Should employees who don’t use all their sick days get paid for them when they leave a job?

The board designing Connecticut’s health insurance exchange grappled with that and other employee benefits questions Thursday. The board is charged with creating and overseeing a marketplace for selling insurance to individuals and small businesses as part of federal health reform, and must make a number of key decisions in the coming months, including defining what benefits health plans must cover.

But the board also has some employer responsibilities of its own as it establishes the quasi-public agency that will run the exchange. It’s expected to employ about a dozen people and will initially be funded by federal grants. The agency must become financially self-sustaining by 2015.

The board voted Thursday to have exchange employees get their health insurance through the state employee plan until the exchange itself is up and running. At that point, employees would get their coverage through one of the plans sold on the exchange.

That matter took little debate Thursday, but the board spent more time on how to handle sick days. Under a proposal board members considered, people who work for the exchange would get 15 paid sick days a year, the same as state employees. Unused sick days would accrue from year to year and could be used if a person needed to take an extended absence. But the proposal would prohibit people from getting paid for the value of unused sick days when their employment with the exchange ends, prompting debate among board members. By contrast, state employees can cash out a portion of the value of their unused sick days when they leave state service.

Lt. Gov. Nancy Wyman, who chairs the exchange board, said not paying departing employees for unused sick time would be sending the message that they’d have to use their sick days or lose them.

State Healthcare Advocate Victoria Veltri disagreed, saying that the issue tapped into broader questions about the philosophy employees bring with them to work, and the expectation that people not use sick days unless they’re sick.

Deputy Insurance Commissioner Anne Melissa Dowling said allowing people to be paid for unused sick days was effectively managing a benefit around expected bad behavior. She favored allowing sick days to accrue from year to year, but not be paid out when employees leave.

Michael Devine, a small business owner, said he also favored allowing sick days to carry over from year to year, which he said would make people more likely to use them in a conscientious manner, saving them in case they needed extended sick time. And Devine said he didn’t mind the idea of someone receiving money at the end of their employment if they showed up every day and didn’t use all their sick time. “You hate to put people in a position where they feel I’m going to lose something,” he said.

Ultimately, board members voted unanimously to allow unused sick time to accrue from year to year, but prohibit anyone from receiving payment for unused time when they leave the exchange. Employees would be allowed to transfer their unused sick days to another employee who needed additional sick time.

The board also agreed to offer a long-term disability policy and require employees to pay the full cost if they want the benefit, and to match 50 percent of employee contributions to 401(k) plans, with the exchange contributing up to 3 percent of their salaries.

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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