Oct 23, 2015 - This information is being requested pursuant to New York State Civil ... 2016 benefit have the option to
Productivity Enhancement Program for 2016 Management Confidential Employees Enrollment Form Name_____________________________________________ Salary Grade____________ Last 4 digits of SS #_______ Health Insurance Plan________________________________ Email _________________________________________ Check one: Individual [ ] or Family Coverage [ ] By signing this document, I elect to participate in the 2016 portion of the Productivity Enhancement Program (PEP) and agree to the provisions contained in the Productivity Enhancement Program Description (hereafter, Program Description) that is outlined on the other side of this document and available in my agency human resources office. I understand that I must meet all the eligibility criteria as set forth in the program description in order to participate. I understand that, in accordance with the program description, I will surrender leave accruals standing to my credit as a result of participation and that ALL of these leave credits will be deducted from my leave balances at the time my enrollment is processed. And, if I am a part-time employee I will forfeit Annual leave on a prorated basis in accordance with my employment percentage for a prorated credit. Furthermore, I understand that no portion of this leave will be returned to me under any circumstances. I wish to apportion this leave forfeiture as follows:
Annual salary of $61,708 or below
______ 3 vacation days; or ______ 6 vacation days
Annual salary of more than $61,708 and up to $80,583
______ 2 vacation days, or ______ 4 vacation days
In exchange for forfeiting this accrued leave I will receive a credit as set forth in the program description to be applied against the employee share cost of 2016 plan year NYSHIP health insurance. Pursuant to the program description, the amount of this credit will be established at the time of enrollment and will be adjusted only upon movement between individual and family coverage. I will not receive any amount of credit that exceeds the cost of the employee share of my NYSHIP health insurance premiums paid during that period. I understand that this enrollment form is for the 2016 program year only. I understand that in order to participate this completed election form must be filed with my agency personnel office by the close of business on November 27, 2015.
Signature________________________________________________________________ Date____________ PERSONAL PRIVACY PROTECTION LAW NOTIFICATION This information is being requested pursuant to New York State Civil Service Law section 161-a for the principal purpose of determining eligibility for the Productivity Enhancement Program for 2016. This information will be used in accordance with Public Officers Law section 96(1). Failure to provide this information may result in a denial of eligibility to participate in the Productivity Enhancement Program for 2016. This information will be maintained by the employee’s Agency Personnel Office. For further information relating only to the Personal Privacy Protection Law, call (518) 457-9375.
For Agency Personnel Office Only: Full-Time______
Part Time ______
Days of Annual leave deducted from employee’s balance: ________
Verification of eligibility. I certify that this applicant meets the eligibility criteria necessary for participation in this program. Name___________________________________ Title___________________________ Signature________________________________ Date___________________________ For Health Benefits Administrators Only: Date Processed____________________ Biweekly Health Insurance Premium Contribution Credit___________________ Name __________________________________ Date___________________________ Signature________________________________ Date___________________________
Binghamton University Human Resources – Employee Benefits To:
Management Confidential (NU 13) Employees
From:
Kim Avery, Human Resources-Employee Benefits
Date:
October 23, 2015
Re:
Productivity Enhancement Program (PEP) for 2016
MEMO
PEP allows eligible Management Confidential (NU 13) employees to exchange vacation leave in return for a monetary credit to be applied toward the reduction of their health insurance premiums. The 2016 PEP enrollment period will be October 26, 2015 through November 27, 2015. Full-time employees in a position earning an annual salary of or below $61,708 who enroll and qualify for the 2016 benefit have the option to forfeit either 3 days for a bi-weekly credit of $19.23 ($500 divided by 26 paychecks) OR 6 days for a credit of $38.46 ($1000 divided by 26 paychecks). Full-time employees in a position earning an annual salary of mover than $61,708 and up to $80,583 who enroll and qualify for the 2016 benefit have the option to forfeit either 2 days for a bi-weekly credit of $19.23 ($500 divided by 26 paychecks) OR 4 days for a bi-weekly credit of $38.46 ($1000 divided by 26 paychecks). All eligible part-time employees who enroll and qualify will forfeit leave on a pro-rated basis in accordance with their payroll/employment percentage in return for a pro-rated credit. These credits will then be applied against the cost of your health insurance premium for paychecks from December 30, 2015 through December 14, 2016. The credit established upon enrollment in the program will be adjusted only if you move between family and individual coverage during the plan year. The vacation leave credits are forfeited at the time of enrollment and cannot be returned to you if you leave service. You will be notified by the Human Resources of when the leave credits are deducted from your time record. Interested employees should submit the enrollment form (on the reverse side) to the Human Resources Office, AD Room 244 by close of business November 27, 2015. In order to be eligible, you must: •
Be employed on a calendar year or college year basis;
•
Be a full-time employee with an annual salary no greater than $80,583 at the time of enrollment or a parttime employee whose annual salary rate does not exceed the full time equivalent salary of $80,583;
•
Be a SUNY M/C employee (bargaining unit 13);
•
Be a NYSHIP enrollee (contract holder) in either the Empire Plan or an HMO; and
•
Have a sufficient vacation leave balance to make the full leave forfeiture without bringing their vacation leave balance below 8 days for full-time employees or a pro-rated balance for part-time employees.
If you have any questions, please call HR/Employee Benefits at Ext. 74850; 76950; or 76953.
