LAW
Writer®
Ohio Laws and Rules
(A) The effective date of medical, dental and vision plan coverage for benefit recipients who elect coverage and enroll dependents shall be determined as follows:
(1) Disability benefit recipients - if a disability benefit recipient elects coverage when disability benefits are granted, coverage shall begin on the first of the month following the date that the retirement board acts to grant disability benefits.
A disability benefit recipient may defer enrollment up to three months if the disability benefit recipient elects coverage when benefits are granted, and in such a case, the effective date of the deferred coverage is the first of the month following termination of other group coverage within the three-month period.
(2) Service retirement benefit recipients - if a service retirement benefit recipient elects coverage when service retirement benefits are granted, coverage shall begin on the first of the month following the date the service retirement application is received by the state teachers retirement system or effective date of retirement, whichever is later.
A service retirement benefit recipient may defer enrollment up to three months if the service retirement benefit recipient elects coverage when benefits are granted and in such case, the effective date of the deferred coverage is the first of the month following the termination of other group coverage within the three-month period.
(3) Survivor benefit recipients - if a survivor benefit recipient submits a health care enrollment application within three months from the end of the month of the member's date of death, coverage shall begin on the first of the month following the member's date of death.
(4) Service retirement beneficiary recipients - if a service retirement beneficiary benefit recipient was enrolled as a dependent of a service retirement benefit recipient at the time of the service retirement benefit recipient's death, coverage shall continue at the same level as when the service retirement beneficiary benefit recipient was enrolled as a dependent unless the service retirement beneficiary benefit recipient contacts the state teachers retirement system within three months of the service retirement benefit recipient's death to elect different medical coverage. Any change will become effective the first of the month after the election is made.
(5) If a benefit recipient does not elect to enroll in coverage under a plan as permitted under paragraph (A) of this rule and later applies for coverage, coverage shall begin as follows:
(a) Coverage will begin on the first day of January following an open enrollment period specified by the state teachers retirement system.
(b) Coverage will begin on the first of the month following termination of other group coverage if application for coverage is received and approved by the state teachers retirement system within the thirty-one days after the termination of such other coverage.
(c) Through December 31, 2010, coverage will begin the first of the month after the completion of a six-month waiting period following application for coverage by a benefit recipient who is not at the time of application covered under another group health care plan or who is covered under another group plan that will not be terminating. The six-month period begins the month in which the application is received by the state teachers retirement system.
(d) Effective January 1, 2011, coverage will begin the first of the month after the completion of a ninety-day waiting period following application for coverage by a benefit recipient who is not at the time of application covered under another group health care plan or who is covered under another group plan that will not be terminating. The ninety-day period begins the month in which the application is received by the state teachers retirement system.
(6) Coverage for a new spouse enrolled by a service retirement or disability benefit recipient will be effective on the first of the month following the marriage, if a written application is received by the retirement system within thirty-one days of the date of marriage or within thirty-one days in which a change in a service retirement plan of payment is effective that qualifies the new spouse for a monthly benefit upon the death of a service retirant.
(7)
(a) Coverage for a newborn or adopted child of a service retirement, disability or survivor benefit recipient will begin on the day of birth or adoption, provided that a written application is received by the retirement system within thirty-one days of birth or adoption.
(b) If coverage for other dependent children is already in effect and a written application is received by the retirement system later than thirty-one days after the birth or adoption, coverage shall be effective the first of the month after receipt of the application.
(c) Through December 31, 2010, if no coverage for other dependent children is already in effect and a written application is received by the retirement system later than thirty-one days after the birth or adoption, coverage shall not be effective until first of the month following the completion of a six-month waiting period. The six-month waiting period begins the month in which the application is received.
(d) Effective January 1, 2011, if coverage for other dependent children is not already in effect and a written application is received by the retirement system later than thirty-one days after the birth or adoption, coverage shall not be effective until the first of the month following the completion of a ninety-day waiting period. The ninety-day waiting period begins the month in which the application is received.
(B) The effective date of long-term care plan coverage shall be as specified by the plan administrator.
Effective:
06/06/2011
R.C.
119.032 review dates:
03/22/2011 and
05/27/2016
Promulgated
Under: 111.15
Statutory
Authority:
3307.04
Rule
Amplifies:
3307.39,
3307.391
Prior
Effective Dates: 12/23/76, 11/28/77, 3/17/89 (Emer.), 6/1/89, 9/23/91 (Emer.),
5/28/92, 6/22/92 (Emer.), 9/10/92, 2/13/93, 9/1/96, 7/3/97, 9/16/98 (Emer.),
11/27/98, 5/25/00, 7/1/01 (Emer.), 9/17/01, 7/1/06, 10/28/10