Acclara Hardship Relief Fund

The Acclara Hardship Relief Fund was created to relieve employees and associated members of unexpected financial hardship by distributing tax-exempt grants composed of tax-deductible charitable contributions made by Acclara and/or individuals interested in supporting the program.

The eligible events and hardships listed below are according to IRS guidelines. If you answer “yes” to all the following criteria, we encourage you to apply for a grant.

1. Are you a …

  • · Full-time employee (defined as those who work a minimum of 30 hours per week)
  • · Part-time employee (working 29 hours/week or less)

2. Has the event occurred within 90 days of your application?

3. Is this the first time within the last 12 months you’ve applied for a grant?

4. Is the grant you’re requesting between $500 and $1,000?

Please note the maximum grant amount a recipient can receive in a year is $1,000.

5. Is the event for which you’re requesting a grant listed below?

  • · QUALIFIED DISASTER: A state or federally-declared disaster, a disaster resulting from common carrier accidents, or a disaster resulting from a terroristic or military action.

  • · DEATH OF AN EMPLOYEE OR THEIR IMMEDIATE FAMILY MEMBER: The death of the employee, spouse, or eligible dependent(s). The loss of income or the cost of funeral expenses or medical bills must significantly impact the family’s resources. The Fund may also be able to pay expenses to bring a child whose parents have passed to live with a new family, typically a relative.

  • · NATURAL DISASTERS: A situation such as a wildfire, flood, tornado, hurricane, severe storm, or earthquake that has damaged or destroyed the employee’s primary residence. The Fund cannot pay to repair other property or replace non-essential items, e.g., electronics, etc. Photographs and/or insurance reports may be required.

  • · SERIOUS ILLNESS OR INJURY OR NON-ROUTINE/EXCEPTIONAL EXPENSE: The Fund is not a substitute for medical insurance; employees do not automatically qualify for a grant when they or their dependents are diagnosed with or suffer a life-threatening or serious illness or injury. A financial need must place significant pressure on the family’s financial resources. Doctor confirmation and/or medical documentation will be required.

  • · DOMESTIC ABUSE: A situation causing the employee and other victims to leave an unsafe residence.

  • · IMPACTS PRIMARY RESIDENCE: This includes but is not limited to fire, major and unpreventable home damage, and serious crime against the employee (robbery, arson, assault, domestic abuse, or another reportable crime) that significantly impacts the family’s resources. A police, fire, or other official incident report may be required.

  • · VICTIM OF A VIOLENT CRIME: A serious crime against the employee (robbery, arson, assault, or other reportable crime) that significantly impacts the family’s resources.

  • · MILITARY DEPLOYMENT: In the time of a natural disaster or national emergency, the employee, spouse, or domestic partner is unexpectedly or unavoidably called to active duty from the military reserves or National Guard.

6. If you qualify for one of the events above, are you facing hardship in any of the areas listed below?

  • > Food, clothing, and housing (Immediate needs only, applicable 2-4 weeks after the event. For rent, temporary housing up to 30 days)
  • > Rent/mortgage for primary residence
  • > Reasonable repairs to damaged property
  • > Essential appliances and furnishings
  • > Utilities (Essential utility expenses: Gas, water, and electricity)
  • > Security deposits (For new housing, if unable to inhabit existing home)
  • > Reasonable evacuation expenses
  • > Reasonable funeral, travel, and burial expenses
  • > Car repairs other than routine maintenance or repairs that could not have been reasonably avoided
  • > Cost of rental car or public transportation for up to 30 days
  • > Medical costs (Namely, significant medical and prescription expenses that are not eligible for insurance reimbursement)
  • > Psychological counseling deemed necessary by a physician following an event and in excess of what is covered by insurance
  • > Expenses resulting from fleeing domestic violence, such as temporary housing
  • > Inability to work due to the event
  • > Unexpected childcare for up to 60 days

If you answered yes to any of the above, please review the below information on “acceptable documentation” for events and expenses.

Regulations restrict us to only make grants for amounts that have been documented by receipts, invoices, or bills for qualifying expenses related to a qualifying event. Please provide us with available details in the following form:

  • Proof of the Event:
    • > NATURAL DISASTER: Damage report from the police, pictures of damages showing how it impacted you and your home, or an insurance claim/incident report verifying the event.

  • > TERRORIST ACT: A newspaper article showing the place and date of the event.

  • > IMPACTS TO PRIMARY RESIDENCE NOT COVERED BY INSURANCE: Includes fire, flood, or unusual life-altering expenses. Please provide a police report, fire department report, insurance car incident report, or a newspaper article showing the place and date of the event.

  • > SERIOUS ILLNESS OR INJURY NOT COVERED BY INSURANCE: Includes employee or eligible dependent. We need to know the date the illness began, which can generally be found in an emergency responder report, doctor’s note, hospital report, other healthcare provider statement, or FMLA or other medical leave documentation showing the date of the event, name, and address of the physician, patient name, dates of service, and the description of illness or injury.

  • > NON-ROUTINE MEDICAL: Please provide FMLA paperwork from the employer, a doctor’s note (does not require diagnoses), or other medical bills, including the name, date of the event, and services.

  • > DEATH: Please provide an obituary, death certificate, or a bill from the funeral home listing the name of the deceased and the person responsible for the bill.

  • > DOMESTIC VIOLENCE: Please provide a restraining order, police report, doctor or therapist note, a statement from a shelter, or a confirmation from the manager or HR.

  • > VICTIM OF A VIOLENT CRIME: Please provide a police report. We also need an emergency responder report, doctor’s note, hospital report, or other healthcare provider statement. Documentation needs to show the date of the event, name and address of the physician, patient name, dates of service, and a description of the injury.