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A Teacher is currently self-isolating and is unable to complete their duties as a teacher from home, can a claim be entered for this situation?
A Mutual Fund claim can be entered for the absence, provided that there would be a requirement for a member of staff to cover the absent teacher.
Where there is no requirement to cover the absent teacher, for example, where a partial or full closure of the school is in effect, then the claim would be considered invalid as no replacement cover is necessary.
How does my school join the scheme?
Those schools wishing to join the Mutual Fund scheme need to apply on an annual basis. Reminders and links to the online form will be sent out towards the end of each financial year via the blog, Need to Know and by email. New applications should be returned by 31st March each year.
Is membership compulsory?
Membership is not compulsory. However, those schools choosing not to join the scheme need to consider entering into an arrangement with an external provider or risk meeting the cost of cover from within their delegated budgets.
Note: Not all external insurers cover all medical conditions.
How does my school leave the scheme?
As of 2011 all schools currently in the Mutual Fund will automatically be assumed to be scheme members for the following year, unless the school signals by the end of March of the current financial year that the school wishes to opt out. To opt out of the Mutual Fund please complete the opting out online form.
Which members of staff are covered on the scheme?
Teachers, Teaching Assistants, Admin, Residential, Technician/Resource, Premises, Catering, Meal Time Assistants.
Staff Not Covered
Premises, catering and meal time assistants were not covered in the scheme until 1st April 2013.
What absences are covered by the scheme?
- Any long-term sickness covered by certificate (including stress)
- Suspension from duties (including gardening leave)
- Full cost of staff transferring to half-pay for 6 months absence
- Adoption Support Leave
- Paternity Leave
- Phased Return (starting 1st April 2012)
- Pre existing conditions *
- Trade union activities
- Jury Service
- Reserve Forces activities
- Maternity leave
- Compassionate leave
* Applies only to schools joining the scheme for the first time or rejoining the scheme after a break of a year or more.
How do I claim for a phased return?
For a phased return claim to be paid an independent report from IMASS (Industrial Medical & Safety Services Ltd) will be required, confirming that a phased return is necessary. Additional details such as the length, start date, end date, type (physical or mental) and total number of days absent will be required when completing the online claim form.
How much does it cost?
The cost of membership is based on the number of full-time equivalent staff employed at the school and the level of cover purchased.
Premiums for teachers and support staff are set and reimbursed at different rates.
A calculator for yearly premiums can be found at the top of the page under the Mutual Fund heading.
Information regarding the levels of cover and reimbursement rates can be found on the Mutual Fund Website.
What are we entitled to claim?
Depending on the level of cover purchased and the type of school you will be subject to a waiting period: a number of days at the beginning of the absence for which you cannot claim – in effect an excess. This only affects the first claim period of any absence. Thereafter reimbursement is made at the relevant rates for teachers and support staff.
When can I claim for staff absence?
All claims for long term sickness must be made within the claims period and for all claims, schools are required to complete the online claim form. This can be accessed on the main Schools Mutual Fund webpage.
How do I find out if my claim was successful?
Once a claim form has been submitted online it is sent to the Mutual Fund Team mailbox in the form of an email. This email is then processed within 5 workings days into the Mutual Fund database. If a field has been completed incorrectly then the claim form will be rejected by the database, and the Mutual Fund team will contact the school via email or phone to ascertain the correct data. The claim will then be processed and either accepted, accepted with an adjustment or rejected. This will create a PDF file notification which will be sent via AnyComms within the Finance Information Community to the school regarding the claim. Should the claim be accepted or accepted with an adjustment the PDF file will state the amount to be paid and the reason for the adjustment. If the claim has been rejected, the PDF file will state the reason for its rejection. All Mutual Fund payments will then be paid at the end of the month and another PDF file will be sent to the school via the AnyComms System which will also list all school adjustments and payments.
My claim has been rejected!
Your letter/email should lay out your basis of appeal and any extenuating circumstances which may have led to the late submission of the claim.
The Board meets at 3 times a year and appeals will be heard at the next meeting.
Late Mutual Fund Claims
To improve the efficiency of claims, Devon Finance Services has developed an online claims form. On completion of the online form a PDF notification file will be sent back to the school within 5 working days via AnyComms within the Finance Information Community, informing the School if your claim has been accepted, rejected or adjusted. If you have not received a notification in that time, please contact the Mutual Fund Team to ensure your claim has been received.
Claims will continue to be paid at the end of the month and a further snapshot file will be available confirming the payment.
Should you realise that a mistake was made on completing the claim form, please email the Mutual Fund Team or phone 01392 382784.
If we don’t claim, will we receive a refund?
Each year, the Mutual Fund balance is rolled forward and the premiums adjusted accordingly. Therefore, whether the fund is in surplus or deficit at year end, schools will not receive a refund nor will monies be clawed back from those schools who have claimed.
Mutual Fund Board
c/o Devon Finance Services
My school was part of the Mutual Fund prior to converting to an academy, is the new academy still part of the Mutual Fund?
If a school was part of the Mutual Fund after 1st April and prior to it converting to an academy, then the new academy will continue to be part of the Mutual Fund and will be able to continue to submit claims as per usual.
A member of staff has more than one contract, am I required to submit a claim form for each contract the individual holds?
Yes, the school is required to submit a claim form for each contract the member of staff holds.
My school is converting to an academy, is it possible for the premium to start in September rather than April so that it is in line with the academy financial year?
This issue was raised in the June 2012 Schools Finance Group meeting and the Mutual Fund board agreed not to make any changes at this time.
My school has been part of the Mutual Fund for more than a year, but we would like to include support staff. If a support member of staff is already off work due to illness prior to paying the premium, can I still claim for that individual?
Unfortunately, if a member of staff is already absent prior to the initial premium being paid then you cannot claim for this individual. If however, the individual does come back to work but unfortunately goes absent due to a new illness, then you can claim for that individual.
A member of staff who is currently on a phased return has taken time off during which time they were supposed to be working as agreed in the phased return. Can I claim for those days that the individual is absent on top of the phased return?
If the individual requires additional time off with the same illness on top of the phased return, the school can claim for the additional days. However, if the added days out of work is due to an unrelated illness then the waiting days still apply as this is classified as a new absence.
A member of staff has returned to work but on the same day went absent again, can I claim for the day that they returned to work?
A school can only claim for the day that the individual returned to work, if a return to work form was completed and the individual was sent home on the same day they returned to work. If no return to work form was completed and the individual went off absent several days later, then this would be classified as a new absence and the waiting days would start again.
I have a member of staff who is currently on half pay and has been for almost 6 months and who has now been given their notice. They are now entitled to 3 months full pay before they leave, can I claim this from the Mutual Fund.
Yes, if the individual has been dismissed or resigns then you may claim for the period of their notice.
How do you calculate how much I will receive for each claim?
The Education Finance Team uses the following method to calculate Mutual Fund Claims.
Number of days claimed X Pay Factor Rate X Reimbursement rate (£136.68 per day for teachers and £56.10 per day for support staff)
The total number of days that you are claiming will be every working day the school is open in the period you’re claiming for, even if the member of staff is part time and wouldn’t have worked all of the dates that are being claimed. This is because we then multiply the number of days claimed by the member of staff’s Full Time Equivalent
A few examples of claims;
If you are claiming for a whole month’s absence (for example 20 days) for a teacher whose pay factor rate is 0.4 the claim would be worked out as follows.
20 Days X 0.4 pay factor rate X £136.68 Teachers Reimbursement Rate = £1093.44
If the teacher’s pay factor rate is 1.0, the claim would be worked out in the same way, as follows.
20 Days X 1.0 pay factor rate X £136.68 Teachers Reimbursement Rate = £2733.60
What if my Phased Return is greater than the standard 6 week phased return claim limit?
If you are claiming for a phased return for an individual, an independent report must be received by IMASS (or similar) confirming that a Phased return is necessary for 7 weeks or more. This claim will then be put forward to our Mutual Fund Appeals Board as it is above and beyond normal practice. Submit your claim via the online claims form on the main Mutual Fund webpage, however, you will also need to email the Mutual Fund Team providing details of the absence, why a phased return of greater than 6 weeks is necessary and details of how many days per week for each week the member of staff will be at work for. For example, week 1 the member of staff worked 1 day a week, week 2 the member of staff worked 1.5 days a week and so on. The board meets 3/4 times a year, and your claim will then be heard at the next meeting.
My IMASS referral report states that an additional supply teacher/teaching assistant is required to work with, and assist the returning teacher throughout the phased return. Can the school claim through the Mutual Fund, the days that the supply teacher and the returning teacher are working together?
If a teacher is returning to work and IMASS (Industrial Medical & Safety Services Ltd) referral report states that the School has to provide supply teacher/teaching assistant cover in order to work with and assist the returning Teacher throughout their Phased Return, then you are able to claim for this through the Mutual Fund. If this occurs, please email the Mutual Fund Team, who will be able to assist you. The Mutual Fund Team will require a timetable of the arrangement to calculate how many days you will be able to claim for.
An individual has been absent from work since XX. It was agreed that the individual will return to work on a 3 week phased return from XX, but on the XX the individual fell ill again with depression linked to the primary ongoing back problem. Can this claim be treated as continuous or will the waiting days be required to be applied again?
With this type of claim if an individual has been absent for a long period of time, the school will need to check with payroll to see when half pay can be claimed. If the individual has returned to work as a phased return and then falls ill again with a different illness, the date of the half pay entitlement will be delayed and therefore a new claim will need to be submitted to the Mutual Fund that will include the waiting days.
The School was not aware that they had automatically enrolled in the Mutual Fund for 2015/16 and therefore did not know that they could claim for staff absences, which is why the claim was submitted late.
This is not a valid reason for a late claim to be submitted and will be rejected by the board. As all schools (including academies, free or maintained) currently in the scheme will automatically be enrolled in the Mutual Fund for the following year unless the Mutual Fund is informed otherwise, prior to 31st March. All schools remaining in the Mutual Fund or joining the scheme for the following year will be provided with a premium notification via SecureNet during April. All schools will be given two weeks in which to contact the Mutual Fund team to raise any query relating to their premium. The Mutual Fund premium will then be raised in the middle of May with a further confirmation sent via the Finance Information Community by AnyComms and all claims received for April and May, will then be processed and paid by the end of May.
A member of staff was absent from work to provide emergency transport/care to a relative, can this be claimed by the Mutual Fund?
Unless the individual employed by the school is actually ill, a school cannot submit a Mutual Fund claim.
The claim was submitted late due to the finance member of staff leaving the school and the finance department not being properly covered until November, when it was noticed that the claim had not been submitted.
It is recommended that every school have in place cover to make sure that Mutual Fund claims are submitted on time and that late claims submitted due to the lack of support cover within the school, will not be accepted as an exceptional circumstance as to why the claim was submitted late.
A member of staff went on two weeks paternity leave in March and the paternity leave continued in to April. However, the single claim for March and April was not received until May. Can the claim for the entire paternity leave still be paid?
The April claim was received within the claim period and will be paid, but the March claim is outside the claim period and therefore will be rejected.
The school had budgeted for support staff being part of the Mutual Fund for the year but had not realised that the school had not requested them to be included as part of the premium. Can the school join midway through the year?
Yes, the school can join the Schools Mutual Fund or add coverage during the year. The school will be subject to a 7% joining fee if they were not part of the scheme the previous year. In these circumstances, the premium plus joining fee will be pro-rated from the point of joining the scheme.