Ariz. Admin. Code § R2-8-205 - Premium Benefit Documentation

A. Every year, prior to the effective date of Coverage, an Employer shall report to the ASRS all the Coverage plans and premium rates the Employer offers to its retired or Disabled employees.

B. An Employer shall inform the ASRS of any changes to the retired member's, Disabled member's, or Contingent Annuitant's Coverage, including enrollment in Coverage, maintained through the Employer within 30 days of the changes taking effect.

C. Using the Employer's secure ASRS website account, or another ASRS approved method, an Employer shall submit the following health insurance enrollment, change, and/or deletion information pursuant to subsection (B):

1. The retired member's, Disabled member's, or Contingent Annuitant's Social Security number or U.S. Tax Identification number;

2. The retired member's, Disabled member's, or Contingent Annuitant's full name;

3. The retired member's, Disabled member's, or Contingent Annuitant's date of birth;

4. The Coverage in which the retired member, Disabled member, or Contingent Annuitant is enrolling;

5. The type of change that is being made to the Coverage;

6. The following information for each dependent enrolled in, or to be enrolled in, or removed from, Coverage:

a. First and last name;

b. Social Security number or U.S. Tax Identification number;

c. Date of birth; and

d. Medicare number, if applicable.

7. The old and new premium amounts for Coverage;

8. The effective date of the change, deletion, and/or enrollment;

9. The Employer's name and telephone number;

10. A certification by the Employer representative's dated signature that the information is current and correct.

Notes

Ariz. Admin. Code § R2-8-205

New Section made by final rulemaking at 10 A.A.R. 1962, effective May 4, 2004 (Supp. 04-2). Section expired under A.R.S. § 41-1056(E) at 16 A.A.R. 1765, effective July 14, 2010 (Supp. 10-3). Adopted by final rulemaking at 23 A.A.R. 1414, effective 7/3/2017. Amended by final expedited rulemaking at 27 A.A.R. 479, effective 3/5/2021. Amended by final rulemaking at 30 A.A.R. 739, effective 5/17/2024.