SCHOOLS’ STAFF SICKNESS AND OTHER ABSENCE INSURANCE
SCHEME
POLICY DOCUMENT (last updated March 2015)
1.
Introduction
1.1
The 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’s maintained schools, and will operate most
efficiently when the majority of schools make use of it.
1.2
The 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.
1.3
Definitions 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
2.1
The 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.
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
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:
o 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).
o 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.
o Reimbursements will be based on the standard reimbursements rates for
the appropriate staffing category.
o A separate guidance note and pro forma claims for reimbursement
(RTW1 and RTW2) are available for Return to Work Programmes.
2.2
Teaching staff refers to all mainstream and special needs teaching staff.
2.3
Non 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
3.1
This 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.
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3.2
School staff employed for extended school activities outside of core school teaching
hours are not covered by this Scheme.
3.3
Schools 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.
3.4
For 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.
3.5
The 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.
3.6
The Scheme provides cover for the actual replacement of an absent member of
staff, at the appropriate Reimbursement Rate.
3.7
Each 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.
3.8
The 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.
3.9
In 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%.
3.10 If 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.
3.11 For 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.
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3.12
Any leave of absence without pay is not covered by the Scheme.
3.13 Personal hospital appointments, which cannot be arranged at other times, are
covered by the Scheme. IVF treatment is not covered by the Scheme.
3.14 Routine 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
4.1
Schools 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.
4.2
Premiums 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.
4.3
Claims 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.
4.4
The Monthly Return of Sickness Absence form, with medical certificates attached as
appropriate, 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.
4.5
Where 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.
4.6
Eligible 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 after schools have paid for their supply cover.
4.7
Claims 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.
4.8
Schools 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.
4.9
The 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
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-
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 Team confirms 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
5.1
The Scheme is managed by the Council’s Learning and Skills School Funding Team
and administered by the Schools Finance Team.
5.2
Specific contact points are:
Day to day administration, advice and support:
Scheme management:
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Julie Bradney
01743 256233
Gwyneth Evans 01743 253875
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