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Kaiser Permanente southern California Region

By Zachary Sullivan,2014-04-08 20:43
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Kaiser Permanente southern California Region

Memorandum

October 23, 2007

From: Benjamin K. Chu, President, KFHP/H, Southern California Region

     Dr. Jeffrey A Weisz, Executive Medical Director, SCPMG

     Walter Allen, Southern California LMP Chair, Coalition of Kaiser Permanente Unions

To: Kaiser Permanente Southern California Employees and Physicians

Subject: Southern California Wildfires’ Disaster Assistance

    The fires that continue to spread across Southern California have affected hundreds of our employees and physicians who are part of the Kaiser Permanente family. Some have lost homes, many have been evacuated from their neighborhoods, and others still face an uncertain future.

    It is in the face of this kind of adversity that we are reminded of how important it is to help one another. That’s why we are coming together during this time of need to offer several forms of emergency assistance for employees and physicians whose lives have been touched by this terrible disaster.

    Our hope is that these programs will offer individuals and families the help they need to cope with the difficulties of this fire and the destruction that it has created. Descriptions of these programs, along with application forms, are provided here for those who need to access this help.

Other resources and information can be found at a Fire Assistance web site on Inside KP.

    http://kpnet.kp.org/california/insidekp/special/spotlight/b_102803_fire_resources.html

Thank you.

    Kaiser Permanente Southern California Region

    Employee and Physician Bulletin

    October 23, 2007

    Disaster Assistance Programs Development

    In partnership with our unions, Kaiser Permanente Southern California Region is offering several disaster relief programs to assist our employees and physicians affected by the severe fires in October 2007 that have impacted seven counties and declared a National Disaster by the President. The following is a brief description of each program. Application forms are attached.

; Short Term Emergency Support provides small monetary grants (up to $500.00 net) for

    urgent and immediate needs such as food, clothing or temporary shelter. This monetary grant

    is available to any employee who was displaced from his/her primary residence for a

    minimum of 48 hours under a mandatory evacuation as a result of the severe fires impacting

    five counties in Southern California. Requests for employees should be faxed to: Human

    Resources at Walnut Center 626-405-6247. Requests for physicians should be faxed to

    Marcia Norgauer, Permanente Benefits Administration at Walnut Center 626-405-6260.

    mployee checks will be coordinated by Payroll and paid out of the Medical Center E

    Disbursement Accounts. This is reportable income that will be included in the year-end W-2

    (or K-1 for partner physicians). Request forms are available in Hospital and Medical Group

    Administration, Human Resources, Union Leaders and Senior Manager offices. Requests for

    Short Term Emergency Support must be submitted by December 1, 2007.

; Emergency Assistance Loans are available for employees and physicians who are awaiting

    other forms of emergency financial aid such as federal programs and insurance claims as a

    result of full or significant loss of their primary residence. Employees and physicians may

    apply for an interest-free loan of up to a maximum of $10,000 (the IRS permissible amount).

    Request forms are available in Hospital and Medical Group Administration, Human

    Resources, Union Leaders and Senior Manager offices. Employees will be required to sign

    a promissory note of repayment. Repayment will commence after 3 months of loan

    disbursement and will be handled over a 12-month period using payroll deductions.

    Requests for Emergency Assistance Loans should be submitted by December 31, 2007.

    However, under extenuating circumstances, requests may be submitted no later than

    February 1, 2008.

    ; Financial Hardship Cash Outs of Vacation, Life Balance Days and/or Earned Time Off

    Account Hours may be available for those who suffer sudden and unexpected loss of

    property due to these extraordinary and unforeseeable circumstances. Between now and

    December 31, 2007, requests as a result of the fire disaster will be taxed at the employee’s

    regular taxation rate, rather than the supplemental tax rate. This is a one-time exception for

    taxation as a result of this unique situation. The policy and forms for employees can be

    obtained from Human Resources Consultants or through the HR website at: http://myhr-

    prd.kp.org/myhr/kp_me/. Click on Find a Form , log on to My HR and select the Financial

    Hardship Request Form #2140. Employee forms are processed through local HR using

existing procedures. Physicians may obtain forms from their Area Payroll Coordinator’s

    office or Permanente Benefits and Retirement Plans.

    ; Retirement Plan Withdrawals:

    Employees who meet eligibility requirements may withdraw a portion of their Kaiser Permanente 401k Plan, Tax Savings Retirement, or Supplemental Retirement Plan - Plan B. Employees should contact Vanguard at 1-800-523-1188 to obtain withdrawal and/or loan information. Hardship withdrawals require documentation. Withdrawals may be subject to taxes and penalties. Employees should consider contacting a financial advisor or a tax professional regarding the tax and retirement implications of distributions from their plans.

    Physicians, under the age of 59 ? may be eligible for a hardship withdrawal from the TSR Plan as defined by the IRS. Hardship withdrawals require documentation and are subject to ordinary income tax as well as early withdrawal penalty. Physicians should consider contacting a financial advisor or a tax professional regarding the tax and retirement implications of distributions from their plans. Physicians should contact Permanente Benefits and Retirement Plans at tie line 8-335-2654 or 626-405-2654.

    SHORT TERM EMERGENCY SUPPORT

    Fire Disaster October 2007

    Name: ________________________________________ Date: ____________________ SS#: ________________________ Employee/Physician #: _______________________ Department: ______________________ Work Location: _____________________

    Amount Requested: $________________ (Up to $500.00 Net)

This is to certify that I have an immediate need for the following due to the Fire Disaster of

    October 2007:

    ; Food

    ; Clothes

    ; Temporary Shelter

    ; Other (please specify):

    ___________________________________________

I prefer to pick up the check at (check one):

    ; Local Human Resources Office

    ; Local Business Office

    ; Local Associate Medical Director Office ( Physicians Only)

    ; Other (please specify):

    ___________________________________________

I prefer to have the check mailed to this address:

    ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

    __________________________________________________________ _____________

     Signature Date

    Fax Employee Request Forms to: Human Resources at 626-405-6247

    Fax Physician Request Forms to: Marcia Norgauer, Permanente Benefits at 626-405-6260

    EMERGENCY LOAN APPLICATION

    Kaiser Permanente Southern California

    (Fire Disaster - October 2007)

    Name: _____________________________________ Date: ___________________ SS#: ______________________ Employee/Physician #: _______________________ Cost Center:____________________ Department: _______________________________ Work Location: ___________________________

    Amount of Loss (if known): $________________________

    Loan Amount Requested (to a maximum of $10,000): $________________ Nature of Loss:

    ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Pending insurance or emergency assistance claims filed with City, State, Federal or Insurance

    Agencies. (Please attach copies of application):

    ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

    If approved, I prefer to sign Loan Agreement and pick up check at (check one):

     ____ Local Human Resource Office

     ____ Local Associate Area Medical Director Office (Physicians Only)

     ____ Other (please specify):

Signature Date

    Fax Employee Request Forms to: Human Resources at 626-405-6247

    Fax Physician Request Forms to: Marcia Norgauer, Permanente Benefits at 626-405-6260

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