Fla. Admin. Code Ann. R. 60P-2.004 - Effective Date of Coverage

(1) The effective date of coverage requested by the employing agency for enrollment or changes in coverage in the Health Program by an employee shall always be the first day of a month, subject to the following:

(a) Subject to the requirements of subsections (2), (3), and (4), the requested effective date for new enrollees shall be no later than 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.

(b) 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.

(2) The coverage of an employee applying for enrollment during his or her initial enrollment period shall become effective as follows:

(a) If the employee's agency personnel office enters the application information as required in subsection 60P-2.002(8), F.A.C., into the state insurance computer system data base prior to the requested effective date, coverage shall be effective on the date requested.

(b) If the employee's agency personnel office does not enter the application information as required in subsection 60P-2.002(7), F.A.C., into the state insurance computer system data base, coverage shall be effective on the date requested provided the Department receives the completed application prior to the requested effective date. If the application is received by the Department after the requested effective date, coverage shall be effective on the first day of the month following the date the application is received. However, if the proper full month's premium is received by the Department prior to the requested effective date, coverage shall become effective on the date requested, even though the application may not be received until after such date.

(3) Coverage changes shall be effective as follows:

(a) If the completed application for a family to individual coverage change is received by the Department before the requested effective date, but after a designated monthly payroll due date, such change shall be effective on the date requested.

(b) If the completed application for an individual to family coverage change is received by the Department after the designated monthly payroll due date but before the requested date of coverage, such change shall be effective on the date requested provided the employee's personal check or money order for the additional employee contribution not payroll deducted is received by the Department prior to the requested effective date. If the completed application is received after the requested effective date, the coverage change shall be effective the first of the month following the date such application and additional employee contribution are received.

(4) The effective date of coverage for an eligible dependent acquired while family coverage is in effect shall be the date such dependent is acquired.

(5) Changes in coverage requested by a retiree or surviving spouse shall become effective the first day of the month following receipt of a written request for such changes by the Department.

(6) The effective date of all enrollments and or changes made during the open enrollment period shall be designated by the Department.

(7) The effective date of coverage for an employee enrolling due to a pending retirement application shall be no later than the retirement date.

(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 State Group Health Program. Upon determination of ineligibility, including failure to make timely payments, the premium received shall be fully reimbursed.

Notes

Fla. Admin. Code Ann. R. 60P-2.004

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS.

New 10-8-78, Amended 10-22-79, 7-1-80, 9-13-82, 8-7-83, Formerly 22K-1.17, Amended 7-16-86, 9-25-86, Formerly 22K-1.204, Amended 8-22-96, Repromulgated 1-31-02, Amended 3-16-05, Amended by Florida Register Volume 43, Number 030, February 14, 2017 effective 3/2/2017.

New 10-8-78, Amended 10-22-79, 7-1-80, 9-13-82, 8-7-83, Formerly 22K-1.17, Amended 7-16-86, 9-25-86, Formerly 22K-1.204, Amended 8-22-96, Repromulgated 1-31-02, Amended 3-16-05, 3-2-17.