60P-10.002. Enrollment and Effective Date of Coverage  


Effective on Thursday, March 30, 2017
  • 1(1) An employee may apply for enrollment in a supplemental insurance plan through his or her personnel office during:

    20(a) During the first sixty (60) calendar days of state employment or a new term of office;

    37(b) During open enrollment;

    41(c) Within thirty-one (31) days of a QSC of losing group health coverage;

    54(d) Within thirty-one (31) days of a QSC of an increase in the number of work hours for an employee.

    74(2) The employing agency shall request an effective date of coverage for enrollment in supplemental insurance plan in accordance with Rule 9560P-10.004, 96F.A.C., and indicate such date on an application along with other required employee and agency information. This information shall include:

    116(a) Employee’s and eligible dependent’s name, social security number, birth date, sex, employee’s home mailing address, employment date, SAMAS organizational code, company, product, coverage code, option codes, and action to be taken;

    148(b) Contains the signature and date of the employee and authorized signature and date of the employing agency certifying eligibility of the employee.

    171(3) The employee acknowledges that eligibility and enrollment are governed by the provisions of Chapters 60P-1 and 60P-10, F.A.C.; authorizes the State to reduce salary as often and in amount necessary to continue coverage; acknowledges premiums may change from time to time; agrees to notify the Department at the time any dependent becomes ineligible for coverage; and agrees that all statements made on application are complete and true.

    239(4) The completed application shall be forwarded to the Department by the employing agency prior to the requested effective date.

    259(5) Attach the original company application, completed and signed by the employee and certified by the employing agency.

    277(6) An employee enrolled in a supplemental insurance plan shall automatically be enrolled in the pretax premium plan pursuant to Chapter 60P-6, F.A.C.

    300(7) The effective date of coverage requested by the employing agency for enrollment or changes in coverage in a supplemental insurance plan shall always be the first day of the month for which a full month’s premium may be deducted using single deductions based upon the employee’s signature date on the application. The requested effective date shall be no earlier than the first day of the month following the employee’s signature date; however, in no case shall such effective date be prior to or on the employee’s employment date. In the case of supplemental policies which require underwriting approval, the effective date of coverage shall be the first day of the month initially requested, following approval or in which a full month’s premium can be deducted.

    426(8) The effective date of coverage for enrollment or changes will be determined by the Department if an error or omission occurs by the employee’s agency personnel office.

    454(9) Receipt of direct payment, endorsement, or deposit of premium by the Department or its agent does not provide coverage if after receipt of the payment, its endorsement, or deposit, the Department or its agent determines that the employee, retiree, or COBRA participant or dependent is not eligible to participate in the Supplemental Insurance Plan. Upon determination of ineligibility, including failure to make timely payments, the premium received shall be fully reimbursed.

    526Rulemaking Authority 528110.123(5) FS. 530Law Implemented 532110.123 FS. 534History–New 8-22-96, Repromulgated 1-31-02, Amended 3-30-17.

    540 

Historical Versions(1)

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Related DOAH Cases:

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