2017-2018 Richmond Area Living Wage Certification Application
The Richmond Area Living Wage Certification Program is a joint program of the Richmond Chapter of the Virginia Interfaith Center for Public Policy and the City of Richmond Office of Community Wealth Building.
Section 1: Basic Employer Information and Program Information
Name of Employer/Business/Organization: _________________________________________
Street Address: ________________________________________________________________
City: State: Zip: ________________________________________________________________
Phone: Website: _______________________________________________________________
Primary Contact: Name & Title: ___________________________________________________
Business e-mail: Primary Contact e-mail: ___________________________________________
2017-18 Program Criteria and Information:
Wages: Our 2017-18 certification has three levels of certifications:
$16.00 or more for the Gold Star Living Wage Certification
$12.50 or more for the Silver Star Living Wage Certification
$11.00 or more for the Aspiring Living Wage Certification
The Richmond Living Wage Certification Program established these categories after reviewing the Richmond rates using the Universal Living Wage calculation, the MIT Living Wage Calculator, the EPI Family Budget and area data. The Aspiring Living Wage Certification is designed to encourage employers to commit toward raising wages over a two-year period.
Health Insurance: We recognize that employers that provide health insurance to the employees have additional costs. Employers that provide health insurance for their employees or reimburse employees for their cost of health insurance can deduct $1.50 per hour from the above rates and still be certified, so $14.50 plus health insurance still qualifies for the Gold Star Living Wage Certification, $11.00 plus health insurance still qualifies for the Silver Star Living Wage Certification and $9 .50 plus health insurance still qualifies for the Aspiring Living Wage Certification.
Special Short-term Workers: An employer may pay less than a living wage to apprentices, temporary or project-based employees, minors working part-time, interns, tipped employees, and a new hire in a probationary period not to exceed 90 days. All of these circumstances will require additional information and will be reviewed by the program’s Certification Committee.
Other Offsets: An employer may offset the wage rate by providing benefits that affect basic needs (healthcare, housing, food, or transportation). Any offset will require additional information and will be reviewed by our certification committee and board of directors.
Posting: As part of Certification, we ask each employer to post a “Living Wage Certification Information” poster provided by the Richmond Area Living Wage Certification Program in an area that is highly visible to your employees and near VA labor law poster. In addition, we urge you to display the poster and logo in places that customers view, such as display windows, websites, circulars and promotional flyers.
Confidentiality: This application is considered confidential and privileged information. It will only be shown to our program coordinator and our certification committee members. No copies will be made, or distributed.
Changes in situations: If an employer is no longer able to pay a living wage, the Richmond Area Living Wage Certification Program asks to be notified. To ensure accurate information from employers, we reserve the right to randomly review a small number of employers quarterly by interviewing a percentage of their employees. Additionally, it is important that the employer understand that the employees may have questions or concerns about the program, and it is important that an employer agree not to take retaliatory action against an employee raising concerns. If a concern is raised, the Richmond Area Living Wage Certification will follow a set of protocol in receiving more information. If an employer is found not to be paying a living wage and is unable to adjust their wages, The Richmond Area Living Wage Certification will remove the business from our list in a non-public manner.
Section 2: Certification Eligibility
How many employees do you have? (#)____________________
A. (#)_____ Employees eligible to receive health insurance benefits.
B. (#)_____ Employees who are eligible and actually receive health insurance benefits.
C. (#)_____ Employees who are not eligible to receive health insurance benefits.
What number of the employees listed above are: (refer to page #3 for clarification on these employees)
A. (#)_____ Apprentices or Interns
B. (#) _____Minors
C. (#)_____ Temporary or Project Based Employees
D. (#)_____ Employees that receive tips as a significant part of their income
E. (#)_____ Other (Please Describe) _____________________________________________________________________
Hourly Pay for your employees: (Circle One)
A. Do you pay $16.00 or more to all of your employees except those listed in question two above? Y N
If yes, you qualify for the Gold Star Living Wage Certification skip to question six. All other applicants need to complete the other questions four and five to determine which category of certification applies.
B. What are the lowest wages you pay your regular employees? _______
This will help determine the level of certification for which you qualify. Please complete questions four and five.
Health, Dental, Vision Coverage:
A. Do you provide Health, Dental, and/or Vision Insurance for any of your employees? Y N
B. If yes, do you have a group plan, pay at least 50 percent of the employee’s cost or at least $250/month for each employee? Y N
C. If you give each employee a contribution toward health care, do you give each person at least $250/month? Y N
Other Potential Qualifying Benefits:
A. Do you provide a vehicle for personal use after work hours? Y N
B. Do you provide housing or a housing stipend to your employees? Y N
C. Do you provide daily shift meals or food assistance to your employees? Y N
D. Do you provide Health, Dental or Vision Insurance but pay less than 50 percent of the cost or under $260 per month? Y N
E. Do you provide child care assistance? Y N
F. Do you offer tuition assistance? Y N
If you answer yes to any of these qualifying benefits, you will be asked to complete an application addendum.
A. Do you hire Independent Contractors that you pay on an hourly basis? Y N
B. How many independent contractors do you regularly use? _____
Qualifying for Living Wage Certification:
A. Did you increase wages to any employees in order to meet our criteria? Y N
B. Did you increase Health Insurance benefits in order to meet our criteria? Y N
C. Did you increase other benefits in order to meet our criteria? Y N
A. Do you certify that your organization embraces the Living Wage concept? Y N
B. Do you certify that your employees are aware that you have applied for the Living Wage Certification? Y N
C. Do you certify that you are not withholding any information that could negatively affect this application? Y N
D. Do you agree that your business will not take retaliatory actions against employees that raise concerns? Y N
E. Do you certify that the information above is true and accurate to the best of your knowledge and that you have the authority to sign this application? Y N
Section 3: Optional Certification Program Benefits (does not affect program eligibility)
Would your leadership be willing to participate in advisory panels or community meetings to introduce the program?
Is your business on Facebook? Y N
Section 4: Definitions
Living Wage: the amount that a single individual must earn hourly to afford their basic necessities, without public or private assistance. For further information on the wage rate visit: www.justeconomicswnc.org.
Living Wage Certified Employer: an employer that is accepted in our program and meets or exceeds the Richmond Area Living Wage Certification program criteria.
Apprentice: an individual that is learning a trade, art, or skill by practical experience under skilled workers in exchange for work.
Intern: a student or graduate in a professional field gaining supervised practical experience in exchange for work.
Minor: An individual under the age of 18.
Temporary/Project based Employee: An “as needed” employee that works intermittently and does not work more than 45 days in a calendar year.
Independent Contractor: a contractor that is in business for him/herself. The person is not under the direct control of your business. Independent contractors must receive a “1099”. Independent Contractors paid an hourly rate and consistently working over 8 hours a week must make $2/hour more than the current living wage to qualify for certification. The additional wage requirements are meant to cover their individual tax requirements.
New Hire: an employee who is within their first 90 days of employment during which the employee and employer are evaluating each other.
Tipped Employee: an employee who consistently relies on tips for a percentage of their income. When averaged out, wage and tips combined must meet the same wage rates described above.