APPLICATION FOR COMPULSORY LEAVE. This application is submitted in accordance with employee contract between the Cleveland Heights-University Heights Board of Education and EAPSC and the Teachers Union, Local 795, AFT. Submit this completed form along with attachments to the Finance Department. Date Employee Name Building Assignment I was required to appear in (Name and Location of Court) in the matter of (Identify proceeding/hearing/student I began my absence on , 20 . I returned to duty on , 20 . This court appearance occurred during a (vacation period/school period) Verification of court appearance is attached. Signature of Employee Any compensation received by the employee, other than the above for compulsory leave pay, including but not limited to witness fees, etc., must be paid to the Board of Education. Time served under compulsory leave will not be charged to sick or personal leave. FIN2935 LEVELAND HEIGHTS-UNIVERSITY HEIGHTS CITY SCHOOL DISTRICT Human Resources Department APPLICATION FOR ADMINISTRATIVE PROFESSIONAL DEVELOPMENT EXPERIENCE (TUITION REIMBURSEMENT) Applicant’s Name Applicant’s Position Date of Request I am enrolling in and seeking approval to request administrative tuition reimbursement for the following course: This class is: directly related to my current position. Indirectly related to my current position. This class will enhance my skills in my current position in the following way(s): This course is being offered (dates): This course is sponsored by (name of college/university/organization): My Supervisor, , granted me prior approval of this class for tuition reimbursement on (date). I understand reimbursement will be provided upon submission of verification of this approval form, enrollment information, and official payment information/receipt. Applicant’s Signature HR2940 9/2008 APPENDIX 4 MEMORANDUM OF UNDERSTANDING INDEX BY TOPIC Adoption Leave 6 Assault Leave 6 Calendar 20 Child Care Leave 8 Compulsory Leave 7 Contracts 19 Dental, Vision, Prescription Drug, Skilled Nursing 15 Disability Insurance 13 Dues 20 Early Notification Payment 21 Elementary Principal Stipend 17 Extended Service 21 FMLA 11 Foreign Assignment Leave 7 Hepatitis B Vaccine 13 Holidays 12 Jury Duty 8 Liability Insurance 15 Life Insurance 15 Longevity Pay 18 Medical and Hospitalization Benefits 13 Medicare 14 Mileage Reimbursement 22 Negotiations Procedure 21 Paternity Leave 9 Personal Leave 9 Physical Exams 13 Professional Development 18 Professional/Non-Professional Leave 10 Salary 17 Section 125 (Flexible Spending Account) 13 SERS/STRS Compensation 22 Severance Pay 18 Severe Weather and Emergencies 12 Sick Leave 10 Summer School/Saturday School/Night School 20 Tax Shelter Provision 18 Unpaid Leave 11 Vacations 19 Workers’ Compensation 16
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APPLICATION FOR COMPULSORY LEAVE. This application is submitted in accordance with employee contract between the Cleveland Heights-University Heights Board of Education and EAPSC and the Teachers Union, Local 795, AFT. Submit this completed form along with attachments to the Finance Department. Date Employee Name Building Assignment I was required to appear in (Name and Location of Court) in the matter of (Identify proceeding/hearing/student I began my absence on , 20 . I returned to duty on , 20 . This court appearance occurred during a (vacation period/school period) Verification of court appearance is attached. Signature of Employee Any compensation received by the employee, other than the above for compulsory leave pay, including but not limited to witness fees, etc., must be paid to the Board of Education. Time served under compulsory leave will not be charged to sick or personal leave. FIN2935 LEVELAND HEIGHTS-UNIVERSITY HEIGHTS CITY SCHOOL DISTRICT Human Resources Department APPLICATION FOR ADMINISTRATIVE PROFESSIONAL DEVELOPMENT EXPERIENCE (TUITION REIMBURSEMENT) Applicant’s Name Applicant’s Position Date of Request I am enrolling in and seeking approval to request administrative tuition reimbursement for the following course: This class is: directly related to my current position. Indirectly related to my current position. This class will enhance my skills in my current position in the following way(s): This course is being offered (dates): This course is sponsored by (name of college/university/organization): My Supervisor, , granted me prior approval of this class for tuition reimbursement on (date). I understand reimbursement will be provided upon submission of verification of this approval form, enrollment information, and official payment information/receipt. Applicant’s Signature HR2940 9/2008 APPENDIX 4 MEMORANDUM OF UNDERSTANDING 5 Medical Mutual of Ohio Non‐Grandfathered Benefits Network Non‐Network Network/Non‐Network Integration Separate ‐ Costs incurred for a non‐network provider will only apply to the non‐network deductible, coinsurance limits and vice versa Benefit Period January 1st through December 31st Benefit Period Deductible ‐ Single/Family $100/$200 $200/$400 Coinsurance 90% 80% Coinsurance Out‐of‐Pocket Maximum (Excluding Deductible) ‐ Single/Family $400/$800 Unlimited Out‐of‐Pocket (Deductible + Coinsurance) $500/$1,000 Unlimited Maximum Out‐of‐Pocket (Deductible + Coinsurance + Medical & Rx Copays) $6,850/$13,700 Unlimited Physician/Office Services Office Visit (Illness/Injury) $15 Copay 90% after deductible Urgent Care Office Visit $15 Copay 90% after deductible Preventive Services Preventive Services, in accordance with state and federal law 100% 100% Outpatient Services Surgical Services 90% after deductible 80% after deductible Diagnostic Services 90% after deductible 80% after deductible Emergency use of an Emergency Room and Emergency Room Physician $25 copay, then 100% $75 copay, then 100% Non‐Emergency use of an Emergency Room and Emergency Room Physician $100 copay, then 100% $100 copay, then 100% Hearing Services Covered Durable Medical Equipment 90% after deductible 80% after deductible Organ Transplant 90% after deductible 80% after deductible Ambulance Services 90% after deductible 80% after deductible Inpatient Facility Semi‐Private Room and Board 90% after deductible 80% after deductible Maternity 90% after deductible 80% after deductible Inpatient & Outpatient Mental Health and Substance Abuse Benefits paid based on corresponding medical benefits Prescription Drug Benefits Retail Program Generic $5 Generic Not Covered Formulary $15 Single Source Brand Not Covered Non‐Formulary $50 Multi‐Source Brand Not Covered Home Delivery Program Generic $10 Generic Not Covered Formulary $30 Single Source Brand Not Covered Non‐Formulary $100 Multi‐Source Brand Not Covered Other Rx Plan Changes MMO's Basic Plus Formulary: Prior Authorization, Quantity Duration Limits and Step Therapy for certain drugs. Retin-A or equivalent coverage is included for plan participants who are age 25 and older for medically necessary purposes only. INDEX BY TOPIC Adoption Leave 6 Assault Leave 6 Calendar 20 Child Care Leave 8 Compulsory Leave 7 Contracts 19 Dental, Vision, Prescription Drug, Skilled Nursing 15 Disability Insurance 13 Dues 20 Early Notification Payment 21 Elementary Principal Stipend 17 Extended Service 21 FMLA 11 Foreign Assignment Leave 7 Hepatitis B Vaccine 13 Holidays 12 Jury Duty 8 Liability Insurance 15 Life Insurance 15 Longevity Pay 18 Medical and Hospitalization Benefits 13 Medicare 14 Mileage Reimbursement 22 Negotiations Procedure 21 Paternity Leave 9 Personal Leave 9 Physical Exams 13 Professional Development 18 Professional/Non-Professional Leave 10 Salary 17 Section 125 (Flexible Spending Account) 13 SERS/STRS Compensation 22 Severance Pay 18 Severe Weather and Emergencies 12 Sick Leave 10 Summer School/Saturday School/Night School 20 Tax Shelter Provision 18 Unpaid Leave 11 Vacations 19 Workers’ Compensation 1619
Appears in 2 contracts
APPLICATION FOR COMPULSORY LEAVE. This application is submitted in accordance with employee contract between the Cleveland Heights-University Heights Board of Education and EAPSC and the Teachers Union, Local 795, AFT. Submit this completed form along with attachments to the Finance Department. Date Employee Name Building Assignment I was required to appear in (Name and Location of Court) in the matter of (Identify proceeding/hearing/student I began my absence on , 20 . I returned to duty on , 20 . This court appearance occurred during a (vacation period/school period) Verification of court appearance is attached. Signature of Employee Any compensation received by the employee, other than the above for compulsory leave pay, including but not limited to witness fees, etc., must be paid to the Board of Education. Time served under compulsory leave will not be charged to sick or personal leave. FIN2935 LEVELAND HEIGHTS-UNIVERSITY HEIGHTS CITY SCHOOL DISTRICT Human Resources Department APPLICATION FOR ADMINISTRATIVE PROFESSIONAL DEVELOPMENT EXPERIENCE (TUITION REIMBURSEMENT) Applicant’s Name Applicant’s Position Date of Request I am enrolling in and seeking approval to request administrative tuition reimbursement for the following course: This class is: directly related to my current position. Indirectly related to my current position. This class will enhance my skills in my current position in the following way(s): This course is being offered (dates): This course is sponsored by (name of college/university/organization): My Supervisor, , granted me prior approval of this class for tuition reimbursement on (date). I understand reimbursement will be provided upon submission of verification of this approval form, enrollment information, and official payment information/receipt. Applicant’s Signature HR2940 9/2008 APPENDIX 4 MEMORANDUM OF UNDERSTANDING INDEX BY TOPIC Adoption Leave 6 Assault Leave 6 Calendar 20 Child Care Leave 8 Compulsory Leave 7 Contracts 19 Dental, Vision, Prescription Drug, Skilled Nursing 15 Disability Insurance 13 Dues 20 Early Notification Payment 21 Elementary Principal Stipend 17 Extended Service 21 FMLA 11 Foreign Assignment Leave 7 Hepatitis B Vaccine 13 Holidays 12 Jury Duty 8 Liability Insurance 15 Life Insurance 15 Longevity Pay 18 Medical and Hospitalization Benefits 13 Medicare 14 Mileage Reimbursement 22 Negotiations Procedure 21 Paternity Leave 9 Personal Leave 9 Physical Exams 13 Professional Development 18 Professional/Non-Professional Leave 10 Salary 17 Section 125 (Flexible Spending Account) 13 SERS/STRS Compensation 22 Severance Pay 18 Severe Weather and Emergencies 12 Sick Leave 10 Summer School/Saturday School/Night School 20 Tax Shelter Provision 18 Unpaid Leave 11 Vacations 19 Workers’ Compensation 1619
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Samples: Agreement
