SCHOOLS’ STAFF SICKNESS AND OTHER ABSENCE INSURANCE SCHEME
POLICY DOCUMENT (last updated March 2015)
1.Introduction
1.1The Schools’ Staff Sickness and Other Absences Scheme (hereafter referred to as the Scheme) is operated as a schools’ self help, non-profit making insurance scheme. It is operated for the benefit of all Shropshire’smaintained schools, and will operate most efficiently when the majority of schools make use of it.
1.2The Scheme is managed internally, within the Council’s Learning and Skills School Funding Team. Any overall operating surpluses, or deficits, are carried forward within the Scheme’s accounts at the end of each financial year. Premium and reimbursement levels are set with the prime objective of securing a viable, sustainable scheme, which provides value for money and flexibility for schools.
1.3Definitions of sickness and absence are specific to this Scheme, and do not necessarily reflect contractual obligations or regulations.
2.Categories of absence and staff covered by the Scheme
2.1The Scheme is designed to limit the liability for actual replacement staffing costs in the following circumstances:
- Absence through eligible and notified sickness.
This covers teaching and non teaching staff.
This cover is available from the first day of sickness for primary and special schools, and after three days for secondary schools. Schools can opt for lower levels of cover.
- Absence for other reasons.
This covers teaching staff only.
Eligible other reasons are:
Serious illness of immediate family relative (up to maximum of 3 days)
Death and funeral/memorial service of immediate family relative(up to maximum of 3 days)
Paternity leave (up to maximum of 2 days)
Attendance at job interview (up to maximum of 2 days)
Absence due to specific appointments when acting as executor to a Will (up to maximum of 1 day)
Teacher’s own wedding or that of an immediate family relative (up to maximum of 1 day)
This cover is only available to primary and special schools opting for immediate cover, and is not available to secondary schools.
- Absence due to suspension
Cover for teachers suspended from duty on full pay.
Cover is only available to schools which opt in at the immediate or three day level of teachers’ cover.
- Headteacher long-term absence
An additional 5% premium provides cover for the additional costs of acting up arrangements in the event of the long term absence of the Headteacher.
- Return to Work Programmes
Where either teaching or non-teaching staff have been on sickness leave covered by the Scheme, and require support through a Return to Work programme on their return, the Scheme will contribute towards the additional costs of that programme, subject to:
- The approval of the Council’s Human Resources team will be required in all cases. No reimbursement will be given without prior approval, which will be confirmed on a signed Return to Work Programme claim (RTW1 or RTW2 for teaching or non teaching staff as appropriate).
- Reimbursements will be time limited and based upon the conditions of the Council’s Human Resources team’s approval, with a maximum 4 week reimbursement period.
- Reimbursements will be based on the standard reimbursements rates for the appropriate staffing category.
- A separate guidance note and pro forma claims for reimbursement (RTW1 and RTW2) are available for Return to Work Programmes.
2.2Teaching staff refers to all mainstream and special needs teaching staff.
2.3Non teaching staff are grouped according to the following classifications:
- Administrative and clerical staff
- Higher Level Teaching Assistants
- Teaching Assistants and SEN Ancillaries
- Nursery staff (including those employed under extended school arrangements)
- Premises staff - Caretakers and cleaners in charge
- Premises staff - Cleaners (where employed by the school. Staff employed under Shire Services’ contracts are not covered by the Scheme).
- Kitchen Staff (where employed by the school. Staff employed under Shire Services’ contracts are not covered by the Scheme)
- Other staff – Midday supervisory assistants
These classifications conform to staffing headings within the Consistent Financial Reporting Framework and within the Council’s accounting code structure (SAMIS).
Within any grouping, all staff must be covered at the same level, but different levels of cover may be selected between groups. Premiums charged to schools will be based on full time equivalent staff numbers within the appropriate grouping.
3.Further Definitions and Guidance
3.1This Scheme is a self-help insurance scheme for Shropshire’s maintained schools. Any schools considering academy or free school status will need to make arrangements for separate external insurance cover from the date that such status is commenced.
3.2School staff employed for extended school activities outside of core school teaching hours are not covered by this Scheme.
3.3Schools may generally opt into the scheme only for a complete financial year commencing 1st April. Exceptionally, for example with a change of Headteacher, a school could join the scheme from 1st September, for an appropriate pro rata premium payment.
3.4For any new entrants, or for changes in levels of cover, it is a condition of acceptance into the Scheme that no pre-existing sickness or absence periods, or awareness of impending incidences, are eligible for cover.
3.5The Scheme covers staff according to their specific working time at school, and generally only when pupils are attending school. This is determined, for the Scheme’s purposes, as:
- Teachers: 190 days, which exclude PD days
- Non-teaching staff: varies according to type of contract, but may include days when pupils are not in school.
3.6The Scheme provides cover for the actual replacement of an absent member of staff, at the appropriate Reimbursement Rate.
3.7Each separate period of personal sickness absence is counted as an individual claim unless it is a recurring illness. In the event of a claim which involves recurring illness, an absence which occurs within 4 working weeks of the last absence date will be recognised as a continuing sickness absence.
3.8The only variance to the standard Reimbursement Rate is when a school has opted to pay the additional percentage premium for Acting Up arrangements. This covers the long term absence of a Headteacher, and will reimburse reasonable and unavoidable additional costs (above the standard Reimbursement Rate) for taking on extra headteacher responsibilities.
3.9In the event of long term absences, the Scheme ceases to reimburse when the member of staff no longer qualifies for payment of salary under standard conditions of service. Similarly, where the absent employee moves down to half pay, reimbursements will be reduced by 50%.
3.10If other circumstances override standard conditions of service in respect of sickness pay, such as Financial Agreements In Lieu of Notice, the Scheme continues to operate according to the original sickness criteria. The conditions outlined at paragraph 3.7 would continue to apply.
3.11For secondary and special schools, a low claims discount/high claims excess arrangement operates at the close of each financial year, on the following basis:
-For schools which claim less than 80% of their total sickness/absence premium for the year, a low claim discount will be reimbursed to them. This will be calculated as 50% of the difference between total claims reimbursed and the 80% threshold.
-For schools which claim more than 120% of their total sickness/absence premium for the year, a high claims excess will be charged to them. This will be calculated as 50% of the difference between total claims reimbursed and the 120% threshold. This excess will be limited in cash terms to £20,000 for a school in any one year.
-Adjustments will be carried out immediately all financial year transactions have been completed, and before schools’ accounts are closed.
3.12Any leave of absence without pay is not covered by the Scheme.
3.13Personal hospital appointments, which cannot be arranged at other times, are covered by the Scheme. IVF treatment is not covered by the Scheme.
3.14Routine visits to the doctor, dentist, anti-natal clinic, physiotherapist etc are not covered by the Scheme. Exceptionally, emergency treatment is covered by the Scheme.
4.Arrangements and Administration
4.1Schools opting into the Scheme must complete the Insurance Notification Form, ensuring that all required insurance levels are requested, and that the “No Cover” box is marked where appropriate.
4.2Premiums will be charged/deducted in full from schools’ accounts as early as possible in the financial year, based on the numbers of relevant staff in post as at 1st May.
4.3Claims for insurance reimbursement must be submitted by schools for each qualifying period of absence, on a monthly basis.Claims must be made on the Insurance Claim Form ISS 1 (Rev), and should be returned to the Schools Finance Team no later than one week after the end of the month to which they relate.
4.4The Monthly Return of Sickness Absence form, with medical certificates attached asappropriate, should be forwarded direct to the Council’s Payroll Services. All other supporting salary claim payments will be input on-line via the schools’ Devolved Resource Link system. Reimbursements will only be approved when both absence and replacement have been confirmed.
4.5Where Agency staff(including Shropshire Supply Teacher Service)are used for supply cover in school, appropriate copies of invoices must be attached to the Form ISS 1 (Rev) and submitted to the Schools Finance Team for confirmation of replacement. Reimbursement for such cover is made at the appropriate standard rate.
4.6Eligible reimbursements will be made to schools based on the current schedule of “Rates of Reimbursement”.In normal circumstances, most reimbursements will be made no later than one month afterschools have paid for their supply cover.
4.7Claims for reimbursement which are received outside the deadline quoted at paragraph 4.3 may not be accepted, particularly if they relate to a financial year which has been closed. Claims made over 3 months in arrears will not be processed.
This enables the Scheme to be accurately monitored, and future premiums assessed with some certainty.
4.8Schools should check reimbursements to ensure that they agree to their own records. Any discrepancies should be notified to the Schools Finance Team as soon as possible, and certainly before the close of the financial year.
4.9The Scheme’s financial year transactions are based on sickness and absence starting in March and running through to the end of February each year. This enables all transactions to be completed by the beginning of May each year, thereby facilitating an early closedown of schools’ accounts. The normal process, from sickness/absence to reimbursement, is:
-sickness/absence occurs, in this example, in March
-replacement supply cover occurs in March
-Insurance Claim Form ISS 1 (Rev) forwarded to the Schools Finance Team in early April
-Monthly Return of Sickness Absence form returned direct to Payroll Services in early April
-All other supporting salary claim payments will be input on-line via the schools’ Devolved Resource Link system.
-payments made to supply cover in payrolls run at the end of April
-The Schools Finance Teamconfirms sickness/absence and actual replacement in early May by scrutinising absence/payroll transactions
-reimbursements entered onto financial system from the middle of May onwards.
5.Contact points
5.1The Scheme is managed by the Council’s Learning and Skills School Funding Team and administered by the Schools Finance Team.
5.2Specific contact points are:
Day to day administration, advice and support: Julie Bradney 01743 256233
Scheme management: Gwyneth Evans 01743 253875
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