That the comprehensive amendment to the Personnel Rules and Regulations entitled,
"Village of Oak Brook Personnel Manual", as attached hereto, supersedes Appendix D of the Code of
Ordinances of the Village of Oak Brook which is entitled, "Personnel Rules and Regulations."
Section 4: That Appendix D of the Code of Ordinances of the Village of Oak Brook is repealed
and no longer in force or effect.
Section 5: That the Village Clerk is hereby authorized and directed to publish this ordinance in
pamphlet form in the manner provided by law.
Section 6: That this ordinance shall be in full force and effect from and after its passage and
approval pursuant to law.
Section 7: That all ordinances, or parts thereof in conflict with the provisions of this ordinance be
and the same are hereby repealed to the extent of such conflict.
Ordinance 99-PL-EXI-G- 639
Amendment to Personnel Rules and
Regulations, Page 2
PASSED THIS 10th day of August, 1999.
Ayes: Trustees Butler, Craig, Savino and President Bush
Nays: None
Absent: Trustees Caleel, Kenny and McInerney
Abstain: one
APPROVED THIS 10th day of August, 1999.
`\\\ \
Approved as to Form:
d
Village Attorney
Published 8-11-99 Pamphlet form
Date Paper
Not Published
August 1999
VILLAGE OF OAK BROOK
PERSONNEL MANUAL
This Personnel Manual is the property of the Village of Oak
Brook. All Village property must be turned in to the employee's
supervisor at the end of his or her employment with the Village.
Village property other than this Manual includes Village
identification cards, keys, equipment, tools, uniforms, and all
other items the Village has furnished to the employee.
ADOPTED BY THE CORPORATE
AUTHORITIES OF THE VILLAGE OF
OAK BROOK, ILLINOIS
ORD. NO: 1999-PL-EXI-G-639
DATE: August 10, 1999
ABOUT THIS MANUAL
Welcome to the Village of Oak Brook.
The policies stated in the Manual are intended as guidelines only and are subject to change at any
time, at the sole discretion of the Board of Trustees.
This manual does not create, and shall not be construed as creating, any contract or offer to
contract with the Village. No property or tenure rights in employment shall be created, or
deemed to be created, by this manual. All provisions of this manual are subject to change, at any
time, with or without notice. No policy, benefit or procedure set forth in this manual Implies or
may be construed to imply that It or any portion thereof is an employment contract. In the event
any of the provisions of this manual conflict with State or Federal law, or with any existing
Collective Bargaining Agreement covering Village employees, the latter shall take precedence.
THE VILLAGE OF OAK BROOK
ADOPTED BY THE CORPORATE
AUTHORITIES OF THE VILLAGE OF
OAK BROOK, ILLINOIS
ORD. NO: 1999-PL-EXI-G-639
DATE: August 10, 1999
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EMPLOYEES' STATEMENT OF BELIEF
We are a multi-talented team, challenged to
serve the community
professionally and responsibly...
YOU MAKE IT HAPPEN!
In support of our statement of belief, we the Village staff hold these
values which enable us to serve in this manner.
VILLAGE OF OAK BROOK
EMPLOYEES' EXPRESSION OF VALUES
• Local government is a noble, worthwhile, and highly
challenging aspect of public service of which we are proud
and willing to be a part.
• Supported by responsible leadership and guidance, and
provided with quality training and equipment, we will
provide the highest level of service to'the community.
• Procedures and guidelines aid us in doing our jobs - it is our
duty to adhere to them as well as to seek change in those that
do not help us serve the community.
• Mutual understanding, respect, and support among the
Village staff and between the community and the staff is vital
in maintaining a constructive work environment that serves
the community.
TABLE OF CONTENTS
ARTICLE I: GENERAL PROVISIONS 1-1
Section 1.01 TITLE 1-1
Section 1.02 PURPOSE 1-1
Section 1.03 SEVERABILITY 1-1
Section 1.04 SCOPE OF RULES 1-1
Section 1.05 ADOPTION AND MODIFICATION OF RULES 1-3
Section 1.06 DEVIATION FROM PROCEDURES 1-3 .
ARTICLE II: ORGANIZATION FOR PERSONNEL ADMINISTRATION II-1
Section 2.01 VILLAGE BOARD OF TRUSTEES I1-1
Section 2.02 VILLAGE MANAGER II-1
Section 2.03 DEPARTMENT HEADS AND SUPERVISORS 11-1
Section 2.04 EMPLOYEES I1-1
ARTICLE III: RECRUITMENT AND EMPLOYMENT 111-1
Section 3.01 EQUAL EMPLOYMENT OPPORTUNITY III-1
Section 3.02 EMPLOYMENT 111-1
Section 3.03 RECRUITMENT AND SELECTION 111-2
Section 3.04 PHYSICAL EXAMINATIONS II1-3
Section 3.05 TRANSFER III-4
Section 3.06 PROMOTION 111-4
Section 3.07 DEMOTION 111-4
Section 3.08 SEPARATION 111-4
Section 3.09 RE-EMPLOYMENT 111-5
ARTICLE IV: HOURS OF WORK AND PAY IV-1
Section 4.01 HOURS OF WORK IV-1
Section 4.02 LUNCH PERIODS & REST PERIODS IV-1
Section 4.03 COMPENSATION FOR OVERTIME WORK IV-1
Section 4.04 TIME RECORDING AND RECORDKEEPING IV-3
Section 4.05 PAYROLL IV-4
Section 4.06 REIMBURSEMENT FOR TRAVEL AND
OTHER EXPENSES IV-5
Section 4.07 SALARY PLAN/SALARY ADMINISTRATION POLICY IV-5
ARTICLE V: BENEFITS AND LEAVES V-1
Section 5.01 APPROVAL OF LEAVE V-1
Section 5.02 SICK LEAVE V-1
Section 5.03 VACATION LEAVE V-2
Section 5.04 PERSONAL DAYS V-4
Section 5.05 HOLIDAYS V-5
Section 5.06 FUNERAL LEAVE V-6
Section 5.07 JURY DUTY V-6
Section 5.08 MILITARY LEAVE V-7
Section 5.09 FAMILY AND MEDICAL LEAVE ACT (FMLA) V-7
Section 5.10 ABSENCE WITHOUT LEAVE V-1 l
Section 5.11 OTHER LEAVE WITHOUT PAY V-11
Section 5.12 INSURANCE BENEFITS V-12
Section 5.13 TRAINING, DEVELOPMENT AND EDUCATION V-13
Section 5.14 PROFESSIONAL SOCIETY MEMBERSHIP;
CONFERENCE ATTENDANCE V-15
Section 5.15 RETIREMENT BENEFITS V-16
Section 5.16 EMPLOYEE ASSISTANCE PROGRAM V-18
Section 5.17 MISCELLANEOUS BENEFITS V-18
Section 5.18 BENEFITS AND DISABILITY PAYMENTS FOR
NON-WORK RELATED INJURIES V-19
ARTICLE VI: SAFETY V1-1
Section 6.01 SAFETY POLICY STATEMENT VI-1
Section 6.02 EMPLOYEE SAFETY INCENTIVE PROGRAM VI-2
Section 6.03 GENERAL SAFETY-RELATED WORK RULES VI-5
Section 6.04 WORK-RELATED INJURIES VI-7
Section 6.05 BENEFITS AND LEAVE FOR INJURY OR SICKNESS
INCURRED IN LINE OF DUTY (WORKER'S
COMPENSATION) VI-10
ARTICLE VII: MISCELLANEOUS POLICIES V11-1
Section 7.01 SEXUAL HARASSMENT POLICY VII-1
Section 7.02 AMERICANS WITH DISABILITIES ACT VII-7
Section 7.03 EMPLOYEE DRUG AND ALCOHOL USE VII-9
Section 7.04 EMPLOYEE ACCESS TO PERSONNEL RECORDS V11-9
Section 7.05 LICENSE, REGISTRATION AND CERTIFICATE
VERIFICATION VII-1 1
Section 7.06 SMOKING POLICY VII-13
Section 7.07 PERSONAL USE OF VILLAGE TELEPHONES VII-13
Section 7.08 GENERAL APPEARANCE VII-13
Section 7.09 GENERAL PROHIBITIONS VII-14
ARTICLE VIII: DISCIPLINARY ACTION VIII-1
Section 8.01 DISCIPLINARY PROCEDURES Vlll-1
Section 8.02 REPRIMAND VIII-1
Section 8.03 SUSPENSION - V111-1
Section 8.04 DEMOTION V111-2
Section 8.05 DISCHARGE V111-2
ARTICLE IX: APPEALS lX-1
Section 9.01 APPEAL PROCEDURE IX-1
APPENDIX A: Salary Plan and Salary Administration Policy
APPENDIX B: Commercial Driver's License Drug 81 Alcohol Testing Policy
APPENDIX C: Village of Oak Brook Health and Dental Plan Summary Plan Description
APPENDIX D: Village of Oak Brook Section 125 Master Plan Document
APPENDIX E: Village of Oak Brook Group Vision Care Plan
APPENDIX F: Village of Oak Brook Travel Request Form
APPENDIX G: Village of Oak Brook Tuition Reimbursement Application Form
ARTICLE I
GENERAL PROVISIONS
1.01 TITLE
These rules shall be known as the "Personnel Rules and Regulations of the Village of Oak Brook" and
may be referred to hereinafter as the "Personnel Manual",or the "Manual".
1.02 PURPOSE
The rules and regulations In this Personnel Manual are provided as guidelines for administering the
Village's personnel management system and Its derivative policies, procedures, and merit-based
principles. They further serve to inform employees about matters regarding employment. They do
not constitute a contract and shall in no way be deemed or construed as creating a contract for any
particular term(s) and condition(s) of employment between any employee and the Village of Oak
Brook.
1.03 SEVERABILITY
If any section, subsection, sentence, clause or other portion of these rules and regulations Is held to be
Invalid by any court or governmental agency of competent jurisdiction, such part of the'rules and
regulations shall be deemed to be a separate, distinct and independent part of these rules and
regulations and the Invalidity thereof shall not affect the validity of any remaining parts of these rules
and regulations.
1.04 SCOPE OF RULES
A. General Application:
The rules and regulations set forth in this Manual apply to all employees of the Village of Oak
Brook. They do not apply to any elected official or appointed member of any recommending
body of the Village.
B. Police Department:
The terms and conditions of employment applicable to Police Officers below the rank of
Sergeant are set forth in the Collective Bargaining Agreement (Between the Village of Oak
Brook and the Fraternal Order of Police Labor Council), as it may be in effect and as it may be
amended from time to time.
To the extent any subject covered in this Manual is addressed in the Collective Bargaining
Agreement, or in the Village of Oak Brook Board of Fire and Police Commissioners Rules and
Regulations, the Agreement or the Rules and Regulations shall govern unless otherwise provided.
All other provisions of this Manual shall apply to Police Officers.
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All Police Department personnel, including Police Officers, are also subject to the Police
Department Rules and Regulations and the Police Department General Orders. In the event of a
conflict between the provisions of this Manual and the Department's Rules and Regulations or
General Orders, the Rules and Regulations or General Orders shall govern.
1. Definitions Applicable to Police Department Personnel:
(a) Police Officer:
A sworn police officer with the title of Patrol Officer or Detective, who Is included
In the collective bargaining unit.
(b) Police Command Officer:
A sworn police officer above the rank of Patrol Officer, who is excluded from the
collective bargaining unit.
(c) Non-sworn Personnel:
A civilian employee in the Police Department.
C. Fire Department:
The terms and conditions of employment for Fire Lieutenants, Firefighters and
Firefighter/Paramedics are set forth In the Collective Bargaining Agreement (Between the Village
of Oak Brook and the Teamsters Local Union #714), as It may be In effect and as it may be
amended from time to time.
To the extent any subject covered in the Manual is addressed in the Collective Bargaining
Agreement, or in the Village of Oak Brook Board of Fire and Police Commissioners Rules and
Regulations, the Agreement or the Rules and Regulations shall govern unless otherwise provided.
All other provisions of this Manual shall apply to Fire Lieutenants, Firefighters and
Firefighter/Paramedics.
All Fire Department personnel (including Fire Lieutenants, Firefighters and
Firefighter/Paramedics) shall also be subject to the Fire Department Rules and Regulations and
the Fire Department Standard Operating Procedures, Guidelines and General Orders. In the
event of a conflict between the provisions of this Manual and the Fire Department's Rules and
Regulations or the Standard Operating Procedures, Guidelines or General Orders, the
Department's Rules and Regulations or Standard Operating Procedures, Guidelines or General
Orders shall govern.
1. Definitions Applicable to Fire Department Personnel:
(a) Firefighter and Firefighter/Paramedic:
A commissioned Fire employee with the rank of Firefighter or
Firefighter/Paramedic,who Is included in the collective bargaining unit.
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(b) Fire Lieutenant:
A commissioned Fire employee with the rank of Fire Lieutenant, who is included in
the collective bargaining unit.
(c) Fire Command Officer:
A commissioned Fire employee above the rank of Fire Lieutenant, who is excluded
from the collective bargaining unit.
(d) Non-commissioned Personnel:
A civilian employee in the Fire Department.
1.05 ADOPTION AND MODIFICATION OF RULES
The authority to adopt the rules and regulations set forth in this Manual is vested solely in the
Village Board.
The Village Board reserves the right at any time to amend, modify, add to, subtract from, or
abolish any of the provisions of this Manual, or those incorporated herein by reference.
Amendments become effective upon the approval of the Board of Trustees as described in this
section. A copy of this Manual as amended Is maintained in each Village department. Where
practicable, amendments shall be distributed to all employees upon approval of the Village
Board.
1.06 DEVIATION FROM PROCEDURES
The Village Manager is authorized to deviate from the procedures set forth in this Manual when
such deviation Is necessary to expedite or promote efficient or effective business practices as
deemed appropriate by the Village Manager.
The rules and regulations set forth in this Manual do not preclude Supervisors, Department
Heads, or the Village Manager from establishing other work rules consistent with the provisions
of this Manual
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ARTICLE If
ORGANIZATION FOR PERSONNEL ADMINISTRATION
Responsibility for administration of this Manual and its derivative policies, procedures and merit-based principles
have been assigned as follows:
2.01 VILLAGE BOARD OF TRUSTEES
The Village Board shall adopt or amend, pursuant to Paragraph 1.05, the rules and regulations that
govern the personnel system. The Police Department's General Orders referred to In Section 1.04
B, the work rules as defined In Section 1.06, and the Fire Department's Standard Operating
Procedures, Guidelines and General Orders referred to in Section 1.04 C shall not require the
approval of the Village Board.
2.02 VILLAGE MANAGER
The Village Manager shall:
1. Ensure that the personnel system, its policies, principles, programs and procedures are
administered according to the rules and regulations set forth in this Manual.
2. Make or approve all appointments to positions under his or her jurisdiction in accordance with
these rules.
3. Have the. authority to delegate the administration of the Village's personnel system, and its
derivative policies, principles, programs and procedures.
2.03 DEPARTMENT HEADS AND SUPERVISORS
Department Heads and Supervisors shall:
1. Adhere to the rules and regulations set forth In this Manual, and to any policies, principles,
programs and procedures established in conjunction with these rules and regulations.
2. Ensure, to the extent possible, that their subordinates comply with the rules and regulations set
forth In this Manual.
2.04 EMPLOYEES
Employees shall adhere to the rules and regulations set forth in this Manual, and to any policies,
principles, programs and procedures established in conjunction'with these rules and regulations.
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ARTICLE III
RECRUITMENT AND EMPLOYMENT
3.01 EQUAL EMPLOYMENT OPPORTUNITY
It Is the policy of the Village of Oak Brook to afford equal employment opportunities regardless of
race, religion, color, national origin or sex. Furthermore, It Is the policy of the Village to adhere to all
applicable local, state and federal laws Including but not limited to age, marital status, veterans status,
disability and handicap discrimination. Any person or agency acting contrary to this policy on behalf
of the Village will be subject to disciplinary action that may Include termination of employment, or in
the case of an agency, have other adverse consequences.
See also Section 7.01, Sexual Harassment, and Section 7.02, Americans with Disabilities Act.
3.02 EMPLOYMENT
A. DeFnitions:
1. A Probationary Full-Time Employee Is an employee hired to work 35 or more hours per
week, who Is eligible for all the benefits of regular full-time employees (subject to applicable
waiting provisions), and who has not yet completed his or her probationary period.
2. A Probationary Part-Time Employee Is an employee hired to work less than 35 hours per
week, who is eligible to receive certain benefits pursuant to State and Federal law, and who
has not yet completed his or her probationary period.
3. A Regular Full-Time Employee is an employee hired to work 35 or more hours per week,
who is eligible for all the benefits of regular full-time employees (subject to applicable
waiting provisions), and who has successfully completed his or her probationary period.
4. A Regular Part-Time Employee Is an employee hired to work less than 35 hours per week,
who Is eligible to receive a vacation benefit If they work a minimum of 910 hours per year
and for 26 consecutive pay periods, who Is also eligible to receive benefits pursuant to
State and Federal law, and who has successfully completed his or her probationary period.
5. A Temporary Employee is an employee hired to work a number of hours per day and/or
week, for a limited period(s), as determined or approved by the Village Manager, who is
eligible to receive only benefits payable pursuant to State and Federal law.
6. A Seasonal Employee is an employee hired to work either full-time or part-time on a
seasonal basis, generally during the summer months unless otherwise specified in the offer
of employment, who is eligible to receive only benefits payable pursuant to State and
Federal law.
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7. A Situational Employee is an employee hired to provide services on an as-needed basis,
primarily serving as Bath 8z Tennis Club restaurant staff employees, who is eligible to
receive only benefits payable pursuant to State and Federal law.
B. Department Heads:
Persons in the following positions are considered to be Village Department Heads:
1. Bath 81 Tennis Club Manager
2. Director of Community Development
3. Director of Information Services and Purchasing
4. Finance Director
5. . Fire Chief
6. Golf Club Manager
7. Library Director
8. Police Chief
9. Public Works Director
10. Village Engineer
] I. Village Manager
C. Probationary Period.
Except for sworn police and fire personnel covered by the Board of Fire and Police
Commissioners rules and regulations, all appointments to Village service are made for a
Probationary period of six (6) months. The initial probationary period may be extended up to
six (6) additional months with the approval of the Village Manager.
Upon completion of the probationary period, the Department Head shall recommend and
determine, in consultation with the Village Manager, whether to appoint the employee to non-
probationary status.
3.03 RECRUITMENT AND SELECTION
A. Recruitment:
To reach the broadest possible pool of qualified job applicants, the Village recruits candidates for
available jobs both from within and outside of the organization.
Whenever possible, job openings are posted internally. Internal recruitment efforts are
undertaken to promote qualified employees. Job openings are displayed in public areas of
Village buildings, and may be advertised In area newspapers, professional and municipal
publications, cable television stations, college job placement publications, and other types of
media. Openings may also be listed with job agencies in efforts to achieve the Village's goal of
reaching a diverse pool of qualified applicants.
B. Selection:
Prospective employees are selected based on criteria determined by the Department Head
and/or Village Manager.
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1. Conditional Offer of Employment:
a. Physical Examination:
All persons to whom a conditional offer of probationary full-time employment is
extended shall undergo a physical examination performed by a Village-designated
physician at the Village's expense. Conditional offers made to individuals who are not
recommended for employment by the examining physician may be withdrawn only if
the physical problem Identified during the examination will prevent the person from
performing the essential job functions and cannot reasonably be accommodated by the
Village.
Except as stated in Subsection 1.b. below, persons who pass the examination are hired,
unless bona fide job-related reasons exist for withdrawing the conditional job offer.
b. Substance Abuse Screenine:
All persons to whom a conditional offer of probationary full-time employment is
extended shall undergo a substance abuse screening performed by a Village-designated
physician at the Village's expense. A confirmed positive test will result in the
withdrawal of a conditional offer of employment.
Employees required to hold a Commercial Driver's License (CDL) are subject to the
U. S. Department of Transportation CDL Drug & Alcohol Regulations. The Village
Policy addressing these regulations Is attached as Appendix B.
2. Recordkeepine:
Records of physical examinations and substance abuse screenings shall be maintained
separately and considered to be confidential. Only persons designated by the Village
Manager as having a need to know may access such records.
3.04 PHYSICAL EXAMINATIONS
In addition to the standard post-offer physical examination described above, the Village requires
special physical examinations, at Village expense, as follows:
a. In instances where circumstances deem advisable by the Village Manager, any Village
employee may be required to undergo a special physical examination.
b. Swom Police and Fire personnel will be required to have a medical examination once
every three (3) years until age 45, once every two years until age 55 and annually after
age 55.
C. Department Heads will be required to have a medical examination once every three (3)
years until age 45, once every two years until age 55 and annually after age 55.
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3.05 TRANSFER
A transfer occurs when a current employee is moved to a position with a similar level of
responsibility and within the same pay grade. Transfers of employees within or between
departments, either on a permanent or a temporary basis, may be made based on the
recommendation of the Department Head(s), and with the approval of the Village Manager.
3.06 PROMOTION
A promotion occurs when a current employee is advanced to a position with greater
responsibility and a higher pay grade. Employees are encouraged to discuss opportunities for
promotion with their supervisor or Department Head. They are also encouraged to Indicate their
Interests in career advancement within the Village on their performance appraisal forms, and to
ask their supervisors for guidance on how they may achieve promotion.
3.07 DEMOTION
A demotion occurs when a current employee Is moved to a position with lesser responsibility and
a lower pay grade. A demotion must be recommended by the Department Head and Is subject
to hearing and approval by the Village Manager. Employees may be demoted to a lower job
classification if they fail to meet the requirements of the Job classification they occupy, and if
there is a position available In a lower Job classification for which they are qualified:
3.08 SEPARATION
A. Resignation:
To resign In good standing, an employee must give his or her Department Head a minimum of
two weeks written notice of his or her expected last work day. Failure to provide the proper
notice shall be noted In the employee's personnel file.
The Department Head shall immediately forward the written notice to the Village Manager
stating the date of the resignation on a Personnel Action Report Form.
B. WaiverlPay In Lieu of Notice:
The Village Manager may waive the two-week notice requirement and require an employee to
leave the Village immediately, If the waiver Is deemed to be in the best interest of the Village.
The Village Manager may further pay the employee, in lieu of notice, their regular rate of pay
for up to ten work days, and ask them to leave the Village immediately.
C. Termination:
See Section 8.OS, Discharge.
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D. Exit Interviews:
The Village Manager or his or her designee shall conduct exit interviews with separating
employees for the purposes of improving the work environment and receiving employee input.
The interview will be scheduled by the Village Manager's Office.
E. Return of Property:
All Village property must be returned prior to receiving the final pay check. Such property
Includes, but Is not limited to, the Personnel Manual, Departmental Manuals, uniforms, keys,
tools or other Village-owned equipment, safety gear, I.D. card, and all other property that
belongs to the Village. Items shall be returned to the employee's supervisor or Department
Head.
3.09 RE-EMPLOYMENT
The Village does not prohibit re-employment of former employees who have resigned in good
standing. If such an employee Is re-employed, there Is no bridging of service time or benefits.
Such an individual shall start as a new employee from the date of re-employment.
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ARTICLE IV
HOURS OF WORK AND PAY
4.01 HOURS OF WORK
A. In General:
The scheduled hours of work for employees may vary among departments based on operational
demands. To the extent practical, scheduled hours of work shall be uniform for employees
assigned to the same unit and performing essentially the same duties. Variations In scheduled
hours of work between employees assigned to the same unit must be approved in advance by
the Department Head and Village Manager.
B. Work Schedule and Work Week.
The normal hours In a work week vary with department and job function. Some departments or
divisions operate 7 hours per day, 35 hours per week; others operate 8 hours per day, 40 hours
per week; certain fire personnel work an average of 56 hours per week. Starting and ending
times are determined by Department Heads with the approval of the Village Manager. Some
schedules routinely require work on Saturdays and Sundays.
The work week Is defined as starting at 12:01 a.m. on Sunday morning and ending midnight
Saturday night. When business or operational needs demand a change In the work schedule of
employees, Department Heads may revise work schedules subject to the approval of the Village
Manager.
4.02 LUNCH PERIODS a REST PERIODS
All employees who are scheduled to work six or more hours in any one work day will be provided a
30 or 60 minute lunch period, depending on their department's work schedule. Lunch periods
should generally be taken between 11:30 a.m. and 2:00 p.m. by employees working the regular
work day as described In Section 4.01 B. Lunch periods are not considered hours worked, except for
commissioned fire personnel.
Employees who work at least a 7 hour work day may receive up to two 15-minute rest periods during
their normal work day as scheduled by the Department Head. Rest periods are considered hours
worked and are paid. Rest periods should not be used to extend lunch periods or other rest periods
unless approved by the supervisor.
4.03 COMPENSATION FOR OVERTIME WORK
A. General Provision:
Employees covered by the Fair Labor Standards Act (FLSA) regulations are referred to as "non-
exempt" employees. Non-exempt employees shall not work more than their regularly scheduled
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daily or weekly shift unless authorized by the Department Head or his or her designee. An
employee who works more than the regularly scheduled daily or weekly shift will be paid for the
extra time whether or not permission has been obtained, but may be subject to discipline for
insubordination if they continue to work unauthorized overtime. It is the responsibility of
supervisors and Department Heads to ensure that employees are not working unauthorized
overtime. Employees may arrive at their work station before their shift begins or remain after
their shift ends, but they may not perform any Village work during such periods.
Overtime shall be paid to non-exempt employees who work hours In excess of the regularly
scheduled hours, except 35 hour a week employees who are paid at their straight time rate for
additional hours between 35 and 40 In a week. The payment may be made in the form of cash
or compensatory time. The time rate for hours worked In excess of 40 hours shall be In all cases
one and a half times the number of overtime hours worked, except as provided In section 5.05
C 3.
B. Exceptions to Overtime Compensation:
1. Exempt Employees:
Certain employees are designated exempt from FLSA regulations. This group of
employees Is referred to as "exempt" employees. Exempt employees are those employees
assigned to bona fide executive, administrative, or professional positions within the meaning
of the FLSA. As such, they are exempt from the wage and hour provisions of the FLSA.
The following positions are exempt from FLSA regulations:
a) Accounting Manager
b) Aquatics Director(seasonal)
C) Assistant Village Manager
d) Bath a Tennis Club Manager
e) Circulation Services Supervisor
f) Director of Community Development
g) Director of Information Services and Purchasing
h) Executive Chef
I) Finance Director
j) Fire Captain
k) Fire Chief
1) Golf Club Manager
m) Golf Course Superintendent
n) Information Systems Specialist
o) Librarian
p) Library Director
q) Plan Reviewer/Chief Building Inspector
r) Police Chief
S) Police Lieutenant
t) Public Works General Foreman
U) Public Works Director
v) Senior Librarian
w) Technical Services Supervisor
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y) Village Attorney
z) Village Engineer
aa) Village Manager
2. Compensatory Time: Non-Exempt Employees
Non-exempt employees are generally allowed to accumulate up to 80 hours of
compensatory time. Compensatory time can be accumulated or used only with permission
of the Department Head.
The bank system works as follows: time is added until the maximum is reached. At any
time during a calendar year, all or part of the time may be used, with Department Head
approval. If some of the time Is taken from the bank, It may subsequently be replaced.
Once an employee's compensatory time bank reaches 80 hours, subsequent overtime
compensation must be paid in cash. The bank may be carried from year to year, but the
accumulated time in the bank may generally not exceed 80 hours. The employee does not
have a fresh opportunity each year to earn a separate new "bank" of 80 hours.
C. Hours Worked:
For purposes of determining overtime compensation, the following types of paid leave are
considered hours worked: vacation, holiday, personal day, funeral leave, jury duty leave, leave
covered by workers' compensation, compensatory time, and sick leave.
In addition, Village required attendance at lectures, meetings and training sessions during regular
work hours is considered hours worked for purposes of determining overtime compensation.
D. Emergency Call-In
A non-exempt employee called in to respond in an emergency (e.g., snow plowing, water main
break) during the employee's off hours will be compensated for a minimum of two (2) hours at
an overtime rate regardless of whether the employee has worked eight (8) hours previously in
that work day.
4.04 TIME RECORDING AND RECORDKEEPING
A. Responsibility of Department Heads:
Department Heads are responsible for ensuring the proper recording of hours worked. Before an
accurate recording of hours worked or absent are submitted to the Finance Department, the
Department Head shall have reviewed, approved and signed the documents to signify that the
documents are complete and correct.
B. Employees'Responsibilities:
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Employees are responsible for accurately completing their own time sheets in compliance with
departmental procedures, and for signing same. Falsification of a time sheet or other time or
pay record is grounds for disciplinary action up to and including termination of employment.
4.05 PAYROLL
A. Payroll Period.
The payroll period covers two work weeks and begins at 12:01 a.m. Sunday and ends 14 days
later at midnight Saturday.
B. Pay Day.
The Village's designated pay day is Thursday of the week following the end of a payroll period.
When pay day falls on an official holiday, payroll checks and direct deposit advice slips are
normally distributed on the preceding business day.
The Finance Department issues and distributes payroll checks and direct deposit advice slips to
Department Heads. Department Heads are responsible for ensuring that paychecks and direct
deposit advice slips are distributed to employees.
C. final Check:
1. Availability:
Upon separating from employment, whenever possible the employee's final check will be
available on the next regularly scheduled pay day.
2. Treatment of Benefit Hours:
Final payroll checks normally include compensation for all hours worked during the last pay
period; unused vacation hours earned during the preceding base vacation period; all
vacation hours accrued on a pro-rata basis during the current base vacation period; unused
earned holiday hours (Police, Fire and Communication Center shift personnel); 20% of
accrued sick leave pursuant to Section 5.02 D.; unused compensatory time (for non-
exempt employees), and separation bonus,where applicable.
3. Deductions and Withholdings:
The Village reserves the right to withhold from the final payroll check, In addition to the
normal deductions and withholdings, any outstanding expenses, deductions (such as
deductions for holiday time taken but not yet earned), and lost or damaged Village
equipment.
D. Payroll Check Errors:
Any employee who believes there is an error in his or her paycheck should notify his or her
Department Head immediately. The Department Head shall notify the Finance Department.
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Corrections will be made, when warranted, no later than the subsequent pay period or as
otherwise required by law.
4.06 REIMBURSEMENT FOR TRAVEL AND OTHER EXPENSES
General Provision:
Employees are entitled to reimbursement for travel expenses when authorized by the Department
Head and incurred in the course of conducting Village business, and for other pre-approved expenses.
1. Mileage:
Employees who are authorized to use their privately owned vehicles for business reasons shall be
reimbursed for mileage at the standard IRS rate.
2. Conferences and Other Out-of-Town Training:
When employees attend conferences or other out-of-town training sessions, they shall be
reimbursed for the reasonable costs of attendance as approved In advance by the department
head and the Village Manager.
3. Expense Reports:
Employees must obtain pre-approval to attend conferences or other out-of-town training using
the Village of Oak Brook Travel Request Form, attached as Appendix F. The Travel Request
Form must be routed to the employee's Department Head, the Finance Director and the Village
Manager for pre-approval. When the employee returns from the conference or training session,
he or she must Itemize expenses on the Travel Request Form, Include receipts and submit the
Form to his or her Department Head. Expense report must be approved by the Village
Manager before employees are reimbursed.
4.07 SALARY PLAN/SALARY ADMINISTRATION POLICY
The Village endeavors to compensate Its employees fairly and competitively. To achieve that
objective, the Village has established a Salary Plan and Salary Administration Policy. These
documents are amended from time to time and are attached hereto as Appendix A.
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ARTICLE V
BENEFITS AND LEAVES
5.01 APPROVAL OF LEAVE
Use of all forms of leave must be approved in advance by the Department Head.
5.02 SICK LEAVE
A. Policy:
Sick leave is not a privilege that an employee may use at his or her discretion. Sick leave may be
used only in the case of:
1. Actual sickness
2. Disability of employee
3. Childbirth by the employee or spouse
4. Medical or dental appointment which cannot reasonably be scheduled during non-
working time
5. Serious illness of members of the immediate family defined as follows, and subject to the
limitations of Section 5.02 C 2:
a. Spouse
b. Son or daughter
c. Mother or father
d. Sister or brother
e. Mother-in-law or father-in-law
f. Sister-in-law or brother-in-law
g. Grandparents or grandparents-in-law
B. Accrual:
Upon the initial hiring of a full-time employee and after the end of the first month thereafter,
such employee shall receive one (1) day's sick leave or eleven (1 1) hours of sick leave for non-
bargaining unit fire officers, regardless of the date of hire. Full-time employees accrue sick leave
at the rate of one (1) day of sick leave for each full month of service, up to a maximum of 180
days; non-bargaining unit fire officers accrue 11 hours of sick leave for each full month of
service, not to exceed 2,016 hours. Unused sick leave may be carried from year to year.
Any full-time employee using more than three (3) sick days in a calendar month, or one (1)
duty day in the case of commissioned Fire personnel, does not accrue sick leave for that month.
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C. Use of Sick Leave:
1. To receive compensation while absent on sick leave, the employee shall notify his
immediate supervisor not less than one (1) hour before the time set for beginning his
or her daily duties.
2. Fire captains may utilize up to one (1) duty day of sick leave, and other full-time
employees may utilize up to three (3) days sick leave for a serious Illness of a member of
the immediate family or because of childbirth or adoption by the employee or spouse,
which shall be charged against accrued sick leave.
3. An employee using sick leave for three or more consecutive scheduled days, or more
than one day for Fire shift personnel, must submit a physician's certificate certifying the
illness before compensation will be allowed. Employees using sick leave for less than
three consecutive scheduled days, or one day for Fire shift personnel, may be required
to submit a physician's certificate. Claiming sick leave under false pretenses is
grounds for disciplinary action up to and Including termination.
4. An employee who Is Injured off duty and who recovers damages from a third party must
reimburse the Village for any Village expenditures, including health benefits, from the
recovery of damages.
D. Payment for Unused Sick Leave Upon Separation
Upon separation following ten (10) years of continuous full-time service with the Village,
employees can elect to receive either:
1. 20% of accrued sick leave not to exceed 180 days or the equivalent of 2,016 hours for fire
captains at the employees' then rate of pay; or
2. The Illinois Municipal Retirement Fund statutory service credit authorized pursuant to the
provisions of Chapter 40 of the Illinois Compiled Statutes.
5.03 VACATION LEAVE
A. Eligibility:
All regular full-time employees are eligible for paid vacation leave. In addition, regular part-
time employees are eligible for paid vacation leave pursuant to the provisions of subsection
5.03 D.
B. Accrual:
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1. Computation of Vacation Leave:
a. Vacation leave Is computed in conjunction with the calendar year (January 1 to
December 31), and earned in the calendar year prior to that in which it may be
used, except that the initial vacation leave for regular part-time employees is
computed pursuant to the provisions of Section 5.03 D.
b. No vacation leave can be used by employees in the same calendar year in which
the employee is hired.
c. All vacation leave to which the employee is entitled in a calendar year shall expire
at the end of that calendar year except that the department head may recommend
for the Village Manager's approval carry-over of up to one (1) week vacation
leave unused due to operational circumstances not caused by the employee.
d. Generally, no employee may have more than the annual allotment of vacation
leave in their individual vacation bank at any time.
2. Two Weeks:
The initial annual vacation allotment shall be two (2) weeks of vacation prorated, based
on the number of months worked in the year of hire. Regular full-time employees are
allowed two (2) weeks of paid vacation leave beginning in the calendar year in which
the second, third and fourth years of service are completed.
The initial annual vacation allotment for Fire personnel above the rank of Fire
Lieutenant working 24-hour shifts shall be six (6) duty days prorated, based on the
number of weeks worked in the year of hire. Fire personnel above the rank of Fire
Lieutenant working 24-hour shifts are allowed six (6) duty days of paid vacation leave
In the calendar year in which the second, third and fourth years of service are
completed.
3. Three Weeks:
Regular full-time employees are allowed three (3) weeks of paid vacation leave
beginning in the calendar year in which the fifth year of service is completed.
Fire personnel above the rank of Fire Lieutenant are allowed eight (8) duty days of paid
vacation leave in the calendar year In which the fifth year of service is completed.
4. Four Weeks:
Regular full-time employees are allowed four (4) weeks of paid vacation leave beginning
In the calendar year in which the tenth year of service is completed.
Fire personnel above the rank of Fire Lieutenant are allowed ten (10) duty days of paid
vacation leave in the calendar year in which the tenth year of service is completed.
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S. Five Weeks:
Regular full-time employees are allowed five (5) weeks of paid vacation leave beginning
In the calendar year in which the twentieth year of service is completed.
Fire personnel above the rank of Fire Lieutenant are allowed thirteen (13) duty days of
paid vacation leave in the calendar year in which the twentieth year of service is
completed.
6. Management Personnel (Village Manager and Department Heads)
Shall be entitled to the following vacation benefits:
a. Two weeks, as computed under Section 5.03 B.2.
b. Three weeks in the calendar year in which the second year of service is completed.
c. Four weeks, as computed under Section 5.03 B.4.
d. Five weeks, as computed under Section 5.03 B.S.
C. Scheduling of Vacation Leave-
The time at which an employee may use vacation leave shall be approved by the
Department Head with due regard to the wishes of the employee and particular regard
to departmental operations. Generally, seniority shall govern in the choice of vacation
time.
D. Vacation Leave for Regular Part-Time Employees
After one year of continuous service with the Village, regular part-time employees
(minimum 910 hours per year) shall be allowed vacation leave at the proportionate
rate. Vacation leave for regular part-time employees shall be adjusted annually in
accordance with the above vacation leave increments based on years of service (see
Section 5.03 B.1.).
5.04 PERSONAL DAYS
All full-time employees are entitled to three (3) personal leave days per calendar year, except
for non-represented Police and Communications Center shift personnel who shall be entitled to
one (1) personal day per calendar year (pro-rated in the initial year of hire). Notwithstanding,
the provisions of this Manual shall not affect any policy of additional personal leave (in excess of
three (3) days) heretofore approved by the President and Board of Trustees regarding full-time
employees employed as of December 1, 1980. Personal leave days must be taken in the
calendar year In which they are granted.
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5.05 HOLIDAYS
A. Eligibility:
Except as stated below, all regular full-time employees are eligible for paid time off for specified
holidays. Unless otherwise specifically authorized by the Village Manager, holidays shall be used
in the calendar year in which they occur.
B. Holidays Observed.
1/2 Day New Year's Eve
New Year's Day
Martin Luther King Birthday (non-represented Police and Communications shift personnel only)
1/2 Day Friday before Easter
Easter Sunday (non-represented Police and Communications Center shift personnel only)
Memorial Day
Independence Day
Labor Day
Thanksgiving Day
Day After Thanksgiving
Christmas Eve
Christmas Day
C. Application:
1. Holiday Compensation:
Paid holiday compensation is computed as one (1) working day's pay at a straight-time
pay rate and is credited to full-time non-exempt employees in addition to the number of
hours actually worked during the pay period.
2. Non-Represented Shift Personnel and Library Personnel:
a.) Non-Represented Shift Personnel receive a time equivalent to other full-time
Village employees for holidays scheduled by the Department Head. Any such
employee, with the consent of the Department Head and the Village Manager,
may cant' over unused holidays scheduled for use during November and
December to the subsequent calendar year upon demonstration of extenuating
circumstances.
b.) Library Personnel required to work on a day that is observed as a holiday pursuant
to 5.05 C 4, shall receive a full-time equivalent to other full-time Village
employees for such holidays. Any such employee, with the consent of the
Department Head and the Village Manager, may carry over unused holidays
scheduled for use during November and December to the subsequent calendar
year upon demonstration of extenuating circumstances.
3. Overtime, Paid Holiday-
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Work performed in addition to the regularly established number of hours a day or days
a week by a full-time, non-exempt employee during a paid holiday is compensated at a
rate of one and one-half(1 Y2) times the regular straight-time rate of pay in addition to
the paid holiday compensation. The overtime rate for hours worked in excess of eight
(8) hours on a holiday, and for all hours worked on a holiday if the employee is called
in to work the holiday on his or her day off, is two (2) times the regular straight-time
rate of pay.
4. Holidays Falling on a Weekend:
a.) On Saturday:
When a holiday, except Christmas Eve and New Year's Eve, falls on Saturday, the
holiday is observed on the preceding Friday. If December 25 and January 1 fall on
Saturday, the Christmas Eve and one-half day New Year's Eve holidays are observed on
the preceding Thursday and Thursday afternoon, respectively.
b.) On Sunday:
When a holiday, except Christmas Eve and New Year's Eve, falls on Sunday, the holiday
Is observed on the following Monday. If December 25 and January 1 fall on Sunday,
the Christmas Eve and one-half day New Year's Eve holiday are observed on the
preceding Friday and Friday afternoon, respectively.
c.) On Monday:
When December 25 and January 1 fall on Monday, the Christmas Eve holiday and the
one-half day New Year's Eve holiday are observed on the preceding Friday and Friday
afternoon, respectively.
S. Work Shift Changes:
Any employee whose shift commenced during a holiday and who worked a full shift
shall be considered as having worked on the holiday.
5.06 FUNERAL LEAVE
The Department Head may grant a regular full-time employee up to three (3) funeral leave days for a
death in the immediate family as defined in Section 5.02 A.S. Fire officers above the rank of
Lieutenant may receive up to one (1) duty day with full pay for the same purpose.
5.07 JURY DUTY
Employees shall be granted time off for required jury duty. Leave with pay may be authorized for
employees called for jury duty as required by statute. When such leave is granted, employees will
receive their full compensation; however, jury duty compensation shall be remitted to the Village.
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5.08 MILITARY LEAVE
Employees who are required to attend military training exercises may request up to two (2) weeks of
unpaid leave per year. Additional unpaid leave for military training may be allowed if such leave does
not otherwise Interfere with the needs of the department, and other employees can reasonably be
scheduled to cover the duties of the absent employee. In all events, applicable Federal law will
govern.
5.09 FAMILY AND MEDICAL LEAVE ACT (FMLA)
A. Leave of Absence-Family and Medical Leave Act
1. Employees who have worked for the Village for the past 12 months and have worked for at
least 1250 hours are eligible for up to 12 weeks In unpaid leave In accordance with the
provisions of the Family and Medical Leave Act (FMLA leave) for the birth of a child, or
related to a serious health condition of the employee, or the employee's spouse, parent or
child.
2. Application for FMLA leave shall be made In writing, stating the reasons for the request, the
date desired for the start of the FMLA leave and probable date of return. Such request shall
be directed to the employee's Department Head.
3. If the Village acquires knowledge that a leave Is being taken for an FMLA qualifying reason,
the Village shall notify the employee that the leave Is designated and will be counted as
FMLA leave. Absent extenuating circumstances, the Village will notify the employee within
two working days after acquiring such knowledge.
4. For purpose of these rules, in computing the 12-month period for FMLA leave privileges,
the preceding 12 months from the date of the requested start of FMLA leave shall be used
to determine the amount of available FMLA leave time for the employee.
5. FMLA leave taken for any reason shall not exceed a maximum combined total of 12 weeks
in any 12-month period.
B. FMLA Leave-Serious Health Condition
1. For purpose of FMLA leave, a serious health condition is a disabling physical or mental
Illness, injury, impairment, or condition, resulting in:
a. Inpatient care in a hospital, nursing home, or hospice; or
b. Outpatient care requiring continuing treatment by a health care provider.
2. A serious health condition Is intended to cover conditions and illnesses that:
a. affect an employee's health to the extent that he or she must be absent from work on a
recurring basis or for more than a few days for treatment or recovery; or
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b. affect the health of the child, spouse or parent such that he or she is unable to
participate in school or regular daily activities on a recurring or continuing basis.
3. Examples of "serious health conditions" Include heart attacks, heart bypass operations and
procedures, most cancers, back conditions requiring extensive therapy or surgical
procedures, strokes, severe respiratory conditions, spinal injuries, appendicitis, pneumonia,
emphysema, severe arthritis, severe nervous disorder, Injuries from serious accident, ongoing
pregnancy, miscarriages, complications or Illnesses related to pregnancy, such as severe
morning sickness, the need for prenatal care, childbirth and recovery from childbirth.
C. FMLA Leave-Employee Health Condition
Subject to the restrictions set forth in Section B, an employee with a serious health condition
that renders the employee unable to work Is entitled to up to 12 weeks of FMLA medical leave
In any 12-month period.
D. FMLA Leave-Birth,Adoption or Foster Care
1. Subject to the restrictions set forth In Section B, an employee is entitled to up to 12 weeks
of FMLA family leave In any 12-month period for any of the following events:
a. Birth of the employee's child; or
b. Placement of child for adoption or as precondition to adoption; or
c. Placement of a child In foster care.
2. Entitlement to FMLA family leave under this section expires 12 months after birth, adoption
or placement.
3. Spouses who are employed by the same employer are only entitled to one 12-week FMLA
family leave. However, this time may be split between such employees.
E. FMLA Leave-Care of Sick Child,Spouse or Parent
1. Subject to the restrictions set forth in Section B, an employee is entitled to up to a maximum
of 12 weeks of FMLA family leave In any 12-month period to care for the employee's child,
spouse, or parent who has a serious health condition.
2. To "care for" includes caring for either physical or psychological needs.
F. FMLA Leave-Medical Certification
1. When an employee requests FMLA medical leave or FMLA family leave to care for a child,
spouse or parent, the Village may require an employee to provide medical certification from
an appropriate health care provider. The Village requires the employee to provide in this
certification the following information:
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a. That the employee or family member has a serious health condition;
b. The date the serious health condition commenced and Its probable duration;
c. The medical facts regarding the serious health condition; and
d. If employee medical leave, a description of the extent to which the employee is unable
to perform his or her job duties;or
e. If family medical leave, that the employee is needed to care for the child, spouse or
parent and the amount of time needed to provide the care.
f. If the employee Is requesting partial or Intermittent leave, the employer may request
verification of the schedule of treatment.
2. For employee FMLA medical leave, the Village may, at the Village's expense, require the
employee to obtain the opinion of a second health care provider chosen by the Village. If
the Village's health care provider disagrees about any of the information in the certification,
the parties will mutually select a third medical provider at the Village's expense. The
decision of the third provider shall be final and binding.
G. FMLA Leave-Scheduling Leave
1. Advance notice is required for foreseeable or planned leave. An employee must provide the
Village with at least 30 days notice of the need for FMLA leave for birth, adoption, foster
care or planned medical treatment when the need for the leave is foreseeable. In any case in
which the need for FMLA leave is foreseeable based on planned treatment or supervision,
the employee must make a reasonable effort to schedule the treatment so as not to unduly
disrupt the employer's operation.
2. When the need for a FMLA leave request Is unforeseeable, notice should be as soon as
practicable.
H. FMLA Leave-Partial Absences
1. Some FMLA leave can be taken Intermittently or on a reduced schedule. By way of
example, employees may take leave In noncontinuous increments; e.g., every afternoon,
every Friday, one week each month, etc.
2. Family leave for birth, adoption or foster care can only be taken on an intermittent or
reduced leave basis with the approval of the Village Manager.
3. Medical leave may be scheduled as medically necessary.
4. The Village may temporarily transfer an employee after taking intermittent or reduced
scheduled leave to an employment position more suitable for recurring period of absence to
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better accommodate the leave. Employee wages and benefits will remain the same as though
no transfer had occurred during the transfer period.
I. FMLA Leave-Denial
1. The Village Manager may deny a requested FMLA leave if the employee fails to provide
proper advance notice, unless the employee was unable to comply because of the need for
emergency health care.
2. The Village may deny a requested leave if the employee does not provide the required
medical certification after being requested to do so unless the employee was unable to
comply because of the need for emergency health care.
J. FMLA Leave-Must Exhaust Available Paid Leave
1. For family leave for birth, adoption or foster placement, an employee is required to exhaust
available sick leave and paid vacation leave before unpaid FMLA leave is commenced. In the
case of employees who schedule holidays, the balance of holidays earned but not used in the
calendar year at the time the leave commences and through the expiration of the leave must
be exhausted before unpaid leave commences.
2. 'For medical leave for a personal or family serious health condition, an employee is required
to exhaust available paid sick (including the one day for Fire officers and three days for other
full-time employees cited In Section 5.02 C.2.), and vacation leave before unpaid FMLA
leave is commenced. For purpose of this section, accumulated sick leave shall be considered
as available only to the extent that the sick leave privilege may be used pursuant to Section
5.02 of this manual. In the case of employees who schedule holidays, the balance of
holidays earned but not used in the calendar year at the time the leave commences and
through the expiration of the leave must be exhausted before unpaid leave commences.
3. In all cases, an employee is not required to exhaust available paid personal days before
unpaid leave Is commenced.
4. Paid leave taken as provided in subsections 1 and 2 above shall be counted as FMLA leave
against the total FMLA leave permitted within any 12-month period.
K. FMLA Leave-Benefits
1. During the period an employee is on FMLA leave, the Village will continue to provide group
health Insurance coverage under the same conditions as it did before the leave began.
2. With the exception of group health coverage, an employee is not entitled to accrue any
other employment benefit while on FMLA leave. This includes, but is not necessarily limited
to vacation and sick leave. Eligible employees may apply for IMRF benefit protection leave.
L. FMLA Leave-Return From Leave
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I. A return date shall be agreed to by the employee and the Village Manager at the time
FMLA leave is granted. Generally, this will be the probable return date specified in the
employee's application, but must always be within the permitted FMLA leave period.
2. An employee may advance the designated return date by serving written notice to the
Village Manager not less than 30 days before the desired alternative return date, provided
that such alternative return date must be within the FMLA leave period available to the
employee. The Village Manager may waive such 30 days notice if the employee requests to
promptly return and a position is available.
3. An employee may request an extension of the FMLA leave by making application to the
Village in the same manner as on the original application, provided that such extension may
not be granted In excess of the total FMLA leave period available to the employee.
4. An employee returning from FMLA leave will be placed in the position the employee held
before the leave began, if the position Is vacant. If the former position is not vacant, the
employee will be returned to a position having equivalent employment benefits, pay, and
other terms and conditions of employment.
M. FMLA Leave-Resignations
An employee who fails to return from a FMLA leave on the designated return date, either as
originally agreed or as extended, shall be considered as having abandoned and resigned the
employment position with the Village and will reimburse the Village for Health Insurance
premiums as provided in the Family and Medical Leave Act of 1993.
5.10 ABSENCE WITHOUT LEAVE
Absence of an employee from duty, including the absence for a day or portion thereof, that is
not authorized by prior approval shall be deemed to be absence without leave.
Any absence without leave shall be without pay and is grounds for disciplinary action. Any
employee who absents himself or herself for three consecutive work days without an authorized
leave shall automatically be considered to have resigned.
5.11 OTHER LEAVE WITHOUT PAY
A. Duration/Purpose
The Village Manager may grant a full-time employee leave of absence without pay for a period
not to exceed 90 calendar days. The Village Manager may grant a renewal of leave of absence
on a quarterly basis not to exceed one year; provided that this provision does not apply to
military leave. The criteria for approval is as follows:
1. Leave without pay shall be granted only when it serves to promote the mutual benefit and
interests of the employee and the Village, in the sole judgment of the Village Manager.
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2. Leave of absence for training or study to enable the employee to render more valuable
service to the Village may be deemed as serving to promote mutual benefit and interest.
3. In the event that an employee has exhausted all forms of leave, including leave pursuant to
the Family and Medical Leave Act, and an emergency occurs, the employee may request an
emergency leave without pay. This request shall be directed to the Department Head, who
shall make a recommendation to the Village Manager, who may approve or deny the
request with whatever conditions he or she deems appropriate.
B. Benerits
Employees who are on leave without pay shall not accrue vacation or sick leave, and will bear
the cost of their medical, dental and vision insurance monthly premiums for the duration of any
leave exceeding 7 calendar days. Eligible employees may apply for IMRF. benefit protection
leave.
C. Reinstatement
When the employee Is ready to return to work, he or she will be reinstated only if the same or a
similar position Is available. The employee Is urged to consult the Village about reinstatement
before taking the leave, and the Village will make Its best effort to inform the employee of the
likelihood of having a position available when the employee plans to return. Under no
circumstances will the Village guarantee availability of a position to an employee who takes an
unpaid leave under this section.
5.12 INSURANCE BENEFITS
A. Health, Dental 8t'Vision:
The Village of Oak Brook is self-insured, and offers medical and dental benefits under a group
health plan. Currently, the options of an Indemnity plan or a Preferred Provider Organization
(P.P.O.) plan are available. The Village also offers benefits through a Group Vision Care.Plan.
Full-time employees and their eligible dependents may participate. Regular part-time employees
normally scheduled to work at least 20 hours per week may also elect to participate by paying
the full equivalent premium cost of the selected coverage (Le. employee, employee plus one or
family). Coverage commences as follows:
Medical on the 91 st day of employment
Dental on the 181 st day of employment
Vision on the 1 st day of the month following the date of employment
The Village also offers an Internal Revenue Code Section 125 flexible benefit plan whereby
employees may contribute funds, on a pre-tax basis, to pay out-of-pocket medical, dental, vision
and child care/dependent care expenses.
The plans are fully described in the Summary Plan Descriptions, which are attached as Appendix
C (Health and Dental Plan), Appendix D (IRC Section 125 Plan) and Appendix E (Vision
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Plan). They may be amended from time to time in accordance with their terms and applicable
law.
B. Life
The Village provides group term life insurance to all regular full-time employees. Life insurance
and accidental death and dismemberment insurance is provided to each regular full-time
employee during the term of their full-time employment in the amount of$50,000.
5.13 TRAINING, DEVELOPMENT AND EDUCATION
A. General Provision
The Village Is committed to the training, development and education of its employees. To
achieve this goal, training plans are developed at the individual department level and are
submitted and approved In conjunction with the annual budget process. Training plans highlight
the developmental needs for each department, and activities are established and prioritized by
balancing those needs with available funds.
The Village encourages employees to attend lectures, meetings, seminars and other job-related
training programs. Advance approval must be obtained from the Department Head and/or
Village Manager, regardless of whether there are fees or other costs involved.
Attendance during regular working hours Is paid. Attendance outside of regular working hours
is paid only if the training Is required by the Village. Required attendance outside of the regular
work day shall be limited to meetings, lectures or training programs that are job-related and
cannot be attended during the regular work day.
When employees voluntarily attend meetings, lectures, college courses, or other training sessions
conducted by independent schools, colleges, associations, or other persons, or entities, their
attendance shall be unpaid, even if the Village pays the tuition for such courses under an
educational assistance program or other policy.
B. Reimbursement Criteria
1. Training
Employees shall be reimbursed for appropriate and necessary costs incurred for attending
seminars or other types of training approved in advance by the Department Head or his or
her designee.
Employees must complete and submit to their Department Heads a Village of Oak Brook
Travel Request Form, attached as Appendix F. This form is used to record estimated
expenses as well as actual expenses associated with training. Employees shall attach to the
Travel Request Form receipts for all itemized expenses. Upon approval, Department Heads
shall forward expense reports and receipts to the Village Manager or his or her designee for
review and final approval.
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2. Education
a. General Provision
The Village will reimburse eligible employees for pre-approved undergraduate and
graduate courses according to the reimbursement schedule and other requirements set
forth below.
b. Eligible Employees
For purposes of this section, eligible employees are those regular full-time employees
who have successfully completed one (1) or more years of service to the Village.
c. Course Selection
The Advanced Educational Program sought by the employee must be job-related and
approved by the Village Manager. The schedule of courses selected by the employee
must be practical and compatible with the schedule of normal working hours for his or
her department.
d. Application for Budgeted Funds
The Village's cost for approved training and education will be met from budgeted
amounts within the employee's department. The employee must submit a Tuition
Reimbursement Application Form (attached as Appendix G) for pre-approval by the
Department Head.
e. Village Contribution to Tuition Expense
(1) The Village will reimburse 100% of the employee's tuition upon presentation of a
tuition receipt and an official grade report from the accredited educational
Institution showing completion of the course with at least a "B" grade or
equivalent. The Village will reimburse 50% of the employee's tuition upon
presentation of a tuition receipt and an official grade report from the accredited
educational Institution showing completion of the course with a "C" grade or
equivalent. Where a course Involves Pass/Fail, the student must petition for a grade
from the professor to qualify for participation. If the employee receives
compensation from another source (e.g. the G.I. Bill, Illinois Law Enforcement
Association, etc.) the Village will pay for that portion not covered by such sources.
With written approval of the Village Manager, an advancement of 50% of the
tuition will be made to the employee prior to taking the course. If the "C" grade,
or equivalent, Is not obtained, or the employee drops the course, the employee will
not be further reimbursed for the tuition and must return the amount advanced.
(2) An employee who separates from the Village less than one year from the time that
he or she completes a course for which tuition reimbursement is received will be
responsible for reimbursing the Village for the full cost of said course tuition. If an
employee separates from the Village after one year, but before two years, from the
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time that he or she completes a course for which tuition reimbursement is received,
he or she will be responsible for reimbursing the Village for one-half ('/s) of the
cost of said course tuition. The Village may credit any reimbursement expenses
against funds owed the employee at the time of separation. This provision Is
effective for all courses begun after January 1, 2000.
f. Time and Expenses Not Reimbursed
No time off with pay will be allowed for an employee to attend courses In connection
with his or her approved educational program. No meal or transportation allowance
will be given, and all books and classroom supplies are to be purchased by the
employee.
g. Educational Recognition Plan
Non probationary, sworn police and fire personnel will be granted annual stipends for
educational attainment. Curricula in Police or Fire Science, Criminal Justice and
Administration, Sociology, Police Science, Psychology and other related fields are
acceptable courses. Other curricula must be approved by the Department Head and
Village Manager. Stipends will be based on the following basis:
Semester Quarterly Annual
Step Hours Hours Stipend
1 30 45 $ 300.00
11 60 90 600.00
111 90 135 900.00
IV 120 180 1,200.00
The Educational Recognition Plan Is retroactive and applies to those police and fire
employees who have accrued educational credit. The stipends are to be added to the
police and fire employees' existing salary immediately upon satisfactory completion of
the requisite number of course hours. Transcripts must be provided indicating all grades
are "C" or better.
The above provisions shall not be applicable to any person initially employed by the
Village subsequent to October 1, 1980.
5.14 PROFESSIONAL SOCIETY MEMBERSHIP; CONFERENCE ATTENDANCE
A. Membership
Village employees are encouraged to affiliate with professional organizations or societies for
which they qualify by profession and position, provided that such affiliation also benefits for the
Village, and membership Is approved in the annual Village budget.
B. Conference Attendance
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1. Full-time employees, with the approval of the Department Head and the Village Manager,
are eligible to attend professional conferences. Attendance is conditioned on the following:
a. The conference Is In a field directly related to the employee's responsibilities.
b. Work load permits their absence from duties.
c. Funds are budgeted and available within the Department.
2. Employees are also encouraged to attend short courses or seminars. Application should be
made to the employee's Department Head or the Village Manager for permission to attend.
Permission to attend may be granted If it Is determined there Is sufficient benefit to both the
employee and the Village of Oak Brook.
C. Compensation and Reimbursement of Expenses
The Village shall compensate an employee in attendance at a conference, provided such
attendance is approved by the respective Department Head, or, in the case of a
Department Head, the Village Manager, for all or portions of the following:
1. 100%of registration fees.
2. All reasonable expenses for meals as approved by the Village Manager.
3. Single room accommodations.
4. Coach fare for air, rail or bus transportation.*
5. Current IRS mileage rate for business use of an automobile.
6. Miscellaneous expenses such as parking, taxi, car rental, fuel for Village vehicles, etc., if
required.
The Village will not reimburse expenses for spouses or others.
*Note: Transportation to conference will be based on the most economical total cost to the
Village of Oak Brook.
Employees must receive pre-approval by completing and submitting to their Department
Heads a Village of Oak Brook Travel Request Form. This form is used to record estimated
expenses as well as actual expenses associated with the conference. Employees shall attach
to the Travel Request Form receipts for all itemized expenses. Upon approval, Department
Heads shall forward expense reports and receipts to the Village Manager or his designee for
review and final approval.
5.15 RETIREMENT BENEFITS
A. General Provision:
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All Village employees, except police and fire sworn personnel, are covered by Social Security.
Additionally, certain eligible employees are covered by the Illinois Municipal Retirement Fund
(IMRF) as provided by Illinois law.
1. Social Security
Both the Village and the employee contribute to Social Security In equal amounts. Benefits
are govemed by the Social Security Act and employees are encouraged to contact the Social
Security Administration periodically to verify their earnings. Benefit estimates may also be
obtained by contacting the Social Security Administration.
2. Illinois Municipal Retirement Fund
The Illinois Municipal Retirement Fund (IMRF) is a statewide defined benefit public
employee retirement plan that has been established pursuant to Illinois law. All employees
who are expected to work a minimum of 1,000 hours per year contribute to IMRF through
payroll deduction in an amount determined by statute. The Village also contributes to IMRF
on behalf of all participating employees.
To qualify for an IMRF retirement pension, an employee must be at least 55 years of age
and have completed eight (8) years of service. The pension benefit is determined by a
formula that is based on years of service and final average earnings. Employees should
contact IMRF for more information.
Illinois Municipal Retirement Fund
2211 York Road, Suite 500
Oak Brook, IL 60523
(630) 368-1010
3. Police and Fire Pension Funds
All sworn personnel of the Police and Fire Departments may apply for participation in the
Police Pension Fund or Firefighters Pension Fund, as applicable. Only employees who are
accepted Into the Fund may participate. The Funds are managed by locally established
boards In accordance with Illinois law. Both the Village and members of the Funds
contribute to the Funds. Members should obtain more detailed information by contacting
either the Police or Firefighters Pension Fund boards.
4. Separation Bonus
Upon termination of employment in good standing, Village employees initially employed by
the Village prior to March 1, 1982 shall be awarded separation bonus pay based upon years
of Village service according to the following schedule:
10-14 Years of Service.................................................... 30 Calendar Days Pay
15-19 Years of Service.................................................... 45 Calendar Days Pay
20 or More Years of Service............................................. 60 Calendar Days Pay
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Employees terminated for cause are not eligible for separation bonus pay.
B. Insurance for Retired Employees:
1. Retired or disabled firefighters, as defined In Article 4 of the Illinois Pension Code, may elect
to receive Village group hospitalization insurance for themselves and/or their dependents
pursuant to Section 5/367(f) of the Illinois Insurance Code (Chapter 215 of the Illinois
Compiled Statutes), provided that the full cost of said coverage shall be paid by the
recipient.
2. Retired or disabled police officers, as defined in Article 3 of the Illinois Pension Code, may
elect to receive Village group hospitalization Insurance for themselves and/or their
dependents pursuant to Section 5/367(g) of the Illinois Insurance Code, provided that the
full cost of said coverage shall be paid by the recipient and provided further that in the event
there Is a conflict between the provisions of Article 3 (Policemen's Pension Fund--
Municipalities 500,000 And Under) of the Illinois Pension Code (Chapter 40 of the Illinois
Compiled Statutes) and the provisions of Article 4 (Firemen's Pension Fund—Municipalides
500,000 And Under) of the Illinois Pension Code, the provisions of Article 3 shall govern.
3. Persons who have ten or more years of continuous regular full-time employment with the
Village of Oak Brook and who are fully qualified for Immediate receipt of an IMRF
retirement or disability pension may elect to receive village group hospitalization Insurance
for themselves and/or their dependents pursuant to the same conditions and procedures
which are applicable to disabled or retired firefighters who are eligible to receive village
group hospitalization Insurance pursuant to paragraph 979(f) of the Illinois Insurance Code,
provided that the full cost of said Insurance shall be paid by the recipient.
5.16 EMPLOYEE ASSISTANCE PROGRAM
The Village provides an Employee Assistance Program (EAP) to all employees and their families.
The EAP is a professional counseling and referral service designed to help employees and their
families with personal problems. A confidential consultation may be arranged with a professional
counselor. Both short-term counseling and, if necessary, referral for additional treatment are
available as part of this program.
Employees may participate In the program by calling the EAP provider. The contact with the
EAP is confidential, and the nature of the problem, as well as the treatment, are generally
privileged Information. No employer authorization 6 necessary to contact the EAP.
Perspectives
Employee Assistance Program
17W733 Butterfield Road
Oakbrook Terrace, IL 60181
(630) 932-8008
5.17 MISCELLANEOUS BENEFITS
A. Uniform Provisions
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Police and Fire Department uniform and clothing allowance provisions are set forth in the
appropriate Collective Bargaining Agreements. The Village will supply all other Police and Fire
Department personnel, Public Works Department personnel and clerical personnel with
designated uniforms. The maintenance cost for uniforms provided to Public Works employees
will be absorbed by the Village. Employees should review the uniform policy pertaining to their
specific departments.
B. Service Awards
Service awards are presented at the completion of 10, 15, 20, 25 and 30 years of continuous
employment to all full-time, part-time and volunteer employees of the Village in recognition and
appreciation of dedication and service to the residents of Oak Brook.
In addition to the awards, all full-time employees of the Village shall receive the following, based
on length of continuous full-time employment:
1. 10 Years: $75 Gift Certificate
2. 15 Years: $100 Gift Certificate
3. 20 Years: $175 Gift Certificate
4. 25 Years: Two (2) weeks additional vacation for that year only or two (2) weeks
additional pay, at the election of the employee.
S. 30 Years: $200 Gift Certificate
C. Mileage Reimbursement
Any employee utilizing his or her private vehicle for Village business as approved by the
respective Department Head or the Village Manager (in case of Department Heads) shall be
entitled to the current IRS reimbursement rate.
5.18 BENEFITS AND DISABILITY PAYMENTS FOR NON-WORK RELATED INIURIES
A. Eligible Village employees are covered by one of three separate pension and disability plans: the
Illinois Municipal Retirement Fund, the Police Pension Fund or the Firefighters Pension Fund.
Eligible employees are subject to the regulations governing disability benefits In each of their
respective plans.
B. A non-work related disability is any physical or mental impairment that makes a participating
employee unable to perform the essential functions of the job description for their position but
that did not arise out of and in the course of employment with the Village.
C. In the event that an employee becomes eligible for and receives disability benefits from any of
the above named funds prior to utilizing all of his or her accumulated sick leave and vacation
leave, such benefits will cease to accrue and cease to be applied to the absence of the employee.
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Any unused sick and vacation leave will remain as a credit to the employee and will be
administered in accordance with Village policy after the disability period is over. In the event of
a permanent disability, the Village shall pay for any accrued, eligible leave.
P
D. The following procedures will be followed in regard to the Village group health and life insurance
program during a period of disability:
I- For the first three (3) months an individual is receiving a non-work related disability payment
from the IMRF, Police Pension Fund or Firefighters Pension Fund, the Village will pay for its
share of the cost of hospitalization and life Insurance monthly premiums.
2. In recognition of the above and In order to qualify for this extension of benefits the
individual receiving disability payments after the completion of the third month shall pay to
the Village each month, an amount equal to the cost to the Village to maintain this
Individual In the health, dental and life Insurance plan.
3. Inclusion of the individual in the health and life Insurance plan shall terminate if for sixty
(60) consecutive days, payment is not received by the Village.
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ARTICLE VI
SAFETY
6.01 SAFETY POLICY STATEMENT
The Village of Oak Brook Is vitally concerned with the safety and welfare of all Village personnel and the
public they serve. The Village acknowledges its obligation as a public employer to provide safe working
conditions for its employees, and a safe environment for the public.
While accidents are unplanned events, proper planning can limit them and control their impact when they do
occur. Loss Prevention Implies Initiating such pre-planning activities as are necessary to minimize unsafe acts,
control unsafe conditions, and contain environmental hazards. Effective loss prevention is an integral part of
the effective and efficient utilization of Village resources.
The Assistant Village Manager serves as the Village's Risk Manager and Safety Coordinator. Among the
responsibilities of this position Is the administration of the Village's various safety-related programs:
• The Safety Committee procedure Involves employees at all levels of the organization in reviewing,
recommending and effecting positive change in safety-related matters.
• The Safety Suggestion Box program Is a method by which employees can submit their ideas and
suggestions pertaining to a single department, to the entire organization or to the Village at large. A
number of loss control suggestions obtained through this program have been implemented to the benefit
of all.
• The Village-wide Return To Work program is designed to return to the job employees who have suffered
work-related Injuries as soon as they are medically able.
• The Employee Safety Incentive program rewards employees who do not have an avoidable accident during
the year with a gift certificate.
• The New Employee Checklist program is intended to orient new employees to safety concerns in their
work places.
• The Vehicle Checkride program is designed to reinforce safe driving techniques for employees when
operating Village vehicles.
• The Safety Inspection Checklist program is a means by which Employee Safety Committee members
physically inspect each department to identify and correct unsafe conditions.
These and other elements of the Village's Loss Prevention Program are formal methods designed to protect
Village employees, Village property, and the public. They also underscore the commitment of the Village to
safe operations and delivery of public services.
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All Village employees are expected, as a condition of employment, to adopt the concept that the safe way to
perform a task is the most efficient and only acceptable way to perform it. Safety is be considered an
important element of supervisor and employee performance evaluation.
6.02 EMPLOYEE SAFETY INCENTIVE PROGRAM
A. Goals and Objectives
The goals and objectives of the Employee Safety Incentive Program are:
1. To Instill in employees the concept that the safe way to perform a task Is the most
efficient and the only acceptable way.
2. To directly compensate those full-time employees who demonstrate a concern for their
safety and the safety of others.
B. Jurisdiction
The Employee Safety incentive Program shall apply to all regular full-time employees currently
on the active payroll, and Is based on the calendar year. Eligible employees who begin work with
the Village after January 1, and who do not have an avoidable accident with costs in excess of
3100 by December 31, will receive a prorated award for the balance of the year. On the
following January 1, the employee will begin a new 12-month period for participation in the
program. Employees leaving the Village service prior to December 31 shall not be eligible for
the Safety Incentive Program.
Gift certificates will be awarded to eligible employees. The amount of the gift certificate will be
determined by the risk group to which the eligible employee belongs. The Employee Safety
Committee will assign employees to the three (3) risk groups. If an employee Is promoted to a
new risk group during the year, the award will be pro-rated for each period of time spent in each
risk group.
Determination of avoldability will be made jointly by the Department Head, Supervisor and the
Department's Employee Safety Committee representative. The affected employee may appeal
the determination to the Executive Safety Committee. Each Executive Safety Committee
member will have one (1) vote after review and, if necessary, Investigation of the accident. A
simple majority of a quorum of five (5) members is needed to decide the appeal.
C. Risk Categories
1. Employees are divided into the following job-based risk categories:
POLICE DEPARTMENT GROup
Chief A
Lieutenant A
Sergeant C
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Desk Sergeant A
Patrol Officer C
Detective C
CSOs C
Administrative Assistant A
Secretary A
Police Records Gerk A
FIRE AND COMMUNITY DEVELOPMENT DEPARTMENT GROUP
Chief A
Captain C
Lieutenant C
Firefighter C
Firefighter/Paramedic C
Secretary A
Director of Community Development A
Plan Reviewer/Chief Bldg. Inspector B
PUBLIC WORKS GROUP
Director B
General Foreman C
Foreman C
Mechanic C
Public Works Employee II C
Public Works Employee I C
Building Maintenance Employee C
Secretary A
Laborer C
ADMINISTRATION GROUP
Village Manager A
Assistant Village Manager A
Administrative Assistant A
Director of Information Services 8z Purchasing A
Information Services Technician A
Information Systems Specialist A
Purchasing and Information Services Clerk A
Communications Supervisor A
Communications Operator A
Deputy Village Clerk A
Secretary A
Records Clerk A
Receptionist A
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LIBRARY _ GROUP
Library Director A
Senior Librarian A
Technical Services Supervisor A
Circulation Services Supervisor A
Librarian A
Secretary A
FINANCE DEPARTMENT GROUP
Finance Director A
Accounting Manager A
Personnel Specialist A
Water Billing Clerk A
Account Clerk A
ENGINEERING DEPARTMENT GROUP
Village Engineer B
Civil Engineer 11 B
Civil Engineer I B
Secretary A
SPORTS CORE GROUP
Bath 8T Tennis Club Manager A
Golf Club Manager A
Golf Course Superintendent C
Executive Chef B
Maintenance Employee C
Secretary A
Mechanic C
Laborer C
CATEGORIES
Group A: Personnel whose dudes are primarily administrative
Group B: Employees who do considerable driving and do not perform Group C duties
Group C: Emergency services personnel and maintenance personnel
INCENTIVES
Group A: $25.00 gift certificate for personnel without an avoidable accident for one
year.
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Group B: $50.00 gift certificate for employees without an avoidable accident for one
year.
Group G $100.00 gift certificate for personnel without an avoidable accident for one
year
6.03 GENERAL SAFETY-RELATED WORK RULES
A. Applicability
All employees in.every department must be aware of, understand, and comply with general work
safety rules. The Intent of these rules is to provide all employees with guidelines and directives to
perform their jobs safely and to reduce their exposure to workplace hazards.
Department heads must establish additional job specific work rules for their employees.
Department rules must be complied with and enforced in the same manner as these rules.
1. The following general safety work rules have been established for all employees and must
be complied with:
a. Report all personal injuries no matter how minor, whether or not first-aid is
requested and whether or not the Injury resulted in lost-time, to the immediate
supervisor as soon as possible and before the end of the work shift.
b. Inspect tools and equipment (including motorized vehicles) before use. Report
defects to supervisors and other potential users. Do not use unsafe tools or
equipment.
C. Operate only machinery employee is trained and authorized to use.
d. Report to work in appropriate clothing suitable for the type of work performed.
e. Wear personal protective equipment as required by the work performed (see
addendum).
f. Refrain from horseplay and practical joking on the job.
g. Work at speeds consistent with safety.
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h. Obey all warning tags and signs.
i. Refrain from removing or making Ineffective safety guards, appliances or
devices from machinery or equipment except for the sole purpose of making
repairs or performing maintenance. All such devices must then be replaced
and/or made effective before operation is resumed.
1• Turn off and lock-out all sources of power before repairs, adjustments or
deaning of equipment or machinery is conducted.
k. Keep work areas clean and free from debris, tools and/or materials not
necessary for the fob.
I. Keep general areas, aisles, and exits clear of tools, equipment and material.
Position same In a manner that decreases the possibility of rolling, falling or
spilling.
M. Use proper techniques for lifting and carrying of material.
n. Obey all smoking regulations and refrain from smoking where flammable
materials are stored or are in use.
o. Operate machinery and equipment In an approved safe manner so as not to
endanger persons or property.
P. Obey all motor vehicle laws.
q• Apply SAFETY above EXPEDIENCY in all situations.
r. Employees may not consume alcohol or drugs while on duty and/or may not
report to work after having consumed alcohol or drugs.
S. Comply with all department safe work rules, procedures and supervisors
Instructions.
B. Personal Protective Equipment
The following personal protective equipment must be wom when the hazards described below
exist:
I. Hard hats to protect the head from failing objects, head bumping situations, or electrical
conductors.
2. Goggles, face shields, or safety glasses to guard against flying debris, welding sparks and
blood borne pathogens.
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3. Ear plugs or ear muffs to guard against prolonged exposure to noise exceeding sound
tolerance levels as defined by law or excessive noise exposures.
4. Respirators, gas masks or self-contained breathing apparatus, as appropriate, to protect
employees against toxic or abnormal atmospheric conditions.
S. Safety shoes to protect feet against the crushing effect of dropped articles.
6. Reflective vests or bright articles to increase personnel or workers visibility while working
In or around traffic lanes.
7. Protective clothing, such as gloves, sleeves, aprons, leggings and full suits to protect
against lacerations, abrasions, bumps, heat, melted metals, spilled chemicals, poison
Ivy/oak, blood bome pathogens, etc.
8. Any personal protective equipment when its use has been ordered by a supervisor
and/or it Is a component of the correct and safe way to perform a job.
When the use of personal protective equipment has been specified for hazardous work, its use is
mandatory. Supervisors are held accountable for Insuring that employees do not work without
use of appropriate personal protective equipment. Individual employees are accountable for
their own personal compliance.
6.04 WORK-RELATED INJURIES
A. Reports of Injury.
1. Immediate Report of Injury:
Employees who are injured while on duty for the Village must make an immediate report of
such injury to their Immediate superior. Every injury, including all those not requiring
medical attention, must be reported to the Department Head within eight (8) hours of an
accident and no later than the first morning of a work day following such Injury.
2. Treatment by Physician:
If the employee is Injured to such an extent that he or she requires medical attention, he or
she shall go immediately to a treatment facility designated by the Village for treatment.
3. Notification of Department Head:
Department Head shall be responsible for notifying the Village Manager or designee of all
injuries reported by employees under their supervision and shall make certain that the proper
written reports are prepared and forwarded to the Village Manager or designee for record
purposes.
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B. Work-Related lniudes: Medical Treatment Procedure and Worker's Compensation Benefits.
1. General Provision
Employees who incur bona fide occupational illnesses or Injuries are entitled to all necessary
medical and hospital care. Additionally, employees who are medically approved to be absent
from work by the Village's authorized physidan(s) may be eligible to receive certain disability
benefits In accordance with the Illinois Worker's Compensation Statute and certain other
related laws.
2. Medical Treatment Procedure
The Village has designated Hinsdale Hospital as the primary medical care facility for work-
related Injuries or Illnesses. Department Heads will Instruct their supervisors to use Hinsdale
Hospital for all of their employees needing medical care during the workday.
a. For employees who sustain life-threatening conditions, Le. severe chest pains, difficulty
breathing, seizures, gun shot wounds, severe bums, severe head injuries, hemorrhaging,
open (compound) fractures and other situations which would be considered life
threatening, the paramedics should be called and the employee taken to the nearest
hospital emergency room.
b. If an employee is injured or becomes III during working hours and medical treatment is
required, and It Is of a non-life-threatening nature, the following procedure shall be
followed:
When the injured employee's supervisor is notified of the injury or illness, he/she
should phone the Hinsdale Hospital Emergency Department, 856-6700, to advise
that the employee Is coming to the Emergency Department. If possible, the
supervisor should also describe the injury and how it happened.
c. The supervisor should notify the Safety Coordinator of the nature of the accident or
Illness in order to determine what steps, If any, are needed to correct certain unsafe
conditions immediately.
d. Where practicable, all employees receiving treatment at the hospital will be given a
"Duty Status Report" Indicating when they may resume their full or partial work dudes
and whether a follow-up visit with the doctor Is required.
e. The "Duty Status Report" should be forwarded to the employee's supervisor, who then
forwards the original to the Safety Coordinator for processing.
f. The employee's supervisor shall also prepare a first report of injury (form 45) and
"Supervisor Report" of the accident and return it to the Personnel Specialist or Safety
Coordinator within 24 hours of the work shift in which the accident occurred, absent
extenuating circumstances.
Vl- 8
3. Worker's Compensation Benefits
a. If, after the initial treatment or examination at the medical clinic, the injured employee
Is authorized to be absent from work and/or will require additional treatment or medical
care, he/she may be eligible for certain disability benefits under the Illinois Worker's
Compensation Act. This will depend on the length of the authorized absence from work
and the nature of his or her employment with the Village.
b. Bills for any follow-up medical/hospital expense incurred by an employee from his or
her personal physician and/or hospital facility for treatment of an on-the-lob Injury must
be forwarded to the Personnel Specialist with an appropriate medical report explaining
the charges before they can be processed for payment or the employee can be
reimbursed.
c. Each employee shall keep the Village informed of his or her current medical condition
when they choose to be treated by their personal physician or hospital rather than the
Village's designated medical provider or facilities.
d. Worker's Compensation benefits may be postponed, withheld or suspended, should the
employee fail or refuse to submit detailed medical reports or other Information from his
or her personal physidan(s) or hospital to the Village or refuse or fail to show up for a
medical examination by the municipality's appointed medical doctor.
e. Employees who sustain on-the-job Injuries or illness, in most occasions, may not receive
Worker's Compensation disability benefits without being first certified as disabled by the
Village's authorized physidan(s).
f. In accordance with the Illinois Worker's Compensation laws and applicable rules of the
Illinois Industrial Commission, any employee absent from work as a result of an alleged
on-the-job injury which has not been certified by the Village's authorized physician, will
be either on his or her own accumulated sick time, if available, or will be off the payroll.
g. Should there arise a difference of opinion between the Village's authorized physician and
the employee's personal physician regarding the employee's length of disability, the
Village, In most cases, will rely on the medical opinion of Its authorized physician, and
the medical differences, If any, may be resolved before the Illinois Industrial
Commission.
4. Return to Work Guidelines
a. Restricted duty assignments may be temporarily provided for an Injured employee if:
(l) An authorized physician has released the employee to return to work with physical
restrictions on the dudes the employee can perform; and
(2) If the duties that the employee is physically able to perform while rehabilitating are
dudes and work normally performed by the Village.
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b. Restricted duty for employees has been established within a three (3) consecutive month
time period, except where the nature of the injury necessarily requires extending the
time with authorized physician approval.
c. An employee who Is deemed able by the authorized physician to return to restricted
duty shall not have the right to refuse such status.
d. The Department head will determine restricted duty tasks for each specific employee.
The following guidelines should be addressed:
(1) A duty or position will not be created for an employee;
(2) The duty or position should be meaningful work that contributes to the mission of
the Village;
(3) No employee will be moved from his regular job to allow an Injured employee to
participate in the restricted duty program;
(4) An employee should be placed in a position consistent with his or her physical
restrictions;
(5) Restricted duty work should be compensated at the current pay rate of the injured
employee.
e. The appropriate department head will monitor the progress of the Injured employee on
a weekly basis. The factors to be monitored Include:
(1) Completion of assigned task;
(2) Medical progress;
(3) Injured employee has continued physician visits or therapy treatments,as necessary.
6.05 BENEFITS AND LEAVE FOR INJURY OR SICKNESS INCURRED IN LINE OF DUTY
(WORKER'S COMPENSATION) (Police and Fire commissioned personnel are excluded from
the provisions of Section 5.23, as they are covered by Chapter 70 of the Illinois Compiled
Statutes)
A. Regular Pay for Four Monde
An employee who Is injured while on duty arising out of and In the course of employment and
entitled under State law to Worker's Compensation, will continue to receive his or her regular
monthly salary rate for a maximum of four (4) months relating to a single injury, counted either
consecutively or non-consecutively.
B. Option to Use Available Leave Time
If, because of this Injury, an employee Is unable to return to work at the expiration of the four
(4) month period, the employee will be entitled to receive the State benefit pursuant to the
Worker's Compensation Act. During the period covered by Worker's Compensation, the
employee may use all available leave time to supplement Worker's Compensation benefits up to
100%of salary.
C. Worker's Compensation Payments
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At the expiration of both the four-month period and any use of available leave time, the
employee will receive compensation in accordance with State laws pertaining to worker's
compensation and the applicable pension act.
D. Worker's Compensation Paid to Village
Any payments received by the employee from Worker's Compensation Insurance shall be paid to
the Village as a partial offset against the Village's payment of salary during the injury or sickness
period up to a maximum of four(4) months.
VI- 1 1
ARTICLE VII
MISCELLANEOUS POLICIES
7.01 SEXUAL HARASSMENT POLICY
A. Statement of Policy
The Village of Oak Brook (hereinafter referred to as "the Village") Is committed to
maintaining a work environment that encourages and fosters appropriate conduct among
employees and respect for Individual values and sensibilities. Sexual harassment of any kind is
prohibited, as a matter of policy, by the Village. Accordingly, the Village intends to enforce
Its Sexual Harassment Policy at all levels within the workplace in order to facilitate an
environment free from sexual harassment. All officers and employees of the Village are
expected to become familiar with the contents of this Policy and to abide by Its requirements.
Sexual harassment, according to the Equal Employment Opportunity Commission and the
Illinois Department of Human Rights, and for purposes of this Policy, consists of unwelcome
sexual advances, requests for sexual favors, other verbal, non-verbal, or physical acts of a
sexual or sex-based nature, where
1. submission to such conduct Is made either explicitly or implicitly a term or condition
of an Individual's employment; or
2. an employment decision affecting an employee Is based on that individual's
acceptance or rejection of such conduct; or
3. such conduct has the purpose or effect of substantially Interfering with an individual's
work performance or creating an intimidating, hostile or offensive working
environment.
Sexual harassment can occur between men and women, or members of the same gender.
This behavior is unacceptable in the workplace Itself and in other work-related settings such
as business trips and business-related social events.
It Is a violation of this policy to retaliate In any way against anyone who has complained
about sexual harassment or discrimination, assisted In filing a complaint, or participated in
the investigation of a complaint, whether that concern relates to harassment of or
discrimination against the individual raising the concern or against another individual. It is a
violation of this policy to retaliate In any way against anyone who opposes an act which that
person believes to be sexual harassment, or because an individual has made a charge, riled a
complaint, testified, assisted, or participated in an investigation, proceeding or hearing under
the Illinois Human Rights Act.
B. Prohibited Conduct
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Prohibited acts of sexual harassment can take a variety of forms ranging from subtle pressure for
sexual activity or contact to physical contact. At times the offender may be unaware that his or
her conduct is offensive or harassing to others. One example of sexual harassment is where a
qualified individual Is denied employment opportunities and benefits that are, Instead, awarded to
an individual who submits (voluntarily or under-coercion) to sexual advances or sexual favors.
Another example is where an Individual must submit to unwelcome sexual conduct in order to
receive an employment opportunity. Other examples of conduct which could be considered
sexual harassment Include:
1. persistent or repeated unwelcome flirting, pressure for dates, sexual propositions, sexual
comments or touching;
2. sexually suggestive jokes, Innuendoes, comments, gestures or sounds (e.g., whistling,
"catcalls", "smooching" or "kissing" noises) directed toward another, or sexually oriented or
degrading comments about another; humor and jokes about sex, anatomy or gender-specific
traits; obscene gestures; leering;
3. preferential treatment of an employee, or a promise of preferential treatment to an
employee, In exchange for dates or sexual conduct; or the denial or threat of denial of
employment, benefits or advancement for refusal to consent to sexual advances;
4. the open display of sexually oriented pictures, posters, slogans or other material offensive to
others;
S. retaliation against an Individual for reporting or complaining about sexually harassing
conduct;
6. unwelcome hugging or kissing, pinching, brushing the body, unwelcome sexual intercourse or
actual assault.
The most severe and overt forms of sexual harassment are easier to determine. On the other end
of the spectrum, some sexual harassment is more subtle and depends to some extent on individual
perception and Interpretation.
An example of the most subtle form of sexual harassment is the use of endearments. The use of
terms such as "honey", "darling" and "sweetheart" Is objectionable to many men and women who
believe that these terms undermine their authority.
Another example is the use of compliment that could potentially be interpreted as sexual in
nature. Below are three statements that might be made about the appearance of a woman in the
workplace.
• "That's an attractive dress you have on."
• "That's an attractive dress. It really looks good on you."
• "That's an attractive dress. You really fill it out well."
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The first statement appears to be simply a compliment. The last Is the most likely to be perceived
as sexual harassment, depending on the Individual's perceptions and values. To avoid the
possibility of offending an employee, It Is best to follow a course of conduct above reproach, or
to err on the side of caution.
C. What to do if you are sexually harassed.
The Governor's Executive Order 7 (1992) provides this advice about what to do if you are
sexually harassed:
"If you are being sexually harassed, here Is what to do. Let the harasser know you
are not receptive. If you are harassed a second time, politely and firmly (do not
be subtle) let that person know you are not Interested.
Write down what happened to you... when It happened, who was there, what was
said by both of you.
If you let the harasser know you are not Interested In his or her suggestions and
the suggestions continue,you are being victimized. Keep records of subtle or
overt job related promises or threats. Talk to other people In your department
whom you trust. Many times a sexual harasser will bother different people at
different times.
Give your supervisor the facts about the incidents. If your supervisor Is the sexual
harasser, see his or her supervisor— talk to your affirmative action officer."
D. Individuals Covered Under the Policy
This policy covers all officers and employees of the Village. The Village will not tolerate,
condone or allow sexual harassment, whether engaged In by fellow employees or officers, or
anyone doing business with the Village. The Village supports and encourages reporting of all
Incidents of sexual harassment, regardless of who the offender may be, and will promptly
Investigate all reported Incidents.
1. Responsibility of Individual Employees:
a. Each Individual employee has the responsibility to refrain from sexual harassment in
the workplace.
b. The harassing employee will be subject to corrective action including discipline up to
and including discharge in accordance with the Village's policy.
C. An employee who either observes or believes herself/himself to be the object of
sexual harassment is responsible for reporting the incident(s) to his or her supervisor,
or if the employee Is uncomfortable reporting the incident to his or her supervisor,
he/she should report the incident to any supervisor in the Village.
2. Responsibility of Supervisory Personnel:
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a. Each supervisor is responsible for maintaining the workplace free of sexual harassment.
This is accomplished by promoting a professional environment and by dealing with
sexual harassment as one would deal with other forms of employee misconduct.
b. Specifically, the supervisor must address an observed incident of sexual harassment or
a complaint with seriousness, document the details of the incident, immediately
report It to the Assistant Village Manager or Village Manager, who will take prompt
action to have the complaint Investigated. This also applies to cases where an
employee tells the supervisor about behavior considered sexual harassment but does
not want to make a formal complaint.
C. The supervisor must report all Incidents or complaints of sexual harassment to the
Department Head or Village Manager on the date of the alleged occurrence, or on
the very next business day.
d. In addition, the supervisor must ensure that no retaliation will result against an
employee making a sexual harassment complaint, assisting in filing a complaint or
participating In the Investigation of a complaint.
e. Any supervisor in need of Information regarding his or her obligations under this
Policy or the procedures to be followed upon receipt of a complaint should contact
the Village Manager.
E. Complaint Process
While the Village encourages individuals who believe they are being harassed to firmly and
promptly notify the offender that his or her behavior is unwelcome, the Village also recognizes
that power and status disparities between an alleged harasser and a target may make such a
confrontation impossible. In the event that such Informal, direct communication between
Individuals is either Ineffective or Impossible, or even when such communication has occurred, the
following steps should be taken to report a sexual harassment complaint.
i. An employee (the "Complainant") who either observes or believes herself/himself to be the
object of sexual harassment should deal with the Incident(s) as directly and firmly as possible
by clearly communicating her/his position to the Complainant's supervisor. If reporting to
the Complainant's supervisor should prove uncomfortable for any reason, or if the offender
Is the Complainant's supervisor, the Complainant should directly contact any supervisor in
the Village. It is not necessary for sexual harassment to be directed at the person making the
complaint.
The following steps may also be taken: document or record each incident (what was said or
done, the date, the time, and the place). Documentation can be strengthened by written
records, such as letters, notes, memos, and telephone messages. All such documentation,
once prepared, shall be immediately transmitted to the supervisor.
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No one making a complaint will be retaliated against for making the complaint, even though
It may ultimately not be substantiated. In addition, any witness will be protected from
retaliation.
2. Investigation of Complaint:
When a complaint has been reduced to writing, the Village Manager will initiate an
Investigation of the suspected sexual harassment as soon as possible. The investigation will
Include an Interview with the Complainant and the employee(s) who made the initial report
(if different than the Complainant), the person(s) toward whom the suspected harassment
was directed and the individuals) accused of the harassment. Any other person who may
have Information regarding the alleged sexual harassment shall also be interviewed.
3. Report:
The person responsible for investigating the complaint shall prepare a written report as soon
as practicable following his or her completion of the investigation. The report shall Include a
finding whether sexual harassment occurred, sexual harassment did not occur, or there is
inconclusive evidence as to whether sexual harassment occurred.
4. Records; Confidentiality:
Employees who report incidents of sexual harassment are encouraged to keep written notes
in order to accurately record the offensive conduct. Every effort shall be made to keep all
matters related to the Investigation and various reports confidential to the extent practicable.
In the event of a lawsuit, however, the Village advises that records it maintains and the
Complainant maintains may not be considered privileged from disclosure.
S. Time Frame for Reporting Complaint:
The Village encourages a prompt report of complaints so that rapid response and
appropriate action may be taken. However, due to the sensitivity of these problems and
because of the emotional toll such misconduct may have on the Individual, sexual harassment
complaints should be reported within thirty (30) days after the complained-of conduct.
Delayed reporting of complaints will not in and of itself preclude the Village from taking
remedial action.
6. Protection Aeainst Retaliation:
The Village will not in any way retaliate against an individual who makes a report of sexual
harassment, assists in filing a complaint, or participates in the investigation of a complaint,
nor permit any officer or employee to do so. Retaliation is a serious violation of this sexual
harassment policy and should be reported immediately. Any person found to have
retaliated against another Individual for reporting sexual harassment will be subject to the
• same disciplinary action up to and including discharge.
7. Appeals Process:
VII-S
If either party directly involved in a sexual harassment investigation is dissatisfied with the
outcome or resolution, that individual has the right to appeal the decision. The dissatisfied
party should submit his or her written comments in a timely manner to the Village Manager,
but In no event later than ten (10) days after receipt of the outcome or resolution of the
Investigation.
F. Corrective Action/Sanctions
Corrective action Including discipline up to and Including discharge will be taken against any
employee found to have engaged in sexual harassment of any other employee. The extent of
sanctions may depend In part upon the length and condition of employment of the particular
employee and the nature of the offense. The Village has the right to apply any sanction or
combination of sanctions, up to and Including termination.
Where sexual harassment has been found to exist, the Village will take all reasonable steps to
eliminate the conduct.
G. Recourse,Investigative and Complaint Process Through Illinois Department of Human Rights and the
Illinois Human Rights Commission
It is hoped that most sexual harassment complaints and incidents can be resolved through the
Village's Internal complaint process established above. However, an employee has the right to
contact, file a complaint with, request an Investigation by, and/or seek recourse through the
Illinois Department of Human Rights (the "Department") and the Illinois Human Rights
Commission (the "Commission"). Any such complaint must be filed within 180 days of the
Incident of sexual harassment or of the incident of unlawful retaliation. The exact rules,
procedures and other Information regarding filing a complaint with, requesting an investigation by
and/or securing recourse from, the Department or Commission (including the nature and extent
of such recourse) can be obtained by contacting the Department or Commission as follows:
If the Department: Illinois Department of Human Rights
100 W. Randolph Street
Suite 10-100
Chicago, IL 60601
(312) 814-6200 or(312) 263-1579 -TDD
If the Commission: Illinois Human Rights Commission
100 W. Randolph Street
Suite 5-100
Chicago, IL 60601
(312) 814-6269
H. Copies of Policy:
A copy of this policy shall be provided to each employee and shall also be provided to the
Department on its request.
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7.02 AMERICANS WITH DISABILITIES ACT
A. Policy:
Pursuant to the requirements of the Americans With Disabilities Act (ADA), the Village of Oak
Brook seeks to promote an environment free from discrimination against qualified individuals with
known physical or mental disabilities covered by law, and will make such reasonable accommodation
as Imposes no undue hardship on the Village of Oak Brook.
B. Definitions:
1. Disability:
a. A physical or mental Impairment that substantially limits one or more of the major life
activities of affected individuals;
b. A record of having such an Impairment;or
C. Being regarded as having such an Impairment.
2. Physical or Mental Impairment:
Any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting
one or more of several body systems, or any mental or psychological disorder. Some examples
are asthma, tuberculosis, AIDS, cancer, diabetes, bipolar disorder and smoke sensitivity.
Excluded are cultural or economic disadvantages such as poverty and lack of education; or
traits such as poor judgment or a quick temper; and physical characteristics such as hair, eye
color, obesity or pregnancy.
3. Substantial Limits:
This means that an Individual Is unable to perform a major life activity which an average person
can perform, or Is highly restricted in performing such an activity. The nature and severity of
the Impairment,the duration, and the long-term Impact of it are also considered In determining
whether it Is a substantially limiting one. Thus, temporary and non-chronic Impairments are
not covered.
4. Maior Life Activity:
These are basic activities that the average person in the general population can perform such as
caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing,
learning and working.
S. Having a Record of Such Impairment:
This protects individuals who have a history of, or have been misclassified as having a physical,
mental or emotional illness.
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6. Regarded as Having Such an Impairment:
This protects Individuals who have no impairment but are treated as if they do. Examples are
someone with a contagious disease which poses no direct threat to others; or someone who is
disfigured.
7. Essential lob Functions:
These are fundamental duties of a job which a person with a disability holds or desires. The
determination as to whether a job function is essential Includes among others such Inquiries as:
• whether the reason the job exists Is to perform the function
• how many employees are available to perform the function
• whether the function Is highly specialized and requires the particular expertise of the
Incumbent
• the amount of time spent performing the function
• the consequences of not requiring the incumbent to perform the function
• the work experience of current or former employees
C. Scope:
The non-discrimination rule established by the ADA covers all applicants and employees who are
qualified individuals with a known disability.
D. Application:
1. Who Is covered:
The Village will not discriminate against a qualified individual with a disability, because of the
disability, In regard to job application procedures, hiring, advancement or discharge of
employees, employee compensation, benefits, job training, and other terms, conditions and
privileges of employment.
A qualified individual with a disability Is one who can satisfy the prerequisites of the job by
having the special skills, experience, education, licenses, and the like, and who can perform the
essential job functions with or without reasonable accommodation.
2. Employment decisions:
Employment decisions will be based on job-related criteria only; however, employees will be
expected to adhere to normal attendance and production requirements.
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3. Requests for accommodation:
Upon request by the employee or applicant, the Village will make reasonable accommodations
to enable a qualified person with a known disability to perform one or more of the essential job
functions.
Department heads or supervisors should notify the Village Manager of any requests received
from employees for accommodation. However, no supervisory employee shall ask a
subordinate whether he or she has some disability requiring accommodation.
4. Complaint procedure:
All questions or complaints regarding non-compliance with the ADA shall be referred to the
Assistant Village Manager who also serves as the Village's Compliance Officer.
7.03 EMPLOYEE DRUG AND ALCOHOL USE
In order to protect the public and to ensure a healthful work place, the Village may require
employees to submit to a urinalysis and/or other appropriate drug and alcohol testing prior to hiring
and subsequent to an on-the-job Injury or accident. In addition, the Village may also test an
employee whenever there Is a reasonable suspicion of drug or alcohol abuse. Refusal to submit to
such testing shall be cause for discipline up to and Including discharge. The results of any drug or
alcohol testing shall be sent to the Village but shall remain confidential to the extent possible under
applicable law. If the results of the test are positive, confirmation testing may follow. The employee
may be advised confidentially to seek assistance and, in appropriate cases, may be provided a
reasonable period of time for rehabilitation. In addition to any discipline which may be imposed, if
an employee tests positive, the employee may be subject to random testing for the following year. If
an employee subject to such random testing again tests positive, the employee will be subject to
further discipline, up to and including discharge. Nothing herein shall be interpreted to prohibit the
imposition of discipline up to and Including discharge on a first offense.
Seasonal employees who are to perform lifeguard duties for the Bath at Tennis Club shall be
required to submit to a urinalysis and/or other appropriate drug and alcohol testing prior to hiring
and pursuant to a random testing program thereafter. A positive test shall result In termination of
employment.
Employees required to hold a Commercial Driver's License (CDL) are subject to the U. S.
Department of Transportation CDL Drug 8t Alcohol Regulations. The Village Policy addressing
these regulations Is attached as Appendix B. Drug and Alcohol testing policies for represented
employees are contained within the respective collective bargaining agreements.
7.04 EMPLOYEE ACCESS TO PERSONNEL RECORDS
A. The Village is subject to the provisions of Public Act 85-1393, which governs access to
personnel records under Illinois Law. In summary, this law as implemented by the Village
provides:
VII-9
1. An employee may request In writing submitted to the Personnel Specialist permission
to inspect his or her own personnel documents relating to the employee's qualifications
for employment, promotion, transfer, additional compensation, discharge or other
disciplinary action. An employee's right to inspect such documents may be invoked
two times per year at reasonable intervals. The Personnel Specialist will provide an
Inspection opportunity within seven (7) working days of receipt of the request.
Inspection will ordinarily take place at a time and place designated by the Personnel
Specialist. Upon written request, the Village will copy personnel documents requested
by the employee at their cost (pursuant to the schedule of costs set forth In the
Village's Freedom of information Act ordinance, unless such fees are waived by the
Village Manager). Such request must specifically designate which documents are to be
copied.
2. An employee may designate another representative to inspect his or her personnel
documents. Said designation must be made In writing and be approved by the Village
Manager.
3. If an employee disagrees with information contained In the personnel records, he/she
may request in writing, directed to the Village Manager, that it be removed. If the
Village does not agree to remove the disputed item, he/she may submit a written
statement to the Village Manager explaining his or her position which will be attached
to the disputed record or document in the Village's file.
4. The right of inspection does not apply to various types of documents maintained by
the Village as set forth by statute, including butnot limited to:
a. Letters of reference
b. Tests (except cumulative test score)
C.. Personal information about any other person where disclosure is an
unwarranted invasion of privacy
d. Records concerning any other pending claim by the employees which may be
discovered In a judicial proceeding
e. Investigatory or security records (unless and until adverse personnel action is
taken based on such information) .
f. Materials relating to "staff planning" such as documents relating (or
potentially relating) to more than one employee concerning the development,
expansion, goals or plans of the Village or any of Its departments. However,
if such materials are used to determine an employee's qualifications for
employment promotion, additional compensation, transfer, discipline or
discharge, they will be produced.
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B. Any questions, problems or requests regarding personnel records should be directed to the
Personnel Specialist, who will be responsible for maintaining records and complying with this
policy. The Village Manager shall make any decision as required to comply with this policy,
Including the determination of what records constitute "personnel documents" subject to
inspection.
7.05 LICENSE, REGISTRATION AND CERTIFICATE VERIFICATION
A. General Provision:
Certain job classifications require incumbents to be licensed, certified, or registered to operate
vehicles, pieces of equipment, or perform other job duties. Employees must comply with the
licensing requirements set forth In their job descriptions. When employees are unable to show proof
of possessing the required license or licenses, they are prohibited from performing those functions
which require them to be licensed.
1. Definition:
Whenever the terms "license", "licensed", or "licensing" are used in this Section, they shall be
Interpreted to Include all licenses, registration, and/or certificates an employee must possess to
perform his or her assigned job duties.
2. Showin¢Proof
Employees must show proof of possessing a valid drivers license before they can operate a
motorized vehicle In the course of conducting Village business, regardless of whether the
vehicle Is employee or Village-owned. Additionally, employees must show proof of other valid
licenses required for their jobs.
3. Procedure:
Department heads will review the license requirements set forth In employees' job descriptions
and submit to the Assistant Village Manager on or about January 1 st of each year a listing of
each employee's license number, type, class and expiration date. The Police Department will
determine whether any of the licenses are suspended or revoked. The Assistant Village
Manager will review the fisting and advise the Village Manager of matters requiring his or her
attention.
4. Non-Compliance:
Employees who are unable to secure and/or maintain the required licenses, shall immediately
notify their department heads and cease to operate those vehicles and/or pieces of equipment
for which they are no longer licensed, registered and/or certified.
VII-1 1
S. Timely Notification:
To be considered timely, employees shall notify their department head of their inability to
comply with the licensing requirements on their first work day following the suspension,
revocation or loss of their license, registration or certificate.
6. Alternative Assignment:
Employees who have met the timely notification requirement as described above may be
assigned to other existing, available jobs for up to 30 calendar days, which may be extended an
additional 60 calendar days at the discretion of the Department Head. To be considered for
an alternative assignment, there must be a reasonable expectation that the employee can
resume, within 90 calendar days, either all the duties of his or her former job, or those of a
different job. However, no employee shall be moved from his or her regular job to make room
for someone who Is unable to perform the former job for reasons described above. Moreover,
priority consideration for alternative assignments goes to employees who are recuperating from
on-the-job Injuries.
7. Unpaid Leave or Suspension:
Employees who are unable to meet the licensing requirements are not guaranteed alternative
job assignments. Employees may be placed on unpaid leave or suspension, if alternative job
assignments are unavailable or denied. The Village Manager in consultation with the
department head will approve or deny alternative job assignments.
8. Failure to Notify:
Employees who fail to notify the department head of their inability to obtain or their loss of
their license, registration or certificate through suspension, revocation, or any other reason may
be subject to discipline up to and including termination. In determining the appropriate
measure of discipline, the Village Manager, In conjunction with the department head, will
consider all the facts and circumstances of each case.
B. Vehicle Use:
1. General Provision:
In Illinois, auto insurance coverage follows the vehicle. If an employee who uses his or her own
vehicle for Village business purposes has an accident, the employee's personal auto coverage
for the vehicle pays for any injuries and/or damages for which the driver is liable. To avoid
risking higher insurance costs and personal liability, employees shall use Village vehicles for
Village business purposes, when one Is reasonably available.
2. Excess Coverage:
Subject to the requirements stated below, the Intergovernmental Risk Management Agency
(IRMA) provides excess automobile liability coverage for employees who drive their personal
vehicles for pre-approved Village business purposes.
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a. Criteria for excess coverage:
The employee must cant' primary auto liability coverage with the following insurance
levels:
■ $100,000 bodily Injury per person
■ $300,000 bodily injury per occurrence
■ 5100,000 property damage or 5300,000 combined single limit
b. EmMoyee's coveraee is mimary:
The employee's personal insurance is primary. IRMA's excess coverage applies only to
liability In excess of any other collectable Insurance.
C. Effective period:
This section Is in effect for as long as there is excess automobile coverage through
IRMA.
7.06 SMOKING POLICY
Smoking Is not permitted in any Village facility provided that guests may be permitted to smoke in the
Bath 8t Tennis Clubhouse, at private parties, when requested by the customer at the time the party Is
booked.
The smoking policy for Village vehicles shall be determined at the department level with due
consideration given to non-smokers. Conflicts between the Interests of a smoker and non-smoker will be
resolved in favor of the non-smoker.
7.07 PERSONAL USE OF VILLAGE TELEPHONES
Making and receiving personal telephone calls Is not prohibited. However, employees are to limit the
amount of time spent making and receiving personal telephone calls. The employee is responsible for
reimbursing the Village for any personal long-distance and toll telephone calls or cellular calls made
from a Village phone. Excessive personal calling or non-payment of personal telephone charges may
subject the employee to disciplinary action.
7.08 GENERAL APPEARANCE
Employees shall be neat and respectable in their appearance except where emergency work makes this
Impossible. In general, employees shall dress in a manner appropriate for the work being performed.
Issues involving the appropriateness of dress shall be resolved by the Department Head.
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7.09 GENERAL PROHIBITIONS
A. Outside Employment.
Outside employment of any full-time Village employee should be kept to a minimum, and is
subject to prior approval of the Village Manager. As a general rule, time off, vacation, and
holidays are granted for the benefit of the employee and are not to be utilized for outside
employment. No outside employment shall be permitted If:
1. It physically or mentally hampers the employee in his or her ability to fulfill the dudes
of his or her position with the Village; or
2. It would reflect adversely upon the employee or the Village; or
3. It Is in conflict In any way with his.or her position as a Village employee.
Each employee who Is engaged In outside employment shall notify his or her Department Head
In writing as to:
l. The name of the employer.
2. The nature of the outside work.
3. The schedule of the outside work.
Each Department Head, or the Village Manager, shall reserve the right to prohibit any outside
employment on the part of any Village employee which employment, In their judgment, might
be detrimental to the best Interests of the Village. In such cases, the employee will be given an
appropriate notice and opportunity to decide how he/she wishes to resolve the conflict.
B. Employment of Relatives:
Except with the approval of the Village Manager, It shall be the policy of the Village of Oak
Brook not to employ relatives of any elected Village official, member of any Village Board or
Commission, the Village Manager, Department Heads, or Village employees within the same
office, department, or division.
C. Conducting Non-Village Business on Village Time:
The conducting of any activities outside of official Village duties while on Village time, or with
Village property, Is prohibited.
D. Use of Village Property:
Except where approved in accordance with specific policies, employees shall not use Village
property for their own purposes, nor shall they remain in or return to the offices or other work
areas of Village buildings outside of the normal business hours without having obtained the
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prior authorization of their supervisor. Examples of items constituting Village property are
stationery, postage meter, computers, floppy disks, tools, machinery and similar items.
E. Political Endorsements:
In no event shall any political endorsement be considered in connection with the appointment
to a position In the Village service.
F. Political Activity and Contributions:
Village employees have a constitutional right to engage in political activity through voluntary
political contributions or voluntary political work. Nothing will be done to abridge the
constitutional right of an employee to participate In the political process. Village employees
shall not participate in political activities while at work, nor shall Village supplies and
equipment, including uniforms, be used In connection with political activities.
G. Solicitation:
Unless authorized by the Department Head or the Village Manager, all solicitation among
Village employees during working hours for charitable or other purposes and all selling of
tickets, magazines or merchandise of any kind Is prohibited. In addition, solicitation by any
person, including Village employees, is not permitted during nonworking times in areas where it
will disturb employees who are working. These restrictions apply to all solicitation, selling or
peddling of every nature whether by Village employees or non-employees.
H. Gifts and Gratuities to Employees:
All Village employees and Village departments are prohibited from accepting gifts, gratuities,
or related donations from citizens at large, vendors, businesses, or other persons with whom
they may come in contact with In the course of their official dudes.
A solicitation of a gift of any kind or value in any amount whatever is strictly prohibited.
Acceptance of gifts and donations not having essential or intrinsic value, such as food that can
be consumed on the premises by the department as a whole, Is not strictly prohibited but
should be received judiciously and with discretion. Receipt of calendars, pocket notebooks,
and other items of an advertising nature are also governed by this no intrinsic value policy.
Procedurally, if a gift or gratuity is received from a citizen or business and is addressed to the
department as a whole, the Department Head should return the gift or gratuity as soon as
possible with an accompanying letter thanking the person or firm for the thought, but
explaining that it Is not expected and Is contrary to Village policy. If a gift for the department
as a whole is submitted to an individual member of the department, it should be forwarded to
the supervisor immediately, and the above course of action should be followed.
VII-15
ARTICLE Vill
DISCIPLINARY ACTION
8.01 DISCIPLINARY PROCEDURES
This section serves as a guideline for the supervisor's use, and notice of what employees may expect if
disciplinary action is warranted. The actual procedure employed depends on the type and seriousness
of the particular offense, as well as the frequency with which it or a substantially similar offense
occurred. In general, disciplinary action will be progressive, but serious first time offenses may warrant
Immediate suspension or dismissal. Each situation will be evaluated separately and on its own merits in
view of these guidelines.
8.02 REPRIMAND
A. Verbal.•
The Department Head or supervisor may verbally reprimand an employee for misconduct.
The reprimand should be given in private (when possible), and a record of the verbal
reprimand (e.g. Personnel Action Report) shall be placed in the employee's official personnel
file.
B. Written:
The Department Head or supervisor may issue a written reprimand to an employee for the
recurrence of an incident for which a verbal reprimand was given, or for a more serious initial
violation. The reprimand shall include a description of the incident and a statement regarding
the resolution of the incident. The employee shall be given an opportunity to sign the written
reprimand Indicating receipt, and failure to sign shall be noted. A copy of the written
reprimand (i.e. Personnel Action Report) shall be placed in the employee's official personnel
file.
8.03 SUSPENSION
A. General Provision:
A Department Head may suspend without pay any employee for cause, provided that such
employee is first notified of the reasons for such action and his or her right to a due process
hearing. A suspension without pay shall be for such length of time as the Department Head
considers commensurate with the severity of the cause. Any suspension without pay is subject
to the approval of the Village Manager. This section shall not apply to police officers and
firefighters who are governed by the rules of the Board of Fire 8z Police Commissioners and
State statute.
VIII-1
Employees exempt from the provisions of the Fair Labor Standards Act (FLSA) may only be
suspended without pay in time Increments of work weeks. Suspensions of Department Heads
are administered at the discretion of the Village Manager and the Village President and Board
of Trustees, as applicable.
8.04 DEMOTION
A Department Head may demote an employee for cause provided that such employee Is first notified of
the reasons for such action and his or her right to a due process hearing. A demotion Is subject to the
approval of the Village Manager. This section shall not apply to police officers and firefighters, who are
governed by the rules of the Board of Fire a Police Commissioners and State statute.
8.05 DISCHARGE
A. Non-Probationary Employees.
A Department Head may terminate a non-probationary employee for cause, provided that
such employee Is first notified of the reasons for such action and his or her right to a due
process hearing. Any such termination Is subject to the approval of the Village Manager.
Department Heads appointed by the Village Manager are "at will" employees and may be
terminated by the Village Manager at any time, with or without cause. Department Heads
appointed by the Village President with the concurrence of the Board of Trustees, may be
terminated only by the Village President and Board of Trustees, upon recommendation of the
Village Manager, at any time, with or without cause. This section shall not apply to police
officers and firefighters, who are governed by the rules of the Board of Fire 8L Police
Commissioners and State statute.
B. Probationary Employees.
A probationary employee may be discharged at any time without cause.
C. Temporary,Seasonal and Situational Employees:
A temporary,seasonal or situational employee may be discharged at any time without cause.
D. Dlsquarftcation From Future Employment.
An employee dismissed from the Village shall be disqualified from future employment by the
Village, unless the Village Manager specifically authorizes such re-employment.
E. Causes for Certain Disciplinary Action Including Termination:
Evidence of the following actions shall be sufficient reason for suspending, demoting or
dismissing an employee, depending on the circumstances:
1. Evidencing negligence, misconduct or incompetence in the performance of one's
duties.
VIII-2
2. Having been convicted of any felony, or of a misdemeanor Involving moral turpitude,
or having engaged in or engaging in criminal conduct either on or off duty.
3. Violating any lawful or official regulation, or failure to obey such regulation which has
resulted in, or can reasonably be expected to result In, loss or Injury to the Village or
the public.
4. Consuming alcoholic beverages while on duty.
5. Intoxication on duty.
6. Selling, delivering, receiving or using any illegal substance.
7. Using offensive conduct or language toward the public, municipal officers, superiors or
co-workers or subordinates.
8. Carelessly or negligently handling the Village's equipment and/or property.
9. Inducing or attempting to Induce an officer or employee of the Village to commit an
unlawful act, or acting in violation of any lawful and reasonable official regulation or
order.
10. Accepting for the performance of one's job duties any fee, reward, gift, dp or other
form of remuneration which does not constitute normal wages, salaries or benefits.
(See Section 7.09 H.)
11. Engaging in conduct which brings discredit upon the Village service.
12. Dishonesty in the performance of duties.
13. Abuse of the sick leave policy(see Section 5.02).
14. Endangering one's own safety, or the safety of others, by failing to use reasonable
safety practices, and/or violating the Village's or the department's safety rules.
15. Unauthorized personal use of Village equipment or other property.
16. Misappropriating or unlawfully disposing of Village funds or property.
17. Withholding Informadon, or providing incorrect or fraudulent information about either
one's own job related injury, illness, Incident or accident.
18. Falsifying Village documents, including time sheets/cards, reports, logs or similar
records, and/or falsely representing the quality and/or quantity of work performed, or
assisting another in concealing the aforementioned actions.
VIII-3
I
19. Misrepresenting or falsifying the Information reported on the employment application
Including all documents submitted with and/or processed as part of the employment
application.
The foregoing Is not intended to be exhaustive of the reasons that might justify disciplinary
action, but Is provided to assist the employee in determining which types of conduct and/or
performance the Village considers to be unacceptable.
VIII-4
ARTICLE IX
APPEALS
9.01 APPEAL PROCEDURE
A. General Provision:
Employees are encouraged to promptly discuss with their supervisor any work-related problem.
It is the Village's policy to attempt to ensure that all personnel actions are fair, and that there is
open communication between employees and between employees, supervisors and Village
management. if efforts fail to resolve a personnel Issue within ten business days after the
supervisor and the employee meet, employees may avail themselves of the following appeal
procedure.
B. Steps:
Except as otherwise stated below, all employees may take the following steps to appeal any
personnel action:
Step 1. Submit the appeal in writing to the supervisor's superior. The superior shall
respond with a written decision within ten business days from the date of
receipt. If efforts fail to resolve the. issue at this level, employees may proceed
to the next step.
Step 2. File a written appeal with the Department Head within five business days from
the date on which the employee receives the written decision generated in Step
2. The Department Head shall respond to the appeal with a written decision
within ten business days from the date of receipt. If efforts fail to resolve the
matter at this level, employees may proceed to the next step.
Step 3. Appeal to the Village Manager, or his designee, who shall respond with a
written decision within ten business days from the date of receipt of the written
appeal. The Village Manager's decision shall be final.
The time frames specified above may be extended at each step by mutual agreement between
the employee and the management employee involved in the appeal resolution process.
It is recognized that some of the steps described above may be inapplicable in certain cases
because of the departmental structure or because of the position of the employee who is bringing
the appeal.
C. Rights:
Employees who register an appeal are assured of freedom from restraint, interference,
discrimination, or reprisal. They may be represented by counsel of their own choosing.
IX-1
D. Dismissal•
The appeals procedure shall not be used for appealing a dismissal from employment with the
Village of Oak Brook.
IX-2
APPENDIX A
'vE OF 0��,
`. 90
o
e e
O N
G O
Z
'Cf COUN11
VILLAGE OF OAK BROOK
1200 OAK BROOK ROAD
OAK BROOK , ILLINOIS 60523-2255
December 17, 1998 PHONE: 630 990.3000
FAX: 630 990-0876
MEMO TO: All Department Heads
FROM: Stephen B. Veitch, Village Manager
SUBJECT: 1999 Salary Plan and Salary Administration Policy for Non-Union Employees
Attached is a copy of Resolution R-714 which amends our Salary Plan and Salary Administration
Policy for non-union employees effective January 1, 1999. A copy of this resolution will also be
distributed to all non-union employees.
The following salary adjustment guidelines should be used for 1999 salary increases based upon
performance evaluations and consistent with the provisions of the Salary Administration Policy:
CatelZory 1999 Guidelines
Unsatisfactory 0%
Below Standards 0%
Needs Improvement 2%
Meets Standards 8.2% (3.2% plus 5% merit)
Above Standards 9.2% (3.2% plus 6% merit)
Excellent 10.2% (3.2% plus 7% merit)
If you have any questions, please contact me or Mike Crotty.
SBV:mr:salary adjustments
Attachment
cc: Michael Crotty, Assistant Village Manager
Marlene Hellwig, Personnel Specialist
f
RESOLUTION 98-SAP-EX2-R-714
A RESOLUTION APPROVING THE
SALARY PLAN AND SALARY ADMINISTRATION POLICY
FOR NON-UNION EMPLOYEES FOR 1999
WHEREAS, pursuant to Article II (Pay Plan)of the Personnel Rules and Regulations of the Village of Oak
Brook(Appendix D to the Code of Ordinances of the Village of Oak Brook), the Village Manager is charged with
developing a uniform and equitable pay plan with the approval of the Village Board; and
WHEREAS, the Village Manager has recommended, based upon the Village Salary Administration policy,
that the minimums and maximums of all pay grades be adjusted 3.2%,with increases effective January 1, 1999;
therefore effective January 1, 1999, the minimums and maximums of all pay grades shall be increased by 3.2%;
and
WHEREAS, the Village Manager has recommended the approval of the attached Salary Plan for non-
union employees commencing January 1, 1999. A copy of this Salary Plan is attached hereto, labeled Exhibit A
and made a part hereof.
NOW, THEREFORE, BE IT RESOLVED BY THE PRESIDENT AND BOARD OF TRUSTEES OF THE
VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS as follows:
Section 1: That the provisions of the preamble hereinabove set forth are hereby adopted as though fully
set forth herein.
Section 2: This Village Board finds that the attached 1999 Salary Plan (Exhibit A) conforms with the
guidelines set forth in the Salary Administration Policy(Exhibit B).
Section 3: That the attached Salary Plan for 1999 (Exhibit A) and Salary Administration Policy (Exhibit B)
are hereby approved;
PASSED AND APPROVED this 8th day of December, 1998, by the President and Board of Trustees
of the Village of Oak Brook, DuPage and Cook Counties, Illinois, according to a roll call vote as follows:
Ayes: Trustees Caleel, Kenny, McInerney, Savino and Shumate
Nays: None
Absent: Trustee Bartecki
Abstain: None
Village Presiden
ATTEST: /
Village erk
payplan.ord
RESOLUTION 99-SAP-EXI-R-725
A RESOLUTION APPROVING AN AMENDMENT TO THE EMPLOYEE
SALARY PLAN FOR NON-UNION EMPLOYEES FOR 1999
WHEREAS,pursuant to Article 11 (Pay Plan)of the Personnel Rules and Regulations of the Village of Oak
Brook(Appendix D to the Code of Ordinances),the Village Manager is charged with developing a uniform and
equitable pay plan with the approval of the Village Board; and
WHEREAS,it is the recommendation of the Village Manager that the position of Director of Community
Development, Salary Grade 9, be reclassified to Salary Grade 11 of the 1999 Employee Salary Plan as set forth
in the attached 1999 Salary Plan-Non-Union Employees,which is labeled Exhibit A and made a part hereof;
NOW,THEREFORE, BE IT RESOLVED BY THE PRESIDENT AND BOARD OF TRUSTEES OF THE
VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS as follows:
Section 1: That the provisions of the preamble hereinabove set forth are hereby adopted as though fully
set forth herein.
motion 2: That the Village Board finds the attached 1999 Employee Salary Plan, as amended, (Exhibit A)
conforms with the guidelines set forth in the Salary Administration Plan which was previously adopted by the
Board on December 8, 1998, pursuant to Resolution 98-SAP-EX2-R-714.
ection 3: That the attached Employee Salary Plan for 1999, as amended, (Exhibit A)is hereby
approved.
PASSED AND APPROVED this 11th day of May, 1999, by the President and Board of Trustees of the
Village of Oak Brook, DuPage and Cook Counties, Illinois, according to a roll call vote as follows:
Ayes: Trustees Butler, Caleel, Craig, Kenny and Savino
Nays: None
Absent: Trustee McInerney
Abstain: None
4 Village President4o
,`y�. :.rl•-" •., •* ail.LC.
t:( ,.2
1999 SALARY PLAN-NON-UNION EMPLOYEES
GRADE POSITION MINIMUM MAXIMUM RANGE
1 Golf Course Laborer $23,364 $31,548 $8,184
Police Records Clerk
P.W.Laborer
Receptionist
Records Management Clerk
2 Account Clerk $26,430 $35,687 $9,257
Purchasing 6 IS Clerk
3 Secretary $27,255 $36,801 $9,546
Water Billing Clerk
4 Communications Operator $31,001 $41,848 $10,847
Community Service Officer
P.W.Employee I
Sports Core Maintenance Employee
5 Building Maintenance Employee $33,065 $44,644 $11,579
Communications Supervisor
Deputy Village Clerk
Information Services Technician
Librarian
Personnel Specialist
P.W.Employee 11
6 Administrative Assistant $36,357 $49,082 $12,725
Circulation Services Supervisor
Sports Core Mechanic
Technical Services Supervisor
7 Civil Engineer 1 $41,001 $55,356 $14,355
Head Mechanic
P.W.Foreman
Senior Librarian
8 Accounting Manager $45,552 $61,502 $15.950
Executive Chef
Golf Course Superintendent
Information Systems Specialist
Plan Reviewer/Chief Building Inspector
Police Sergeant
P.W.General Foreman
9 Assistant Village Manager $52,704 $71,156 $18,452
Civil Engineer II
Fire Captain
Police Lieutenant
10 Bath&Tennis Club Manager $54,294 $78,721 S24,427
Director of Information Services 8 Purchasing
Golf Club Manager
Library Director
11 Director of Community Development $57,462 $83,324 525,862
i
Finance Director
Fire Chief/Building Commissioner
Police Chief
Public Works Director f
Village Engineer
Approved: may
Effective: May 15, 1999
EXHIBIT A(1 of 3) frm:salary
VILLAGE OF OAK BROOK-DISTRIBUTION OF SALARY PLAN POSITIONS
i 2 3 4 5 8 7 8
LEGISLATIVE AND
POSITION GENERAL POLICE FIRE 3 COMMUNITY SPORTS CORE
IN GRADE MANAGEMENT FINANCIAL SERVICES PUBLIC WORKS ENGINEERING LIBRARY DEPARTMENT DEVELOPMENT
GRADE 1 °Receptionist •Police Records °Golf Course Laborer
°Rec.MgmLClerk Clerk
GRADE 2 •Purchasing b IS °Acct Clerk
Clerk
GRADE 3 •Secretary •Water Billing •Secretary •Secretary •Secretary •Secretary •Secretary •Secretary
Clerk
GRADE 4 °Communications •P.W.Employee 1 •C.S.O. °Maint.Employee
Operator
GRADE 5 °Communications °Personnel °BIdg.MainLEmpl. •Librarian
Supervisor Specialist °P.W.Employee II
°Information
Services Tech.
°Deputy Village Clerk
GRADES •Admin.Asst •Ckculadon •Admin.Asst °Mechanic
Services Supvr.
•Technical
Services Supvr.
GRADE 7 °Foreman •Civil Engr.l •Senior Librarian
°Head Mechanic
GRADES °Information °Accounting Mgr. °General Foreman •Sergeant •Plan Reviewer/Chief °Executive Chef
Systems Specialist Bldg Inspector °Golf Course Supt.
GRADE 9 °Asst.Village Mgr. °Civil Engr.II •Lieutenant •Captain
GRADE 10 •Dir.of Info Services •Library Director °B&T Club Mgr.
8 Purchasing °Golf Club Mgr.
GRADE 11 °Finance Director °Director °Engineer •Chief •Chlef/Building
Commissioner
•Director of Community
Development
Adopted and Approved: May 11, 1999
Effective: May 15, 1999
salpran4lrm EXHIBIT A(Page 2 of 3)
VILLAGE OF OAK BROOK
1999 SALARY PLAN
PAID-ON-CALL, REGULAR PART-TIME FIRE PERSONNEL AND SPECIAL DUTY RATE
COMPENSATION SCHEDULE
Paid-On-Call Firefighters $16.38 per hour for 1 st hour&$8.19 per A hour thereafter responding to fire
Paid-On-Call Firefighters $11.70 per hour for 1 st hour& $5.85 per%:hour thereafter for training and drill
Paid-On-Call Assistant Chiefs $18.71 per hour for 1 st hour& $9.36 per Y2 hour thereafter for emergency calls
Paid-On-Call Assistant Chiefs $14.01 per hour for 1 st hour& $7.01 per Y2 hour thereafter for required training
Special Duty Rates Pursuant to Section 11-25 of the Code of Ordinances
1.5 x 1998 Patrol Officer Range Midpoint
1.5 x 43,546 = 65,319 _ 2080 =31.40/hr.
Minimum Hourly Maximum Hourly
Inspector/Coordinator/Administrative Aide 15.50 20.93
Director of Fire Prevention 19.67 26.56
Assistant EM Coordinator 19.67 26.56
Chief Electrical Inspector 19.67 26.56
Approved: May 11, 1999
Effective: May 15, 1999
EXHIBIT A (Page 3 of 3)
salplanlfrm
SALARY ADMINISTRATION POLICY-NON-UNION EMPLOYEES
I. INTRODUCTION
The Salary Administration Policy is intended to establish a compensation program which is both
internally equitable and competitive with the prevailing wages paid within Oak Brook's Labor
Market Area. It is also based on a system of performance evaluations designed to recognize and
reward employees whose performance meets or exceeds standards established at the department
level as well as standards which apply generally to employees of the Village of Oak Brook.
For the purpose of maintaining wage levels that remain competitive in the appropriate market,
adjustments to the Salary Plan are normally computed annually based on a percent change that
considers the Consumer Price Index for the Chicago-Gary-Lake Co.region as published by the U. S.
Department of Labor, the Employment Cost index as published by the U. S. Department of Labor,
and the pay practices in the Village's comparable communities. The Board-approved percentage
adjustment is applied to the minimums and maximums for all pay grades, with increases effective
January Ist of the subsequent year. The Village Board may, in its discretion,authorize adjustments
to the Salary Plan based on other factors(see Section II.C.below).
The Village of Oak Brook's Salary Administration Policy,as well as the fringe benefits applicable to
employees shall be further monitored every three years. An independent compensation consultant
shall be retained by the Village to compare the compensation of Village of Oak Brook positions with
similar positions in the region, and to compare the fringe benefits offered to Village of Oak Brook
employees with fringe benefits available to other employees of the region. The consultant was
retained in 1994 and will be retained every three years thereafter.
The independent consultant will submit a report including recommendations for modifications in the
Salary Plan and/or the fringe benefits package.
II. GUIDELINES
The following guidelines shall apply to review and modification of the Salary Plan:
A. Review and Adjustment of Plan - When making annual adjustments to the Plan, the change in
the Consumer Price Index for "all items" applicable to the Chicago-Gary-Lake Co. region as
published for September 30th of each year by the U. S. Department of Labor, the Employment
Cost Index for September 30th of each year as published by the U. S. Department of Labor and
the pay practices of the Village's comparable communities will normally be considered.
B. Range Spread Within Each Pay Grade - Grades 1 through 9 shall have a 35% spread from
entrance to maximum salary paid. Grades 10 and I 1 include department heads and shall have a
45%spread.
C. Other Adjustments to the Salary Plan - The Salary Plan may, in the discretion of the Village
Board and upon the recommendation of the Village Manager, be adjusted based on the
evaluations and recommendations of an independent compensation consultant engaged by the
Village of Oak Brook,or based on other factors as deemed appropriate by the Board.
Approved: Dec. 8, 1998 EXHIBIT B Page I of 5
Effective: Jan. 1, 1999
III.STEPS
1. Obtain the September 30th Consumer Price Index and Employment Cost Index published by
the U.S. Department of Labor.
2. Obtain salary data from the Village's comparable communities.
3. Determine the percentage adjustment and calculate the minimum and maximum for each grade
accordingly.
4. Determine merit adjustment guidelines, which shall be designed to permit an employee
performing at a "Meets Standards" level to progress through the salary range in approximately
a seven year period. Employees performing at "Above Standards" or "Excellent" should
progress through the range within a six or five year period, respectively.
IV. MAINTENANCE
The Village Manager shall be responsible for reviewing the data supporting the annual grade
adjustment, as well as the performance salary guidelines, and submitting the revised Salary Plan to
the Board of Trustees for its approval.
The Village Manager shall also be responsible for engaging an independent compensation consultant
once every three years, and forwarding the study, evaluations, and recommendations to the Village
Board for its consideration.
V. PROCEDURES
A. Starting Rate at Initial Employment: Original appointments to any position will normally be
made at the entrance rate. Upon recommendation of the department head, the Village Manager
may approve initial compensation at a rate higher than the minimum rate in the pay range for
the grade, provided that any such acceptance is based on the outstanding and unusual character
of the employee's experience and ability over and above the minimum qualifications required
for that position.
B. Merit adjustments will be determined based upon the employee's performance as described in
the Employee Performance Appraisal and the recommendation of the employee's department
head, with review and approval by the Village Manager. Merit adjustments shall occur within
the parameters of the Salary Plan and in no event shall it exceed the maximum of the range for
the position.
C. Salary Adjustment Schedule: It is the policy of the Village of Oak Brook that salary
adjustments shall be made in a timely and orderly manner. Frequency of salary adjustments are
based upon each employee's performance and the employee's position within the applicable
grade.
1. Employees are evaluated at six month intervals for the first t-,%o years of
employment. Thereafter, evaluations occur annually on the employee's
anniversary date until the maximum compensation for the pay grade in which the
employee's position is classified is reached. "Anniversary date" is determined as
follows:
Approved: Dec. 8. 1998 EXHIBIT B Noe 2 of 5
Effective: Jan. 1, 1999
(a) Generally,the anniversary date is the date of hire;
(b) For employees going from part-time to full-time, status the anniversary
date shall be the date the full-time position is assumed;
(c) For employees whose position is simply reclassified to a new grade(i.e.,
the job duties of the existing position have evolved such that
reclassification and possibly re-titling is warranted), the anniversary date
remains the date of hire;
(d) A promotion is deemed to have occurred when an employee assumes a
new position in a higher pay grade and is performing substantially
different duties than performed previously. For full-time employees
promoted to a new grade and new position, the date of promotion is the
new anniversary date;and
(e) Promoted employees will be reviewed every six (6) months for one (1)
year after their promotion or until they reach maximum compensation for
their respective pay grade.
2. Once an employee has reached the maximum compensation for the pay grade in
which his/her position is classified, the employee's anniversary date reverts to
January 1,and normal salary adjustments shall be effective as of that date.
3. Performance appraisals shall occur at least once each year, and may occur more
frequently, if warranted. Special merit adjustments may occur when warranted
and are not bound by the Salary Adjustment Schedule.
D. Merit Bonus: Top-of-grade full-time employees who achieve an "Above Standards" or
"Excellent" appraisal on the Employee Performance Appraisal Report shall receive a merit
bonus annually in January of each calendar year as follows:
Above Standards Excellent
(Frequently Exceeds Standards) (Exceeds all Department Standards)
$750 $1,500
Any such merit bonus shall not be considered a merit adjustment as provided in Section V.B.
hereof.
E. Special Merit Adjustments and Special Merit Bonuses: Department heads may recommend to
the Village Manager, and the Village Manager may approve, special-salary adjustments or
special merit bonuses at intervals other than as provided in paragraph V.C. hereof. Such
special merit adjustments or bonuses shall be based upon exceptional performance far
exceeding the normal standards for the position, or exceptional service to the Village beyond
the normal scope of duties expected for the position. Special merit adjustments or bonuses
shall have no effect on the schedule for normal performance evaluations and merit adjustments.
Special merit adjustments or bonuses are deemed to be extraordinary events, and may be
granted only after notice to the Village Board, and an opportunity for the Board to disapprove
the action.
Approved: Dec. 8, 1998 EXHIBIT B Page 3 of
Effective: Jan. 1, 1999
F. Village Manager: The Village Manager position is not included in the Salary Plan. The salary
of the Village Manager may be adjusted only by action of the Village Board, subject to the
terms of the current employment agreement in effect between the Board and the Village
Manager.
G. Promotions: In a case where an employee is promoted from one position to another, any
increase in salary shall not be viewed as a merit adjustment, but shall represent recognition of
the additional responsibility inherent in the new position.
H. Performance Appraisal: The objectives of a performance appraisal are several: '
I. To develop and improve performance and to maintain performance at the highest
possible level.
2. To provide for variation in compensation and incentive based as directly as possible
upon merit.
3. To assist supervisors in personnel administration and organizational management.
It is the responsibility of the department head or supervisor completing the Employee Appraisal
Report to review the appraisal with the employee in Person. During this meeting,the evaluator
is expected to discuss the employee's performance in general and point out to the employee,
first, the areas in which the employee is performing effectively, and, secondly, those areas
where improvement is needed. The evaluator is also expected to solicit the employee's views
on the appraisal.
I. Working Out of Classification: Any full-time employee performing authorized work out of
that employee's grade for a minimum of 14 days shall be entitled to additional compensation
during the period of such employment. This compensation shall be 105% of the employee's
present salary, but may not be greater than that of any employee currently working in the
position in question. Further, an employee working out of classification sf�all be entitled to
such additional compensation only if the employee spends the preponderance of time
performing the duties of the position.
LEVELS OF PERFORMANCE-DEFINITIONS
Unsatisfactory
(Consistently Below Standards)
Performance so poor that little useful contribution is made. Such performance calls for immediate remedial
action.
It should be noted that employees performing at this level should be notified as soon as this becomes
apparent. Under no circumstances should employees be allowed to remain in pay status until their
scheduled evaluation date; they should be advised of their substandard performance and its possible
consequences without delay.
Below Standards
In one or more of the significant standards, the employee is falling "below"standards.
Approved: De_ c. 8, 1998 EXHIBIT B Page 4 of 5
Effective: Jan. 1, 1999
Needs Improvement
Performance that would be expected during early periods on a new job as well as during the training phase
of an individual's employment. Usually,the individual develops and moves beyond this level at the average
rate set by the supervisor or Department Head,based on the standards of performance required. It should be
used when an employee is in a training phase as well as when an experienced employee's performance has
dropped from a previous higher level.
Supervisors must set written action plans for each employee who is rated as needs improvement in each
area where the rating applies as well as timetables and deadlines for the improvement to occur.
Meets Standards
(Consistently Meets Standards)
Performance meets standards set by the Department Head. This generally applies to seasoned employees
who have completed their training phase and have accepted full responsibility for the completion of the
duties of their position.
The ratinz is not based on a comparison of the employee's Performance with fellow employees in the same
or similar positron; it must be based solely on a comparison of the employee's performance to the standards
set by the Department and communicated to the employee.
Above Standards
(Frequently Exceeds Standards)
Performance of this caliber will be uncommon within each Department. The rating will apply to employee
performance which exceeds all Department standards and is represented by outstanding achievements over
and above the normal work assigned.
Examples of the outstanding achievements must be documented and submitted with the Performance
Evaluation form with an appropriate statement as to how the achievements favorably impacted the
Department.
Excellent
(Exceeds all Department Standards)
Performance of this caliber is exceedingly rare. It may occur in employees who are unusually gifted in a
particular area,or whose skills surpass all standards set for the average employee. It may also be earned for
excellent performance in response to an unusual occurrence which would normally not constitute an
employee's regular duties and responsibilities.
Examples of the employees particular achievements must be submitted with the Performance Evaluation
form.
Approved: Dec. 8, 1998 EXHIBIT B Page 5 of 5
Effective: Jan. 1, 1999
APPENDIX B
ORDINANCE 95-GL-CDL-EXl-S-837
AN ORDINANCE ADOPTING A
COMMERCIAL DRIVER'S LICENSE
DRUG & ALCOHOL TESTING POLICY
WHEREAS, the U.S. Department of Transportation Federal Highway
Administration has published rules and regulations requiring employers to test
drivers who have a Commercial Driver's License for the misuse of alcoholic and
controlled substances; and
WHEREAS, the Village of Oak Brook must comply with the federal rules and
regulations by January 1, 1996; and
WHEREAS, a Village policy incorporating the provisions of the federal
regulations has been prepared; and
WHEREAS, the purpose of the policy is to prevent accidents and injuries
resulting from the misuse of alcohol and/or controlled substance abuse by
drivers of commercial motor vehicles,
NOW, THEREFORE, BE IT ORDAINED BY THE PRESIDENT AND BOARD OF TRUSTEES OF
THE VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS as follows:
Section 1: That the provisions of the preamble hereinabove set forth
are hereby adopted as though fully set forth herein.
Section 2: That the Village of Oak Brook policy on commercial driver's
license drug and alcohol testing, a copy of which is attached hereto and
incorporated herein as Exhibit A, is hereby approved and adopted in its
entirety.
Section 3: That this ordinance shall be in full force and effect from
and after passage and approval pursuant to law.
PASSED THIS 12th day of December, 1995.
Ayes: —Trustees Bartecki, Kenny, McInerney, Payovich, Savino and Shumate
Nays: None
Absent: None
Abstain: None
APPROVED THIS 12th day of December, 1995.
i lage President
Ordinance 95-GL-CDL-EXI-S-837
Adopting a CDL Drug & Alcohol
Testing Policy, Page 2
of 0,4
'ATTEST
f Form:
Village Attorney
Published
Date Paper
Not Published ACC
EXHIBIT A
VILLAGE OF OAK BROOK POLICY
Commercial Driver's License
Drug & Alcohol Testing
A. General Policy: The Village shall comply with the provisions of the U.S. Department of
Transportation Federal Highway Administration's(FHWA) published rules and regulations
(49 CFR Part 382) that require employers to test drivers who have a Commercial Driver's
License for the misuse of alcoholic and controlled substances.
B. Definitions: The terms used in this policy shall have the same meanings ascribed to said terms
in 49 CFR 382.107 or 49 CFR 40.3, as applicable.
C. Applicability: This policy applies to every employee who is required to maintain a
Commercial Driver's License as part of their job requirements, including full-time, casual,
intermittent or occasional employees and, for purposes of pre-employment testing only, any
person applying for a job who will be required to drive a commercial motor vehicle. This
policy is also applicable to leased drivers and independent owner-operated contractors who
are either directly employed by or under lease to the Village or who operate a commercial
motor vehicle at the direction of or with the consent of the Village.
D. Purpose: The purpose of the policy is to prevent accidents and injuries resulting from the
misuse of alcohol and/or controlled substance abuse by drivers of commercial motor vehicles.
It is intended to comply with the FHWA's published regulations(49 CFR Part 382) that
require employers to test drivers who have a Commercial Driver's License for the misuse of
alcoholic and controlled substances. Nothing in this policy shall preclude the Village from
establishing rules, regulations, policies and/or procedures otherwise permitted by law, as long
as such rules do not conflict with the special requirements of said regulations. The Omnibus
Transportation Employee Testing Act of 1991 requires the testing of employees and mandates
anti-drug and alcohol misuse and prevention programs.
E. Testing Requirements: The Village shall test for controlled substances and alcohol in the
following circumstances:
1. Pre-Employment: Testing of this kind shall occur prior to the first time and employee
performs a safety-sensitive function. Said employee shall not be allowed to perform a
safety-sensitive function unless the alcohol test result indicates an alcohol concentration
less than 0.04 and the controlled substances test result indicates a verified negative result.
If the alcohol test result is 0.02 or greater but less than 0.04, the provisions of subsection
F.3 of this policy shall apply. The Village may choose not to administer such alcohol or
controlled substance tests if an exception set forth in 49 CFR 382.301 is applicable.
2. Post Accident: Testing of this kind shall occur when any employee is involved in an
accident involving a commercial motor vehicle in which a safety-sensitive function was
being performed with respect to the vehicle and a fatality occurs, or the employee receives
a citation for a moving traffic violation arising from the accident. After the test, the
employee shall remain at home with pay until test results are received by the Assistant to
the Village Manager or his/her designee(hereinafter"Assistant to the Village Manager).
If an alcohol test required under this section is not administered within two (2) hours
following the accident, the Village shall prepare and maintain on file a record stating the
reasons the test was not promptly administered. If an alcohol test required by this section
is not administered within eight (8) hours following the accident, the Village shall not
administer the test and shall prepare and maintain the same record.
If a controlled substance test required under this subsection is not administered within
thirty-two (32) hours following the accident, the Village shall not administer the test and
shall prepare and maintain on file a record stating the reasons the test was not promptly
administered.
An employee subject to a post-accident test shall remain readily available for such testing,
or may be deemed to have refused to submit to testing; provided, however, that this
section shall not be construed to require the delay of necessary medical attention for
injured people or to prohibit an employee from leaving the scene of the accident for the
period necessary to obtain assistance in responding to the accident or to obtain necessary
emergency medical care.
The Village shall provide employees with all necessary post accident information,
procedures and instructions prior to an employee operating a commercial motor vehicle.
The results of a breath or blood test for alcohol or a urine test for controlled substances
conducted by Federal or State officials having independent authority for the test shall be
considered to meet the requirements of this section, provided such tests conform to
applicable law and the results are obtained by the Village.
3. Reasonable Suspicion: Testing of this kind shall occur when there is reasonable suspicion
to.believe that an employee has violated any of the provisions of subsections F.2, 4, 5, 6, 7
or 8. Such reasonable suspicion must be based on specific, contemporaneous, articulable
observations concerning the appearance, behavior, speech or body odors of the employee.
With regard to suspected controlled substance use, such observations may include
indications of the chronic and withdrawal effects of controlled substances.
The observations required for a reasonable suspicion test shall be made by a supervisor
who is trained pursuant to 49 CFR 382.603. The person making the determination of
reasonable suspicion shall not conduct the test.
Alcohol testing under this subsection may be done only if the required observations are
made during,just preceding or just after the period of the work day that the employee is
required to be in compliance with this policy. An employee may be directed to undergo a
reasonable suspicion test while the employee is performing safety-sensitive functions,just
before the employee is to perform safety-sensitive functions, or just after the employee has
2
ceased performing such functions.
Notwithstanding the absence of a reasonable suspicion alcohol test, no employee shall
report for duty or remain on duty requiring the performance of safety-sensitive functions
while such employee is under the influence of or impaired by alcohol, as shown by the
behavioral, speech and performance indicators of alcohol misuse. The Village shall not
permit the employee to perform or continue to perform safety-sensitive functions until:
a. an alcohol test is administered and the employee's alcohol concentration measures
less than 0.02; or,
b. twenty-four(24) hours have elapsed following the determination of reasonable
suspicions.
Except as provided in the preceding paragraph, the Village shall not take any action under
this policy against an employee based solely on the employee's behavior and appearance,
with respect to alcohol use, in the absence of an alcohol test. This does not prohibit the
Village from taking any otherwise authorized action consistent with law.
A written record shall be made of the observations leading to a controlled substance
reasonable suspicion test, and signed by the supervisor who made the observations, within
twenty-four(24) hours of the observed behavior or before the results of the controlled
substance test are released, whichever is earlier. Such record shall be filed with the Public
Works Superintendent.
Employees required to submit to this test will be escorted by a supervisor or his/her
designee to the test site. After the test, the employee will remain at home with pay until
test results are received by the Assistant to the Village Manager.
4. Random: Testing of this kind shall occur as required by the U.S. Department of
Transportation, in which all employees required to have a Commercial Driver's License
will be subject to random drug and alcohol testing in accordance with Federal regulations.
From the average number of employees required to have a Commercial Driver's License at
the Village, fifty percent(50%) shall be randomly selected each year for controlled
substance testing and twenty-five percent (25%) shall be randomly selected each year for
alcohol testing as required by 49 CFR 382.305. If the FHWA Administrator adjusts the
percentage for alcohol testing pursuant to 49 CFR 382.305, the Village shall adjust the
testing accordingly.
The selection of employees for random testing shall be made by a scientifically valid
method by which each employee has an equal chance of being tested each time selections
are made. The tests shall be unannounced and the dates for administering the tests shall be
spread reasonably throughout the year.
An employee who is selected for a random test shall proceed to the test site immediately;
3
provided, however, that if the employee is performing a safety-sensitive function, said
employee shall cease to perform the safety-sensitive function and proceed to the test site
as soon as possible.
An employee shall only be tested for alcohol under this subsection while said employee is
performing safety-sensitive functions, or just before or just after performing such
functions.
After the test, the employee shall return to duty until test results are received by the
Assistant to the Village Manager.
5. Return to Duty: Testing of this kind shall be administered to employees who have
violated the provisions of sections F.1, 2, 4, 5, 6, 7 or 8 below. If the employee violated
the alcohol provisions, a return to duty alcohol test must be administered and indicate an
alcohol concentration of less than 0.02 and if the employee violated the controlled
substances provision, a return to duty controlled substances test must be administered and
indicate a verified negative result before such employee is permitted to return to duty
requiring the performance of a safety-sensitive function.
6. Follow-Up: Testing of this kind shall occur if it is determined that an employee is in need
of assistance in dealing with the alcohol or controlled substance problems pursuant to
section J below. The employee shall be subject to unannounced follow-up testing
pursuant to section J below. After the test, the employee shall return to duty until test
results are received by the Assistant to the Village Manager. Follow-up alcohol testing
shall be conducted only when the employee is performing safety-sensitive functions or just
before or just after performance of such functions.
F. Alcohol and Controlled Substances Prohibitions: The following prohibitions are applicable to
all employees subject to this policy:
1. No employee shall be on duty or operate a commercial motor vehicle while possessing
alcohol, unless the alcohol is manifested and transported as part of a shipment.
2. No employee shall use alcohol while performing safety-sensitive functions.
3. No employee shall perform or continue to perform safety-sensitive functions, including
driving a commercial motor vehicle, for twenty-four(24) hours following an alcohol test
result indicating an alcohol concentration of 0.02 or greater but less than 0.04.
4. No employee shall report for duty or remain on duty requiring the performance of safety-
sensitive functions while having alcohol concentration of 0.04 or greater and/or a positive
test for controlled substances.
5. No employee shall perform safety-sensitive functions if they have consumed alcohol within
the last four(4) hours.
4
6. No employee shall report to duty, or remain on duty requiring the performance of safety-
sensitive functions, with any amount of controlled substances in their system, except when
the use is prescribed by a physician who has informed the employee that the substance will
not affect the employee's ability to safely operate a commercial motor vehicle. Employees
shall inform the Public Works Superintendent of any therapeutic drug use.
7. No employee shall use alcohol for eight(8) hours following an accident where a post
accident test is required or until he/she undergoes a post accident test, whichever occurs
first.
8. No employee shall refuse to submit to a post accident, random, reasonable suspicion, or
follow-up alcohol test and/or controlled substances test.
9. If the Village has actual knowledge that an employee has violated any of the provisions of
this section F, said employee shall not be permitted to perform any safety-sensitive
functions.
G. Alcohol Testing: All alcohol testing required by this policy shall be performed pursuant to the
procedures set forth in 49 CFR Part 40 and as follows:
1. Before performance of a test under this policy, the employee shall be notified that such
test is required by 49 CFR Part 382.
2. All testing shall be performed by using an Evidential Breath Testing device. The test shall
be conducted by a Breath Alcohol Technician who is trained in the operation of the testing
device.
3. Any result less than 0.02 alcohol concentration is considered a negative test. If the result
is 0.02 or greater, a second confirmation test shall be conducted.
4. If the alcohol concentration is 0.02 or greater but less than 0.04, the employee will
immediately be removed from duty for at least twenty-four(24) hours. A concentration of
0.04 or greater will require immediate removal from duty and referral to a substance abuse
professional pursuant to section J below.
5. Employees who violate the alcohol misuse rules shall be referred to a substance abuse
professional pursuant to section J below.
H. Controlled Substance Testing: All controlled substances testing required by this policy shall
be performed pursuant to the procedures set forth in 49 CFR Part 40 and as follows:
1. Before performance of a test under this policy, the employee shall be notified that such
test is required by 49 CFR Part 382.
5
2. The controlled substances tested include the following drugs: Marijuana, Cocaine,
Amphetamines, Opiates and Phencyclidine(PCP).
3. All positive drug test results shall be reviewed and interpreted by a Medical Review
Officer(MRO). A MRO shall be a licensed physician with knowledge of substance abuse.
The MRO shall not be an employee of the testing laboratory.
4. In the event that the primary specimen is verified as positive, the employee shall have the
option to have the split specimen sent to a different laboratory for analysis. To exercise
this option, the employee must make a request to the MRO within seventy-two (72) hours
of being told that the primary specimen was positive.
5. An employee who does not pass a required drug test (a primary specimen is verified as
positive) shall be relieved immediately from duty.
6. Employees who violate the controlled substance misuse rules shall be referred to a
substance abuse professional pursuant to section J below.
I. Procedures and Records:
1. All records required by 49 CFR Part 382 and Part 40 will be maintained by the Assistant
to the Village Manager and remain confidential except as required by law or authorized or
required by 49 CFR 382.405. The Village shall prepare and submit an annual calendar
year summary of test results as required by 49 CFR 382.403.
2. An employee is entitled, upon written request, to obtain copies of any records pertaining
to the employee's use of controlled substances or alcohol, including test results. Records
shall be provided promptly, and shall not be contingent upon payment for records other
than those specifically requested. Records shall be made available to a subsequent
employer or other identified person upon receipt of a written request from the employee.
3. The Village shall notify an employee of the results of a pre-employment controlled
substances test if such employee requests such results within sixty (60) calendar days of
being notified of the disposition of the employment application. The Village shall notify
an employee of the results of random, reasonable suspicion and post accident tests for
controlled substances if the results are verified positive, as well as which substance or
substances were verified as positive.
4. Except employees tested randomly as provided in EA, employees who are tested and are
waiting for the results of their test(s) are to remain in contact with the Village. Employees
are also required to advise the Village of their whereabouts and the telephone number of
where they can be reached during this time.
5. The Village shall, no later than fourteen (14) days after the first time an employee
performs a safety-sensitive function, obtain, pursuant to said employee's consent,
6
information from the employee's previous employers regarding alcohol tests with a result
of 0.04 or greater, positive controlled substance test results and any refusals to be tested,
within the preceding two (2)years.
6. If an employee has an alcohol test with a concentration of 0.04 or greater, or a verified
positive controlled substance test or refuses to be tested, the Village shall not permit such
employee to perform safety-sensitive functions without obtaining information on a
subsequent substance abuse professional evaluation and return to duty testing.
7. By law, acknowledgment and agreement to this policy as required of covered employees
is a condition of employment.
- 8. No employee who has violated any of the provisions of section F.1, 2, 4, 5, 6, 7 or 8 shall
perform safety-sensitive functions, including driving a commercial motor vehicle, unless
said employee has been evaluated by a substance abuse professional pursuant to section J
below.
9. All employees who are covered under this policy shall receive all of the educational
material required by 49 CFR 382.601 and shall sign a statement, to be maintained by the
Village, certifying receipt of such material.
10. The Assistant to the Village Manager shall make reasonable efforts to contact and request
anyone who submitted a specimen under this policy, regardless of his or her employment
status, to contact and discuss the results of the controlled substance test with a MRO.
The Assistant to the Village Manager shall immediately notify the MRO that the employee
has been notified to contact the MRO within twenty-four(24) hours.
J. Referral and Treatment: Any employee who violates any of the provisions of section F.1, 2,
4, 5, 6, 7 or 8 hereof shall be advised by the Village of the resources available to the employee
in evaluating and resolving problems associated with the misuse of alcohol and use of
controlled substances, including names, addresses and telephone numbers of substance abuse
professionals and treatment programs. In addition, such employee shall be evaluated by a
substance abuse professional to determine what, if any, assistance such employee needs in
resolving problems associated with alcohol misuse and controlled substances use.
Prior to returning to duty requiring the performance of a safety-sensitive function, any
employee who has been identified as needing such assistance shall, in addition to being subject
to return to duty testing required by section E.5. be evaluated to determine that such
employee has properly followed any prescribed rehabilitation program. Such employee shall
also be subject to follow-up testing at least six(6) times in the first twelve(12) months
following return to duty in accordance with 49 CFR 382.605.
All referrals by a substance abuse professional shall comply with all the requirements of 49
CFR 382.605 (e).
7
The requirements of this subsection J. shall not apply to applicants who refuse to submit to a
pre-employment test or who have a pre-employment alcohol test with a result of 0.04 or
greater or a verified positive controlled substances test.
K. Traffic Violation/CDL Disqualification: According to Illinois State law, serious traffic
violations white operating a Village vehicle may result in temporary or lifetime disqualification
for CDL holders. If an employee loses his/her CDL due to a violation and is not reinstated
within 30 days, he/she is subject to discipline up to and including termination. All CDL
holders should also note that any serious traffic violations that occur while operating a non-
Village vehicle can also result in a disqualification of the CDL license.
Under Illinois law all drivers operating a vehicle on highways automatically give their consent
to submit to tests which determine the blood alcohol level while driving. Since April 1, 1992,
the legal Breath Alcohol Content (BAC) for CDL holders has been 0.04.
The following violations committed by a CDL holder shall result in a disqualification from
using a CDL, under Illinois law, for at least 12 months for the first incidence of:
1. Refusing to submit to, or failure to complete a breathalyzer test.
2. Operating a Village vehicle with a blood alcohol concentration of 0.04 or greater.
3. Conviction (no matter what the BAC reading is) of driving under the influence.
Any driver who commits a second violation of any of the above listed offenses, arising from
two or more separate incidents, is disqualified from a CDL for life. It should be noted that
alcohol related convictions that occur in non-Village vehicles may also result in the
disqualification of a CDL.
A conviction for other violations, such as the ones listed below, can also lead to a
disqualification of at least 12 months on a CDL.
1. Knowingly and willfully leaving the scene of an accident while operating a Village vehicle.
2. Committing a felony while operating a Village vehicle.
A conviction for the violations listed below will result in the lifetime disqualification of a CDL.
1. A second violation of either of the two (2) offenses listed above, or a combination of the
alcohol violations listed on the previous page.
2. The use of a Village vehicle in the commission of a felony involving the manufacturing,
distributing or dispensing of a controlled substance.
8
Committing any of the violations listed in the last two paragraphs, while driving a non-Village
vehicle, may also result in the suspension of your CDL.
L. Disciplinary Action: Anyone who violates any of the requirements of 49 CFR Part 382 is,
pursuant to 49 CFR 382.507, subject to the penalty provisions of 49 USC 521 (b). In
addition, independent of the provisions of 49 CFR Part 382, an employee may be subject to
disciplinary action by the Village up to and including termination for violation of any of the
provisions of this policy.
9
APPENDIX C
HEALTH AND WELFARE BENEFIT
PLAN DOCUMENT
FOR
vE OF OAt
e e .
'cFrourtl
VILLAGE OF
OAK BROOK
PLAN DATE: October 1, 1992
Revised September I, 1997
TABLE OF CONTENTS
SECTION PA-QE
BENEFIT PLAN SUMMARY........................................... 2
STATEMENT OF RIGHTS............................................... 3
INTRODUCTION............................................................. 4.5
SCIIEDULE OF BENEFITS............................................. 6-8
MAJOR MEDICAL EXPENSE BENEFITS.................... 9-15
DENTAL EXPENSE BENEFITS..................................... 16-19
ELIGIBILITY OF COVERAGE...................................... 20-21
EFFECTIVE DATE OF COVERAGE............................. 22-23
TERMINATION OF COVERAGE................................... 24-25
PRE-EXISTING CONDITIONS...................................... 26
COORDINATION OF BENEFITS.................................. 27-29
FEDERAL CONTINUATION OF BENEFITS............... 30-32
GENERAL PLAN EXCLUSIONS&LIMITATIONS.... 33-35
GENERAL PROVISIONS............................................... 36-48
1
BENEFITS PLAN SUMMARY
1. PLAN
GENERAL PROVISIONS
Thc name of the Plan is The Village of Oak Brook Employes Benefit Plan,%%hick describes the benefits,terms 'University'(or college)means an institution accredited in any current publication of accredited institutions of higher
and provisions for pa)mont of benefits. education acceptable to the Plan Administrator.
2. PLAN EFFECTIVE DATE-July 1.1992-Revised Septembtr I,1997 "Village"means The Village of Oak Brook.
3. EMPLOYER/SPONSOR 'Well-Baby Care'means modical treatment,services or supplies rendered to a child within the first seven days from
Name The Village of Oak Brook the date of birth,while confined to a hospital. This coverage applies solely for the purpose of health maintenance and
Address 1200 Oak Brook Rd. Oak Brook,IL.60521.2255 not for the treatment of an illness or injury.
Phone 630-990-3000
Federal Employers ID No.-36-6009534
4. PLAN ADMINISTRATOR/FIDUCIARY
Namc(s) The Village of Oak Brook
Phone 630.990-3000
5. CLAIMS ADMINISTRATION COMPANY
Name Health Plan Management.Inc.
101 Waukegan Road,Ste.700, Lake Bluff.IL 60044
Phone 847-234.8870
6. AGENT FOR SERVICE OF LEGAL PROCESS
Service of legal process may be made upon the Plan Sponsor/Employer or Plan Administrator.
7. INSURANCE COMPANY(Life&Accidental Death&Dismemberment)
Fully insured by a legal reserve life insurance company.
8. PLAN FISCAL YEAR-
The Plan's fiscal)car ends December 11.
9. PLAN TYPE
A partially self-funded employee welfare plan providing medical benefits.
10. GENERAL PROVISIONS
Eligibility requirements. iertnination provisions and descriptions of circumstances %%hich may result in
disqualification,ineligibility or denial or loss of any benefits are described in the booklet.
11. PRE-CERTIFICATION COMPANY
Name Medical Cost Management(MCM)
Address I 1 I W.Jackson,22nd Fl..Chicago IL 60604
Phone 800-367-9938
12. PREFERRED PLAN ORGANIZATION t
Name Preferred Plan
Address 10600 W.Higgins Road,Ste.405,Rosemont,IL 60018
Phone 847-364-0235
13. PLAN ADMINISTRATIVE NUMBER
To be used when reporting claims-93072.
2
47
GENERAL PROVISIONS
t STATEMENT OF RIGHTS
The term"Reasonable and Customary"(R&C)refcrs to the designation ofa charge as being the usual charge made by
a Physician or other provider of services,supplies,medications,or equipment that does not exceed the general level of
charges made by other providers rendering or furnishing such care or treatment within the same area. The term"area" WHEREAS the Village of Oak Brook desires to establish a plan to maintain health and certain other benefits for its
in this definition means a county or such other area as is necessary to obtain a iepresentative cross section of such emplo%=who are beneficiaries ofthc Plan,it therefore creates and establishes the Village of Oak Brook Health Care
charges. Due consideration will be given to the nature and severity of the condition being treated and any medical Plan,hcrcinafter referred to as the"Plan"and this document thereinafter referred to as the"Plan Document".
complications or unusual circumstances which require additional time,skill,or expertise.
Purpose
"Registered Nurse"means an individual who has received specialized nursing training and is authorized to use the
designation of"R.N,"and who is duly licensed by the state or regulatory agency responsible for such licensing in the The purpose of this Plan Document is to set forth the provisions of the Plan which provide for the payment or
state in which the individual performs such nursing services. reimbursement for all or a portion of covered medical expenses.
"Rehabilitation Facility'means a legally operating institution or distinct part of an institution which has a transfer Benefits of this Plan shall be payable for expenses incurred on the effective date of this Plan Document,and after•
agreement with one or more Hospitals,and which is primarily engaged in providing comprehensive multi-disciplinary except as specified.
physical restorative services,post-acute Hospital and rehabilitative inpatient care and is duly licensed by the appropriate
governmental agency to provide such services. It does not include institutions which provide only minimal care, This Plan Document supersedes all other Plan Documents and issued amendments and shall be the sole document
custodial care,ambulatory or part-time care services,or an institutions which primarily provide treatment of mental used in determining benefits to which members are eligible and may be amended from time to time by the Plan
disorders,chemical dependency or tuberculosis except if such facilities are licensed,certified or approved as a Administrator to reflect changes in benefits or eligibility requirements. It is not in lieu of and does not affect any
Rehabilitation Facility for the treatment of medical conditions or drug addiction or alcoholism in the jurisdiction where requirements for coverage by Workers'Compensation. Any change so made shall be binding on each individual
located•or is accredited as such a facility by the Joint Commission for the Accreditation of Health Care Organizations covered and on any other individual or individuals referred to in this Plan Document.
or the Commission for the Accreditation on Rehabilitation Facilities.
Wherever used in this Plan Document,masculine pronouns shall include both masculine and feminine genders unless
"Room and Board" refcrs to all charges,by whatever name called.which are made by a Hospital.Hospice,or the context indicates otherwise.
Convalescent Nursing Facility as a condition of occupancy. Such charges do not include the professional services of
Physicians nor•inicnsive nursing care by whatever named called.
"Semi-Private"refers to a class of accommodations in a hospital orconalescent nursing facility in which at(cast two
patients'beds are available per room.
"Speech TherapyMathology"means a program of care which evaluates the patient's motor-speech skills,expressive and
receptive language skills, writing and reading skills,and determines if the patient requires an extensive hearing
evaluation by an audiologist. The therapist also evaluates the patient's cognitive functioning,as well as his social
interaction skills such as the ability to maintain cyc contact and initiate conversation. Therapy may also involve
developing the patient's speech, listening and conversational skills, and higher-level cognitive skills such as
understanding abstract thought,making decisions,sequencing,etc.
—TEFRA"refcrs to the Tax Equity and Fiscal Responsibility Act of 1982,as amended from time to time.
"Total Disability"means a physical state of a Covered Person resulting from an illness or injury which wholly and
continuously prevents him:
• In the ease of a Participant,from engaging in any and every business or occupation and from performing any
and.all work for compensation or profit;and
• In the case of a Dependent.from performing the normal activities of a person of like age and sex in good health.
7
46
INTRODUCTION GENERAL PROVISIONS
PURPOSE
'Physician' means a legally licensed medical or dental doctor or surgeon, chiropractor, osteopath, chiropodist•
podiatrist•optometrist,certified consulting psychologist or clinician to the extent that name,within the scope of their
license•are permitted to perform services provided in this Plan. A Physician shall rot include the Covered Person or
The purpose of the Plan Document is to set forth the provisions of the Plan vv hick provide for the payment or any Close Relative of the Covered Person unless attendance by same is required during an emergency life threatening
reimbursement of all or a portion of eligible medical expenses. situation as determined by the Plan Administrator.
EFFECTIVE DATE/ANNIVERSARY DATE 'Physical Therapy means a plan of care provided to return a patient to the highest level of motor functioning possible.
T The physical dwmpist extensively evaluates the patients muscle tone,movement,balance, endurance,ability to The effective date of the initial Plan is July I, 1992 and the anniversan date is each July Ist,l)eruflcr. ambulate•ability to plan motor movements,strength and coordination. lithe patient requires special oquipment(such
CLAIMS a Nbccichair•walker or splint)•the therapist evaluates the patient's ability to use the equipment and determine the
• S ADMINISTRATION COMPANY as
size and type of equipment for the specific patient. The therapist constructs a program of exercises and
The CL,uns Administrator oft}x:Plan is Health Plan Management.Inc.located at 101 Waukegan Road,Suite 700•Lake movements to maximize the patient's motor skills.
Bluff.IL 60044. 'Plan'means without qualification this Plan Document.
NAMED FIDUCIARY AND PLAN ADMINISTRATOR 'Plan Administrator'means The Village of Oak Brook is responsible for the day-today functions and arrangement of
this Plan. The Plan Administrator may employ persons or firms to process claims and perform other Plan connected
The Named Fiduciary and Plan Administrator is The Village of Oak Brook,who shall have the authority to control and services.
manage the operation and administration of the Plan. Tlx:Named Plan Administrator may dekgate responsibilities for
the operation and administration of the Plan. The Village shall have the authority to amend the Plan•to determine its 'Plan Supervisor'means the person or firm employed by the Village to provide consulting scrvias to the Village in
Policies, to appoint and remove other supervisors• file their compensation (if any), and exercise the general connection with the operation of the Plan and any other functions,including the processing and payment of claims.
administrative authority over them.no administrator has the sole authority and responsibility to review and make final
decisions on all claims to benefits hereunder. "Pre-Admission Tests or Exams'means tests or exams made beforc a Covered Person enters the Hospital for in-patient
surgery,when:
CONTRIBUTIONS TO THE PLAN
' the tests or exams pertain to the planned surgery;
The amount of contributions to the Plan are to be made on the following basis. • the tests or exams are ordered by a Physician.
' the Physician requests Hospital admission of the person for surgery,and the Hospital confirms the request;and
The Village shall from time to time evaluate the costs of the Plan and determine the amount to be contributed the Hospital admits the person within throe days after the test or exam results are known.
by the Village and the amount to be contributed by or for each covered participant.
Notwithstanding any other provision of the Plan,the Village's obligation to pay claims otherwise allowable The three-day rule will be waived if-
under the terms of the Plan shall be limitod to its obligation to make contributions to the Plan as set forth in the planned Hospital stay is canceled.or
the preceding paragraph. Payment of said claims in accordance with these procedures shall discharge • a change in the person's condition precludes the need for surgery.
completely the Village's obligation with respect to such payments.
'Pregnancy means the physical state which results in childbirth• abortion, or miscarriage, and any medical
In the event that the Village terminated the Plan.the Village and Covered Participants shall have no further complications arising out of or resulting from such state.
obligation to make additional contributions to the Plan.
'Premature Birth'means the birth ofany child with a kxv birth rate of 2500 grams(3.5 pounds)or less and/or any child
bom before 77 wLcks gestation and/or any child with evidence of incomplete development.
'Psychiatric Care."also known as psychoanalytic care•means treatment for a mental illness or disbrder,a function
nervous disorder,alcoholism or drug addiction.
'Psychologist'means an individual holding the degree of Ph.D.or Master's and acting within the scope of his license.
4
45
t
GENERAL PROVISIONS INTRODUCTION
medical clinic•by whatever actual name it may be called.however,a clinic located on or in conjunction with or in any CLAIM PROCEDURE
way made a part of a regular Hospital shall be excluded from the terms of this definition. The Village shall provide adequate notice in writing to any Covered Participants whose claim for benefits under this
Plan has been denied,setting forth the specific reasons for such denial and written in a manner calculated to be
"Named Fiduciary"means the Company who has the authority to control and manage the operation and administration understood by the Participant. Further,the Village shall afford a reasonable opportunity to any Participant.whose
of the Plan. The Fiduciary has discretionary authority to determine eligibility for benefits or to construe the tens of claim for benefits has been denied,for a full and fair review of the decision denying the claim by the person designated
this Plan. by the Village for that purpose. Details of the Claim Procedure will be given to Plan Participants.
"Newbom"refers to an infant from the date of his birth until the initial hospital discharge or until the infant is fourteen PROTECTION AGAINST CREDITORS
(14)days old,whichever occurs first. No benefit payment under this Plan shall be subject in any way to alienation,sale.transfer,pledge.attachment.
gamishmcnt,execution or encumbrance of any kind,and any attempt to accomplish the same shill be void. If the
"Occupational Therapy"means a program of care which focuses on the physical•cognitive and perceptual disabilities Village shall find that such an attempt has been made%ith respect to any payment due or to become due to any Covered
that influence the patient's ability to perform functional tasks.The therapist evaluates the patient's ability use his fingers Participant,the Village in its sole discretion may terminate the interest of such covered Participant or former Covered
and hands(fine motor skills),perceptual skills,cognitive functioning and eye-hand coordination.Therapy sessions may Participant in such payment,and in such case shall apply the amount of such Covered Participant.or former Covered
also involve physical movement exercises. Functional task also may be used. Therapy which is intended to address Participant,his spouse,parent,adult child.guardian of a minor child,brother or sister or other relative of a dependent
primarily vocational rehabilitation issues(i.e..return to work skills)will not be considered covered services under this of such Covered Participant or former Covered Participant,as the Village may determine and any such application shall
plan. be a complete discharge of all liability with respect to such benefit payment.
"Orthotic Appliance"means an external device intended to correct any defect in forth or function of the human body. PLAN AMENDMENTS
This document contains all the terms of the Plan and maybe amended from time to time by the Village. Any changes
"Outpatient"refers to the classification ofa Covered Person%fief that Covered Person received medical care.treatment, so made shall be binding on each Covered Participant and on any other Covcrcd Persons referred to in this Plan
services or supplies at a clinic,a Physician's office,a Hospital when not a registered bed patient at that Hospital,an Document.
Outpatient Psychiatric Facility or an Outpatient Alcoholism Treatment Facility.
GOVERNING FEDERAL,STATE,OR LOCAL GOVERNMENTAL REGULATIONS/STATUTES
"Outpatient Alcoholism Treatment Facility"means an institution which provides a program for diagnosis,evaluation. From time to time this Plan• or pars thereof, may be required to meet or adhere to specific governmental
and effective treatment of alcoholism:provides detoxification services needed with its effective treatment program; regulations/statutes which may affect a Covered Person's benefits,hereunder. To assure that all Covered Person's
provides infirmary level medical services or arranges with a Hospital in the area for any other medical services that may benefits or rights so governod are protected,the Plan shall adopt.on the required effective date set forth by such
be required;is at all times supervised by a staff of Physicians.provides at all times skilled nursing care by licensed rcgulation/statute.any and/or all requirements which legally affect this Plan. The Plan Administrator shall,at his
nurses under direction by full-time registered graduate nurses:prepares and maintains a written plan of treatment of arlicst convenience.amend the Plan to conform with the required regulation/statutes. All such Plan changes may be
each patient based on medical,psychological and social needs which is supervised by a Physician:and meets licensing administered immediately or retroactively as though such change had been previously adopted prior to the actual date
standards. the Plan is formally amended.
"Outpatient Psychiatric Facility"mcaru an administratively distinct governmental,public,private,or independent unit TERMINATION OF PLAN
or part of such unit that provides outpatient mental health services and which provides for a psychiatrist%tea has The Village reserves the right at any time to terminate the Plan by a written instrument to that chfi'ct. All previous
regularly scheduled hours in the facility,and wino assumes the overall responsibility for coordinating the care of all contributions by the Village shall continue to be used for the purpose ofpaying benefits under the provisions ofthis Plan
patients. with respect to claims arising before such terminations,or shall be used for the purpose of providing similar health
benefits to Covered Participants•until all contributions arc exhausted.
"Participant"means a person directly employed full-time in the regular business of and compensated for services by
the Village and properly enrolled in the Plan. PLAN IS NOT A CONTRACT
This Plan Document constitutes the entire Plan. The Plan will not be deemed to constitute a contract of employment
"Participant Coverage"mans coverage hereunder providing benefits payable as consequence of an injury or illness of or give any participant of the Village the right to be retained in the service of the Village or to interfere with the right
a Participant. of the Village to discharge or otherwise terminate the employment of any Participant.
5
44
SCHEDULE OF BENEFITS GENERAL PROVISIONS
ELIGIBLE CLASS OR CLASSES OF EMPLOYEES: 'Illness'means a bodily disorder,disease,physical sickness,mental infirmity,or function nervous disorderofa Covered
Person. A recurrent illness will be considered as one illness. Concurrent illnesses will be considered one illness unless
All active full tinxo non-union employees,and union cmplo)oes who are eligible as a result of a collective bargaining the concurrent illnesses are totally unrelated. All such disorders existing simulLaneously which are due to the same or
agnxnwnt of The Village of Oak Brook. related causes shall be considered one illness
An active full time emplo)ce must be regularly scheduled to work at bast 30 hours per oak for the Village 'Incurred Expenses' means those services and supplies rendered to a Covered Person. Such expenses shall be
EFFECTIVE DATE OF COVERAGE
considered to have been incurred at the time or date the service or supply is actually provided.
Coverage starts on the first day of permanent full-time employment. 'Injury'means a condition caused by accidental means which results in damage to the Covered Person's body from an
exlerral force. Any loss which is caused by or contributed to by a hernia of any kind will be considered a loss under
MAJOR MEDICAL BENEFITS MAXIMUM the definition of illness,and not as a loss resulting from accidental injury.
BENEFIT S 1,000,000 per lifetime 'Inpatient'refers to the classification of a Covered Person what that person is admitted to a Hospital,hospice,or
convalescent or chiropractic care facility for treatment,and charges are made for room and board to the Covered Person
Benefit for Chemical Dependcncq• 525,000 per lifetime as a result of such treatment.
DEDUCTIBLE- Single Coverage- $250 per calendar year. 'Intensive Care Unit'means a section,ward,or wing within the Hospital which is separated from other facilities and:
Family Coverage- S 150 per person to a maximum of 5450 per family.
COPAYMENT PERCENTAGE FOR: Is operated exclusively for the purpose of providing professional medical treatment for critically ill patients;
Outpatient Treatment of Mental and Hass special supplies and
Nervous Disorders 507 Pa PP equipment necessary for such medial treatment available on a standby basis for
immediate use;and
Outpatient Treatment of Chemical Dependency 50% of maximum covered expense of S73; Provides constant observation and treatment by registered nurses(R.N.'s)or other highly trained hospital
maximum 5750 per calendar year. personnel
All Other Covered Expenses
'Licensed Practical Nurse'means an individual who has received specialized training and practical nursing experience.
Network 90%of the first S3.000 per individual; and is duly licensed to perform such nursing services by the state or a regulatory agency responsible for such licensing
100%thereafter per calendar year. in the state in which that individual performs such services.
Non-Network 80%of the first 55,000 per individual: 'Medically Necessary'means health care services,supplies or treatment which,in the judgment of the attending
100%thereafter per calendar year. physician,is appropriate and consistent with the diagnosis and which,in accordance with generally accepted medical
standards,could not have been omitted without adversely affecting the patient's condition or the quality of medical care
ROUTINE PUYSICALS- 100% - 5300 Maximum payment-Every two rendered.
years for employees only.
'Medicare'means the programs established by Title 1 of Public Law 89-98(79 statutes 29 1)as amended entitled
WELL BABY CARE- 100% of nursery, circumcision& Ist Pediatric 'Health Insurance for the Aged Act'and which includes Pars A and B and Title XVIII of Social Security Act(as
Visit. amended by Public Law 89-97,79)as amended from time to time.
MAMMOGRAMS- Subject to deductible&co-insurance. `Minor Emergency Medical Clinic'means a fra•standing facility which is engaged primarily in providing minor
1 pnor to age 35 emergency and episodic medical care to a Covered Person. A board-cemificd Physician,a Rcgistcrfd Nurse,and a
Every My)cars ages 35-39 Registered X-Ray Technician must be in attendance at all limes that the clinic is open. The clinics'facilities must
1 per year after age 40 include x-ray and laboratory equipment and a life support system. For the purpose of this Plan,a clinic Meeting these
BENESCRIPT PRESCRIPTION CARD- 510 co-pay for Brand name drugs requirements will be considered to be a minor emergency
$3 co-pay for Generic drugs
MAIL ORDER MAINTANCE DRUG PROGRAM: 90 day supply
S 15 for Brand name drugs
S7 for Generic drugs
6
43
y
t GENERAL PROVISIONS SCHEDULE OF BENEFITS
"Home Health Care Plan"means a program for conditioned care and treatment of the Covered Person established and
approved in writing by the Covered Person's attending Physician. The attending Physician must certify that the proper OUT-OF-POCKET LIMITS(Excluding Deductibles)':
treatment of the illness or injury would require continued confinement as a resident inpatient in a hospital in the absence
of the services and supplies provided as part of the home health are plan. Network S500 per calendar year
"Hospice"means a health care program providing a coordinated set of services rendered at home,in outpatient settings Non-Network S 1,000 per calendar year
or in institutional settings for Covered Persons suffering from a condition that has a terminal prognosis.A hospice must
have an interdisciplinary group of personnel which includes at least one Physician and one R.N.,and it must maintain *The combined maximum out of pocket for both Network and Non-Network Providers is S 1.000 per calendar year.
central clinical records on all patients. A Hospice must meet the standards of the National Hospice Organization
(NHO)and applicable sate licensing requirements.
SPECIAL NOTE:
"Hospice Bcncfit Period"means a specified amount of time during which the Covered Person undergoes treatment by
a hospice. Such Covered Person certifies a diagnosis of terminally ill,and the Covered Person is accepted into a hospice AJF.JJJCAL CASF-A4ANA(;FWENT
program. The period shall end the earliest of six months from this date or at the death of the Covered Person. Anew
benefit period may begin if the attending Physician certifies that the patient is still terminally ill;however,additional Medical Case Management is frqucntly used to manage long and serious recuperative periods for accidents and
proof may be required by the Plan Administrator before such new benefit period can begin. illnesses such as:
"Hospital"means an institution which meets all of the following conditions: Malignant Neoplasms
Neonatal High Risk Infant
• It is engaged primarily in providing medial care and treatment to ill and injured persons on a inpatient basis Cerebral Vascular Accident(CVA)
at the patient's expense:and Multiple Sclerosis
Amyotrophie Lateral Sclerosis(ALS)
• It is constituted,licensed,and operated in accordance with the laws of jurisdiction in which it is located which Leukemia
pertains to Hospitals.and Major Head Trauma and Brain Injury Secondary to Illness
Spinal Cord Injuries
• It maintains on its premises all the facilities necessary to provide for the diagnosis and medical and surgical Amputations
treatment of an illness or an injury.and Multiple Fractures
Sevcrc Bums
• Such treatment is provided for compensation by or under the supervision of Physicians with continuous twenty- Conditions requiring Cardiac Surgery
four(24)hour nursing services by registered graduate nurses(R.N.'s):and
Included in these services are referrals to altermatc care facilities,arranging for home health care.rental of equipment
• It qualifies as a Hospital,a psychiatric hospital,or a tuberculosis hospital and is accredited by the Joint and other support facilities.
Commission on the Accreditation of Healthcare Organizations(JCAHO):and
Special benefit considerations subject to the lifetime plan maximums may be available for alternative trcatment/facilities
• It is a provider of services under Medicare.and in lieu of in-hospital confinements if the recommendation is presented in writing to the Plan by the authorized case
management company.
• It is not,other than incidentally,a place for rest,a place for the aged,a place for drug addicts,a place for
alcoholics,or a nursing home.
"Hospital Miscellaneous Expenses"means the actual charges made by a Hospital in is own behalf for services and
supplies rendered to the Covered Person which are medically necessary for the treatment of such Covered Person.
Hospital Miscellaneous Expenses do not include charges for room and board or for professional services(including
intensive nursing care by whatever name called),regardless of whether the services are rcndercd under the direction of
the Hospital or otherwise.
42 7
i
SCHEDULE OF BENEFITS I
GENERAL PROVISIONS
Those situations specifically excluded from the definition of a Dependent are:
DENTAL BENEFITS MAXIMUM A spouse who is legally separated or divorced from the Participant;or
BENEFIT•Dental ' Any Person on active military duty;or
S 1.000 per calendar year Any person eligible for coverage under this plan as an individual participant.
BENEFIT-Orthodontia 52,000 lifetime
'Dependent Coverage'means eligibility under the terms of the Plan for the benefits payable as a consequence of eligible
DEDUCTIBLE(Does not apply to Orthodontia $23 r calendar expenses incurred for an illness br injury ofa Dependent.
PP ) per year,per individual
"Durable Medical Equipment"means equipment which is:
COPAYMENT PERCENTAGE FOR. Able to withstand
repeated use;
• Preventive Services . Primarily and customarily used to serve a medical purpose;and i
80/. Not generally useful
• Basic Services BOY° • 8 Y person in the absence of illness or injury.
• Major Services 50% 'Family"means a Covered Participant and his legally eligible dependents.Orthodontia 50%
"Full-Time Employment'means a Participant is employed by the Village for the minimum hours per week required by
the Plan and such weak occurs either at the usual plats of business of the Village or at'a location to which the business
of the Village requires the Participant to travel,and for which he receives regular earnings from the Village and/or the
Participant mccu all eligibility requirements mandated by the Village for its employees.
"Full-Time Student'means a Participant's Dependent child who is enrolled in and regularly attends an accredited college
or university and maintains the required minimum number of credit hours at that college or university in order to
maintain full-time student status.
'I lome Health Care Agency means a public or private agency or organization that specialized in providing medical
care and treatment in the home. Such a provider must meet all of the following conditions:
' It is primarily engaged in and duly licensed,if such licensing is required•by the appropriate licensing authority
to provide skilled nursing services and other therapeutic services.
' It has policies established by a professional group associated with the agency or organization. This
professional group must include at least one Physician and at least one registered graduate nurse(R.N.)to
govern the services provided and it must provide for full-time supervision of such services by a Physician or
registered graduate nurse. ±
' It nuinains a complete medical record on each individual.
• It has a full-time administrator.
a
MAJOR MEDICAL EXPENSE BENEFIT
GENERAL PROVISIONS
t BENEFIT
"Cosmetic Procedure"means a procedure performed solely for the improvement of a Covered Pcrsods appearance The Major Medical Expense Benefit is payable for Covered Expenses incurred for an injury or illness while covered.
rather than for the improvement or restoration of bodily function. after satisfaction of the Deductible.
"Covered Expenses"means charges incurred which are eligible for payment under this Plan. Covered Expenses are BENEFIT PERIOD
considered to be incurred at the time the service or supply is provided. A Benefit Period begins each January I and ends on December 31 of the same Bcncfit Period.
"Covered Persons" means any Participant or Dependent of a Participant meeting the eligibility requirements for DEDUCTIBLE
coverage as specified in this Plan,and properly enrolled in the Plan. The Deductible applies once to each Covered Person for each Benefit Period. The Deductible is the amount of Covcred
Expense a person must pay before benefits begin. The Deductible is shown in the Schedule of Benefits.
"Custodial Care"means that type of care or service,wherever famishod and by whatever name called,which is
designated primarily to assist a Covered Person,whctheror not Totally Disabled,in the activities ofdaily living. Such DEDUCTIBLE PROVISIONS
activities include,but are not limited to:bathing,dressing,food preparation for special diets,assistance in walking or The Deductible has these special provisions:
in getting in and out of bed,and supervision over medication winch can normally be self-administered.
• Three Month Cam-Over:Any portion of the Deductible applied during the last three months of a Bencfit
"Deductible"means a specified dollar amount of Covered Expenses which must be incurred during a Benefit Period Period also applies for the next Benefit Period.
before any other Covered Expenses can be considered for payment according to the applicable Benefit Percentage.
Common Accident: When 2 or more covered family members arc injured in the same accident.only one
"Dependent"means: deductible must be met for the resulting Expense during that Benefit Period.
The Participant's legal spouse who is a resident of the same household and country in which the participant resides. • Family Deductible: No more than 3 Covered Persons from the same family need meet the Deductible in any
Such spouse must have met all requirements of a valid marriage contract in the State of Marriage of such parties. one Benefit Period.
The Participant's child who meets all of the following conditions: BENEFIT PERCENTAGE PROVISION
Benefits for each Benefit Period will be computed this way:
• Is a resident of the same country in which the Participant resides:
• Is unmarried. ' First,a Deductible may have to be met. Then,the Plan will pay a percentage of the Covered Expense incurred
• Is a natural child,stepchild,legally adopted child,or a child who has been placed under the legal guardianship during that Benefit Period. This Benefit Percentage is shown in the Schedule of Benefits.
of the Participant.
• Is in legal custody of and financially dependent upon the Participant. This requirement is waived if the In no event may benefits execod the maximum(s)shown in the Schedule of Benefits.
Participant is required to provide coverage due to court order or divorce decree for a child rat in his custody
or not wholly dependent on him:and AIEDICAL A1AX1AlUAf FOR ALL COVERED EXPENS&S
• Is less than nineteen(19)years of age. This requirement is waived if the child is at least nineteen(19)years Medical benefits for each Covered Person may not exceed the Medical Maximum shown in the Schedule of Benefits:
of age but less than twenty-five(15)years of age,and is dependent upon the Participant for at least 50% The amount of the Medical Maximum available to a Person is reduced by the amount of Medical benefits paid. At the
financial support,and is a regular full-time student at a college or university. start of each Benefit Period-a reduced Medical Maximum will be increased by the lesser of:
• 52000.00:or
This age requirement is waived for any mentally retarded or physically handicapped child,provided that the child is • the total amount of the Medical Benefit paid.
incapable of self-sustaining employment and is chiefly dependent upon the Participant for support and maintenance.
Proof of incapacity must be furnished to the Village and additional proof may be requested from time to time. 'Medical Maximum"means the total amount of Covcrcd Expenses incurred by a Covered Person for all illnesses or
injuries from the later of:
• the Effective Date of this Plan.or
• the Effective Date of such Cowered Person's coverage under this Plan until the earlier of the following:
• this Plan is terminated,or
• such Covered Persons coverage ultimately ends.
This includes any time periods in which such person was not continuously covered.
40 y
MAJOR IM1IEDICAL EXPENSE BENEFIT
CENERAL PROVISIONS
CIIANGES IN COVERAGE CLASSIFICATION "Close Relative'means the spouse,parent•brother•sister,child,or spouse's parent of the Covered Person.
If a change in the coverage classification of a Covered Person which would otherwise increase the Medical Maximum
applicable to the Covered Person becomes effective in accordance with the terms of the Plan,then such increase shall "COBRA'refers to the Consolidated Omnibus Budget Reconciliation Act of 1983 or any provision or section thereof
not apply with respect to the Major Medical Expense Benefits applicable to the Covered Person until the first day on which is herein specifically referred to,and such Act•provision or section as may be amended.
which the participant is Actively at Work within his eligible class,or on which the dependent is not confined in a
Hospital,and the amount of the Medical Maximum applicable to him either remains or has been re-established as the 'Convalescent Nursing Facility"means an institution,or distinct part thereof,operated pursuant to all and one which
full amount of his previous coverage classification as specified in the Schedule of Benefits•or elsewhere in the Plan. meets all of the following conditions:
Ira change in the covered classification of a Covered Person which would otherwise decrease the Medical Maximum It is licensed to provide•and is engaged in providing,on an inpatient basis•for person convalescing from injury
applicable to the dependent bccomus effective in accordance with the terms of the Plan,such decrease shall apply or illness•professional nursing services rendered by a registered graduate nurse(R.N.)or by a licensed
immediately with respect to the Major Medical Expense Benefits applicable to the Covered Person,except that if the practical nurse(L.P.N.)under the direction of a registered graduate nurse and physical restoration services to
Covered Person is Totally Disabled on the date of change,the decrease shall not apply to the benefits payable for assist patients to reach a degree to bodily function to permit self-care in essential daily living activities:and
eligible charges incurred during the subsequent period ofcontinuous Total Disability within the Benefit Period in which
the change occurs and due solely to the illness or injury which caused the Total Disability. Is services sae provided for compensation from its patierus and under the full-time supervision of Physician
or registered graduate nurse(R.N.).and
ALLOCATION AND APPORTIONMENT OF BENEFITS
The Village reserves the right to allocate the Deductible to any eligible charges and to apportion the bencfis to the It provides 24 hours per day nursing services by licensed nurses,under the direction of a full-time registered
Covered Person and any assignees. Such allocation and apportionment shall be conclusive and shall be binding upon graduate nurse;and it maintains a complete medical record on each patient;and
the Covered Person and all assignnecs.
'
PRE-HOSPITAL REVIEW PROGRAM It has an effective utilization review plan;and
"PRE-CERTIFICATION"under this Plan means that prior to admission to a Hospital for a non-cmergeney admission. It is not,other than incidentally a place for rest,the aged•drug addicts,alcoholics•mental retardates,custodial
the Plan Supervisor or its authorized representative will discuss with the attending Physician the diagnosis•the need or educational care•or care of mental disorders;and
for hospitalization versus alternative treatment and the probable length of stay.
'
When the admission is for an emergency,the Plan or is authorized representative must be notified within 48 hours of It is approved and licensed by Medicare.
the admission. This term shall also apply to expenses incurred in an institution referring to itself as a Skilled Nursing Facility.
"CONTINUED LENGTH OF STAY"under this Plan means when a period ofhospitalization is longer than originally Extended Care Facility,Convalescent Nursing Home•or any such other similar name.
authorized•the attending Physician must contact the Plan or its authorized representative and request additional days 'Convalescent Period"means a period of time commencing with the date of confinement by a Covered Person to a
of hospitalization. Convalescent Nursing Facility. Such confinement must mat all of the following conditions:
The number to call to begin the Pre-admission process is:Medical Cost Management,Inc.(MCM)1-810-367-9938. • Such confinement must commtenec within fourteen(14)days of being discharged from a hospital;and
Benefits for covered charges for medically necessary hospital confinement which would normally be payable will be • Said hospital confinement must have been for a period of no less than three(3)consecutive days;and
reduced by 50%if admission and length of stay approval is not obtained as specified above.
' Both the hospital and convalescent confinements must have been for the care and treatment of the same illness
If confinement extends beyond the approved length of stay,additional days must be authorized by MCM. The same or injury.
requirements and reduction penalties will apply to the additional days.
A Convalescent Period will terminate when the Cowered Person has been free of confinement in any and all institutions
Charges for any part of a hospital confinement not domed to be medically necessary by MCM will be excluded. providing hospital or nursing care for a period of ninety(90)consecutive days. A new convalescent period shall not
NOTE:MCM does not verifj•,authorize or guaranty payment of benefits. MCM authorization rtneans only necessity commence until a previous convalescent period has terminated..
of treatment. It is not a certification of benefits.
10
79
i GENERAL PROVISIONS MAJOR MEDICAL EXPENSE BENEFIT
"Actively at Work"or"Active Work"means that you arc doing all of the main duties of your job with the Company
where these duties are normally carried out. The term"Actively at Work'means the active expenditure of time and Effective January I,1998,the plan=y not restrict benefits for any hospital length of stay in connection with childbirth
energy in the service of the Company. A Participant shall be deemed Actively at Work on each day of a regular paid of the mother or newborn child to less than 48 hours following a normal delivery or to less than 96 hours following a
vacation,or on a regular non-working day on which he is not Totally Disabled,provided he was Actively at Work on cesarean section.
the last preceding regular working day.
PREFERRED PLAN PROVIDER ORGANIZATION-PPO
'Ambulatory Surgical Center"means a facility: Prcferred Plan is a Preferred Provider Organization(PPO)consisting of a network of participating Hospitals and
Physicians. Participants will receive a directory of these providers to choose from for their health care.
' which provides elective surgical care:
' to which the patient is admitted and discharged within the same working day;and Participants choose whether or not to use Preferred Plan providers when health care services arc needed. If a PPO
• is not part of a Hospital. provider renders care or services,the Covered Person may receive additional benefits as shown in the Schedule of
Benefits. Also,no payment is required at the time the service is rendered.
However,the following shall not be construed to be an Ambulatory Surgical Center;
' a facility existing for the primary purpose of performing terminations of pregnancy;
an office maintained by a Physician for the practice of medicine;or
• an office maintained for the practice of dentistry.
"Amendment"means a formal document that chang6 the provisions of the Plan Document,duly signed by the
authorized person or person as designated by the Plan Administrator.
'Benefit Percentage"means that portion of eligible expenses to be paid by the Plan in accordance with the coverage
provisions as stated in the Plan. It is the basis used to deternine any out-of-pocket expenses in excess of the annual
deductible which are to be paid by the Participant.
"Benefit Period'refers to a time period of one year,as shown on the Schedule of Benefits. Such benefit period will
terminate on the earliest of the following dates:
• the last day of the one year period so established:or
• the day the Maximum Medical Benefit applicable to the Covered Person becomes payable:or
• the day the covered person ceases to be covered for Major Medical Expense Benefits.
"Benefit(Plan)Year"means a period of time commencing with the effective date of this.Plan or the Plan Anniversary,
and terminating on the date of the next succeeding Plan Anniversary.
"Birthing Center"means a facility which provides primarily birthing services:meets all licensing and certification
requires and operates within all such licenses;is staffed and equipped to provide all before,during and after labor
trcatment to women and newborn children: is under the direction of a doctor wfio specializes in obstetrics and
gynecology and is responsible for such treatment:maintains written medical records for each patient:and has written
policies and agreements for consultation with and transfer to a Hospital for care beyond the capacity of the Birthing
Center.
"Calendar Year"means a period of time commencing on January I and ending December 31 of the same given)car.
38 it
MAJOR MEDICAL EXPENSE BENEFIT
COVERED EXPENSES
GENERAL PROVISIONS
Covered Expenses include,but are not limited to,the following: TIME LIMITATION
If any'time limitation of the Plan with respect to giving notice of claim or fumishing proof of loss•or the bringing of
' Charges made by a Hospital for: an action at law or in equity is less than that permitted by the laws of the states in which the Plan is existent,such
• Daily room and herd(limited to semi-private rate)and general nursing services,or confinement in an ' limitation is hereby extended to agree with the minimum period permitted by such law.
Intensive Care Unit,not to exceed reasonable and customary rates. Nursery charges for a healthy NO EFFECT ON WORKERS'COMPENSATION
newborn dependent child will be covered. Charges made by a Hospital having only private rooms will be
paid at 90%of the private room rate. This Plan's provisions are not in lieu of,do not affect any requirement for,or pay in addition to Workers'Compensation
Insurance.
Necessary services and supplies other than room and board furnished by the hospital,including inpatient
miscellaneous service and supplies,outpatient hospital treatments for chronic conditions and emergency CONFORMITY WITH LAW
room use•physical therapy treatments•hemodialysis,and x-ray and linear therapy.
If an),provision of this Plan is contrary to any law to which it is subject,such provision is hereby amended to conform
' Charges made by a Convalescent Nursing Facility for the following services and supplies furnished by the thereto.
facility incurred in connection with convalescence from the illness or injury for which the:Covered Person is
confined will be eligible for benefits. Allowable expenses shall be subject to Reasonable and Customary STATEMENTS
charges and will include:
In the absence of fraud,all statements made by a Covered Person will be deemed representations and rat warranties.
Room and board,including any charges made by the facility as a condition of occupancy.or on a regular No such representations will void the Plan benefits or be used in defense of a claim hereunder unless a copy of the
daily or wvekly basis such as genera(nursing services.If private room accommodations are used,the daily instrument containing such representation is or has been fumished to such Covered Person.
room and board charge allowed will not exceed the facility's average semi-private charges or an average
semi-private rate made by a representative cross section of similar institutions in the area. MISCELLANEOUS
Medical services customarily provided by the convalescent facility with the exception of private duty or Section titles are for convenience of reference only,and are not to be considered in interpreting this Plan.
special nursing services and Physicians'fees.
Failure to enforce any provision of this Plan shall not affect the right thereafter to enforce such provision,nor shall such
Drugs•biologicals.solutions,dressings and casts,fumished for use during the convalescent period,but failure affect its right to enforce any other provision of this Plan.
no other supplies.
DEFINITIONS
' The services of legally qualified Physician for medical care and/or surgical treatments including office,home
visits•hospital inpatient care,hospital outpatient visits/exams,clinic care,and surgical opinion consultations. Certain words and phrases used in this Plan Document are listed lx:low,along with the definition or explanation of the
manner in which the term is used for purposes of this Plan.
' Fees of registered graduate nurses(R.N.'s)or licensed practical nurses(L.P.N.'s)for private duty nursing.
Masculine pronouns used in this Plan Document shall include masculine or feminine gender unless the context indicates
' Treatment or services rendered by a licensed physical therapist in a home setting or at a facility or institution otherwise.
whose primary purpose is to provide medical care for an illness or injury.
Wherever any words are used herein in the singular or plural,they shall be construed as though they were in the plural
' Fees of legally qualified Physician or qualified speech therapist for restoratory or rchabilitory speech therapy or singular,as the case may be,in all cases where they would so apply,
leer specch loss or impairments due loan illness or injury. If the speech loss is due to a congenital anomaly,
surgery to correct the anomaly must have been perforned prior to the therapy. Unless a bux:frt amount is shown in the Schedule or Benefits•certain definitions listed in this Plan arc for information
only. t
Charges for professional ambulance service to the nearest facility equipped to handle the medical emergency.
Charges for drugs requiring the written prescription of a licensed Physician. Such drugs must be necessary
for the treatment of an illness or injury.
Charges for x-rays,microscopic tests,and laboratory tests.
' Charges for radiation therapy or treatment.
1Z )7
MAJOR MEDICAL EXPENSE BENEFIT
t
GENERAL PROVISIONS
EXAMINATION • Charges for the processing and administration of blood or blood components•but not for the cost of the actual
blood or blood components it replaced.
The Village shall have the right and opportunity to have the Covered Person examined whose injury or sickness is the
basis of a claim hereunder when and so often as it may reasonably be required during pendency of a claim hereunder. Charges for electrocardiograms,electroencephalograms.pneumocncephalograms.basal metabolism tests.or
The Village shall also have the right and opportunity to have an autopsy performed in case of death where it is not similar welkstablished diagnostic tats generally approved by Physicians throughout the United States.
forbidden by law.
Charges for the cost and administration of an anesthetic.
PAYMENT OF CLAIMS
Charges for dressing,sutures•casts•splints,trusses.crutches,braces.or other necessary medical supplies.with
Claims must be filed within the year following the date the expense was incurred. However,when an employee's the exception of dental braces or corrective shoes.
coverage terminates for any reason,written proof of claim must be given within 90 days of the date of termination of
coverage.provided that the Plan remains in force. However,upon termination of the Plan•final claims must be received Charges for the rental of a wheelchair,hospital bed or iron lung or other durable medical equipment required
within 30 days of termination. for temporary therapeutic use,or the purchase of this equipment if economically justified.whichever is less.
' Charges for artificial limbs•eyes or larynx.but not the replacement thereof,and orthotic appliances.
All Plan benefits are pay able to the Participant,or subject to any written direction of the Participant. All or a portion
of any indemnities prm ided by the Plan on account of hospital,nursing,medical or surgical services may,at the Services for voluntary sterilization for Participants and Dependent Spouses.
Participant's option and unless the Participant requesu otherwise in writing not later than the time of filing proofs of
such loss,be paid directly to the hospital or person rendering such services l Irwrvrr,if any such benefit remains Charges made by an ambulatory surgical center or minor emergency medical clinic when treatment has been
unpaid at the death of the Participant or if the Participant is a minor or is.in the —.-I ilk Village.legally incapable rendered.
of giving a valid receipt and discharge for any payment,the Village may at iu optpm,pay such benefits to any one or
more of the following relatives of the Participant,spouse,mother,father,child,siblings. Any payment so made will Elective Abortions.
constitute a complete discharge of the Village's obligation to the extent of such payment,and the Village will not be
required to see the application of the money so paid. ' Services and supplies in connection with transplant procedures,subject to the following conditions:
If a claim is not paid in full,the Village will furnish notice to the Participant which will specify the reason or decision - A Second opinion must be obtained prior to undergoing any transplant procedure. This mandatory second
the additional infomnation required to perfect the claim. Upon written request by the Participant within sixty(60)days opinion must concur with the attending Physician's findings regarding the medical necessity of such
after notice is received,the Village will review the claim in question and give a fuel written decision on the review procedure. The Physician rendering the second opinion must be qualified to render such a service either
within sixty(60)days,or one hundred!wait•(120)days under special circumstances,after such request is received. through experience•specialist training or education,or such similar criteria.and must not be affiliated in
any way with the Physician who will be performing the actual surgery.
RIGHTS OF RECOVERY
If the donor is covered under this Plan•eligible medical expenses incurred by the donor will be considered
Whenever payments have been made by the Village with respect to allowable expenses in excess of the maximum for benefits.
amount of payment necessary to satisfy the intent of this Plan,the Village shall have the right.exercisable alone and
in its sole discretion.to recover such excess paymenu. - If the recipient is covered under this Plan•eligible medical expenses incurred by the recipient will be
considered for benefits. Expenses incurred by the donor,who is not ordinarily covered under this Plan
LEGAL PROCEEDINGS according to Participant eligibility rcquircnnents,will be considered.
No action at law or in equity shall be brought to recover on the Plan prior to the expiration of sixty(60)days after proof Eligible expenses to the extent that such expenses arc not payable by the donor's plan. In no event will
of loss has been filed in accordance with the requirements of the Plan,nor shall such action be brought at all unless benefits be payable in excess of the Medical Maximum Benefit still available to cach recipient.
brought within throe(3)years from the expiration of the time within which proof of loss is required by the Plan.
If both the donor and the recipient are covered under this Plan•eligible medical expenses incurred by each
person will be treated separately for each person.
The reasonable and customary cost of securing an organ from a cadaver or tissue bank,including the
surgeon's charge for removal of the organ and a Ilospital's charge for storage or transportation of the
organ•will be considered a Covered Expense.
Benefits will be provided only for a coma,heart.hcartAung.lung,liver,pancreas.kidney bone marrow.
heart valve.muscular-skeletal or parathyroid human organ or tissue transplant.
36 13
MAJOR MEDICAL EXPENSE BENEFIT GENERAL PROVISIONS
' Charges made by a Home Health Care Agency for care in accordance with a Home Health Care Plan. SUBROGATION
Allowable expenses will include: This Plan may withhold payment of benefits when a party other than the Covered Person or Plan may be liable for
expenses until such liability is legally determined.
- Pan-time or intermittent nursing care by a rcgistrstd graduate nurse(R.N.)or by a licensed practical nurse
(L.P.N.),a vocational nurse or public health nurse who is under the direct supervision ofa registered nurse. In the event of any paytnent for services under the Plan,the Plan Administrator shall,to the extent of such payment,
(I home health visit-i hours); be subrogated to all the rights of recovery of the Covered Person arising out of any claim or cause of action which may
accrue because of the alleged negligent conduct of a third party. Any such Covered Person hereby agrees to reimburse
Home health aides;and the Plan for any benefits so paid hereunder out of any monies recovered from such third party as the result of
judgement,settlement or otherwise;and such Covered Person hereby agrees to take such action,to fumish such
Medical supplies,drugs and medicines prescribed by a Physician,and laboratory services provided by or information and assistance,and to execute and deliver all necessary instruments as the Plan Administrator may require
on behalf of a Hospital,but only to the extent that the)-would have been covered under this Plan if the to facilitate the enforcernent of their rights. This provision shall not apply,however,to a recovery obtained by a
Covered Person had remained in the Hospital. Covered Person from an insurance company on a polity under which such Covered Person is entitled to indemnity as
Syecificall)•excluded under the Home Health Care benefit are the following: a named insured person.
• Services and supplies not included in the Nome Health Care Plan; NOTICE AND PROOF OF CLAIM
• Services of a person who ordinarily resides in the home of the Covered Person,or is a Close Relative of Written notice of injury or of illness upon which claim may be based must be given to the Village within twenty(20)
the Covered Person. days of the date of commencement of the first loss for which benefits arising out of such injury or illness may be
Services of an),social worker,unless such person is properly licensed and reeommcrtded by a Physician claimed.
as defined by this Plan;or
• Transportation services. Notice given by or in behalf of the claimant to the Village with particulars sufficient to identify the Covered Person shall
be deemed to be notice to the Village. Failure to famish notice within the time provided in the Plan shall not invalidate
' Charges for Prc-Admission Tests or Exams when performed on an out-patient basis as shown in the Schedule any claim if it shall be shown not to have been reasonably possible to furnish such notice and that such notice was
of Benefits.Such tests must be performed: furnished as soon as was reasonably possible.
Within 3 days of a scheduled Hospital confinement;and The Village,upon receipt of the ice required by the Plan,will furnish to the claimant such forms as arc usually
At the same Hospital where such confinement will occur furnished by it for filing proof of loss. If such forms are not so furnished by it for filing proof of loss. If such forms
and be ordered by the attending Physician. are not so fumished within fifteen(1 S)days after the Village receives such notice,the claimant shall be deemed to have
complied with the requirements of the Plan as to proof of loss upon submitting,within the time fixed in the Plan for
Charges for maternity expenses for a Participant or Covered Dependent. filing proofs of loss,written proof covering the occurrence,character and extent of the loss for which a claim is made.
Charges for newborn nursery,circumcision and the first pediatric visit for a child under 7 days. Affirmative proof of loss of time on account of disability or of hospital eonfuement for which a claim is made must
be furnished to the Village within ninety(90)days after termination of the period for which the claim is made.
Charges for Birthing Centers. Affirmative proof of any other loss on which a claim is made must be furnished to the Village within ninety(90)days
after the date of such loss. Failure to furnish proof within the time provided in the Plan shall not invalidate or reduce
Chargesofinsulin,insulin supplies,insulin pump.clinitest,cervical collars.colostomy bags.ilcostomysupplies any claim if it shall be shown not to have been reasonably possible to furnish such proof and that such proof was
and catheters. furnished as soon as reasonably possible. However,when Covered Person's coverage terminates for any reason,
written proof of a claim must be given to the Village within ninety(90)days of the date of termination of coverage,
' Charges for Hospice Care and Bereavement Counseling. provided that the Plan remains in force. However,upon termination of the Plan,final claims must be received within
thirty(30)days of termination.
1
EXCLUDED AND LIMITED EXPENSES
Charges for certain procedures,treatments,services or supplies arc excluded or may be limited in payment under this
Plan. The specific exclusions and limitations are explained in the section entitled'General Plan Exclusions and
Limitations".
11 35
GENERAL PLAN EXCLUSIONS AND LIMITATIONS DENTAL EXPENSE BENEFIT
t
• Charges incurred for services,supplies,devices,treatments,procedures,drugs which are not reasonable and
necessary or that are investigational or experimental for the diagnosis or treatment of an illness,disease,or The plan will pay the applicable benefit percentage•shown in the Dental Schedule of Benefits,of the Reasonable and
injury for which any of such items are prescribed. Charges excluded are those incurred for such items which Customary charges for the Covered Expenses listed below any other benefits arc payable under any other section of
(1)are not accepted as standard medical treatment for the illness,disease or injury being treated by physicians this Plan:
practicing the suitable medical specialty;(2)arc the subject of scientific or medical research or study to
determine the item's effectiveness and safety;(3)have not been granted,at the time services were rendered,any All benefits on behalf of any one Coccred Person,in a Calendar Year,may not exceed the calendar year
required approval by a federal or state governmental agency, including without limitation, the Federal maximum shown in the Schedule;
Department of Health and Human Services Food and Drug Administration, or any comparable state
governmental agency,and the Federal Health Care Finance Administration as approved for reimbursement Where the alternate dental procedure for treating a dental condition which would provide adequate and
under Medicare Title XVIII;or(4)are performed subject to the Covered Person's inforrtsed consent under a appropriate dental are,in accordance with generally accepted professional standards ofdental practice,the
lrcatmcnt protocol that explains the treatment or procedure as being conducted under a human subject study benefit paid for the procedure actually employed may not exceed the fee for the least expensive of all these
or experiment; procedures.
' For an inpatient stay when the stay is primarily for a behavioral problem,social maladjustment or any other • In the event a Covered Person transfers from the are of one Dentist or Physician to another Dcntist or
antisocial action which is not specifically the result of mental illness; Physician who renders services for more than one dental procedure,the Plan will be liable for not more than
' Care and treatment of an injury or sickness that results from engaging in a hazardous hobby. A hobby is the amount it would have been liable for had but one Dentist or Physician rendered the service;
hazardous if it is an unusual activity which is characterized by a constant threat of danger or risk of bodily • The Deductible shown in the Schedule,must be met each Calendar Year before benefits for services subject
harm. Examples of hazardous hobbies are skydiving.auto racing,hang gliding.ATV operating without a to the Deductible become payable. Only those services may be used to satisfy the Deductible;
helmet,or bungs jumping;
COVERED EXPENSES
' Charges for unbundled procedures. However,the unbundled procedures will be rebundlcd for assignment of
the proper comprehensive CPT code,and benefits will be paid accordingly. Unbundling occurs when two or Covered Expenses are the Reasonable and Customary Charges for;
more CPT procedure codes are used to describe procedures performed when a single,more comprehensive CPT
code exists that accurately describes entire procedure performed; Class I Preventative Dental Services consisting of:
' Chclation Therapy; • Initial oral examination,regardless of the medical necessity.
The Plan will make its decision based upon information and positions developed by any one or more of the following: ' Periodic oral examinations,regardless of the medical necessity,but not more than once every six months.
American Medical Associates,Federal Drug Administration.Council on Medial Specialty Societies.National Institute • Prophylaxis,regardless of medial necessity,including cleaning•routine scaling and polishing•but not more
of Health.State Medical Associates,or other similar organizations. than once every six months.
Topical fluoride application for Covered Persons regardless of medical necessity,but not more than once c%vry
six months.
• Palliative emergency treatment and emergency oral exams.
' Dental x-rays. Full mouth x-rays once in any 24 month period. Bitew•ings every 24 months.
Sealants.
Space maintainers for missing primary teeth.
34 15
DENTAL EXPENSE BENEFIT GENERAL PLAN EXCLUSIONS AND LIMITATIONS
Class I I Basic Dental Services consisting of: Outside the United States if the Covered Person traveled to such a location for the sole purpose of obtaining
medical services,drugs,supplies or services not customarily rendered within the boundaries of the United
' Fillings. States;
' Simple extractions not requiring Bap or bone removal. ' For hospitalization when such confinement occurs primarily for physiotherapy,hydrotherapy,convalescent.
custodial or rest care;
' Endodontics.
Repair of removable dentures. For Physicians'foes for any treatment which is not rendered by or in the physical presence ofa Physician;
'
' In connection with eye refractions,radial keratotomy,the purchase or fining ofeycgtasses,contact lenses;
Reccmcnting of crowns,inlays and/or bridges.
Nearing aids.
•
Biopsies of oral tissue. ,
' For treatment on or to the teeth,the nerves or rods of the teeth,gingival tissue or alveolar processes;however.
' Pulp vitality tests,but net more than once during any twelve(12)consecutive monde. benefits will be payable for charges incurred(1)for an alveolectomy,gingivectomy or for the removal of
impacted teeth(no allowance for other extractions)on an outpatient basis,unless hospital confinement is
' Visit by a Dentist or Physician to a Covered Person's home when medically necessary in order to render a deemed to be medically necessary by the attending Physician,and(2)for treatment required due to accidental
Covered Expense. bodily injury to natural teeth sustained while covered. Such expenses must be incurred within six(6)months
of the date of accident. Section(2)of this exception shall not in any event be deemed to include charges for
Oral Surgery. treatment for the repair or replacement ofa denture.
' Space maintainers up to age 19,excluding orthodontics. For or in coruection with artificial insemination or in-vitro fertilization;
' Apicoectomy. • Binh Control Pills:
' I lemiseclion. • Non prescription medication;
General anesthesia administered in connection with a covered dental service only if administered by an For professional nursing services if rendered by other than a registered graduate nurse(R.N.)or licensed
individual licensed to administer general anesthesia•other than the Dentist or Physician performing the service practical nurse(L.P.N.);
for which such anesthesia is administered.
Periodontics limited lo: In connection with the rn-crsal ofa sterilization procedure;
'
' For routine Child Care;except as shown on the schedule of benefits;
-Gingiveetomy and gingivoplasty.
-Gingival curettage. For a patient's failure to keep a scheduled visit or exam or for completion ofa claim forth:
-Osscous surgery.including Bap entry d closure.
-Surgical periodontic examination. Cost of medical records or information necessary to process this claim;
-Mucogingivoplastic surgery
-Management of acute periodontal infection d;oral lesions. • For smoking cessation programs,weight control programs or treatment of obesity not caused by organic
condition.
' Stainless steel crowns.
• For sex transformations or sexual dysfunction; t
' Consultations required by the attending dentist.
' Occupational therapy intended primarily to assess rehabilitation issues(i.e.return to work skills):
16 33
GENERAL PLAN EXCLUSIONS AND LIMITATIONS DENTAL EXPENSE BENEFIT
l
The following exclusions apply to expenses which will NOT be paid by the Plan. Charges incurred: Class 111 Major Dental Services consisting of:
• Prior to the effective date of coverage under the Plan,or after coverage is terminated,unless Extension of Inlays(not part of bridge)
Benefice applies:
• Onlays(rat part of bridge)
' As a result of war or any act or war.whether declared or undeclared,or caused during service in the armed
forces of any country: Crowns(not part of bridge).However.benefits will be provided for the replacement ofa defective or lost crown
inserted after the effective date of coverage until five(S)years have elapsed from the date of insertion,or for
• Arising out of,or in the course of,any occupation for wage or profit,or for which the Covered Person is temporary crowns.
entitled to benefits under any Worker's Compensation or Occupational Disease Law,or any such similar law:
• Dentures,full and partial,and bridges,fixed and removable,subject to the following:
• While confined in a hospital owned or operated by the United Slates Government or any Agency thereof,or
charges for services and treatments or supplies fumishcd by the United States Government or any Agency a. Benefits for replacement of an appliance will not be provided for any replacement made less than five(S)
thereof: years after a placement or replacement which was covered under this benefit section or for dentures or
bridges which are able to be made serviceable:and
• For which the Covered Person is not,in the absence of this coverage,legally obligated to pay or for which a
charge would not ordinarily be made in the absence of this coverage. b. If,in the construction of a denture or bridge,the Covered Person and Dentist or Physician decide on
personal restorations or to employ specialized techniques as opposed to standard procedures,the benefits
• During the commission of a crime by the Covered Person or while engaged in an illegal act,illegal occupation providod will be limited to the standard procedures or prosthodontic services as reasonably determined by
or felonious act or aggravated assault. the Plan.
• In connection with any intentionally self-inflicted injury or illness,whether sane or insane: Denture adjustments and relining. Benefits for denture adjustments arc limited,during the first six(6)months
following denture placement,to services rendered by a Dentist or Physician other than the Dentist or Physician
• For routine medial examinations or routine health check-ups,nutritional supplements,or immunizations not who provided or repaired the appliance,or such Dentist's or Physician in-office associates.
necessary for the treatment of any injury or illness,except as shown on the Schedule of Benefits:
' Fixed bridge repairs.
• For services or supplies which constitute personal comfort or beautification items,television or telephone use,
or in connection with custodial are,education or training,occupational therapy,or expenses actually incurred Class IV Orthodontic Dental Services
by other persons:
Dental Benefits include coverage for orthodontic appliances and treatments when they arc being provided to correct
' In connection with the are or treatment of•or surgery performed for,a cosmetic procedure. This does rat problems of growth and development(which nuy be the cause ormatocciusion.perkxiontaI disease.tcniparoinandibular
apply when such treatment is rendered to correct a condition resulting from an accidental injury sustained while d)sfunction or combinations of these problems). Ttxse benefits are limited as follows:
coverage is in effect,or to correct a congenital anomaly,i.e.,a birth defect,for a Covered Dependent.
• Benefits are only available for persons under age 19 and will end at the end of the month in which that age is
• In connection with services and supplies which are not necessary for treatment of the injury or illness,or are reached.
in excess of reasonable and customary charges,or arc not recommended and approved by a Physician,unless
specifically shown as a Covered Expense elsewhere in the Plan. • Diagnostic benefits,including examination,study models•x-rays and all other diagnostic aids,will be provided
only once in any S year period•beginning with the date of the first visit to the Dentist.
• For service,supplies or treatments not recognized by American Medial Association as generally accepted and
medially necessary for the diagnosis and/or treatment of an active illness or injury:or charges for procedures. Benefits for active orthodontic treatment arc limited to 36 consecutive months of iratment and benefits for
surgical or otherwise.which are specifically listed by the American Medial Association as having no medial retention treatment are limited to IS consecutive months. If a Covered Person is receiving trcatmcnt when his
value. coverage begins,these time periods will be reduced by the number of months that he has been receiving
treatment prior to his coverage beginning.
' For services rendered by a Physician.Dentist,nurse or licensed therapist who is a close relative of the Covered
Person,or resides in the same household of the Covered Person.
32 17
DENTAL EXPENSE BENEFIT FEDERAL CONTINUATION OF BENEFITS
Bcnefits w ill not be provided for the replacement or repair of any appliance used during orthodontic treatment. The subsequent premiums must be paid the Village,by the qualified continua,in advance,at the times and in the
' Alter orthodontic trratrruent has been completed,no further benefits will be provided until S years Aavc elapsed. manner specified by the Village. No further notice of when premiums are due will be given.
The monthly premium will be the total rate which would have been charged for the group health bcnerits had the
PRE-DETERMINATION OF BENEFITS qualified continua stayed covered under the group plan on a regular basis. It includes any amount that would have
been paid by the Village. An additional charge of two percent of the total premium charge may also be required by the
The plan may require a Dentist's written plan in advance describing any course of treatment for which the Dental Village.
Covered Expenses are expected to equal or exceed 5300. If the qualified continuee fails to give the Village notice orhis intent to continue,he fails to pay any required premiums
DENTAL EXCLUSIONS in a timely manner,he waives his continuation rights.
Crate in Payment of Premiums:A qualified continua premium payment is timely if,with respect to the first payment
This benefit does not cover any expense or portion of expense for: after the qualified continuos elects to continue,such payment is made within 45 days of such election. In all other cases,
' Dental service with respect to congenital malformation or primarily for cosmetic or aesthetic purposes except such premium payment is timely if it's made within 31 days of the specified due date.
as specified in this benefit section. When This Continuation Ends: A qualified continua's continued group health benefits end on the first of the
' Appliances or restorations necessary to increase vertical dimensions or restore the occlusion. following:
• with respect to continuation upon the employee's termination of employment or reduction of work hours.
Gold foil restorations. the end of the 19 month period wfiich starts on the date the group health benefits would otherwise end;
' Any services,treatment or supplies not listed as an eligible benefit;or • with respect to continuation upon the employee's death,the employee's legal divorce or legal separation,
the end of a covered Dependents's eligibility,or the employee's eligibility for Medicare,the end of the 36
' Any expense excluded by the General Plan Exclusions and Limitations of the Plan. month period which surfs on the date the group health benefits would otherwise end;
• the date the plan ends;
' the end of the period for which the last premium payment is made;
• the date on which the qualified beneficiary first becomes,after the date of the election,covered under any
other group health plan as an employee or a dependent,or otherwise becomes entitled to benefits under
Title XVIII of the Social Security Act(Medicare).
to
31
FEDERAL CONTINUATION OF BENEFITS ELIGIBILITY OF COVERAGE
t • .
If A Dependent Loses Eligibility: Ira Dependent child's group health benefits end due to his loss of Dependent Coverage provided under this Plan for Participants and their Dependents shall be in accordance with the Eligibility.
eligibility as defined by this plan-other than the employee's coverage ending,he can elect to continue such benefits. Effective Date,and Termination provisions as stated in this Plan Document,including any Coverage Claasifncatwn
However,such Dependant child must be a qualified continuee. The continuation can last for up to 36 months,subject stated on the Schedule of Benefits page.
to"When Coverage Ends".
If coverage classifications are designated on the Schedule of Benefits,any change in the amount of coverage available
Concurrent Continuations: If a Dependent elects to continue his group health benefits due to the employee's to a Covered Person occasioned by a change in the Participant's classification shall become effective automatically on
termination of employment or reduction of work hours,and during the 18 months continuation period the Dependent the classification change date;ho%%ever,if the Participant is not actively at work within the eligible class on the date
becomes eligible for 36 months of continued group health benefits due to any of the reasons stated above,the 36 month the amount of his coverage would otherwise increase,such increase shall not become effective until the next following
continuation period starts on the date the 18 month continuation period started,and the two continuation periods will day on which he is actively at work within the eligible class. Ira Participant's coverage is to be continued during
be deemed to have run concurrently. disability,approved leave of absence or temporary layoff,the amount of his coverage shall be the amount for which
be was covered on his last day of active work. In the case of a Dependent,such increase shall not become effective
The Qualified Continuee's Responsibilities:A person eligible for continuation under this section must notify the automaticaiiv iron that date the dependent is confined in a hospital or elsewhere. Such incrcasc will become effective.
Company,in writing,of however,on the day next following the dependent's final discharge from the hospital.This limitation will not apply to
a newborn who is hospital confined solely because of his birth.
• the legal divorce or legal separation of the employee from his spouse;or
PARTICIPANT ELIGIBILITY
• the loss of Dependent eligibility,as defined in this plan,of a covered Dependent child.
A Participant eligible for coverage under the Plan shall include only full-time employees who meet all of tic following
Such notice must be given to the Village within 60 days of either of these events. conditions:
The Village's Responsibilities: The Village must notify the qualified continuee,in writing of: A. Is employed by the Village on a permanent,full-time basis for the hours per week shown in the Schedule of
Benefits;and
• his right to continue this plan's group health benefits;
B. Has been in active service(An employee will be considered"in active service"on any day he or she perfonns
• the monthly premium he must pay to continue such benefits;and in the customary manner all of the regular duties of his or her employment. An employe will be deemed"in
active service"on each day of a regular paid vacation or on a regular non-working day on which he is not
• the times and manner in which such monthly payments must be made. totally disabled,provided he was in active service on the last preceding work day.) for a continuous period of
time as shown in the Schedule of Benefits:and
Such written notice must be given to the qualified continuee within 14 days of:
C. Is within the classification(if any)shown in the Schedule of Benefits;
• the date a qualified continua's group health benefits would otherwise end due to the employee's death.the OR
employee's termination of employment or reduction of work hours, or the employea eligibility for
Medicare:or D. Eligible retirees if so specified in the Schedule of Benefits under Eligible Classes of Employees:
' the date a qualified continuee notifies the Village,in writing-of the employees legal divorce or legal With respect to such eligible person employed by the Village on the effective date of this Plan,the date of cligibility
separation from his spouse,or the loss of Dependent eligibility of a coverod Dependent child. shall be the effective date of the Plan.
Election of Continuation:To continue his group health benefits,the qualified eontinuce must give the Village written With respect to such an eligible person who becomes employed by the Village after the effective date of the Plan,the
notice that he elects to continue. This must be done within 60 days of the date a qualified continua received notice of date of eligibility shall be the same as A.B and C above.
his continuation rights from the Village as described above. And the qualified continua must pay his first month's
premium in a timely manner. A Participant eligible for Dependent coverage shall be any Participant%%host Dependents mccl the definition of a
Dependent as stated in the Plan. Each Participant will become eligible for Dependent Coverage on the latest of the
following:
The date he becomes eligible for participant coverage:or
The date on which he first acquires a Dependent;or
The date he first conics within the classification(if any)eligible for Dependent Coverage as stated on the
Schedule of Benefits.
30 19
ELIGIBILITY OF COVERAGE
If both the husband and wife are employed by the Village,and both are eligible for Dependent Coverage,either the FEDERAL CONTINUATION OF BENEFITS
husband or wife but not both,may elect Dependent Coverage for their eligible Dependents. Important Notice:This section applies to dental,hospital,major medical,prescription drug,and surgical coverages
DEPENDENT ELIGIBILITY
only. In this section,these coverages are rcferrcd to as'group health benefits'.
This section does not apply to coverage which apply to loss of life,or loss of income due to disability. These coverages
A Dependent will be considered eligible for coverage on the date the Participant becomes eligible for Dependent cannot be continued under this section.
Coverage,subject to all limitations and requirements of this Plan,and in accordance with the following:
Under this soctiott,'qualified continuos'means any person,who on the day before any event which would qualify him
Ncwvbom children of a Covered Participant will only be covered from the moment of birth for injury or illness, for continuation under this section,is covered for group health benefits under this plan as:(a)an active,covered
including the necessary care or trcaunxnt of medically diagnosed congenital defects,birth abnormalities or employee.(b)the spouse of an active,covered employee:or 0 the Dependent child of an active,covered employee.
prematurity,as follow;: Further,any children born or adopted during COBRA coverage arc qualifned beneficiaries.Any other person who
If the Participant has eligible Dependents and has Dependent Coverage on his spouse prior to the birth,the became covered under this plan during a continuation provided by this section is not a qualified continua.
I.
ncwbom child will be covered. Conversion:Continuing the group health benefits does not stop a qualified continua from converting such benefits
when continuation ends. But,conversion will be based on any applicable conversion privilege provisions,if any,of
2 If the Participant has no eligible Dependents prior to the birth of the newborn child,the newborn child must this plan in force at the time the continuation ends.
be properly enrolled as a Dependent of the Participant within thirty(30)days of the child's date of birth.
If An Employee's Croup Health Benefits End: If an employee's group health benefits end due to his termination
A spouse will be considered an Eligible Dependent from the date of marriage,provided the spouse is properly of employment or reduction of work hours,he can ekes to continue such benefits for up to 18 months,if:
enrolled as a Dependent of the Participant within thirty(30)days of the date of marriage.
- If a Dependent is acquired other than at the time of his birth,due to a court order,deers,or marriage,that he was not terminated due to gross misconduct;
Dependent will be considered an eligible Dependent from the date of such court order,decree,or marriage, • he is not covered for benefits from any other group .
provided that this new Dependent is properly enrolled as a Dependent of the Participant within thirty(30)days plan at the time his group health benefits under this
of the court order,decree,or mamage. plan would otherwise end.and
' he is not eligible for Medicare.
In the event certification of disability,under the Social Security Administration takes place foranry qualified beneficiary
at the time or within 60 days of the time COBRA coverage begins,coverage may be continued for 29 months. If the
individual entitled to the disability extension has non-disabled family members who are entitled to COBRA continuous
coverage,the non-disabled family members are also entitled to the 29 month extended period of coverage.
The continuation: (a) can cover the employee and any other qualified continua: and (b) is subject to 'When
Continuation Ends'.
If An Employee Dies While Covered: Ifan employee dies while covered,any qualified continua whose group health
benefits would otherwise end,can elect to continue such benefits. The Continuation can last for up to 36 months,
subject to'When Continuation Ends'.
If An Employee's hlarriaee Ends: If an employee's marriage ends due to legal divorce or legal Separation.any
qualified continua whoa group health benefits would otherwise end can elect to continue such benefits. The
continuation can last up to 36 months,subject to'When Continuation Ends'. t
20
29
t
COORDINATION OF BENEFITS EFFECTIVE DATE OF COVERAGE
These rules do rat apply when a court decree fires the responsibility-for the health care costs of a child whose parents
have separated or divorced. Any Plan in which the child is covered as the Dependent of a parent with this legal
responsibility will always pay first. PARTICIPANT EFFECTIVE DATE
In some cases,the order of pa)ment may still be unclear. Priority then goes to the Plan which has covered the person .Participant coverage under the Plan shall become effective with respect to any cligible person on the date of his
for the longest continuous time. eligibility,provided written application fa such coverage is made on or before such date. If application is made within
thirty(30)days after the date of eligibility,the Participant coverage for the eligible person shall become effective on
RIGHT TO RECEIVE AND RELEASE NEEDED INFORMATION the day shown in the Schedule of Benefits.
The Village has the right to obtain or give information needed to coordinate benefit payments with other Plans. This Iran eligible person is not Actively at Work on the date this Participant coverage would otherwise become effective,
can be from,or to,any other insurance company,organization,or person. The Village nood not give notice to get his coverage shall become effective on the day he rctums to Active Work.
anyone's consent to do this.
All Participant coverage under the Plan shall commend at 12:01 A.M.Standard Time,on the date such coverage is
Any person who claims benefits must give the Village the information needed to coordinate benefit payments. effective.provided such Participant is able to be Actively at Work at such time. If the Participant is not Actively at
Work on the date this Participant coverage would otherwise take effect,but was able to do so at 12:01 A.M.Standard
RIGHT TO MAKE PAYMENTS Time had such work been commenced at that time.such Participant shall be eligible for coverage on that date.
The Village has the right to pay any other organization as needed to properly carry out this provision. These paymens DEPENDENTS EFFECTIVE DATE
that the Village makes in good faith are considered beniefits paid under this Plan. Also,they discharge the Village from
further liability•to the extent the payments are made. Each Participant who makes written request for Dependent Coverage hercundcr,on a forth approved by the Village.
shall,subject to the further provisions of this section•become covered for Dependent coverage as follows:
RIGHT OF RECOVERY
- If the Participant makes such written request on or before the date he becomes eligible for Dependent coverage.
If this Plan paid more than it should have,it has the right to recover the excess amount. This can be from the person he shall become covered.with respect to those persons who are then his Dependents,on the date he becomes
for whom the payments were made. It can also be from any insurance company or organization. covered for Participant coverage.
COORDINATION WITH MEDICARE - Ifthe Participant makes such written request after he becomes cligible for Dependent coverage within the thirty
(30)day period immediately following the first day on which he is both eligible for Dependent coverage and
Notwithstanding all other provisions of this Plan,all Covered Persons who are eligible for Medicare Benefits will be actively at work,be shall become covered on the date of such request or on the date he becomes covered for
entitled to benefis under this Plan in addition to Medicare. However,any benefits of this Plan will be coordinated with Participant coverage.whichever date is later,with respect to those persons who arc then his Dependents.
Medicare in accordance with the Coordination of Benefits Provision of this Plan and subject to the rules and regulations
as specified by the Tax Equity and Fiscal Responsibility Act of 1992 and COBRA.as revised. If any Covered Person - If a Dependent of a Participant is confined in a I lospital and/or totally disabled on the date such Participant
eligible for Medicare fails to enroll therefore,benefib will be paid as though he had enrolled. would otherwise become covered for Dependent coverage with respect to such Dependent,the Participant will
not became covered with respoct to such Dependent until the day following the Dependent's final discharge
from the Hospital and/or the date the dependent is able to perform all of the nom ml activities of a person of
the same age and sex in good health. This limitation shall not apply to an infant with respect to whom a
Participant would otherwise become covered for Dependent coverage on the date of such infants birth,except
for those limitations outlined in the Covered Expenses and Exclusions and Limitations Sections of this Plan
or other sections relating to a newhom child.
28 21
EFFECTIVE DATE OF COVERAGE COORDINATION OF BENEFITS
SPECIAL ENROLLMENT PERIODS
' Group automobile insurance;
t
Special Enrollment Periods must be provides for employees or dependents who lose other health coverage. The Individual automobile insurance coverage on an automobile leased or owned by the Village;or
following rules apply: • Individual automobile insurance coverage based upon the principles of'No-Fault"coverage.
' The loss of other coverage must be because of(a)loss of eligibility or(b)the employer's cessation of EFFECT ON BENEFITS
premium payment. It does not include loss of coverage due to failure to make timely premium payments
or loss for cause. The Coordination of Benefits provision assures that the total benefits paid from all Plans are not more than the actual
Allowable Expenses. This includes all benefits that a Plan would pay if a claim were made,whether or not the claim
• The Employee must request the special enrollment period within thirty(30)days of ethaustion of other is filed.
coverage,if they originally declined coverage under your plan.
' Coverage shall be effective no later than the first day of the first calendar month following the date the ORDER OF BENEFIT DETERMINATION
enrollment forms are received for the employee or spouse;date of birth for newborn: date of placement If a person is covered under this Plan and another Plan at the same time,the Plans will pay benefits in this order:
for adoption of child.
'
' The employee must be given a notice of enrollnx:nt rights on or before the time of initial enrollment,only Any Plan that has no Coordination of Benefits provision will pay first.
if they decline coverage under your plan. Plans that have Coordination of Benefits provision will then pay as follows:
' Special enrollment period must also be offered to employees who experience essentially a change in status -First Any Plan in which the Covered Person is not covered as a Dependent.
relating to the addition of a dependent. In other words,if they have not been covered,but they acquire a
dependent,then a special enrollment period must be offered. -Second Any Plan in which the Covered Person is covered as the Dependent.
-Third When two or more Plants cover a child as a Dependent of different parents the Plans
will pay in the following order:
Any Plan in which the Covered Person is covered as the Dependent of person whose month
and date of birth occur earlier in a calendar year,irrespective of year of birth.
Any Plan in which the Covered Person is covered as the Dependent of a person whose month
and date of birth occur later in a calendar year,irtespoctive of year of birth.
If both parents have the same birthday,the Plan which covered the parent for the longest time
will pay before the Plan which covered the parent for a shorter period of time.
However,other rules apply if a claim is made for a covered Dependent child whose parents are separated or divorced:
-First Any Plan in which the child is covered as a Dependent of the parent who has custody.
-Second Any Plan in which the child is covered as a Dependent of the spouse ofthe parent with custody of the child;
and
t
-Third Any Plan in which the child is covered as the Dependent of the parent who does not have custody.
22
27
COORDINATION OF BENEFITS
TERMINATION OF COVERAGE
The Coordination of Benefits provision is intended to prevent the payment of benefits which exceed expenses. It applies
when the Participant or any eligible Dependent who is covered by this Plan is also covered by any other plan or plans. PARTICIPATION TERMINATION
When more than one coverage exists,one plan normally pays its benefits in full and the other plans pay a reduced
benefit. This Plan will always pay either its benefits in full or a reduced amount which.µfen added to the benefits A Participant's coverage will end on the earlier of the following dates:
payable by the other plan or plans,will not exceed 100%ofa)knwable expenses. Only the amount paid by the Plan will
be charged against the Plan maximums. • The Participant's last day worked.
The Coordination of Benefits provision applies wfinether or not a claim is filed under the other plans. If needed. - Date the Participant ceases to be in a class of Participants eligible for coverage;
authorization must be given this Plan to obtain information as to benefits or services available from the other plan or
plans,to recover overpayments. Date the Participant fails to make any required contribution for coverage;
All b-owftts contained in the Plan Document arc subject to this provision. ' Date the Plan is terminated;or with respect to any Participant benefits of the Plan,the date the termination of
such benefit:
DEFINITIONS
• Date the Village terminates the Participant's coverage;
"Allowable Expense"means any Expense which is:
• Date the Participant dies;
for Reasonable and Customary Charges;
and covered at least in part by one or more of the Plans under which the person is covered. • Date the Participant enters the armed forces of any country as a full-time member,if active duty is to exceed
thirty(30)days;or
%Vhcn a Plan provides services directly,the reasonable cash value of each service is deemed to be both an Allowable
Expense and a benefit paid. ' Date the Participant loses eligibility under Federal.State or Local Governing regulations.
"Claim Determination Period"means a full or partial calendar year,during which the person for whom the claim is A Participant whose Active Work ceases because of illness or injury°shall be considered employed by the Village for
made is covered under this Plan. the purposes of his coverage under the Plan,and such coverage may continue until the Village,acting in accordance
with its own internal policy which precludes individual selection,terminates such coverage. Hoµ•ever,in no event will
"Plan"means any policy,contract,or other arrangement to pay the cost of medical or dental care. This includes: a Participant whose Active Work ceases be covered under the Plan for more than six(6)months.
Group insurance or any other arrangement for coverage for Covered Persons in a group whether on an insured A Participant whose Active Work ceases due to temporary(3 days or less)layoff shall be considered employed by the
or uninsured basis,including but not limited to: Village for the purposes of coverage under the Plan.
Hospital indemnity benefits;and Coverage or Participant whose Active Work ceases due to an approved leave of absence granted for reasons other
Hospital reimbursement-type plans which permit the covered person to elect indemnity at the time of them injury or illness may be continued until the Village,acting in accordance with,Federal.State,or Local regulatory
claims; requirements or its internal policy,which precludes individual selection,terminates such coverage.
I lospital or medical service organizations on a group basis,group practice and other group pre-payment plans: A Participant whose coverage terminates by reason of termination oremployment,and who resumes enrollment with
the Village within a sixty(60)day period immediately following the date of such termination,shall become eligible for
Hospital or medical service organizations on an individual basis having a provision similar in effect to this reinstatement ofcovcmgc on the date he resumes employment subject to all plan limitationsand exclusions. Deductibles
provision: and out-of-pocket credits previously applied for the year will be re-instated. Prior employers re-hirod after 60 days of
termination shall be considered as new employees in accordance with plan guidelines.
A Licensed Health Maintenance Organization(H.M.O.):
Any coverage for students which is sponsored by,or provided through,a school or other educational institution; t
Any coverage under a Governmental program,and any coverage required or provided by any statute;
26 23
t TERMINATION OF COVERAGE PRE-EXISTING CONDITIONS
DEPENDENT TERMINATION No ment will be made for health claim expenses;pensu for any prcr;xisting condition."Pre-Existing Condition"means
Subject to the Continuation of Benefits and Extended Benefits provisions,Dependent Coverage of a Participant will A condition for%bieh medical advice,diagnosis,care,treatment or a prescribed drug was recommended or
end on the earlier of the following dates: received during the six months immediately preceding the effective date of coverage.
Date the Dependent ceases to be an eligible Dependent as&-:fined in the Plan; All illness or injury will no longer be considered a"Pre-Existing Condition"when the Participant has been covered by
• Date of termination of the Participant's coverage undo the Plan; this Plan for 12 consecutive months.
Late entrants(those who did not enroll within 70 days of eligibility)will be subject to prc-existing condition limitation
Date the Participant ceases to be in a class of Participants eligible for dependent coverage: for a period of I a months.
' Date the Participant or Dependent fails to make any required contribution for Dependent coverage; I loc%cver,no preexisting limitation will apply to pregnancy,or to newbom or adopted children who are enrolled within
•
Date the Plan is terminated;or with respect to any Dcpcndcnt's benefits of the Plant,the date of termination of 30 days of birth of placed adoption.
such benefit; Furthermore,credit towards the preexisting exclusion period will be given for the periods of prior coverage not having
• Date the Village terminates the Dependent's coverage; lapsed longer than 63 days. .•
Date the Participant dies: Written documentation of the period of creditable coverage will be required.
Creditable prior coverage includes group and individual coverage.
' The date the Dependent enters the armed forces of any country as a full-time member,if active duty is to
exceed thirty(30)days;or
• Date the Dependent loses eligibility under Federal.State,or Local Governing regulations.
i
24 25
AMENDMENT
VILLAGE OF OAK BROOK
PLAN DOCUMENT
IT IS UNDERSTOOD AND AGREED THAT:
The Coordination with Medicare Statement found on page 28 of the document is hereby amended
to include the following:
The Plan will be primary for all active employees and covered dependents with Medicare,
regardless of their age. The plan will be primary for retirees and covered dependents under age 65
who are not yet eligible for Medicare. However, special Medicare rules apply for covered persons
with end-stage renal disease. Medicare will be primary for retired employees.
IN WITNESS THEREOF: the undersigned has caused this Amendment to be adopted on this
0 t;� day of 14A.,P-a , 19 9 , to be effective on
19 9 7.
DBy.
(Witness)
-AMENDMENT
VILLAGE OF OAK BROOK
PLAN DOCUMENT
IT IS UNDERSTOOD AND AGREED THAT:
The Eligibility of Coverage section found on pages 19-20 of the document is hereby amended to
include the following:
Coverage provided under this Plan for Participants and their Dependents shalt be in accordance with the
Eligibility,Effective Date,and Termination provisions as stated in this Plan Document, including any
Coverage Classification stated on the Schedule of Benefits page.
If coverage classifications arc designated on the Schedule of Benefits,any change in the amount of
coverage available to a Covered Person occasioned by a change in the Participant's classification shall
become effective automatically on the classification change date;however,if the Participant is not actively
at work within the eligible class on the date the amount of his coverage would otherwise increase,such
increase shall not become effective until the next following day on which he is actively at work within the
eligible class. If a Participant's coverage is to be continued during disability,approved leave of absence or
temporary lay-off,the amount of his coverage shall be the amount for which he was covered on his last day
of active work. In the case of a Dependent,such increase shall not become effective automatically if on
that date the dependent is confined in a hospital or elsewhere. Such increase will become effective,
however,on the day next following the dependent's final discharge from the hospital.This limitation will
not apply to a newborn who is hospital confined solely because of his birth.
PARTICIPANT ELIGIBILITY
A Participant eligible for coverage under the Plan shall include only full-time employees who meet all of the
following conditions:
A. Is employed by the Village on a permanent, full-time basis for the hours per week shown in the
Schedule of Benefits;and
B. Has been in active service(An employee will be considered "in active service"on any day he or she
performs in the customary manner all of the regular duties of his or her employment. An employee will
be deemed"in active service"on each day of a regular paid vacation or on a regular non-working day
on which he is not totally disabled, provided he was in active service on the last preceding.cork day.)
for a continuous period of time as shown in the Schedule of Benefits; and
C. Is within the classification (if any) shown in the Schedule of Benefits;
OR
D. Eligible retirees:
1. Retired or disabled firemen,as defined in article 4 of the Illinois Pension Code, may elect
to receive Village group hospitalization insurance for themselves and/or their dependents
pursuant to paragraph 979(1]of the Illinois Insurance Code(chapter 215 of the Illinois
Compiled Statutes), provided that the full cost of said insurance shall be paid by the
recipient.
2. Retired or disabled police officers,as defined in article 3 of the Illinois Pension Code,may
elect to receive Village group hospitalization insurance for themselves and/or their
dependents under the same terms as retired or disabled firemen,provided that the full cost
of said insurance shall be paid by the recipient and provided further that in the event there
is a conflict between the provisions of article 3 (Police Pension Fund-Municipalities
500,000 and Under)of the Illinois Pension Code(chapter 40 of the Illinois Compiled
Statutes)and the provisions of article 4 (Firefighters' Pension Fund-Municipalities
500,000 and Under)of the Illinois Pension Code, the provisions of article 3 shall govcm.
3. Persons who have tcn(10)or more years of continuous full-time employment%%ith the
Village and who are eligible to receive an IMRF retirement or disability pension may elect
to receive Village group hospitaliza-tion insurance for themselves and/or their dependents
pursuant to the same conditions and procedures which arc applicable to disabled or retired
firemen who are eligible to receive Village group hospitalization insurance pursuant to
paragraph 9790 of the Illinois Insurance Code, provided that the full cost of said
insurance shall be paid by the recipient.
With respect to such eligible person employed by the Village on the effective date of this Plan,the date of
eligibility shall be the cffcctive date of the Plan.
With respect to such an eligible person who becomes employed by the Village aflcr the cffcctive date of the
Plan, the date of eligibility shall be the same as A, B and C above.
A Participant eligible for Dependent coverage shall be any Participant whose Dependents meet the
definition of a Dependent as stated in the Plan. Each Participant will become eligible for Dependent
Coverage on the latest of the following:
The date he becomes eligible for participant coverage; or
The date on which he first acquires a Dependent;or
The date he first comes within the classification (if any)eligible for Dependent Coverage
as stated on the Schedule of Benefits.
DEPENDENT ELIGIBILITY
A Dependent will be considered eligible for coverage on the date the Participant becomes eligible for
Dependent Coverage,subject to all limitations and requirements of this Plan,and in accordance%%ith the
fol lowing:
i
Newborn children of a Covered Participant will only be covered from the moment of birth for injury or
illness, including the necessary care or treatment of medically diagnosed congenital defects, birth
abnormalities or prematurity, as follows:
I
1. If the Participant has eligible Dependents and has Dependent Coverage on his spouse prior to the birth,
the newborn child will be covered.
2. If the Participant has no eligible Dependents prior to the birth of the newbom child,the newborn child
must be properly enrolled as a Dependent of the Participant within thirty(30)days of the child's date of
birth.
- A spouse will be considered an Eligible Dependent from the date of marriage,provided the spouse is
properly enrolled as a Dependent of the Participant within thirty(30)days of the date of marriage.
- If a Dependent is acquired other than at the time of his birth,due to a court order,decree,or marriage,
that Dependent will be considered an eligible Dependent from the date of such court order,decree,or
marriage,provided that this new Dependent is properly enrolled as a Dependent of the Participant
within thirty(30)days of the court order,decree,or marriage.
this IN WITNESS THEREOF: the undersigned has caused this Amendment to be adopted on
day l�cs(
Y of . 1999 , to be effective on
Q By.
(Witness)
6E OF 04r
v 90
a �
B e
• c
A
'CFCOUNiY •`��`
VILLAGE OF OAK BROOK
1200 OAK BROOK ROAD
OAK BROOK , ILLINOIS 60523-2255
PHONE: 630 990-3000
FAX: 630 990.0376
MEMORANDUM
DATE: December 15, 1998
TO: Health Plan Participants
FROM: Michael A. Crotty, Assistant Village Manager t-1
RE: Mastectomy Provision of Omnibus Budget Bill
I have attached notification from Health Plan Management regarding surgical benefits for
a mastectomy. For your information, the Village's health plan already covers
reconstruction of the breast on which the mastectomy has been performed and coverage
for prostheses. Per the attached notification, the Village's health plan will cover surgery
and reconstruction of the other breast to produce symmetrical appearance effective July
1, 1999 (the beginning of the next plan year).
Please keep the attached notification with your summary plan description. If you have
questions,please feel free to contact me or Marlene at extension 5736.
/mac _
attachment
CC. Marlene Hellwig, Personnel Specialist
I
i
Health Plan Management, Inc.
101 Waukegan Road
Suite 700
Lake Bluff IL 60044
To: All H.P.M. Clients and Brokers (847)234-8870
(847)234-9244 Fax
From: Catherine Ward
Date: 11/9/98
Re: Mastectomy Provision Passed in Budget Bill
The recently passed Omnibus Budget Bill amended ERISA by adding a new section that requires
group health plans providing medical and surgical benefits with respect to a mastectomy to
provide the following coverage to a plan participant who elects breast reconstruction in
connection with such mastectomy: 1) reconstruction of the breast on which the mastectomy has
been performed; 2) surgery and reconstruction of the other breast to produce symmetrical
appearance; and 3) coverage for prostheses and physical complications of all stages of
mastectomy, including lymphedsmas; in a manner determined in consultation with the attending
physician and the patient. Such coverage may be subject to annual deductibles and coinsurance
provisions as may be deemed appropriate and as are consistent with those established for other
benefits under the plan or coverage.,
Effective Date-This amendment shall apply with respect to plan years beginning on or after the
date of enactment of this Act (October 21,1998).
Notice- A group health plan, and a health insurance issuer in connection with a group health plan
shall provide notice to each participant and beneficiary under a plan regarding the coverage
required in accordance with regulations promulgated by the Secretary. Such notice shall be in
writing and prominently positioned in any literature or correspondence made available or
distributed by the plan or issuer and shall be transmitted: 1) in the next mailing made by the plan
or issuer to the participant or beneficiary; 2) as part of any yearly informational packet sent to the
participant or beneficiary; or, 3) not later than January 1,1999; whichever is earlier. For new
enrollees, written notice of the availability of such coverage shall be delivered to the participant
upon enrollment and annually thereafter. Note: In notifying plan participants no later than January
1,1999 of this provision, plans should make it very clear as to when the provision will go into
effect (i.e., for plan years beginning on or after the date of enactment of the Act) so that plan
participants will not be misled into thinking that the effective date is immediate.
Nothing in this provision shall be construed to prevent a group health plan or a health insurance
issuer offering group health insurance coverage form negotiating the level and type of
reimbursement with a provider for care provided in accordance with this provision.
I
The Act does not preempt state law requiring insurance coverage for reconstruction. Currently,
29 states have passed laws requiring fully-insured plans to provide coverage for breast
reconstruction. This new law does not preempt state laws providing at least the same level of
coverage. Of course, self-funded plans must comply with the Federal statute.
Health ,Plan Management, Inc.
101 Waukegan Road
Suite 700
Lake Blu/(, IL 60044
(847)234-8870
Page 2 - continue (847)234-9244 Fax
The KPA Plan Document contains a"conformity with law" statement which indicates that a
Plan will be considered automatically amended to comply with mandated benefits. This new
language regarding mastectomy coverage will be specifically added the next time your documents
are revised.
In the interim, the mastectomy content of this memo should be reproduced on your letterhead and
distributed to each employee covered in the Plan. Your enactment date will be the anniversary
date of your Plan following 10/21/93.
If you have any questions regarding this, please contact me. .
Sincerely,
Catherine E. Ward
President
C W/lg
i
i'
APPENDIX D
RESOLUTION 97-AG-IS-EXI-R-693
A RESOLUTION APPROVING AND AUTHORIZING EXECUTION
OF THE VILLAGE OF OAK BROOK
FLEXIBLE BENEFITS PLAN
WHEREAS, Section 125 of the Internal Revenue Code authorizes employers to sponsor flexible
benefit packages for their eligible employees; and
WHEREAS, the Village of Oak Brook, Illinois, (the"VILLAGE") desires to participate in a
plan of flexible compensation for the eligible employees of the VILLAGE; and
WHEREAS, the purpose of the Plan is to allow the eligible employees of the Village a method
of funding for: (1) the premium contribution for their Village-sponsored group medical and/or life
coverages; (2) qualified dependent care; and (3) qualified unreimbursed medical/dental claims, using
pre-tax monies rather than after-tax monies; and
WHEREAS, the Village Board of the Village of Oak Brook deems it necessary and in the best
interests of the VILLAGE to participate in the Flexible Benefits Plan;
NOW, THEREFORE, BE IT RESOLVED BY THE PRESIDENT AND BOARD OF
TRUSTEES OF THE VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS,
as follows:
Section 1: That the provisions of the preamble hereinabove set forth are hereby adopted as
though fully set forth herein.
Section 2: That the Flexible Benefit, Master Plan Document, is attached hereto as Exhibit A and
by this reference incorporated herein and made a part hereof, is hereby approved.
Section 3: That the Village President, Village Clerk, Village Manager and other officers or
employers of the VILLAGE are hereby empowered and directed to execute and deliver all documents,
certificates and other instruments necessary to further the intent and purpose of this Resolution.
Section 4: That this Resolution shall be in full force and effect from and after its adoption as
provided by law.
PASSED AND APPROVED this Bch day of July, 1997 by the President and Board of
Trustees of the Village of Oak Brook, DuPage and Cook Counties, Illinois, according to a roll call vote
as follows:
Resolution 97-AG-IS-EXI-R- 693
Flexible Benefits Plan
Page 2
Ayes: Trustees Bartecki, Caleel, Kenny, McInerney, Savino and Shumate
Nays: None
Absent: None '
Abstain: None
Village President
ATTEST:
C7S of Oq,f
Village rl. Tru• c. __ `1 ��
tom: fl
f
i
FLEXIBLE BENEFIT
MASTER PLAN DOCUMENT
Article 1. Establishment and Purpose.
Section 1.1 Establishment. Village of Oak Brook, (hereinafter called the "Client")
establishes, effective as of September 1, 1997, a plan of flexible compensation for the
eligible employees of the Client which shall be known as the Village of Oak Brook Flexible
Benefits Plan (hereinafter called the "Plan").
Section 1.2 Purpose. The purpose of the Plan is to allow the eligible employees a method
of funding, (1) The premium charges for their employer-sponsored group medical and/or
life coverages; (2) dependent care; and/or (3) unreimbursed medical/dental claims, using
pre-tax monies rather than after-tax monies. The plan is intended to comply with the
provisions of Section 79, 105, 106 and 129 of the Internal Revenue Code of 1954, as
amended by Tax Reform Act of 1984.
Article 2. Administration and Definitions.
Section 2.1 Administration. The plan shall be administered by the Client, the Plan
Sponsor, who shall bear all administrative costs of the Plan.
Section 2.2 Power of the Administrator. The Administrator of the Plan shall have all
powers necessary to administer the Plan and;
A. Interpret the provisions of the Plan;
B. Be responsible for any necessary changes in accounting procedures created by the
establishment of the Plan;
C. Establish rules for the Administration of the Plan and to prescribe any forms required
to administer the Plan.
D. Hire professional administrator(s) to administer the Plan.
Section 2.3 Actions of the Client. All determinations, interpretations, rules and decisions
of the Client shall be conclusive and binding upon all persons having, or claiming to have,
any interest or rights under the Plan.
Section 2.4 Delegation. . The Client shall have the power to delegate specific duties and
responsibilities to officers or other employees of the Client or other individuals or entities.
Any delegation by the Client may allow further delegation by the individual or entity to
Page -2-
whom the delegation is made. Any delegation may be rescinded by the Client at any time.
Each person or entity to whom a duty or responsibility has been delegated shall be
responsible for the exercise of such duty or responsibility, but shall not be responsible for
any act or the failure to act of any other person or entity.
Section 2.5. General Definitions.
A. "Participant" means a person who is an employee on or after the effective date and
who satisfies the participation condition of Article 3. An individual who becomes a
Participant shall remain a Participant until all benefits due him/her under the
provisions of the Plan have been paid or otherwise have been satisfied.
B. "Period of Coverage" means the Plan Year, except that for any Employee who
becomes a Participant after the start of a Plan Year, the Participant's enrollment will
extend through the remainder of the Plan Year.
C. "Plan" means Village of Oak Brook Flexible Benefits Plan as set forth herein and as
amended or restated from time to time.
D. "First Plan Year" means the four month period from September 1, 1997 to December
31, 1997. Subsequently, "Plan Year" means the twelve (12) month period
commencing January 1 and ending the following December 31st, with subsequent
Plan Years commencing January 1.
Article 3. Participation/Termination Conditions.
Section 3.1 Participation conditions. As a condition of participation and receipt of benefits
under this Plan, the Participant agrees to:
A. Furnish to the Client the Flexible Benefits Plan Payroll Deduction Authorization
provided for in Section 3.2 below.
B. Observe all Plan rules and regulations.
C. Designate a portion of his/her Compensation as Pay Conversion Contributions in
accordance with the provisions of Article 4.
Page -3-
Section 3.2 Flexible Benefits Plan Payroll Deduction Authorization. As a condition of
participation, all employees who are eligible and wish to be participants shall (1) execute
and deliver to the Client prior to their first day of participation, a signed application to
participate in the Plan; (2) designate the required portion of their compensation for the Plan
Year in question as Pay Conversion Contributions as described in Article 4; (3) make a
benefit election, and (4) supply any other pertinent information that the Client reasonably
requires. Unless otherwise provided by the Client, that application shall be delivered to the
Client at least thirty (30) days prior to the first day of the Employee's Participation. Also, as
of this deadline, those eligible employees who decline participation must provide a signed
statement to this effect. .
Section 3.3 Commencement of Participation. Eligible employees may become participants
only on the first day of a Plan Year, or as stated in (A) under Section 2.5. New employees
hired after commencement of the Plan Year will become eligible to participate on the first
day of the month following a 30 day waiting period.
Section 3.4 Provision for Run-Out Period. Expenses with dates of service falling within the
current Plan Year, may be eligible for processing as late as 60 days beyond the end of the
Plan Year.
Section 3.5 Termination of Coverage. A participant who terminates employment during
the Plan Year with a balance remaining in his/her account, may continue to submit eligible
expenses against that balance for a period up to 60 days after the date of termination.
This will be known as the Closing Date which may not exceed the end of the run-out period
described in Section 3.4. Only those expenses incurred prior to the date of the participant's
termination will be considered for reimbursement.
Article 4. 'Pay Conversion and Benefit Elections.
Section 4.1 Pay Conversion. Each participant shall at the beginning of each Plan Year
designate a portion of his/her compensation for each Plan Year as Pay Conversion (to
spending account). Pay Conversion Contributions shall reduce the Participant's
Compensation proportionately on each pay period during the Plan Year following his/her
effective date in the Plan.
Section 4.2 Benefit Elections. Each Participant shall make a benefit election, in the manner
provided herein, to apply his/her Pay Conversion Contributions during each Plan Year in
such proportions as he/she chooses, to the following:
Page -4-
A. To pay the Participant's premium or contributions for Client Sponsored medical
insurance or coverage as set forth in Article 5:
and/or
B. To reimburse the participant for properly documented dependent care charges:
and/or
C. To reimburse the Participant for properly documented unreimbursed medical/dental
care charges. A participant's initial benefit election shall be made as part of his/her
Flexible Benefits Plan Payroll Deduction Authorization Form. Thereafter, a
Participant may change his/her benefit election for a subsequent Plan Year by
completing a new Flexible Benefits Plan Payroll Deduction Authorization form at
least thirty (30) days prior the first day of the Plan Year for which such change is to
be effective. A Participant's benefit election for any Plan Year shall be irrevocable
during the Plan Year, except for the automatic adjustment provided in Article 5 and
except that (a) the Client, in its capacity as Plan Administrator, may arbitrarily limit a
Participant's contribution, and (b) in the event that there is a Life Event occurrence, a
Participant shall be entitled to change his/her benefit election in a manner that is
consistent with such Life Event occurrence by providing the Client a new Flexible
Benefit Plan Payroll Deduction Authorization Form and a written letter of
explanation for the change. Any such change shall be effective the first day of the
first calendar month beginning not less than thirty (30) days after the date of such
Participant's written notice is received by the Client.
Article 5 Medical Insurance or Coverage Benefits
Section 5.1 Medical Insurance or Coverage Benefits. To the extent a Participant so elects,
a portion of the Participant's Pay Conversion Contributions shall be used to pay the
Participant's share of the cost of coverage for himself/herself or his/her eligible dependents
under any existing Client sponsored health, medical, dental or hospitalization insurance (or
plan) or other similar health and accident plan for Employees' child or dependent care or
unreimbursed medical/dental claims. If there is a change in the cost of a particular type of
coverage selected by a Participant, the Participant's election shall automatically be adjusted
to reflect such change.
Article 6 Amendments and Termination
Section 6.1 Amendments. The Client may amend the Plan, in full or in part, at any time
and as often as it deems necessary. Any such amendment shall be filed with the Plan
Document.
I
Page -5-
Section 6.2 Benefits Provided Through Third Parties. In the case of any benefits provided
.pursuant to any insurance policy or other contract with a third party, the Client may amend
- the Plan by changing insurers, policies or contracts without changing the language of their
Plan Document, provided that copies of the contracts or policies are filed with the Plan
Documents and the Participants are informed as to the effects, if any, of such changes.
Section 6.3 Termination. The Client expects the Plan to be permanent, but necessarily
must, and hereby does, reserve the right to terminate the Plan at any time. In the event of a
Plan termination, Pay Conversion Contributions will cease. Thereafter neither the Client
nor any of its employees shall have any further financial obligations hereunder except such
that have accrued up to the date of termination and have not been satisfied. The Client must
provide the employees notification of such Plan Termination at least thirty (30) days in
advance of such actual action being taken.
Article 7 Miscellaneous
Section 7.1 No Guarantee of Employment. The adoption and maintenance of the Plan shall
not be deemed to be a contract of employment between the Client and any employee.
Nothing contained herein shall give any employee the right to be retained in the
employment of the Client or to interfere with the right of the Client to discharge any
employee at any time, nor shall it give the Client the right to require any employee to
remain in its employment or to interfere with the employee's right to terminate his/her
employment at any time.
Section 7.2 Limitation of Liability. The Client does not guarantee benefits payable under
any policy or contract of insurance, or coverage, described herein, and any benefit payable
thereunder shall be the exclusive right of the insurer or entity that issued such contract or
policy.
Section 73 Non-Alienation. No benefit payable at any time under this Plan shall be subject
in any manner to alienation, sale, transfer, assignment, pledge, attachment, or encumbrance
of any kind.
I
Section 7.4 Applicable Law. The Plan and all rights hereunder shall be governed by and
construed according to the laws of the State of Illinois except to the extent such laws are
preempted by the laws of the United States of America.
Page -6-
Section 7.5 Benefits Provided through Third Parties. In the case of any benefit through a
third party, such as an insurance company, or another Third Party Administrator, pursuant
to a contract or policy with such third party, if there is any conflict or inconsistency between
the description of benefits contained in this Plan and such contract or policy, the terms of
such contract po 'c all
�LQ7
Signa re - Administrator Date
fz(flxpindo 6.0)
I
APPENDIX E
WHO IS ELIGIBLE? LIMITS AND EXCLUSIONS
EXTRA COST - This plan Is designed to cover
EMPLOYEES: Eligibility under this vision care your visual needs rather than cosmetic materials.
plan Is determined by the Village of Oak Brook. Thus, there will be an extra cost If you select:
a) Coated Lenses
DEPENDENTS: Dependents of employees are b) Tinted Lenses (other that Pink *1 or #2)
covered by this vision care plan If your employer c) Contact Lenses (except as noted in the VILLAGE OF OAK BROOK
selected family coverage.Eligible dependents are section on contact lenses)
defined by your employer. d) Blended Lenses
e) Oversize Lenses
f) A frame that exceeds the plan allowance
g) Two pairs of glasses Instead of bifocals
h) Laminated Lenses
1) Anlseikonic Lenses
VISION SERVICE PLAN IS EASY J) Faceted Lenses
Group ou wish to use the Ian, fill out the ITEMS NOT COVERED - There are no benefits
1. When y P
attached request card and mail to VSP. for professional services or materials associated Vision
with:
2. VSP will verify eligibility and send you a 1. Plano lenses of any kind.
benefit form and list of doctors in your area. Care
2. Orthoptics or vision training, subnormal vision
3. After selecting a doctor from the list, call and aids or non-prescription lenses.
make an appointment. Present the benefit Plan
form to the doctor at the time of your first 3. Lenses and frames furnished under this
visit and before any services are provided. program that are lost or broken. These will
There Is no more paperwork for you. not be replaced unless you are eligible for
frames or lenses at that time.
4. If materials, (frames, lenses, contacts) are
required, the doctor will order your 4. Medical or surgical treatment of the eyes.
prescription from a VSP approved laboratory,
verify accuracy and dispense the eyewear to 5. Services or materials provided as a result of ■ Vision Examination
you. any Workman's Compensation Law, or similar ■ Lenses • Frames
legislation, or obtained through or required by
any government agency or program whether ■ Professional S e ry i c e s
federal, state or any subdivision thereof.
NOTE: If you choose a non-member doctor, the
procedure is similar, but you must send an 6. Any eye examination required by an employer
itemized bill for services and materials along with as a condition of employment, or any services
the benefit form to VSP. You will then be or materials provided by any other vision care ••.�'��/.
reimbursed according to the out-of-network plan, or group benefit plan containing benefits
reimbursement schedule.You are responsible for for vision care.
paying the bill In full to the non-member doctor.
NOTE: This Is only a summary. For additional
information, contact your health benefit
275 (6/92) representative.
iaisi vaunNcm
WHAT IS VISION SERVICE PLAN? WHAT IF I SELECT CONTACT LENSES HOW OFTEN CAN I RECEIVE VISION CARE?
Vision Service Plan (VSP) is a joint venture of INSTEAD OF GLASSES? Examination: Once every 12 months
various state vision service corporations Contact lenses for cosmetic purposes are also Lenses: One pair every 12 months
throughout the nation with a network of covered by this plan. However, If you choose Frames: One pair every 24 months
approximately 20,000 participating doctors. VSP contacts instead of prescription spectacle lenses Contact Lenses: One pair every 12 months
doctors agree to see all VSP members as regular and frames, a total maximum allowance of$100 Contact lenses are In lieu of spectacle lenses
patients, to complete the paperwork and to will be made toward the cost of the vision You can select one but not both contact lenses
accept VSP fees as full payment for covered examination, extended examination to fit and spectacle lenses.
services. VSP is available to your family where contacts, contact lenses and follow-up visits.
they work, live or go to school (in any state). Deductibles will not apply. You will pay any WHAT IF MY DOCTOR IS NOT ON
balance above $100. THE VSP LIST?
WHAT ARE THE BENEFITS? VSP will reimburse you for services received fron
Through Vision Service Plan's (VSP) network of Non-prescription lenses, also known as piano any licensed optometrist, ophthalmologist, 01
participating doctors, members are eligible to lenses, are not covered. Non-prescription, optician not shown on the VSP list of doctors
receive (within the plan guidelines) a colored contact lenses are not covered. However,
comprehensive vision examination, spectacle
lenses and frames. Contact lenses are covered at 100% only if the you will need TO PAY the non-VSP doctor the
following conditions prevail and prior full retail charge for materials plus the ful.
• VISION EXAMINATION: This is a complete authorization Is received: examination fee.
analysis of the visual function, including a • Following cataract surgery or
prescription for glasses when needed.A vision • When vision cannot be corrected to 20/70 in you will also need TO SUBMIT an itemized bill
examination is available every twelve months. the better eye except by the use of contact with the VSP Benefit Form to VSP to receive
lenses. maximum reimbursement.
• SPECTACLE LENSES: The VSP member
doctor will order the proper lenses from a VSP you should be aware that the maximum re-
approved laboratory. By ordering from a VSP OUT-OF-POCKET COSTS imbursement(listed below) DOES NOT guarantee
laboratory, the member is assured of Provided you select a doctor from the VSP list, full payment for services received.
substantial savings on materials. This also this plan covers the visual care described herein
assures that the finest quality lenses and (examination, professional services, lenses and IMPORTANT: VSP cannot guarantee member
professional workmanship will be provided. frames within the plan limit) at no expense to you satisfaction when services are rendered by a
The VSP doctor will verify the accuracy of the except a $10 deductible toward the vision non-VSP doctor. Over 90% of VSP members
finished lenses. Plano (non-prescription) examination and a $15 deductible toward the receive services from VSP doctors to eliminate
lenses are not covered. New lenses are lenses and frames. Deductibles are paid to the high out-of-pocket cost and claims filing.
available every twelve months. VSP doctor at the time of service.
WHEN SELECTING ANON-MEMBER
• FRAMES: The VSP doctor will assist you In DOCTOR, VSP WILL REIMBURSE YOU:
the selection of quality frames. The plan NON COVERED SERVICES Professional Fees
selected by your employer has a limit on the Vision therapy, frame repair and adjustment and Vision Examination, up to $25
cost for frames. We recommend you ask the polishing contact lenses are examples of Materials Pair
doctor to show you frames within the frame additional care/service fees. Designer frames, Single vision lenses, up to $30
allowance. You can select from others; but if tinted or oversized lenses are examples of Bifocal lenses, up to $35
you select one which costs more than the additional material costs for you. These Trifocal lenses, up to $45
amount allowed (or a large frame which additional services and materials are offered at a Lenticular lenses, up to $60
requires oversized lenses), there will be an reduced cost to VSP members. Payment for Frames, up to $25
additional out-of-pocket charge. One set of additional services are to be arranged between Contact Lenses
frames is available every twenty-four months. you and the doctor. Necessary $150
Cosmetic $100
APPENDIX F
Village of Oak Brook
Travel Request Form
Employee Name: Title:
Account M
Purpose ot Travel:
Estimated Expenses
Destination: Tiansporta b- S
Departuro Date Return Date Lodging
Meek
Authorisation Recommended: Registration
Miscellaneous
Department Eked Date Total Estimate S
Funds Available: Trams Armed:
Finance Officer Data Village M er Date
Actual Expe nses
Registration MisoeYaneous
Day Date Breakfast* Lunch• Dinner• Lodging Fees Expense Total comments
i
I
I
Totals
Include Tips
Transportation:
Airline: S f
Automobile: Mks Q S. $
Other (Attach Receipts): S
Total Transportation: S
Total Expenses: S
Less: Prepaid by Village s Attach
Original
Advance to Employee s Receipts
Amount Due to<From>Employee s
I
i
Submitted ey:
Employee
Approved By:
Department Head Village Manager Date
APPENDIX G
VILLAGE OF OAK BROOK
1200 OAK BROOK ROAD
OAK BROOK, IL 60523
(630)990-3000
TUITION REIMBURSEMENT APPLICATION FORM
PLEASE PRINT
APPLICANT'S NAME
DEPARTMENT NAME JOB TITLE
DATE OF HIRE SOCIAL SECURITY#
COURSE TITLE AND NUMBER CREDITS TUITION
TOTAL S
COURSE DATES FROM TO INSTITUTION
ADDRESS MAJOR
INDICATE JOB-RELATEDNESS OF COURSE(S)
I,the undersigned,understand and agree to the terms and conditions of the village of Oak Brook Tuition
Reimbursement Program.
SIGNATURE DATE
DEPARTMENT HEAD APPROVAL
is a full time employee of the Village of Oak Brook and is in
in good standing. The course(s)listed above are:
YES NO
related to current job
related to future position
If related to future position,please explain:
Department Head's Signature Date
Manager's Signature Date
CERTIFICATION OF COURSE COMPLETION(To be completed by the employee after completion of
courses)
I have satisfactorily completed the courses listed below and have paid S in tuition and
allowed program fees for those courses in the amounts Indicated. Attached are copies of my bills,my
canceled checks and my grade report.
COURSE TITLE TUITION-RELATED FEES
(Check one)I am I am not receiving specific financial aid for tuition from other sources.
If assistance is received under any other program,furnish details below:
Employee Signature Date
DEPARTMENT HEAD APPROVAL(To be completed by the employee's department head)
This employee was a permanent,full time employee at the completion of
the course.
Previous assistance granted in the current year S Reimbursement approved in the amount of
S
DEPARTMENT HEAD SIGNATURE DATE
MANAGER'S SIGNATURE DATE