GROUP LIFE INSURANCE
EXAMPLE | (1)
EFFECTIVE DATE OF PAY INCREASE |
(2) DAY PRECEDING EFFECTIVE DATE OF PAY INCREASE |
(3)
EFFECTIVE DATE OF INCREASED INSURANCE COVERAGE |
---|---|---|---|
(A) | 07/01/92 | 06/30/92 | 10/01/92 |
(B) | 10/01/92 | 09/30/92 | 10/01/92 |
(C) | 10/02/92 | 10/01/92 | 04/01/93 |
Thus, increases in compensation effective on the dates shown in Col., (1) above, will result in increases in the amount of life insurance which shall take effect on the dates shown in Col., (3). The increased deduction shall be taken on the payroll which is payable next after April 1, or October 1 and which pays for the respective pay period preceding that in which April 1, or October 1 occurs or which ends on April 1, or October 1.
The agency should check the employee's group life deduction for accuracy against its source data. If incorrect, make the necessary correction on the payroll.
The following are examples reflecting effective dates of insurance coverage and of payroll deductions for the employee's portion of insurance premiums:
Example 1:
Pay Period October 16-29, 1992, payable November 13, 1992.
Pay Period October 30 - November 12, 1992, payable November 27, 1992.
Example 2:
Pay Period July 10-23, 1992, payable August 7, 1992.
Pay Period July 24 - August 6, 1992, payable August 21, 1992.
Example 3:
Pay Period January 8 - 21, 1993, payable February 19, 1993.
Pay Period February 22 - February 4, 1993, payable February 4, 1993.
The insurance of any employee insured under this section shall cease on termination of employment, subject to any conversion privilege or adjustment to the amount entitled to at retirement as provided in the group insurance policy. See Section 5-257(d) of the Connecticut General Statutes for conversion privileges at retirement.
In the event of the death of the insured employee, payment of life insurance will be made in either a lump sum or installments to the designated beneficiary. The employee may change their designated beneficiary at any time by completing an Aetna "Change of Beneficiary" card which may be obtained from the Group Life Insurance Section of the Comptroller's Special Services Division. It should be noted that a change in beneficiary for Group Life Insurance purposes has no effect on the named beneficiary in the state retirement system. Similarly, making a change in beneficiary for state retirement purposes does not automatically change the beneficiary for Group Life Insurance.
An eligible employee may decide not to participate in the basic life insurance plan or an insured employee may wish to withdraw from participation in the basic insurance plan. In either situation, the employee should be given a waiver card for completion and signature. It should be promptly returned to the agency. In turn, the agency should submit the original card to the Comptroller's Office, Special Services Division.
Once having waived participation, the employee may obtain insurance only after evidence of insurability as determined by Aetna Insurance Company.
OPTIONAL SUPPLEMENTAL GROUP LIFE INSURANCE EMPLOYEES
NOT INCLUDED IN ANY PREVAILING BARGAINING UNIT CONTRACT
Section 5-257(e) of the Connecticut General Statutes provides that in addition to any life insurance coverage pursuant to subsection (b) optional group life insurance coverage up to a maximum of fifty thousand dollars ($50,000) may be purchased by any employee who is not included in any prevailing bargaining unit contract and whose yearly gross compensation (rate) is at least forty-five thousand five hundred dollars ($45,500). The actual cost of such optional coverage shall be fully borne by the employee. The State Comptroller shall deduct the necessary amount from the employee's pay.
If the eligible employee elects an amount of supplemental life insurance coverage that is less than the maximum amount provided for in Public Act No. 87-403(e)($50,000), the initial amount must be at least $5,000. It may subsequently be increased in multiples of $5,000.
A new employee may enroll in the optional supplemental group life insurance program concurrently with enrollment in the employee's group life insurance program subject to the eligibility requirements as indicated in Section I above.
If a new employee chooses not to enroll in the supplemental group life insurance program when first eligible and at a later date decides to enroll, the supplemental enrollment will be effective on either the next April 1 or the next October 1 in amounts as indicated in Section I above, provided the employee has completed the Evidence of Insurability as determined by Aetna Insurance Company.
An employee transferring from the status of inclusion in a collective bargaining unit contract to the status of non-inclusion in any prevailing collective bargaining unit contract may enroll in the supplemental group life insurance program subject to the eligibility requirements as indicated in Section I above.
On the occasion of a transfer, the enrollment will be accepted effective either the next April 1 or the next October 1.
The supplemental group life insurance coverage may be reduced only on written request from the insured.
An employee transferring from the status of non-inclusion in a prevailing collective bargaining unit contract to the status of inclusion in a prevailing collective bargaining unit contract must be dis-enrolled in this supplemental group life insurance program. The agency must inform the employee, in writing, of this change in coverage.
If the employee transfer is to a bargaining unit whose contract provides for supplemental group life insurance, then the employee may participate in the programs subject to the provisions of the collective bargaining unit contract.
Disability waiver of premium is NOT applicable to supplemental group life insurance. The supplemental coverage may remain in force provided the insured is continued as an employee and continues to pay the premium. If the premium is not paid as required, the coverage will lapse and reinstatement will not be allowed until the insured returns to work. The agency must inform the employee, in writing, of this change of coverage.
Supplemental group life insurance may remain in force as long as the insured is receiving workers' compensation benefits provided the insured continues to pay the premium. If the premium is not paid, as required, the insurance coverage will lapse and reinstatement will be allowed only within the continuing consecutive twelve-month period. The agency must inform the employee, in writing, of this change of coverage.
An eligible employee may decide not to participate in the optional supplemental life insurance plan, or an employee may wish to withdraw from participation in the optional supplemental life insurance plan. In either situation, the employee should be given a waiver card for completion and signature. It should be promptly returned to the agency. In turn, the agency should submit the original card to the Comptroller's Office, Special Services Division.
Once having waived participation, the employee may obtain optional supplemental life insurance only after evidence of insurability as determined by Aetna Insurance Company.
On termination of employment, retirement or other, the supplemental group life insurance may be converted subject to the conversion provision of the policy.
Section 5-257(e) of the Connecticut General Statutes provides that such optional coverage shall not be included when calculating the amount of reduced life insurance coverage due retired employees.
For information regarding conversion, contact:
Office of the State Comptroller, Special Services Division Phone: 566-3871
As stated in the opening paragraph of this memorandum, "The actual cost of such optional coverage shall be fully borne by the employee". Check Group Life Insurance booklet for schedule of cost or contact the Special Services Division of the Office of the State Comptroller for a copy. Payroll deductions must be made in accordance with established procedures using D/OE 40, sort code 00237. The deductions for the basic employee's group life insurance must continue to be coded D/OE 66, sort code 00014.
A supply of the forms may be obtained by ordering from the Supervisor, Group Life Insurance Unit.
If you have any questions, contact the Supervisor, Group Life Insurance at 566-4559. DO NOT REFER EMPLOYEES TO THIS NUMBER.
ELIGIBILITY FOR GROUP LIFE INSURANCE AND HEALTH SERVICES
(SECTIONS 5-257 AND 5-259 OF THE CONNECTICUT GENERAL STATUTES)
NOTE: When provisional appointees are to be added to health insurance coverage, the employee hire date should show the actual date hired and the abbreviation, PROV, to show that the late accession was not the appointee's fault.
Provisional appointees will be eligible for health insurance coverage following the completion of six months continuous service, if service is continued in another status following the completion of a four month appointment without an examination being given. The procedure to effect this coverage should be started early enough so that the appointee concerned will have coverage effective on the first of the month following the completion of six months continuous service.
HEALTH INSURANCE
If an employee is on LAW due to illness or injury, then the coverage for such employee and covered dependents will be continued for a period of up to twelve months from the beginning of such absence on the records of the agency where the employee last worked. The state will continue to pay its portion of the cost and the employee must make arrangements with the agency's payroll section to pay their portion. The employee's share must be received at the agency in advance of the due date for the bi-weekly payment in order for coverage to continue. Refer to the current "Schedule of Self-Administered Health Insurance Billing" for payroll deductions and for the mailing of checks to Blue Cross/Blue Shield and various HMO's.
Employees going on leave of absence, without pay for any reason other than illness or injury may continue the state's health plan under the provisions of COBRA. In order to simplify operations, the following procedure will be followed for those going on leave of absence without pay other than for illness or injury.
If the duration of the period of LAW will be less than four months, the agency will continue to carry the person on LAW on its Health Plan bills and collect the full amount of the premium from him.
If the duration of the period on LAW will be four months or over, the employee must be offered continuation coverage when under COBRA procedures.
Payment of the state's portion will continue as long as the employee remains on compensation. The employee's share of family coverage (if any) must still be paid. Arrangements must be made for either direct payment to the agency by the employee or if leave benefits are used to supplement compensation then payroll deduction of the employee's share may be continued, as long as the supplemental amount is sufficient to cover the deductions.
NOTE: If the employee's family portion is not paid in accordance with the "Schedule", their health insurance must be terminated.
Qualifying events with a 24-month eligibility period are:
Qualifying events with a 36-month eligibility period are:
COBRA continuation coverage for an employee involved in a "qualifying event" shall be eligible for the same group health coverage received immediately before the "qualifying event". Qualified beneficiaries of such employees will have a status similar to an active employee.
The agency must generate the qualifying event notice within 14 days of the event. COBRA beneficiary(ies) have 60 days from the date of notice or loss of coverage whichever is later. You should check your record to ascertain the date to which the employee has paid for coverage. Include the date of loss of coverage in your notification letter and on the Office of Comptroller Form CO-887 (New 4/81).
Included with your COBRA notice should be a COBRA enrollment form and a self-addressed envelope. The upper portion of the enrollment form should be completed by the agency. Retain a copy for your files and send a copy to the Special Services Division of the Comptroller's Office. The qualified beneficiary(ies) must mail the completed form to Blue Cross/Blue Shield, using the pre-addressed envelope. They have 45 days from the date they elect COBRA to pay for the retroactive coverage.
A supply of enrollment forms and envelopes may be obtained by calling a Blue Cross/Blue Shield COBRA Administrator at 1-800-433-5436 or (203) 287-6715. If the employee is a participant of the CIGNA Dental Plan, they should be given a CIGNA Dental Plan COBRA form which can be obtained from the Special Services Division of the Comptroller's Office (see Exhibit 28 & 28A).
Rules for picking up or dropping dependents will be the same as for active employment, except that no coverage will be provided which the employee was not carrying as an active employee.
If there are any questions relative to eligibility or procedures outlined, please contact the Special Services Division at 566-5057.
Health plan coverage shall be continued for employees who are out on approved disability due to pregnancy, while they are being paid for accrued sick leave, vacation time, personal leave or earned time. During this period, employee and state portions of the cost will appear on the payroll.
If such employees are granted a leave of absence without pay, they will be treated as though on leave of absence due to illness, as set forth in Section 1 of this Health Insurance Section.
HEALTH AND DENTAL SERVICES
Blue Cross/Blue Shield/Major Medical
NOTE: Employees must have all elements of Blue Cross/Blue Shield/ Major Medical equally.
Health Maintenance Organization(s) (HMO(s)
PROCEDURES FOR CONTINUANCE OF INSURANCE BENEFITS
WHILE ON LEAVE OF ABSENCE OR TERMINATION OF EMPLOYMENT.
GROUP LIFE INSURANCE
An employee may continue basic and supplemental life insurance during an authorized leave of absence for the reasons listed below, provided the employee continues to make premium payments during such leave:
If an employee is on leave of absence due to illness resulting from pregnancy, the insurance may continue until she is released by her physician to return to work, but such leave will not extend beyond one year. If the employee continues on leave after such release by her physician, the absence will be considered a leave for other reasons and the continuation of the life insurance will be limited to two (2) months.
To insure continuing coverage during a leave of absence, payment of premiums must be made in advance for the periods not covered by payroll deductions. Payments must be made for two months at a time and submitted by the fifteenth (15th) of the month preceding the two month period to the Agency Payroll Officer. NO BILLS WILL BE SENT. FAILURE TO MAKE PREMIUM PAYMENTS WILL CAUSE CANCELLATION OF COVERAGE.
Assuming all required payments are made during the leave of absence, an employee must resume payroll deductions immediately upon return to work in order to maintain continuity of coverage. Failure to do so will require evidence of insurability as approved by Aetna if the employee wishes to rejoin at a later date.
If coverage is cancelled for non-payment during a leave of absence and the employee wishes to participate in the life insurance plan at a later date, evidence of insurability will be required.
Any other medical issue relating to the family leave provision of Section 5-248(a) of the Connecticut General Statutes should be referred to Comptroller's Memo #92-29.
An employee who terminates active work for any reason should contact the State Comptroller's Office, Life Insurance Unit to determine what arrangements, if any, can be made to continue the insurance in force or to exercise any rights under the group policy when insurance terminates.
If any employee's life insurance ceases because of termination of employment, termination of membership in the class of employees eligible or State retirement, the amount of life insurance which ceases (or a lesser amount, if desired) may be converted to an individual life insurance policy.
In order to convert, written application must be received by Aetna for an individual policy and the first premium must be paid within thirty-one (31) days after cessation of insurance for any of the above reasons. No evidence of insurability will be required. The individual policy will become effective at the end of the thirty-one (31) day period during which conversion is possible.
AGREEMENT ON GIVEBACKS BY THE COALITION BARGAINING UNITS
"HEALTH INSURANCE PREMIUM CONVERSION PLAN"
In accordance with the terms of a recently concluded collective bargaining agreement between the State and the State Employees Bargaining Agent Coalition (SEBAC), employee group health insurance premium deductions were taken on a pre-tax basis commencing with the payroll checks date March 20, 1992. The pre-tax deduction will be automatic for employees who are covered by the SEBAC agreement; employees who are not covered by the SEBAC agreement will be given an opportunity to retain their current post-tax health insurance premium deduction, as discussed below. In order to accomplish the health insurance deduction on a pre-tax basis, the state will "pick-up" the required employee payment for group health insurance and, in turn, will reduce the employee's gross wage by the exact amount of that premium "pick-up" payment. This transaction is advantageous because health insurance payments made by the state are tax exempt; employee payments for health insurance do not enjoy a tax exempt status. Consequently, the "pick-up" allows employees to exclude their health insurance premium payments from state, federal and FICA taxes. The result is an increase in the net pay of participating employees.
Information regarding this program, its establishment, administration, taxability, social security impact, retirement impact, etc., will be provided separately by the Department of Administrative Service (DAS).
The Comptroller's Office has been informed by DAS that this benefit is to be extended to non-collective bargaining employees as provided by Section 5-200(r) of the Connecticut General Statutes.
As is stated in Section I, employees who are not covered by the SEBAC agreement must be given an opportunity to decline participation in the health insurance premium "pick-up" program. In that connection, the Department of Administrative Services, serving as the administrator of the "pick-up" program, will send a copy of a letter to the home address of each employee who is not covered under the SEBAC agreement. Said employee had until March 6, 1992 to waive participation in the "pick-up" program; any such employee who failed to waive participation in the program through proper notification to their payroll or personnel office will be included in the program. Notification should be provided by signing the waiver form that is part of DAS's letter.
The employee's signed negative election form must be kept on file at the employing agency.
Once an employee makes the choice to waive participation in the "pick-up" program for a tax year, they will not be able to participate until the next tax year unless there is a change in an employee's family status. For qualifying changes in family status, please refer to the administrative information supplied by DAS.
This benefit is available only for employees on the active payroll. Payments for health insurance premiums made other than by payroll deduction will not receive the favorable tax treatment.
This program was implemented for the pay period February 21 through March 5, 1992 (check date March 20, 1992).
A mass change was made centrally changing the employee's insurance premium deduction(s) to the new deduction code(s) (D/OE) that have been established for premiums paid on a pre-tax basis. NO ACTION NEEDS TO BE TAKEN AT THE AGENCY.
Plan Administration:
Department of Administrative Services, Management Relations, 566-2265
Payroll Procedures - Office of the State Comptroller
Forms and On-Line: | Central Payroll Division, 566-5428 |
Remote Job Entry: | Computer Services Division, 566-3214 |
SCHEDULE FOR BLUE CROSS, CMS AND HMO DEDUCTIONS ON PAYROLL