Ana səhifə

Loda frequently Asked Questions


Yüklə 48.62 Kb.
tarix25.06.2016
ölçüsü48.62 Kb.
LODA Frequently Asked Questions

For more information about the Line of Duty Act (LODA) Fund visit valoda.org, which contains details about the program, links to the Code of Virginia Line of Duty Act section and the 2011 Appropriations Act and important dates. If you have further questions, email LODA@varetire.org.


LODA Fund (2011 Appropriations Act):

http://leg1.state.va.us/cgi-bin/legp504.exe?101+bud+21-258+pdf

Line of Duty Act (Code of Virginia Section 9.1-400 et. seq.):

http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+9.1-400

LODA Resources from Virginia Department of Accounts: http://www.doa.virginia.gov/Admin_Services/Line_Of_Duty/Line_of_Duty_Act.cfm

I. Eligibility

Q: Who is eligible for LODA coverage?
Hazardous duty personnel including volunteers, and paid full-time and part-time employees who fall under the guidelines of eligible personnel under the Line of Duty Act Code of Virginia (§9.1-400 et. seq.)
Q: My locality does not have an ordinance or resolution that officially recognizes our volunteer fire or rescue squad as official members of our public safety program. Are my volunteers still covered under LODA?
If the volunteer fire or rescue agency is not officially recognized by a resolution or ordinance, members of that organization are not eligible for LODA benefits. To be eligible for benefits, the Code of Virginia Line of Duty Act requires a volunteer to be …a member of any fire company or department or rescue squad that has been recognized by an ordinance or a resolution of the governing body of any county, city or town of the Commonwealth as an integral part of the official safety program of such county, city or town (Code of Virginia Line of Duty Act (Code of Virginia Section 9.1-400 et. seq.)
For more information about LODA eligibility, please contact Connie Jones, the Line of Duty Act Coordinator, Virginia Department of Accounts at connie.jones@doa.virginia.gov.
Q: How do I know how many people are actually covered under LODA in my locality?
VRS will base your covered lives on any eligible employees covered under VRS and the census data you reported to VRS that included volunteers and employees. If you have not completed your census, VRS will bill your locality based on the best data available to us.

Q: Are the following positions eligible for the LODA benefits?

A. Conservator of the Peace: Eligibility for each Conservator of the Peace will be determined on a case by case basis. Please see the definition set forth in §9.1-400 or contact the Department of Accounts’ Line of Duty Act Coordinator, Connie Jones at Connie.Jones@DOA.virginia.gov for further information.
B. Animal Control- Animal control handlers are not covered unless they are covered as animal protection police officers as set forth in the Code § 15.2-632:

§ 15.2-632. Department of public safety.

The department of public safety if and when established shall be under the supervision of a director of public safety appointed by the county manager. Such department shall consist of the following divisions:

Division of police, in charge of a chief of police and consisting of such other police officers and personnel as may be appointed, including an animal protection police officer who shall have all of the powers of an animal control officer conferred by general law and one or more deputy animal protection police officers to assist the animal protection police officer in the performance of his duties. In addition, the animal protection police officer and his deputies shall have all of the powers vested in law-enforcement officers as defined in § 9.1-101, provided they have met the minimum qualifications and have been certified under §§ 15.2-1705 and 15.2-1706.

Q: If an otherwise eligible volunteer or employee for my locality was not included on the LODA census roster, but is injured responding to an emergency, is he or she excluded from coverage under LODA?   

No. Every effort should be made to provide an accurate census roster to VRS for both employees and volunteers. This is essential to ensure LODA costs are funded adequately and shared fairly among participating localities and state agencies. If despite your best efforts some eligible individuals are not included in the census roster provided to VRS, LODA coverage will not be denied on this basis alone. Similarly, if ineligible individuals are included in your census roster, LODA coverage will not be provided merely due to the fact that a premium was paid to VRS. The State Comptroller must determine eligibility for LODA claims on a case-by-case basis based on the facts of each case. If a person has a change in his or her role or if the definitions of various types of volunteers change, you should note it in the census roster you provide to VRS.



II. The LODA Fund Census

Q: My locality has not received a LODA census roster from VRS yet, when were rosters sent out?
VRS mailed census rosters to counties and cities during April. VRS will send census rosters to towns and regional jails late this summer.
Q: How can I obtain an electronic copy of my locality’s LODA census roster?
Contact VRS at LODA@varetire.org to request an electronic copy of your locality’s LODA Roster.
Q: How are the towns being handled?

VRS will send letters to towns that we believe have law enforcement departments or fire and rescue departments that are covered by a town resolution or ordinance. Volunteer fire and rescue services for towns are covered generally by the county government’s ordinance or resolution. The county government may apportion the employer contributions to the town. If you have questions concerning your specific town, please send an email to LODA@varetire.org.



Q: My census roster is lengthy and would take a lot of time to verify. Can I send my own roster to VRS?
Yes, please feel free to use your own data if you find it more efficient; however, please format the data in same manner as the LODA roster you received. Please include the following fields: Last Name, First Name, Middle Initial, Gender, Date of Birth, Primary Agency and Personnel Type (Paid or Volunteer) and display them in separate columns as provided in this example:
Example:

L.Name

F.Name

MI

GENDER

DOB

PRIMARY AGENCY NAME

PERSONNEL TYPE

Doe

John

M

M

9/24/1980

ABC Volunteer Fire House

Volunteer Firefighter


Q: Why are my police officers and sheriff’s personnel not included in the roster you sent me?
If you are a VRS employer, your police officers, sheriff and sheriff’s deputies are listed as VRS-covered members, so there is no need to identify them. However, we do need you to confirm or add any paid or volunteer hazardous duty employees or volunteers that are not currently in the VRS system.
Q: Should I put retirees on the roster for at least five years in order to be covered for the presumption clause?
No, do not put retirees on the roster you provide to VRS. Potential expenses associated with the presumption clause are incorporated in the per capita fee.
Q: The data in the roster I received is greatly outdated or incorrect. Where did you receive this information?
VRS compiled the rosters using information from the Virginia Department of Health’s Office of Emergency Medical Services and the Virginia Department of Fire Programs, as of October 2010. Since this information is dated, we need your help in carefully reviewing the data and providing correct data back to VRS. Please keep in mind that this is the first time this comprehensive information has been collected and we anticipate future refinements to the process. VRS did undertake a data clean-up effort to eliminate some individuals who appeared to be outliers, such as those over the age of 80. Over time, we anticipate that the data verification process will provide a greater level of detail about the volunteer population.
Q: I don’t know who to contact in order to identify the volunteers in my locality. Can you give me some suggestions?


  • The Code of Virginia requires the Clerk of the Court in your locality to maintain a current roster of the volunteer fire fighters in your locality.

  • The local Chief of Police and Fire Chief usually maintain a current roster of volunteers.

  • The Virginia Office of Emergency Medical Services maintains a roster of EMT volunteers in their “StateBridge” database.

  • In the absence of a centralized system, you may have to contact individual volunteer rescue squads and fire departments.


Q: What criteria will the State Comptroller use to determine if my roster is accurate?

The Virginia Department of Accounts may review census rosters provided to VRS for volunteers to ensure accuracy relative to other statutorily required organizational and individual membership documentation requirements. For example:



  • Volunteer firefighters – proof of membership must be supported by records supplied to the Clerk of the Court.

  • Rescue squad members – proof of membership must be supported by records such as meeting minutes, call runs or squad personnel records.

Q: Some of our members are auxiliary members (such as volunteers who help with fundraising activities, etc.) who are not in hazardous duty positions. Should I include these individuals in my census count?
No, count personnel only if they are active employees or volunteers, specifically first responders. For purposes of the census, fundraisers should not be included in your LODA Fund roster. The Virginia Department of Accounts is responsible for the administration of Line of Duty Act benefits and makes final eligibility claims determinations on a case-by-case basis in accordance with the Code of Virginia.
Q: Some counties, cities or towns have lifelong or emeritus volunteer members who are really social members and who no longer take calls. Should we include them in our LODA rosters?

No, do not include these individuals in the LODA Fund roster.



Q: Do we include commercial, private or for-profit entities on our roster if they are listed in our ordinance?
No, please do not include the commercial, private or for-profit entities, even if they are listed in your ordinance.

III. VRS Premium Billing

Option One: Participate in the LODA Fund invested by VRS. Since each locality will be enrolled automatically in the Fund, participation requires no action by the locality. Action is required only if the locality wishes to opt out of the LODA Fund. Participation in the LODA Fund by the locality is irrevocable.
Option Two: Opt out of the LODA Fund. To opt out of the fund, the governing body must pass an opt-out resolution. The decision to opt out is an irrevocable decision, which means the locality cannot change the decision at a later date. When opting out, the locality may choose to self-fund benefits either on a prefunded basis, where the locality sets aside money or invests money to fund any future claims, on a pay-as-you-go basis or by engaging a third-party insurer.
The 2011 General Assembly extended the deadline for localities to irrevocably opt out of the LODA Fund to July 1, 2012. In order to opt out, the governing body must pass the resolution provided by VRS and the locality must submit a signed copy of the LODA opt-out resolution to VRS. Instructions for opting out of the LODA Fund can be found on the LODA website www.valoda.org. Any resolutions submitted in lieu of the official LODA resolution will not be accepted. Localities with active claims, that choose to opt out of the LODA Fund, will be billed by the State Comptroller for their actual claims expenses incurred in fiscal year 2011 as well as an administrative fee.

Localities that opt out of the LODA Fund prior to July 1, 2011 will not be billed by VRS for fiscal year 2012 contributions. If you choose to make an irrevocable election to opt out of the LODA Fund prior to the start of fiscal year 2012 (July 1, 2011 to June 30, 2012), the resolution must be passed with an effective date of July 1, 2011 and sent to VRS no later than July 31, 2011. Otherwise, to opt out of the LODA Fund you must make an irrevocable election and pass a resolution on or before July 1, 2012.  



At its December 16 meeting, the VRS Board of Trustees approved the Line of Duty Act (LODA) Fund contribution rate of $233.89 for fiscal year 2012. This is a per capita rate, meaning this is the amount each locality would pay per covered employee. However, the charge for volunteers is 25 percent of this rate. Unless an opt out resolution has been received, VRS will bill the locality at the per capita rate based on the census data submitted to VRS. The contribution rate is $233.89 for all eligible employees and $58.47 for volunteers. VRS will bill localities for FY2012 contributions in late summer with payment due in early fall. Keep in mind that if you opt out of the LODA Fund effective July 1, 2012, you still will be responsible for the fiscal year 2011 claims expenses. The State Comptroller will bill you for these claims. See the chart below for how volunteers and employees who serve in more than one locality will be billed.


Cost by Personnel Type


Locality Served

Paid*

Volunteer*

Billing

Within One Locality





Charged one time at Paid Employee Rate.

Within One Locality






Charged one time at Paid Employee Rate.

Within One Locality






25% of Paid Employee Rate.

Multiple Localities





  • Paid Employee Rate applied to locality where individual is employed.

  • Locality where individual is employed will not be charged a volunteer rate.

  • 25% rate applied to each locality where individual volunteers

Part-time






Charged one time at Paid Employee Rate.


*Paid Employee (part-time or full-time) rate of $233.89 per capita

*Volunteer 25% of the paid per capita rate, or $58.47

Q: Can you give us a better explanation of how to arrive at the cost per capita?
The 2011 Appropriations Act requires that the LODA contribution rate be calculated on a current disbursement or pay-as-you-go basis. The rate for FY 2012 is $233.89. This rate is composed of the elements in the chart below. The table below also shows what the rate would be under a prefunded or actuarial basis. Currently, the VRS Board of Trustees has only approved the rate for fiscal year 2012 ($233.89).



Q: Are LODA contribution rates going to be included in our VRS employer rate?
No. VRS will invoice employers separately for LODA contributions in August 2011 with payments due in the fall. Retirement contributions are calculated independently of the LODA Fund.
Q: What is the rate for part-time employees?
All paid employees, whether part time or full time, are billed at the same rate of $233.89 per capita.
Q: Who will pay for the ‘legacy claims’ if a locality opts in or opt out?  Does a locality start with a clean slate if it opts out?
If you opt out of the LODA Fund, you will take any legacy claims with you. Legacy claims include current claims and any pending claims not yet approved by the Department of Accounts. The cost of legacy claims will be pooled into the LODA Fund for those remaining in LODA Fund.
Localities that opt out of the LODA Fund will be responsible for fiscal year 2011 claims and an administrative fee assessed by the State Comptroller.

Q: What will the Department of Accounts (DOA) charge non-participating localities for administrative costs?
For fiscal years 2011 and 2012, the following fees are applicable to localities that opt out of the VRS fund:

  • Eligibility Determination – review and analysis of each new claim form and related investigative report to determine eligibility and the amount due to the claimant for any out-of-pocket health insurance premium payments incurred between the eligibility date and the eligibility determination date will carry a one-time per case (i.e., per claimant) fee of $1,575.00.

  • Benefit Processing – review and analysis of health insurance coverage/premiums and billing, collecting and paying health insurance premiums for approved LODA claimants will carry an annual per case (i.e., per claimant) fee of $160.00.  The fee will apply to all existing cases as of the start of fiscal year 2011.  For new cases approved during fiscal year 2011 the fee will apply beginning in fiscal year 2012.

  • These fees are subject to change beginning in fiscal year 2013.


Q: If an individual works in a locality in a public safety capacity, such as a police officer, but also volunteers with the same locality in either fire or rescue, will that locality pay premiums on that individual twice?  
A single locality will be billed only once for an employee who also serves as a volunteer for the same locality. Benefits don’t vary based on an individual’s status as a paid employee or volunteer, so the locality simply will be billed once.  Allocation of cost to multiple departments within a locality is a locality decision. See chart above for more information on how volunteers and paid employees in a locality or multiple localities will be treated.
IV. DOA Claims Billing for Nonparticipating Localities

Q: If my locality opts out effective July 1, 2011, when will we receive the bill for the cost of claims paid in FY 2011?

Bills for all claims payments made by DOA during FY 2011 (note: includes both claims payments made directly by DOA and health insurance premium reimbursements to localities) and DOA annual administrative fees will go out the middle of August 2011 and payment will be due by June 1, 2012.



Q: If my locality opts out effective July 1, 2011, when will we receive bills for the cost of claims paid in FY 2012?

  • Bills for DOA’s FY 2012 annual administrative fees will go out in August 2011 and payment will be due by September 30, 2011.

  • Bills for claims payments made directly by DOA (e.g., Medicare supplements, individual insurance plans) will go out quarterly, with the first billing planned for mid-October, 2011 and payment will be due in 30 days.

  • Bills for new claims approved on or after July 1, 2011 (i.e. FY 2012), including any applicable retroactive claims costs and any applicable DOA fees for eligibility determination, will go out when the eligibility determination is finalized and payment will be due in 30 days.

Q: Will localities that opt out of the Fund still be reimbursed by DOA for insurance premiums paid by the locality on behalf of claimants who remain in localities’ health insurance pools?

No. However, opt out localities will be required to report insurance premium coverage and costs to DOA annually and/or when coverage or costs change.



Q: Will DOA bill my third party LODA insurer (if applicable) for any claims payments paid by DOA?

No. DOA will only bill the locality for claims or other expenses paid under the LODA.



Q: Will my locality be billed for new claims approved during FY 2012 if my locality does not opt out until July 1, 2012?

The answer depends on the date of death or the date the doctor stated that the disability became permanent. For LODA purposes, this date is termed the date the claim is “incurred.” Localities participating in the LODA fund during FY 2012 but which then opt out are responsible for all costs (including claims and eligibility determination administrative fees) associated with any new claims incurred in any fiscal year other than 2012.



Q: Will my locality be billed for any other costs for claims other than those incurred during FY 2012 if my locality does not opt out until July 1, 2012?

Other than the costs for claims “incurred” in FY 2012, the locality will not be billed for any claims payments made by DOA during FY 2012 or for any FY 2012 DOA administrative fees.

The locality will be billed for any claims payments made by DOA for your locality’s covered employees or volunteers during FY 2011 and for DOA’s FY 2011 administrative fees in August 2012 and payment will be due in 30 days.

Q: If my locality opts out (whether at the end of FY 2011 or FY 2012), when will we receive bills for the cost of claims paid in FY 2013?


  • Bills for DOA’s FY 2013 annual administrative fees will go out in August 2012 and payment will be due by September 30, 2012.

  • Bills for claims payments made directly by DOA (e.g., Medicare supplements, individual insurance plans) will go out quarterly, with the first billing planned for mid-October, 2012 and payment will be due in 30 days.

  • Bills for new claims approved on or after July 1, 2012 (i.e. FY 2013), including any applicable retroactive claims costs and any applicable DOA fees for eligibility determination, will go out when the eligibility determination is finalized and payment will be due in 30 days.


Q: If a paid public safety employee also volunteers for a separate locality, how is the claim billed if this individual dies “off duty” under the heart/lung/cancer presumption? 

Assuming a situation in which both localities opt out of the fund and are faced with a claim as described, the cost of the claim will be shared by both localities. DOA would apply an 80%/20% split in costs, with the higher percentage being assigned to the employing locality.


Q: The Line of Duty website indicates the amount to be paid to a beneficiary as $100,000, but our ordinance states $10,000.  Was this changed since the enactment of our ordinance? Would $10,000 be the amount the county would have to pay since that is what is stated in our ordinance? Has the amount of the LODA benefit changed overtime?
The death benefit amount provided by the LODA (Line of Duty Act) has changed over time and is now $100,000. Localities will be billed for the full benefits cost as provided for in the Code of Virginia, http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+9.1-400.

Q. Will the cost of the State Police investigation be included in DOA's administrative fee?
No. This will be a separate charge billed by the State Police.



Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©atelim.com 2016
rəhbərliyinə müraciət