Introduction
Being disabled can be emotionally and
financially difficult for both you and your family. That’s why the Company offers
a disability program to help you in
the event that you are disabled and unable to work full-time.
The
Company’s disability program includes Sickness Allowance and the Disability
Benefit Plan. Both plans are provided to you at no cost, meaning the Company
pays the full cost of coverage.
Sickness Allowance is
designed to provide you with benefits for absences that are not expected to
last for a long period of time. If your disability continues for a longer
period of time, the Disability Benefit Plan will provide benefits to help meet
your ongoing living expenses while you are totally disabled.
An “At-A-Glance” chart
of your disability benefits is on the next page, followed by detailed
information about the plans.
Your Disability Benefits At-A-Glance
|
|
Short-Term Annual Accrued Sickness Allowance |
Extended-Term Sickness Leave |
Disability |
|
Brief Description |
For absences not expected to last for a long period of time. |
For absences due to an illness or injury that is expected to last more than three days. |
For disabilities lasting more than 60 days. |
|
|
You receive 100% of your regular earnings. If you elect to use your annual accrued sickness allowance for an illness or injury that lasts more than seven calendar days, your earnings will be reduced by other deductible disability benefits for which you are eligible |
You receive 100% of your regular earnings, less deductible disability benefits (after the seventh calendar day) such as State Disability Insurance (SDI) or Workers’ Compensation for which you are eligible. |
You receive 60% of your monthly earnings less deductible disability benefits for which you are eligible. |
|
Who Pays for |
The Company. |
The Company. |
The Company. |
About Sickness Allowance
Your
Short-Term Annual Accrued Sickness Allowance Amount (Current-Term Sick Leave)
Each calendar year, you
will be credited with a certain number of hours of Sickness Allowance based on
years of service to be completed with the Company by the end of that same year.
Previous years of service with Pacific Enterprises (PE) or any Sempra Energy
company will also count toward years of service.
Sickness Allowance for New Hires
You become eligible for
Short-Term Annual Sickness Allowance after six months of employment if you are
a regular full-time employee of the Company. If the end of this six-month
period occurs in the same calendar year you are hired, you will be credited
with 40 hours of Current-Term Sick Leave.
This partial Sickness Allowance is designed to provide some coverage until the first
full calendar year you participate.
Example: Here is an example showing three employees with different hire dates.
|
Employee |
Hire Date |
Eligibility Date |
Short-Term Annual Sickness Allowance Credited |
|
Steve |
|
|
40 hours for |
|
Theresa |
|
|
40 hours for |
|
Mei |
|
|
0 hours for 1999 because Mei has not reached the eligibility
date by |
Sickness Allowance Based on Years of Service
The Short-Term Annual Sickness Allowance you receive each calendar year
is based on the number of years of service you will have completed with the
Company by the end of the calendar year, as shown in the following table:
|
Years of Service to be |
Sickness Allowance |
|
6 months |
40 hours |
|
1 |
40 hours |
|
2 |
80 hours |
|
3 |
120 hours |
|
4 |
120 hours |
Example: Continuing
the earlier example, here’s how much Short-Term Annual Sickness Allowance
Steve, Theresa and Mei would receive in 1999 and 2000.
|
Employee |
Hire Date |
1999 |
2000 |
|
|
Short-Term Sickness Allowance Credited |
Years of Service To Be Completed |
Short-Term Annual Sickness Allowance Credited |
||
|
Steve |
|
40 hours |
1 year |
40 hours |
|
Theresa |
|
40 hours |
1 year |
40 hours |
|
Mei |
|
0 hours |
1 year |
40 hours |
Note: When Mei completes six months of service on
Current-Term Sick Leave
is used the first three days of an employee’s absence due to sickness or
injury. It may also be used to sustain pay prior to receiving LTD benefits, at
the employee’s request, if Extended-Term Sickness Allowance and Bonus Sickness
Allowance, if any, have been used up.
Fifty percent of an
employee’s Current-Term Sick Leave may also be used to attend to an illness of
the employee’s spouse, child or parent as those terms are defined in
Extended-Term Sick Leave Allowance
Employees in active service who have completed five (5) years or more of
regular employment shall receive the following Extended-Term Sick Leave
Allowance, in addition to the Short-Term Annual Sickness Allowance:
|
Year in Which |
Calendar Weeks |
Equivalent |
|
5 years |
1 week |
40 hours |
|
6 years |
2 weeks |
80 hours |
|
7 years |
3 weeks |
120 hours |
|
8 years |
4 weeks |
160 hours |
|
9 years |
5 weeks |
200 hours |
|
10 or more years |
6 weeks |
240 hours |
Extended-Term Sick Leave Allowance is used if you are absent due to
illness or injury for more than three work days. It may also be used if you do
not have available Current-Term Sick Leave.
Any portion of an
employee’s Extended-Term Sick Leave Allowance which has been used during any
calendar year will be replenished the first day of the next calendar year. An
employee’s Extended-Term Sick Leave Allowance is not an annual accrual and is
not available to use for the illness of a spouse, domestic partner, child or
parent.
Maximum Benefit Amount
For each day of Sickness
Allowance you use, you will receive 100% of your regular earnings less any
State Disability or Workers’ Compensation benefits for which you are eligible.
To receive the maximum benefit amount, you must apply for California State
Disability Insurance (SDI) benefits if:
n
You are
disabled due to non work-related causes for more than seven consecutive
calendar days
n
You are
absent for more than seven calendar days due to a Workers’ Compensation claim
that has been delayed or denied, or
n
You are
absent for more than seven calendar days due to a Workers’ Compensation injury or illness that occurs beyond five years from the original date of
injury or illness.
Using Your Sickness Allowance
You can use your
Sickness Allowance if you are unable to work due to an illness or injury as
follows:
|
Duration of Your Absence |
What Happens |
|
If you’re absent for
three days |
You will use your Current-Term Sick Leave. You may be required to provide medical information. You will be notified if this is the case. |
|
If you expect to be
absent for more than three days |
You will use three days of Current-Term Sick Leave and on the fourth work day begin to use your Extended-Term Sick Leave. You must provide a written statement from your doctor after two weeks of disability, or sooner if requested, with the following information: n Evidence that you are under the regular care of a doctor n The date your disability began n Prognosis n Treatment plan n Medication prescribed, if any, and dosage n Test or x-ray results, if any (or other objective data) n Specific information that precludes you from performing your regular job duties (e.g., maximum weight to be lifted, amount of bending, stooping, walking) n Expected return-to-work date. |
|
If you’re disabled
continuously or intermittently from one calendar year to the next due to the
same or a related medical problem |
The total number of Short-Term Annual Sickness Allowance hours you use for the disability for both years cannot be greater than the Short-Term Annual Sickness Allowance you receive each year. This does not apply if your absences are separated by a return to work of at least 90 days. |
|
If you’re continuously
disabled for more than 60 days and become eligible for Disability Plan
benefits |
You will begin to receive Disability Plan benefits. You must be back at work for at least 180 days before using either your Short-Term Annual or Extended-Term Sickness Allowance for a related disability. |
Other than functional
job limitations that may be shared with your supervisor, medical information
will remain confidential and be kept in a separate medical file.
Bonus Sickness Allowance
If you become disabled
after you complete ten or more calendar years with the Company, you may be
eligible for Bonus Sickness Allowance. You will be eligible for 160 hours of
Bonus Sickness Allowance if you have used less than 160 hours of sick time
(paid or unpaid) for non work-related reasons during the five previous calendar
years. Your eligibility for Bonus Sickness Allowance must be verified and
approved by the Company’s payroll department. Bonus Sickness Allowance becomes
part of your Extended-Term Sick Leave and is available after you have used 240
hours of sick leave for a disability.
Example: Let’s assume that Jim has
completed ten or more calendar years of service in 1999. Jim then becomes
disabled in 2000. Jim has used the following number of Sickness Allowance hours
over the last five years:
|
Year |
Date Allowance |
Hours Used |
|
1995 |
|
8 |
|
1996 |
|
40 |
|
1997 |
|
16 |
|
1998 |
|
32 |
|
1999 |
|
40 |
|
|
|
136 |
Since Jim used less than
160 hours of sick time from
Using Your Bonus Sickness Allowance
The following chart explains how to use Bonus Sickness Allowance:
|
When can I use Bonus
Sickness Allowance? |
After you have used all of your Extended-Term Sick Leave Allowance. |
|
What happens if my
disability continues into the next calendar year? |
You can continue using your Bonus Sickness Allowance until it is depleted. |
|
What happens if I use
all my Bonus Sickness Allowance? |
You can elect to use any remaining Current-Term Sick Leave, vacation or holiday credits or begin to receive LTD benefits if you are still disabled. |
|
What happens if I don’t
use all of my Bonus Sickness Allowance? |
Your unused Bonus Sickness Allowance remains available and will be carried over from one calendar year to the next. |
|
How is the Bonus
Sickness Allowance I use replaced? |
Once you use all or part of your Bonus Sickness Allowance, it will be restored to 160 hours when you use less than 160 hours of Sickness Allowance during a new five-year period. |
Coordinating Benefits with Other
Disability Income
Your Sickness Allowance
benefit will be reduced by the maximum benefit you are eligible to receive from
California State Disability Insurance (SDI) or Workers’ Compensation.
If you are eligible for
less than the maximum SDI benefit, you must provide Disability Management
Services (DMS) with proof of the lesser amount. DMS will coordinate payment of
Workers’ Compensation benefits.
Please see “Other
Sources of Disability Income” on page 21 for a brief description of SDI and
Workers’ Compensation benefits.
Using Vacation/Holiday Time as Sick Pay
If you use all your
Sickness Allowance, including any Bonus Sickness Allowance, you can then use
any holiday credits and available vacation allowance, including purchased
vacation, for verified absences from work. If your disability lasts longer than
six months and extends into the next year, you will not earn any additional
vacation until you return to work.
If You Are Disabled and Continue to
Work
If the Company receives
medical information indicating that you are unable to perform the regular
duties of your job but are capable of performing other full-time work, you may
be placed in a limited-duty assignment. Limited-duty assignments are based on
availability and may not exceed 90 calendar days, except for disabilities relating
to pregnancy.
If limited-duty work is
available, you will be required to return to work in that assignment. If you
are on leave authorized by the Family Medical Leave Act, you will not be
required to accept a limited-duty assignment. Refusal of a limited duty
assignment, however, will mean that you will not qualify for a paid leave.
If You Become Disabled While on
Vacation
If you become disabled
while on vacation, you can cancel the remainder of your scheduled vacation
period and use your available Sickness Allowance. You must notify your
supervisor at the onset of your disability and provide medical proof as soon as
possible. If you are hospitalized, you must notify your supervisor as soon as
possible but not later than the day you are discharged from the hospital. If
you are traveling, you must return home as soon as it is medically safe for you
to travel.
Reporting Absences
To use your Sickness Allowance, you should follow these steps to report
absences:
|
Your Situation |
What You Need to Do |
|
On your first day of
absence |
You must notify your supervisor or another employee designated by your supervisor to receive such information. |
|
If you have been absent
for two weeks or more |
You must submit medical information to your supervisor or DMS, including the information listed on page 6. You must also submit this information when requested by the Company. |
|
If you cannot return to
work on your expected return-to-work date |
You must submit a new doctor’s note explaining the extension. |
|
If you’re requested to
undergo an evaluation |
You must do so with a doctor designated by the Company. This evaluation will be paid for entirely by the Company. If the Company-appointed doctor disagrees with your doctor, the Company-appointed doctor’s opinion will prevail for the purposes of determining your eligibility for Sickness Allowance. |
|
If you choose to have a
third opinion and you do not have an open Workers’ Compensation claim |
You should request DMS to schedule an appointment for you. You will be examined by a doctor who is randomly selected from an approved list of doctors who have agreed to provide neutral third opinions. You must pay for the third opinion at the time of the examination. The services will not be covered by your medical plan. The third medical opinion is binding on both the employee and the Company. |
|
If the third opinion
doctor confirms your doctor’s opinion |
You will be reimbursed for the cost of the evaluation and for reasonable transportation costs. You will also receive any Sickness Allowance or disability benefits for which you are eligible. |
|
Important! |
|
This medical evaluation
process applies specifically to the determination |
About the Disability Benefit Plan
When Cov erage Begins
Your Disability Benefit
Plan coverage will automatically start on the first day of the month following
12 months of continuous active service with any of the Sempra Energy companies
since the date of your hire.
If you are absent from
work due to injury, sickness, temporary layoff or leave of absence, your
coverage will begin on the date you return to active employment.
If your employment ends
and you are rehired within 12 months, your previous work while in an eligible
group will apply toward the waiting period.
All other policy provisions apply.
You will not earn credit
toward continuous service while you are on layoff status. However, you will
receive credit toward continuous service if you are on the following types of
leave:
n
Approved
personal leave for 30 days or less
n
Approved
military leave
n
Family care
leave or
n
Union leave.