Haw. Code R. § 4.11 - Cancellation of Enrollment; Effective Dates of Cancellation
(a)
Cancellation Due to Ineligibility. The enrollment of any
ineligible person who was enrolled in error or is ineligible to enroll in or be
covered in a benefit plan offered or sponsored by the Fund shall be canceled:
(1) When the person is notified by the Fund of the
error or ineligibility prior to the effective date of the enrollment, the person
shall be treated as if the enrollment application was not submitted.
(2) When the person is notified by the Fund in
writing after the effective date of the enrollment, but at least thirty (30) days in
advance, the enrollment may be canceled retroactively (a rescission) to the date the
person was ineligible if cancellation is due to Fraud or Intentional
Misrepresentation of a material fact, as defined in Rule 1.02 or
(3) When the person is notified by the Fund in
writing after the effective date of the enrollment, the enrollment will be cancelled
prospectively effective the first day of the first pay period following the date
that ineligibility is determined by the Fund. Employee-beneficiaries may be liable
for the employer portion of premiums paid for any ineligible person and/or any
benefits that were provided as per Rule 4.12(d).
(b)
Cancellation Due to Failure to Pay
Contribution Shortage. If an employee-beneficiary does not make full
payment of all contributions due within thirty (30) days of the date of the notice
of contribution shortage in Rule 4.10, the employee-beneficiary's enrollment in all
health benefit plans, and all dependent-beneficiaries' health benefit plans under
that enrollment shall be cancelled as of the first day following the last period for
which full payment of the employee-beneficiary's required semimonthly or monthly
contributions were paid and transmitted to the Fund and the employee-beneficiary
will be ineligible for Fund health benefits. If an employee-beneficiary is currently
on a leave of absence covered under the Family Medical Leave Act (FMLA), the
employee-beneficiary and dependent beneficiary(s) enrollment in all health benefit
plans shall be cancelled thirty (30) days from the date of the notice of
contribution shortage. The employee-beneficiary may only apply for a new enrollment
as per Rule 4.13(a). However, the enrollment and eligibility for benefits of the
employee-beneficiary and his or her dependent-beneficiaries may be reinstated as
provided in Rule 4.13(b). Cancellation of an employee-beneficiary's enrollment
pursuant to this rule shall not affect the Fund's right to collect any and all
contribution shortages from the employee-beneficiary.
(c)
Cancellation Due to Failure to
Comply with Rules. If an employee-beneficiary materially fails to
comply with any of the Fund's rules, the employee-beneficiary's enrollment in all of
the benefit plans offered or sponsored by the Fund and all coverages for
dependent-beneficiaries under that enrollment may be canceled after thirty (30) days
advance written notice of such has been provided to the employee-beneficiary. The
board may set standards and procedures for providing notice to
employee-beneficiaries under this rule. The notice shall at a minimum specify how
the employee-beneficiary has failed to comply with the Fund's rules, and a date by
which the employee-beneficiary must comply with the Fund's rules in order to avoid
cancellation. The effective date of the cancellation shall be the date set forth in
the notice as to when the employee-beneficiary must comply with the Fund's rules in
order to avoid cancellation.
(d)
Cancellation Due to Acquiring Coverage From a Non-Fund
Plan. An employee-beneficiary or dependent-beneficiary may cancel
enrollment in a Fund benefit plan upon acquiring coverage from a non-Fund plan or
when moving to a country in which they are eligible for publicly provided healthcare
or similar, by filing an enrollment application to the employee-beneficiary's
employer or, if none, directly with the Fund requesting cancellation. The enrollment
application must be filed with the employee-beneficiary's employer, or, if none,
directly to the Fund within ninety (90) days of acquiring coverage from the non-Fund
plan or moving to another country as noted above. The effective date of cancellation
shall be the end of the pay period in which the employee-beneficiary or
dependent-beneficiary moves to another country as noted above or acquires coverage
from the non-Fund plan, except when the employee-beneficiary or
dependent-beneficiary acquires coverage from the non-Fund plan on the first or the
sixteenth of the month, in which case coverage ends at the end of the prior pay
period.
The Fund shall determine the required proof documents.
(e)
Cancellation When
Beginning a Leave of Absence Without Pay. An employee-beneficiary may
voluntarily cancel enrollment in all Fund benefit plans when beginning a leave of
absence without pay that is expected to last more than one month. An enrollment
application must be filed with the employee-beneficiary's employer requesting
cancellation of all plans within forty five (45) days of the beginning of the leave
of absence without pay. The effective date of the cancellation shall be the end of
the pay period during which the leave of absence without pay begins.
Employee-beneficiaries who cancel coverage in accordance with this section may
re-enroll in the same benefit plans upon return from the leave of absence without
pay by completing an enrollment application and submitting it to the
employee-beneficiary's employer within forty five (45) days of returning from the
leave of absence.
Notes
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