HomeMy WebLinkAboutMINUTES - 04192006 - C.64 I
TO: BOARD OF SUPERVISORS O
-� Contra
/� rss Costa
FROM: Danna Fabella, Acting Dlrecto 4�
Employment and Human Services County
°sr-----
A COUF�
John Cottrell, Director
In Home Supportive Services, Public Authority
DATE: April 19,2006
SUBJECT: In Home Supportive Services, Public Authority Application for Elective Coverage of
Disability Insurance
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION-
2006/
ADOPT Resolution No. 220 authorizing the Contra Costa County In Home Supportive Services, Public
Authority to participate in the State of California Employment Development Department Short Term Disability
Insurance program; and AUTHORIZE the Chair of the Board of Supervisors to sign and file the application with
the California Employment Development Department.
FINANCIAL IMPACT-
No County costs.
BACKGROUND@
The elective coverage of short-term disability insurance, including paid family leave (PFL), has been requested
by IHSS Public Authority employees and is available to local public entities. California Unemployment
Insurance Code section 709 provides that Jany local public entity located in this State may elect to become an
employer for state disability insurance purposes only, with respect to all its employees. The electing entity
agrees to remain a covered employer for not less than two complete calendar years. Coverage may be
terminated at the end of the two-calendar-year period or at the end of any calendar year thereafter by giving the
Department written notification by January 31 of the succeeding year. In order to file this election with the
California Employment Development Department, the Board of Supervisors must pass a Resolution
(Attachment A). Upon approval of this ellection, employee contributions to state disability insurance are
required and will be paid at the rate established for each year up to the annual taxable wage limit. Employee
contributions are used exclusively to finance the State Disability Insurance Program. Deductions for employee
contributions should be made at the time wages are paid.
Every employing unit shall post and maintain a printed notice (DE 1375C, Notice to Employees Elective -
Coverage Application For State Disability Insurance) of the application on the premises. Individual employees
shall be given two reasonable opportunities to file objection or to be heard in the matter prior to the Chair's
approval of election. The fourteen IHHS employees are not covered at this time and have e vressed a desire to
be so covered.
CONTINUED ON ATTACHMENT: X YES SIGNATURE: J4r
✓kECOMMENDATION OF COUNTY ADMINISTRATOR _RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURES
ACTION OF BOA )DN /// � ? O'(/o� APPROVED AS RECOMMENDED_ OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT - ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED 07
JOHN CUL N,CLER(OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact: JOHN COTTRELL 6-1257
cc: EHSD(CONTRACTS UNIT)—EB
BOBADMLER, SD
COUNTYTY ADMINISTRATOR
Auditor-Controller BY 'DEPUTY
THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Resolution on May 2, 2006 by the following vote: sE L
AYES: Gioia,Piepho,DeSaulnier,GI(ver and Uilkema o ..14,14
NOES: None 40
ABSENT: None
ABSTAIN: None OST1 COl1I3
SUBJECT: Elective Coverage of State ) Resolution No. 2006/220
Disability Coverage )
WHEREAS, Section 709 of the California Unemployment Insurance Code provides that any public
entity located in this State specified in Section 135(a)(3) may elect to become an employer for state
disability insurance purposes only, with respect to all its employees, and may file its written election
with the California Employment Development Department; and
WHEREAS, an election under Section 709 may be made on its own motion by the appropriate
governing board of the entity making the election, or may be made by such governing board pursuant
to a petition signed by a majority of thle employees; and
WHEREAS, coverage must be elected for at least two complete calendar years; and
WHEREAS, coverage may I approved for all present and future employees of the public entity; and
WHEREAS, upon approval of an election, employee contributions for state disability insurance are
required at the rate established for each year up to the annual taxable wage limit; and
WHEREAS, every employing unit shall post and maintain the printed notice of such election or
application on the premises; and
WHEREAS, the Board of Supervisors believes the employees of the In Home Support Services
Public Authority should be covered by state disability insurance, including paid family leave;
It is hereby RESOLVED by the Board that: the Board of Supervisors authorizes the In Home Support
Services Public Authority to elect to become an employer for state disability insurance purposes only
under Section 709 of the California Unemployment Insurance Code for all its employees; and be it
FURTHER RESOLVED, that the Chalir of the Board of Supervisors shall sign and file with the
California Employment Development Department an application under Section 709 of the California
Unemployment Insurance Code so that In Home Support Services Public Authority may become an
employer subject to the Code for at least two complete calendar years.
I hereby certify that this is a true and correct copy of an
action taken and entered on the minutes of the Board of
Supervisors on the date sh wn l^
ATTESTED: (Date) �1 O�
of
John Cullen, Clerk of the Boa Supervisors
And nty Administrator
By ® Deputy
RESOLUTION 2006/220
Employment
EDD Development
Department
State of California
APPLICATION FOR ELECTIVE COVERAGE OF DISABILITY INSURANCE* ONLY
LOCAL PUBLIC ENTITIES AND INDIAN TRIBES
FOR DEPARTMENT USE ONLY
Reference: California Unemployment Insurance Code(CUIC)Section 709 EMPLOYER ACCOUNT NUMBER STATISTICAL CODE
IMPORTANT EFFECTIVE DATE DATE EMPLOYER NOTIFIED
Do not complete this form unless you wish to apply far State Disability APPROVED BY DATE APROVED
Insurance only under Section 709 for ALL of your employees
(excluding elected officials and appointees by the Govemor).
Coverage under this section of the CUIC does not mike provision SEND NUMBER OF EMPLOYEES
for Unemployment Insurance benefits.
PLEASE TYPE OR PRINT
1. NAME OF GOVERNMENT ENTITY OR INDIAN TRIBE BUSINESS TELEPHONE
In Home Supt)o by2- Sevvtces Ptt)qkir. Authont,/ CC12�5) GACO - us-f
2. BUSINESS ADDRESS(NUMBER,STREET,CITY,COUNTY,STATE,ZIP CODE)
133a A(-nok] Drive , `cul ,_ \<1f5 , Mactlne2 CAS (A-AE553
3. MAILING ADDRESS(NUMBER,STREET,CITY,COUNTY,STATE,ZIP CODE)
come
4. TYPE OF LOCAL PUBLIC ENTITY n
❑ County ❑ City ❑ Indian Tribe ® Other(Specify)
5. Law under which agency was established: (Complete a,b,c,or d)(Does not apply to Indian Tribes)
TITLE OF ACT NUMBER DATE
a. California Tax Law
TITLE OF CODE DIVISION PART CHAPTER
b• California Codes
TITLE OF CHARTER DATE
c. Charter
TITLE OF ORDINANCEI DATE
d. Ordinance
6. Members of governing body of Local Public Entity orllndian Tribe,such as Board of Supervisors,City Council,District Directors,Tribal Council,etc.
NAME TITLE RESIDENCE ADDRESS* TELEPHONE SSA NUMBER''k
11`JSo Sol eo _ e,S�+d _610)l`4-
.JAI 61i010 �i�r��r 1�(S�vi/{- j_ Su ryi ,r' rI Cerrito qJIL530 3Z3(
20,:1 'D14I6t; go q'5) 16goo
�1 c1t-� /,(. �'ie !no 1�1�� CJ.�lir'I DIS}rift LL � •S�r' Ucz^tel► �f6� , 83
�2. e F , tlllKernr� Isfricf� SSI - ✓Ser 65`1 a�tlni' 11 r�+ /S3 W)/o3
ZHt� pji sSU lrarit, ,G.
AJ(Irj�, Ue.S,aLfllnler bi&ki4+.T- S VWf Vlscr (—'0I1C1y--� `l-f5y0 5763
15'• C.14-,laod k. q2,5) 9-
GG�PT�f 1�. 6JOVer ISVie/VT v ylSOr Aoff*t CIL ri'f5b5� '�13�
NOTE: If your application is approved,the elective coverage agreement will be subject to all of the requirements and conditions outlined in
DE 1378L, Information Concerning Elective Coverage Under Section 709 of the CUIC. Please retain your copy of DE 1378L for
reference. IV peC� t1 Qt�j( 1G(� ctc{�r�SS. 1�tJr cfCSCfOsgrJ(e d� SS� l�Ltr+t�Z/
Includes Paid Family Leave(PFL)beginning Janua I rV 1,2004. Covnf May.
DE 1378M Rev.Rev. 10(3-05)(INTERNET) Page 1 of 2 CU
7. Appointive Positions: (These persons are eligible for coverage unless appointed by the Governor)
TITLE OF POSITION NUMBER OF POSITIONS NUMBER OF PERSONS
BY WHOM APPOINTED
INITHIS CATEGORY DESIRING COVERAGE
4
8. Total number of employees to be covered,excluding
elected officers and those appointed by the Governor q
9. On what date do you wish elective coverage to commence? Keep in mind that the commencement date of an elective coverage agreement shall not
be prior to the first day of the calendar quarter in which the applicafpn is filed,nor later than the first day of the following calendar quarter,
❑First day of current quarter LSI First day of next quarter
NOTE: Deductions should not be made from your employee's wages for the purpose of paying employee contributions required under the CUIC until your
election is approved.
Attach a copy of the resolution in which the governing body described in Item 6 approved the filing of an application for elective coverage under
Section 709 of the CUIC.
The governmental or tribal entity described in Item(7 hereby files its application under Section 709 of the CUIC to become an employer subject to the
CUIC. It is understood that upon approval of the election by the Director,the governmental or tribal entity will be an employer subject to the CUIC for
State Disability Insurance purposes only to the same extent as other employers as of the date specified in the approval,and will remain a subject
employer for at least two complete calendar years. Thereafter,this election may be terminated as provided by the CUIC.
I certify that this application has been examined by me,and to the best of my knowledge and belief,it is true and correct and made in good faith
under the provisions of the California Unemployme I it Insurance Code.
This certificate must be signed by one or more of the persons under Item 6.
SIGNATURE TITLE DATE
S��t�vi s��2S
Return completed application to:
State of California
Employment Development Department
Taxpayer Assistance Center,Attn: Specialized Coverage Desk
P.O.Box 2068
Rancho Cordova,CA 95741-2068
Questions may be directed to the above address or call(916)654-6288.
DE 1378M Rev.Rev. 10(3-05)(INTERNET) Page 2 of 2 Cu
\ E m p I o y m e n t This form Will to the basic record of YOUR EMPLOYMENT DEVELOPMENT DEPARTMENT
EDDDevelopment ACCOUNT. DO NOT FILE THIS FORM UNTIL Taxpayer Assistance Center,Attn:Specialized Coverage Desk
Department YOU HAVE PAID WAGES THAT EXCEED P.O.Box 2068
Stale o f California $100.00.Please read the INSTRUCTIONS on the Rancho Cordova, CA 95741-2068
back before completing this form.PLEASE PRINT (916)654-62881 FAX(916)4642904
OR TYPE.!Return this form to: '! www.eddca.gov
I
REGISTRATION FORM FOR GOVERNMENTAL ORGANIZATIONS, PUBLIC SCHOOLS, &INDIAN TRIBES
ACCOUNT NUMSER DEPT QUARTER ON-UNE PROCESS DATE TAS CODE
USE
Industry specific registration forms are required relative to each type of employer. Please use the appropriate form to register.
Commercial/Pacific Maritime/Fishing Boat DE1 Household Workers DE 1HW
Agricultural DE 1AG Non-Profit DE 1NP
Government/Public Schools/Indian Tribes DE 1GS Personal Income Tax Only DE 1P
A. HAVE YOU EVER BEEN REGISTERED IF YES,ENTER THE FOLLOWING:
WITH THE DEPARTMENT? ACCOUNT NUMBER BUSINESS NAME ADDRESS PHONE NO.
❑
N No Yes
B. INDICATE FIRST QUARTER AND YEAR IN WHICH WAGES EXCEEDED$100.
❑Jan.-Mar.20_ ❑Apr.-June 20_ ❑July-Sept.20_ N Oct.-Dec.2899
C. ORGANIZATION TYPE I D. COUNTY WHERE BUSINESS IS LOCATED
❑(SD)SCHOOL DISTRICT ❑(IT)INDIAN TRIBE
❑(GO)GOVERNMENTAL ®(OT)OTHER(Specify) Public Entity Contra Costa County
E. BUSINESS NAMEOWNERSHIP BEGAN OPERATING FEDERAL I.D.NUMBER
In Home Supportive Services Public Authority MONTH: DAY: YEAR: 94-6000509
F. ORGANIZATION OR TRIBE NAME NATURE OF ACTIVITY
Same In Home Supportive Services/Registry
G. List all principal officers or administrators TITLE SOCIAL SECURITY NUMBER DRIVER'S LICENSE
NUMBER
John Cottrell Executive Director 552-86-5636 D5793585
Frances Smith Program Manager 563-46-8048 D0834390
H. MAILING ADDRESS CITY STATE ZIP CODE PHONE NUMBER
1330 Amold Drive Suite 143 Martinez CA 94553 92 646-1257
1. BUSINESS ADDRESS(if different from mailing address) CITY STATE ZIP CODE PHONE NUMBER
Same
J.WOULD YOU LIKE INFORMATION ON THE FOLLOWING ALTERNATIVE UNEMPLOYMENT INSURANCE FINANCING?
❑ Reimbursable Cost of Benefits ❑ School Employees Fund
❑ Election of Disability Coverage ® No,assign tax-rate method
K. EMPLOYER TYPE NUMBER OF
❑(07)Public/Charter School ❑ (11)Indian Tribe E](15)State Colleges ® (21)Public Entity ❑ (28)State Hospital EMPLOYEES
I
❑ (08)District Hospital ❑(14)University of CA ❑(16)District Fair ❑ (26)Fed-State Withholdings 14
L. SUPPORTIVE SERVICES
If you are part of a larger organization and you ire primarily engaged in providing supportive services to other establishments of the larger
organization,check one of these boxes.
(1) ❑Control administrative(headquarters,etc.) (3) ❑Storage(warehouse) (5) N Does not apply
(2) ❑ Research,development,or testing I (4) ❑Other(specify)
M.CONTACT PERSON FOR BUSINESS TITLE ADDRESS PHONE (925)646-1257
John Cottrell Executive Ekirelctor 1330 Arnold Or Ste 143 Martinez CA 94553 FAX (925)646-1261
N. DECLARATION _.-_.._...
These state "enr Ir, is are her is AI` I Ir t to the best knowledge and belief of the undersigned.
Signature / �� ` .- Date (U �•( /Q (� Residence Phone �ll'7 Jzi 3`l Y`I
Title Executive Director/ I Residence Address )l r YI c' Wit
(Officer,Administrator,etc.) I Street billy State ZIP Code
O. PAYROLL TAX EDUCATION: Attend a payroll tax seminar that wi11 help you understand how,what,and when to report state payroll taxes.
Visit our Web site at www.edd.ce.gov/taxsem or call us at(888)745-3886 for more information.
DE 1GS Rev.6(12-05)(INTERNET) Page 1 of 2 CU
INSTRUCTIONS FOR DE 1GS REGISTRATION FORM FOR GOVERNMENTAL
ORGANIZATIONS, PUBLIC SCHOOLS, & INDIAN TRIBES
An employer is required by law to file a regi)tration form with the Employment Development Department(EDD)within
Fifteen (15)calendar days after paying over$100 in wages for employment in a calendar quarter, or whenever a change
in ownership occurs. Please complete all items on the front of this DE IGS and mail your completed registration form to
EDD,Taxpayer Assistance Center, Attn: Specialized Coverage Desk/P.O. Box 2068/Rancho Cordova, CA 95741-2068.
NEED MORE HELP OR INFORMATIONT
• Contact the nearest Taxpayer Education and Assistance(TEA)office listed in your local telephone directory under State
Government, EDD or call a TEA Customer IService Representative at 1-888-745-3886 with questions about whether your business
entity is subject to reporting and paying state payroll taxes. For TTY(nonverbal)access,call 1-800-547-9565.
• Access the EDD Web site at www.edd.ca.gov.
A. PRIOR REGISTRATION—If any part of the ownership in Item E is operating or has ever operated at another location,
check"yes"and provide the account number, business name, address, and telephone number if known.
B. WAGES—Check the appropriate box for the quarter in which you first paid wages and fill in the last two digits of the
year.
C. ORGANIZATION TYPE—Check the bi x that best describes the legal form of the ownership shown in Item E.
D. COUNTY WHERE BUSINESS IS LOCATED—Enter county name.
E. BUSINESS NAME—Give the name b} which your business is known to the public. Enter"None" if the business name
is the same as the organization or tribe name. Enter the date the new ownership began operating. Enter Federal
Employer Identification Number(s). If not yet assigned, enter"Applied For."
F. ORGANIZATION NAME—Give the name of the organization under which your business operates. Indian tribes must
provide the full tribal name as shown on the Federal Register. Give a brief description of the nature of activity
performed, e.g., National Guard, Public'School District, County,two-year college, university.
G. LIST ALL PRINCIPAL OFFICERS OR ADMINISTRATORS—Enter the full name, middle initial, surname,title, social
security number, and driver's license number for each officer, administrator, or tribal council member.
H. MAILING ADDRESS—Enter the mailing address where EDD correspondence and forms should be sent. Provide
daytime business telephone number.
I. BUSINESS ADDRESS—Enter the California address and telephone number where the business in Item D is
physically conducted. If more than one California location, list on a separate sheet and attach to this form. Indian
tribes must also provide the mailing address for the tribal council.
J. ALTERNATIVE FINANCING—If you would like information on alternative methods of financing unemployment
insurance, check the appropriate boxes for the information you want. Check"NO"if you want tax-rate method.
K. EMPLOYER TYPE—Check the box that best describes your employer type. Enter total number of employees for the
ownership shown in Item E.
L. SUPPORTIVE SERVICES—Check the box that best describes the organization shown in Item E.
M. CONTACT PERSON—Enter the name,title,telephone and fax numbers of the person authorized by the ownership
shown in Item E to provide information to EDD staff.
N. DECLARATION—This declaration should be signed by one of the individuals listed in Item F.
O. PAYROLL TAX EDUCATION—EDD provides educational opportunities for taxpayers to learn how to report
employees'wages and pay taxes, pointing out the pitfalls that create errors and unnecessary billings. Help is only a
telephone call or Web site away.
We will notify you of your EDD account number by mail. To help you understand your tax withholding and filing
responsibilities you will be sent a California Employer's Guide, DE 44. Please keep your account status current by
notifying a TEA Customer Service Representative at 1-888-745-3886 of all future changes to the original registration
information.
Tribal employers should call the tribal UI information number(916) 653-8135 for registration assistance or other questions.
DE IGS Rev.6(12-05)(INTERNET) Page 2 of 2 cu
INSTRUCTIONS FOR DE IGS REGISTRATION FORM FOR GOVERNMENTAL
ORGANIZATIONS, PUBLIC SCHOOLS, & INDIAN TRIBES
An employer is required by law to file a reg stration form with the Employment Development Department(EDD) within
Fifteen(15)calendar days after paying over$100 in wages for employment in a calendar quarter, or whenever a change
in ownership occurs. Please complete all items on the front of this DE 1 GS and mail your completed registration form to
EDD,Taxpayer Assistance Center, Attn: Specialized Coverage Desk/P.O. Box 2068/Rancho Cordova, CA 95741-2068.
NEED MORE HELP OR INFORMATION?
• Contact the nearest Taxpayer Education and Assistance(TEA)office listed in your local telephone directory under State
Government, EDD or call a TEA CustomerlService Representative at 1-888-745-3886 with questions about whether your business
entity is subject to reporting and paying state payroll taxes. For TTY(nonverbal)access,call 1-800-547-9565.
• Access the EDD Web site at www.edd.ca.gov.
A. PRIOR REGISTRATION—If any part of the ownership in Item E is operating or has ever operated at another location,
check"yes"and provide the account n i mber, business name, address, and telephone number if known.
B. WAGES—Check the appropriate box for the quarter in which you first paid wages and fill in the last two digits of the
year.
C. ORGANIZATION TYPE—Check the bi x that best describes the legal form of the ownership shown in Item E.
D. COUNTY WHERE BUSINESS IS LOCATED—Enter county name.
E. BUSINESS NAME—Give the name by which your business is known to the public. Enter"None" if the business name
is the same as the organization or tribe name. Enter the date the new ownership began operating. Enter Federal
Employer Identification Number(s). If not yet assigned, enter"Applied For."
F. ORGANIZATION NAME—Give the name of the organization under which your business operates. Indian tribes must
provide the full tribal name as shown on the Federal Register. Give a brief description of the nature of activity
performed, e.g., National Guard, Publi r School District, County,two-year college, university.
G. LIST ALL PRINCIPAL OFFICERS OR ADMINISTRATORS—Enter the full name, middle initial, surname, title, social
security number, and driver's license number for each officer, administrator, or tribal council member.
H. MAILING ADDRESS—Enter the mailing address where EDD correspondence and forms should be sent. Provide
daytime business telephone number.
1. BUSINESS ADDRESS—Enter the California address and telephone number where the business in Item D is
physically conducted. If more than one California location, list on a separate sheet and attach to this form. Indian
tribes must also provide the mailing address for the tribal council.
J. ALTERNATIVE FINANCING—If you would like information on alternative methods of financing unemployment
insurance,check the appropriate boxes for the information you want. Check"NO"if you want tax-rate method.
K. EMPLOYER TYPE—Check the box that best describes your employer type. Enter total number of employees for the
ownership shown in Item E.
L. SUPPORTIVE SERVICES—Check the box that best describes the organization shown in Item E.
M. CONTACT PERSON—Enter the name,title,telephone and fax numbers of the person authorized by the ownership
shown in Item E to provide information to EDD staff.
N. DECLARATION—This declaration should be signed by one of the individuals listed in Item F.
O. PAYROLL TAX EDUCATION—EDD provides educational opportunities for taxpayers to learn how to report
employees'wages and pay taxes, pointing out the pitfalls that create errors and unnecessary billings. Help is only a
telephone call or Web site away.
We will notify you of your EDD account number by mail. To help you understand your tax withholding and filing
responsibilities you will be sent a California Employer's Guide, DE 44. Please keep your account status current by
notifying a TEA Customer Service Representative at 1-888-745-3886 of all future changes to the original registration
information.
Tribal employers should call the tribal UI information number(916) 653-8135 for registration assistance or other questions.
DE IGS Rev.6(12-05)(INTERNET) Page 2 of 2 - cu
Employment
E®p DepartmenDevelopmentt
State of California
STATE OF CALIFORNIA- EMPLOYMENT DEVELOPMENT DEPARTMENT
SCHOOL EMPLOYEES FUND
SELECTION OF FINANCING METHOD AND ELECTION TO COVER EXCLUDED SERVICES
Beginning January 1, 1978, all employees,classified,certificated, and others,of a school district
(Kindergarten through 10 grades) and a community college district are subject to the compulsory
provisions of the California Unemployment Insurance Code for unemployment insurance purposes.
Exclusions in the Education Code no longer apply.
i. SELECTION OF FINANCING FOR UNEMPLOYMENT INSURANCE(Check only one)
❑ School Employees Fu d, Section 821-832, California Unemployment Insurance Code
(financing in effect since January 1, 1972).
❑ Prorated cost of benefits paid (direct reimbursement to the Unemployment Insurance Fund).
® Payments of contributions by regular contribution rate method (Tax Rated method as
commonly used by the private/commercial employers).
If you elect financing methlod with the School Employees Fund or direct reimbursement,your
election may only be cancelled on January 1"of any year after you have been in effect for
TWO FULL CALENDAR YEARS.
II. ELECTION TO COVER EXCLUDED SERVICES
At your option, you may elect to cover certain types of services that are still excluded from the
compulsory provisions of the California Unemployment Insurance Code. Such an ELECTION
must be for not less than two full calendar years,with the financing method to be the same as
that selected for compulsory covered.
Most EXCLUDED SERVI ICES are usually not applicable to school districts. Examples are
services performed for a church,for a hospital by a patient,for a foreign government, or for
penal institutions by inmates.
School districts may ELECT coverage for the following EXCLUDED SERVICES by checking the
appropriate block(s):
❑ Services performed in the employ of a school,college, or university, if such service is
performed (Section 642 of the California Unemployment Insurance Code):
(a) By a student enrolled and regularly attending classes at such school district or
community college.
(b) By a spouse of such student who is advised at the time such spouse commences to
perform service that the employment of such spouse is provided under a program to
provide financial assistance to such student by such school district or community college.
DE 1 SE Rev.5(9-05)(INTERNET) Page 1 of 2 CU
Employment
ED® Developme
eartmenn
Dp
State of California
STATE OF CALIFORNIA-EMPLOYMENT DEVELOPMENT DEPARTMENT
SCHOOL EMPLOYEES FUND
SELECTION OF FINANCING METHOD AND ELECTION TO COVER EXCLUDED SERVICES
Beginning January 1, 1978, all employees, classified, certificated, and others, of a school district
(Kindergarten through 121b grades) and a community college district are subject to the compulsory
provisions of the California Unemployment Insurance Code for unemployment insurance purposes.
Exclusions in the Education Code no longer apply.
I. SELECTION OF FINANCING FOR UNEMPLOYMENT INSURANCE(Check only one)
❑ School Employees Fund, Section 821-832, California Unemployment Insurance Code
(financing in effect since January 1, 1972).
❑ Prorated cost of benefits paid (direct reimbursement to the Unemployment Insurance Fund).
® Payments of contributions by regular contribution rate method (Tax Rated method as
commonly used by the private/commercial employers).
If you elect financing method with the School Employees Fund or direct reimbursement,your
election may only be cancelled on January 10of any year after you have been in effect for
TWO FULL CALENDAR YEARS.
It. ELECTION TO COVER EXCLUDED SERVICES
At your option,you may elect to cover certain types of services that are still excluded from the
compulsory provisions of the California Unemployment Insurance Code. Such an ELECTION
must be for not less than two full calendar years,with the financing method to be the same as
that selected for compulsol ry covered.
Most EXCLUDED SERVICES are usually not applicable to school districts. Examples are
services performed for a church,for a hospital by a patient,for a foreign government, or for
penal institutions by inmates.
School districts may ELECT coverage for the following EXCLUDED SERVICES by checking the
appropriate block(s):
❑ Services performed in the employ of a school,college, or university, if such service is
performed (Section 642 of the California Unemployment Insurance Code):
(a) By a student enrolled and regularly attending classes at such school district or
community college.
(b) By a spouse of such student who is advised at the time such spouse commences to
perform serviceslthat the employment of such spouse is provided under a program to
provide financial assistance to such student by such school district or community college.
DE ISE Rev.5(9-05)(INTERNET) Page 1 of 2 CU
❑ Service in a program combining academic instruction and work experience for full-time
students under age 22 (Section 646 of the California Unemployment Insurance Code).
❑ Services performed by an ordained, commissioned or licensed minister or member of
religious order.
Services performed by an individual in the exercise of his or her duties as any of the following
in the employ of any public)entity:
❑ A member of a legislative body,or a member of the judiciary, of a state or political
subdivision thereof.
❑ A member of a State National Guard or Air National Guard.
❑ An employee serving on a temporary basis in case of fire, storm, snow, earthquake, flood,or
other similar emergency.
❑ in a position which, under or pursuant to state law, is designated as either of the following:
1. A major,non-tenurl d policymaking or advisory.position,
2. A policymaking orIadvisory position,the performance of the duties of which ordinarily
does not require more than eight hours per week.
❑ Services for a rehabilitation program by a participant in the program.
E:1 Services by a participant in a work-relief or work training program assisted or financed in
whole or in part by a federal or state agency.
IF YOU HAVE ANY QUES I INS, PLEASE CALL THE SCHOOL EMPLOYEES FUND AT
(916)65375380 OR FAX(9 6 653-5576.
Execut-1vC Dkt-e'C-I-0r
Authori gnature I Position Title Date
1 Ft ZF't i 25 i (�12a) (vel fti (Zfo l
Name of Organization Phone Number Fax Number
(include area code)
Return form, DE 1 SE,to:
Employment Development Department
School Employees Fund
800 Capitol Mall, MIC 13
Sacramento, CA 95814
Or
FAX to(916)653-5576
DE 1 SE Rev.5(9-05)(INTERNET) Page 2 of 2 cu
❑ Service in a program combining academic instruction and work experience for full-time
students under age 22 (Section 646 of the California Unemployment Insurance Code).
❑ Services performed by�an ordained, commissioned or licensed minister or member of
religious order.
Services performed by an individual in the exercise of his or her duties as any of the following
in the employ of any public)entity:
❑ A member of a legislative body, or a member of the judiciary, of a state or political
subdivision thereof.
❑ A member of a State National Guard or Air National Guard.
ElAn employee serving on a temporary basis in case of fire, storm, snow, earthquake, flood, or
other similar emergency.
❑ In a position which, under or pursuant to state law, is designated as either of the following:
1. A major non-tenu e d policymaking or advisory position,
2. A policymaking orladvisory position,the performance of the duties of which ordinarily
does not require more than eight hours per week.
❑ Services for a rehabililation program by a participant in the program.
❑ Services by a particip Int in a work-relief or work training program assisted or financed in
whole or in part by a federal or state agency.
IF YOU HAVE ANY QUES INS, PLEASE CALL THE SCHOOL EMPLOYEES FUND AT
(916) 653-5380 OR FAX(9 6 653-5576.
Execu ✓e Dtt-ecibr /l� Ch [61/
Authori gnature Position Title Date
1415;2�' PttiD11C FSU"(h t X-1AN4 (0-'1 25 Rzt9 ) [r-�llo- 1z01
Name of Organization Phone Number Fax Number
(include area code)
Return form, DE 1 SE,to:
Employment Development Department
School Employees Fund
800 Capitol Mall, MIC 13
Sacramento, CA 95814
Or
FAX to(9 16)653-5576
DE ISE Rev.5(9-05)(INTERNET) Page 2 of 2 Cu
s
- Contra
SUPERVISORS
,!s Costa
sella, Acting Directot �o
j . ��
.ent and Human Services os._
ra o; County;N:�
ottrell, Director
me Supportive Services, Public Authority C_
DATe. .-it 19,2006
SUBJECT: .a Home Supportive Services, Public Authority Application for Elective Coverage of
Disability Insurance
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION-
2006/
ADOPT Resolution No. 220 authorizing the Contra Costa County In Home Supportive Services, Public
Authority to participate in the State of California Employment Development Department Short Term Disability
Insurance program; and AUTHORIZE the Chair of the Board of Supervisors to sign and file the application with
the California Employment Development Department.
FINANCIAL, IMPACT:
No County costs.
RACKGROUND:
The elective coverage of short-term disability insurance, including paid family leave (PFL), has been requested
by IHSS Public Authority employees and is available to local public entities. California Unemployment
Insurance Code section 709 provides that any local public entity located in this State may elect to become an
employer for state disability insurance purposes only, with respect to all its employees. The electing entity
agrees to remain a covered employer for not less than two complete calendar years. Coverage may be
terminated at the end of the two-calendar-year period or at the end of any calendar year thereafter by giving the
Department written notification by January 31 of the succeeding year. In order to file this election with the
California Employment Development Department, the Board of Supervisors must pass a Resolution
(Attachment A). Upon approval of this election, employee contributions to state disability insurance are
required and will be paid at the rate established for each year up to the annual taxable wage limit. Employee
contributions are used exclusively to finance the State Disability Insurance Program. Deductions for employee
contributions should be made at the time wages are paid.
Every employing unit shall post and maintain a printed notice (DE 1375C,Notice to Employees Elective
Coverage Application For State Disability Insurance) of the application on the premises. Individual employees
shall be given two reasonable opportunities to file objection or to.be heard in the matter prior to the Chair's
approval of election. The fourteen IHHS employees are not covered at this time and have e ressed a desire to
be so covered. ///�, _ O J19_
CONTINUED ON ATTACHMENT: X YES SIGNATURE: /t- 247 h �d�f�/G
, --RECOMMENDATION OF COUNTY ADMINISTRATOR _RECOMMENDATION O�'F'' BOARD COMMITTEE
APPROVE OTHER
r
SIGNATURES
ACTION OF BOA )DN /// J (/i W"V APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT �� ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED
JOHN CUL N,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact: JOHN COTTRELL 6-1257
cc: EHSD(CONTRACTS UNIT)—EB
BOB SD /J_ p/ �
COUNTYTY ADM ADMININI STRATOR 0
Auditor-Controller BY DEPUTY
SUPERVISORS Contra
Costa
s lla, Acting Director' County
.ent and Human Services
ottrell, Director
me Supportive Services,Public Authority C_
DATe. Al 19,2006
SUBJECT: n Home Supportive Services, Public Authority Application for Elective Coverage of
Disability Insurance
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTION-
2006/
ADOPT Resolution No. 220 authorizing the Contra Costa County In Home Supportive Services, Public
Authority to participate in the State of California Employment Development Department Short Term Disability
Insurance program; and AUTHORIZE the Chair of the Board of Supervisors to sign and file the application with
the California Employment Development Department.
FINANCIAL, IMPACT:
No County costs.
BACKGROUND:
The elective coverage of short-term disability insurance, including paid family leave (PPL), has been requested
by IHSS Public Authority employees and is available to local public entities. California Unemployment
Insurance Code section 709 provides that any local public entity located in this State may elect to become an
employer for state disability insurance purposes only, with respect to all its employees. The electing entity
agrees to remain a covered employer for not less than two complete calendar years. Coverage may be
terminated at the end of the two-calendar-year period or at the end of any calendar year thereafter by giving the
Department written notification by January 31 of the succeeding year. In order to file this election with the
California Employment Development Department, the Board of Supervisors must pass a Resolution
(Attachment A). Upon approval of this election, employee contributions to state disability insurance are
required and will be paid at the rate established for each-year up to the annual taxable wage limit. Employee
contributions are used exclusively to finance the State Disability Insurance Program. Deductions for employee
contributions should be made at the time wages are paid.
Every employing unit shall post and maintain a printed notice (DE 1375C,Notice to Employees Elective -
Coverage Application For State Disability Insurance) of the application on the premises. Individual employees
shall be given two reasonable opportunities to file objection or to be heard in the matter prior to the Chair's
approval of election. The fourteen 1H14S employees are not covered at this time and have e ressed a desire to
be so covered. Jam /
L90
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
✓RECOMMENDATION OF COUNTY ADMINISTRATOR _RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
r
SIGNATURES
ACTION OF BOA D N APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED
JOHN CUL N,CLERK OF THE BOARD OF
SUPERVIS70RS AND COUNTY ADMINISTRATOR
Contact: JOHN COTTRELL 6-1257
cc: EHSD(CONTRACTS UNIT)—EB
BOBSD r /�
COUNTYTY ADM ADMININI STRATOR 0
Auditor-Controller BY DEPUTY