Ohio Admin. Code 3349-7-70 - Group insurance benefits
(A)
Purpose
(B)
Scope
(C)
Definitions
(1)
Consult rule
3349-7-01 of the Administrative
Code.
(2)
"Dependent Child" under federal law refers to the
biological child, stepchild, or adopted child of an employee who is under the
age of twenty-six and does not have their own insurance coverage through an
employer. Pursuant to state law, a dependent child can also include the
biological child, stepchild, or adopted child of an employee who is under the
age of twenty-eight and is: unmarried; a resident of Ohio or a full-time
student at an accredited public or private institution of higher education; not
employed by an employer that offers any health benefit plan for which the child
is eligible; and not eligible for insurance coverage under medicaid or
medicare.
(3)
"Eligible Dependents" include the spouse of an eligible
employee, or as specified in a lawful separation agreement or divorce decree,
and all dependent children as defined in this rule.
(4)
"Eligible
Employee" includes full time employees of the university including faculty,
administrative staff, unclassified hourly employee and classified civil service
employees. Part-time employees and student employees are not
eligible.
(5)
"Group Insurance Benefits" are a selection of benefits
received by an eligible employee provided in accordance with the financial
resources and priorities of the university.
(6)
"Spouse" refers
to individuals who are recognized as lawfully married under the law of any
state.
(D)
Rule statement
(1)
The university may allow for a number of different
group insurance benefit options. Information concerning these options are
contained in separate provider publications.
(2)
Elected group
insurance benefits are effective on the employee's first date of employment
unless otherwise noted.
(3)
Coverage for each dependent will be effective with the
latter of:
(a)
The effective date of full-time appointment for the eligible
employee; or,
(b)
The date on which a person became an eligible
dependent.
(4)
The eligible employee must notify the human resources
department of any changes in eligibility status for all
dependents.
(5)
Eligibility for group insurance benefits terminates
based on any of the following events:
(a)
The employee is
no longer a full-time employee of the university;
(b)
A dependent no
longer meets the definition of "eligible dependent"; or
(c)
The death of an
employee. All group insurance benefits for the surviving spouse and dependent
children terminates on the last day of the second month following the month of
the death of an eligible employee;
(d)
The retirement of
an employee. Group insurance benefits coverage terminates on the date of
retirement for those employees who are recipients of Ohio retirement system
benefits (except for life insurance). For employees hired before January 1,
1992, comprehensive medical coverage for eligible dependents of Ohio retirement
system retirees continues if:
(i)
The retired employee had ten consecutive years of
full-time service with the university immediately prior to retirement;
and
(ii)
The eligible dependent was insured when the retired
employee's health insurance benefits coverage terminated.
(e)
A
group rule terminates; or,
(f)
The university
elects to terminate coverage for a given benefit.
(6)
Employees on
approved leaves of absence without pay may continue group insurance benefits
for up to one year at their expense.
(7)
Group insurance
benefits remain in effect while an employee is on active military duty for up
to thirty-one days. Employees are responsible for their contribution for any
health insurance premiums during this thirty-one day period. Employees with
longer periods of active military service may elect to continue group insurance
benefits for up to eighteen months at their expense.
(8)
Arrangements may
be made for continuation of group insurance benefits for the eligible employee
or eligible dependents under cobra by contacting the human resources
department.
Notes
Promulgated Under: 111.15
Statutory Authority: 111.15
Rule Amplifies: 3350.12
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