Fla. Admin. Code Ann. R. 60P-10.002 - Enrollment and Effective Date of Coverage
(1) An employee may apply for enrollment in a
supplemental insurance plan through his or her personnel office during:
(a) During the first sixty (60) calendar days
of state employment or a new term of office;
(b) During open enrollment;
(c) Within thirty-one (31) days of a QSC of
losing group health coverage;
(d)
Within thirty-one (31) days of a QSC of an increase in the number of work hours
for an employee.
(2) The
employing agency shall request an effective date of coverage for enrollment in
supplemental insurance plan in accordance with Rule
60P-10.004, F.A.C., and indicate
such date on an application along with other required employee and agency
information. This information shall include:
(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;
(b) Contains the signature and date of the
employee and authorized signature and date of the employing agency certifying
eligibility of the employee.
(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.
(4) The
completed application shall be forwarded to the Department by the employing
agency prior to the requested effective date.
(5) Attach the original company application,
completed and signed by the employee and certified by the employing
agency.
(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.
(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.
(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.
(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.
Notes
Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS.
New 8-22-96, Repromulgated 1-31-02, Amended 3-30-17.
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