notification by employees resigning or retiring while on military leave or due to disability as verified by a
physician; or the date the determination of permanent disability is made by the Consolidated Public
Retirement Board and/or the United States Social Security Administration.@ Restoration of sick leave for
employees returning to eligible employment shall be accomplished in accordance with subsection
14.4.e. of the Rule.
'5‐16‐13(c), you may be eligible to continue insurance
According to the provisions of W. V
. C
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coverage for up to three months following your reduction‐in‐force. Additionally, after expiring any
coverage granted by State law, the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), 29
USC Sec. 1162, may provide for an additional period of coverage. You should contact the Public
Employees Insurance Agency at 304‐558‐7850 or 1‐888‐680‐7342 for specific information concerning
eligibility, coverage, and premium payment.
You may meet with me or write me concerning this reduction‐in‐force, providing you do so no later than
[date ‐ at least 15 calendar days after date of letter]. For any appeal rights you may have, please refer
to W. V
. C
§6C‐2‐1 et seq., the West Virginia Public Employees Grievance Procedure. If you choose
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to exercise your grievance rights, you must submit your grievance, on the prescribed form, within fifteen
(15) working days of the effective date of this action, to [name and address of Chief Administrator] at
Level One of the Procedure. As provided in the statute, you may proceed to Level Three of the
Procedure by filing your grievance directly with the Public Employees Grievance Board upon the
agreement of the chief administrator, or when dismissed, suspended without pay, or demoted or
reclassified resulting in a loss of compensation or benefits. You must provide copies of your grievance
accordingly to the Public Employees Grievance Board at 1596 Kanawha Boulevard, East, Charleston,
West Virginia, 25311; [agency copy ‐ name and address]; and the Director of the Division of Personnel,
Building 6, Room B‐416, State Capitol Complex, Charleston, West Virginia, 25305. Details regarding the
grievance procedure, as well as grievance forms, are available at the Board’s web site at
(304) 558‐3361 or toll‐free at (866) 747‐6743.
Please let me know if you have any questions.
Sincerely,
[Appropriate Signature Authority]
c: Agency Personnel File
West Virginia Division of Personnel
[OPTIONAL LANGUAGE ‐ If the employer meets with the employee and hand delivers the letter, the
employer may request that the employee verify receipt by signing the following acknowledgment
typed at the bottom of the letter.]
I have received a copy and am aware of the contents of the foregoing letter
___________________________________
__________________
Employee Signature
Date