Chapter 742-7 Benefits

742-7-01 Issue date of pension checks.

The issue date of pension checks to police and fire retirants and their eligible survivors shall be the first of each month.

Effective: 4/23/2015
Five Year Review (FYR) Dates: 02/04/2015 and 04/23/2020
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.37, 742.39
Prior Effective Dates: 1/1/1977, 2/14/2005

742-7-02 Use of member's records.

(A) All records and files of the board and Ohio police & fire pension fund ("OP& F") shall be public information, including an employer's status of the payment of contributions generally due under Revised Code sections 742.30, 742.31, 742.33, and 742.34, but shall not include any member's personal history record (as hereinafter defined), except as otherwise provided by law. A member's personal history record (as hereinafter defined) may only be released to the member or a third party upon OP& F'S receipt of a written authorization from the member or his/her authorized representative or agent using forms provided by OP& F or a form substantially similar to OP& F'S form, subject to any internal policies adopted by OP& F and to the extent provided by such authorization, but any such authorization must be signed before a notary public.

(B) "Member's personal history record" includes all information related to an OP& F member, including the name, address, telephone number, social security number, record of contributions, correspondence to or from OP& F, any report of a pre-employment physical, any medical reports and recommendations (subject to the terms of paragraph (C) of this rule), the status of any application for benefits, any record identifying the service history or service credit of a member or benefit recipient, but excluding:

(1) The member's status with OP& F (i.e. active, retired, or disabled),

(2) The provision of law under which a member retired,

(3) The award given to a member or his/her survivors, as the case may be, by the board of trustees for a disability reconsideration or application for benefits under the Ohio public safety officers death benefit fund and the member's name and employer; and

(4) Disability award, both appeal and initial determinations granted by the board of trustees and accepted by the member.

(5) Any information disclosed by OP& F in accordance with the permitted exceptions of the Health Insurance Portability And Accountability Act of 1996 and OP& F HIPAA policies and procedures.

(C) Medical reports and recommendations are considered to be the property of Ohio police & fire pension fund. The medical reports and recommendations for a member may be released to the member, unless an OP& F physician or psychiatrist determines for OP& F that the disclosure of information is likely to have an adverse effect on the member. In the event the OP& F physician or psychiatrist determines that a disclosure of medical reports and recommendations to a member will have an adverse effect on the member, the information shall only be released to a physician, psychiatrist, or psychologist who is designated by the member or his/her authorized representative or agent only after OP& F's receipt of a written authorization from the member or his/her authorized representative or agent using forms provided by OP& F or a form substantially similar to OP& F's form, subject to any internal policies adopted by OP& F to the extent provided by such authorization. Notwithstanding any other restrictions referenced in this rule, the medical reports and recommendations of a member may be released to OP& F appointed physicians and vocational evaluators when necessary for the proper administration of the benefits offered by OP& F. Except as otherwise provided in this rule, these records may be released to the member and may be released to the member's attorney, physician, or duly authorized agent only upon written authorization of the member or the member's authorized representative or agent using forms provided by OP& F or a form substantially similar to OP& F's form, but any such authorization must be signed before a notary public. Any other release is prohibited.

(D) As provided by law and only at the request of any organization or association of members of OP& F, OP& F shall provide a list of names and addresses of members and other system retirants (as defined in Revised Code section 742.01 ). OP& F shall comply with such a request at least once a year.

(E) Reasonable fees may be charged for any expenses incurred in compiling, copying, mailing, or examining the records of OP& F.

(F) The executive director may designate a staff member to authenticate retirement system's records of OP& F that will be sent to a court officer of this state.

(G) An authorization given by a member or his/her authorized agent or representative shall be valid for only one year from the date that it was issued.

(H) OP& F shall make the determination on compliance with the terms of this rule and its decision shall be final.

(I) For purposes of this rule, a "Member" shall have the meaning set forth in division (E) of Revised Code section 742.01.

Five Year Review (FYR) Dates: 11/02/2015 and 11/02/2020
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.41
Prior Effective Dates: 1/1/77, 7/16/84, 5/12/86, 10/16/86, 5/4/00, 8/8/00, 12/23/00, 5/24/03 (Emer.), 7/31/03, 10/13/05, 10/4/10

742-7-03 Payment date of benefits.

Except as otherwise required by law, all benefit checks shall be paid by Ohio police and fire pension fund ("OP& F") as follows :

(1) For benefit recipients who request the payment of benefits by direct deposits, OP& F shall transfer the funds to the benefit recipient's account on record on the first business day of each month;

(2) For benefit recipients who do not request the payment of benefits by direct deposit, OP& F shall mail checks on the last business day of the month for benefits due the following month, even though the issue date of the check will be the first day of the next month, as provided for in rule 742-7-01 of the Administrative Code. In the event a benefit recipient negotiates the check prior to its issue date and OP& F incurs a fee for such transaction, the board of trustees may adopt a policy that provides for the reimbursement of such fees by the benefit recipient.

(3) In the event the first business day of the month falls on a legal holiday, the funds will be available for benefit recipients who request direct deposit on the first business day following the legal holiday.

Effective: 09/28/2014
Five Year Review (FYR) Dates: 07/14/2014 and 09/28/2019
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.37, 742.40
Prior Effective Dates: 5/4/2000

742-7-04 Extended benefits.

(A) For purposes of division (E) of section 742.37 of the Revised Code (hereinafter referred to as the "Extended Benefits"), "full time curriculum requirements" shall mean at least twelve hours, subject to the other provisions of this rule.

(B) As provided for in division (E) of section 742.37 of the Revised Code, the criteria determined by OP& F's board of trustees for the institution of learning or training is that the school must be a high school, vocational or trade school, college or university and the course of study must be designed for at least one school year of full-time study or its equivalent in part-time study, subject to the limitations referenced in paragraph (D) of this rule.

(C) In order to apply for "Extended Benefits," the parent or guardian and the student must complete an application in the form approved by OP& F. In addition, a separate application must be completed and filed with OP& F for each child who wishes to apply for "Extended Benefits."

(D) If a student is out of school more than four months and returns to school, a new application must be made before benefit payments will be resumed.

(1) If the child's pension was terminated when he/she attained age eighteen if he/she did not attend an "institution of learning or training" and he/she attends an "institution of learning or training" that meets the foregoing criteria, a new application for him/her shall be completed and filed with OP& F in the OP& F approved form before his/her benefits will be paid if he/she meets the statutory criteria set forth in division (E) of section 742.37 of the Revised Code, and such benefits shall commence the earlier of the month following OP& F's receipt of the fully-completed application or the date on which the child began attending an institution of learning or training.

(2) If an unmarried child of a deceased member between the ages of eighteen and twenty-one files for "Extended Benefits" and he/she has never received a benefit from OP& F under division (E) of section 742.37 of the Revised Code, a copy of his/her birth certificate must accompany the completed application before OP& F can pay the benefit.

(3) For purposes of the application process for "Extended Benefits," a certification from the school the eligible child is attending is required as a part of the application process. A new certification must be completed for each school period of enrollment otherwise, the child will not be eligible for benefits under division (E) of section 742.37 of the Revised Code.

For purposes of determining whether the student has met the requirement for "two-thirds of regular school work," OP& F will allow students to be paid through the vacation period, which is considered as four months and can be taken any time during the year. If the student takes more than four months, he/she is not eligible for a benefit for the extra time off. For example, OP& F will pay a full year of "Extended Benefits" if the eligible child is in school, takes the summer months off, but returns to school in September; or, if the child takes a quarter off and goes to school in the summer.

(E) Since "Extended Benefits" will be paid to surviving children of OP& F members, the benefits for children shall be paid to the parent or guardian and the eligible child, unless the eligible child is no longer minor. The parent or guardian, or the child if no longer a minor, as the case may be, shall be held responsible for any overpayments of benefits that result from the surviving child no longer being eligible to receive "Extended Benefits" due under division (E) of section 742.37 of the Revised Code and this rule.

Five Year Review (FYR) Dates: 05/05/2016 and 05/05/2021
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.37(E)
Prior Effective Dates: 1/1/77, 2/22/02, 06/30/2011

742-7-06 Health care premiums. [Rescinded].

Rescinded eff 10-22-04

742-7-07 Pre-retirement survivor annuity.

(A) The board will authorize payment of the benefits created by section 742.3714 of the Revised Code when the board determines that:

(1) A deceased or former member was, on the date of death, eligible to retire and to receive an immediate pension under division (C)(1) or (C)(3) of section 742.37 of the Revised Code, but had not retired because he/she had not severed employment as a police officer or fire fighter; and

(2) The deceased member is survived by a spouse or "contingent dependent beneficiary" eligible to receive the benefit.

(B) A "contingent dependent beneficiary" is eligible to receive the benefits provided by section 742.3714 of the Revised Code if, on the date of the member's death, the "contingent dependent beneficiary":

(1) Can show that he/she was dependent upon the member for at least fifty per cent of his or her annual income; and

(2) Had been designated as a "contingent dependent beneficiary" on a form provided by the board that was properly executed by the member.

(C) Annually, the board shall make reasonable efforts to notify all members who are eligible to name a "contingent dependent beneficiary" of their right to do so. A form to designate a "contingent dependent beneficiary" shall be made available to a member upon request, with the understanding that the notice will be sent to the most recent address on file with Ohio police and fire pension fund ("OP& F"). The form is properly executed only when it has been completed and signed by the member, notarized, and received by OP& F at its office. A member may designate only one person to be a "contingent dependent beneficiary." A member may change the designation at any time by completing a new form; only the latest dated designation will be effective. No person is a "contingent dependent beneficiary" eligible to receive benefits, unless OP& F has a properly executed form on file as of the date of the member's death.

Five Year Review (FYR) Dates: 10/5/2017 and 07/19/2022
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.3711, 742.3714
Prior Effective Dates: 06/06/1984, 04/29/2002, 05/17/2007, 07/19/2012

742-7-08 Cost-of-living allowance.

(A) The benefits and contributions of any member shall be calculated on the basis of the member's salary as defined by divisions (G) and (L) of section 742.01 of the Revised Code and rule 742-3-02 of the Administrative Code.

(B) All members having fifteen years of service credit as of January 1, 1989 shall be provided a form upon which they can elect the basis of benefit and contribution calculations under section 742.3716 of the Revised Code. For purposes of this determining a member's eligibility for this election, years of service credit shall include any credit purchased prior to January 1, 1989.

(C) A beneficiary's "anniversary date" shall be July first, for those eligible for the first cost-of-living allowance on that date or the anniversary of the beneficiary's effective date of retirement or benefits for those not eligible for the first cost-of-living allowance. When a beneficiary's anniversary date does not fall on the first of a month, a pro rata payment of the first month's cost-of-living allowance shall be paid.

(D) A beneficiary's "base benefit" shall be the amount of a benefit first calculated upon retirement, and shall exclude any medicare reimbursement, any amount by which a member reduces benefits under an optional plan of payment pursuant to section 742.3711 of the Revised Code, any actuarial reduction for early retirement, and any previous cost-of-living increases.

(E) The benefit paid to an eligible survivor under an optional plan of payment shall be based upon the amount last received by the member, excluding medicare reimbursement and the amount of any reduction chosen by the member, but including any cost-of-living allowance received by the member. Such survivor shall be entitled to cost-of-living adjustments based upon the original base of the survivor under the optional plan of payment.

(F) Upon the election by an eligible member to cancel an optional plan of payment and to return to a single life annuity, previously awarded cost-of-living allowances shall be adjusted to the amount the member would have received had the member always been paid a single life annuity.

Effective: 4/23/2015
Five Year Review (FYR) Dates: 02/04/2015 and 04/23/2020
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.37
Prior Effective Dates: 7/24/86 (Emer.), 10/16/86, 10/09/87 (Emer.), 1/10/88, 2/7/00 (Emer.), 5/1/2000, 2/14/2005

742-7-09 Medicare part "A" or "B" eligibility; payment of medicare part "B" premium; treatment of medicare part "B" payment.

(A) Each recipient of service, disability, or survivor benefits who receives health care benefits from the Ohio police and fire pension fund ("OP& F") and his/her enrolled dependents shall enroll in medicare part "A" and "B" at his or her first eligibility date. If a person covered under OP& F's health care plan fails to enroll in medicare part "A" or "B" at his/her first eligibility date, OP& F's appropriate third party administrators will process the claims of such person in accordance with the terms of OP& F's health care plan and reserves all rights to recover monies associated with a covered person's failure to comply with such provisions.

(B) For purposes of section 742.45 of the Revised Code, "satisfactory evidence of the payment for coverage" shall mean filing of the medicare part "B" reimbursement statement in the form approved by OP& F or the medicare billing statement, along with a copy of the applicant's medicare card or a letter from medicare in lieu of a medicare card. No retroactive reimbursement will be made. For any inaccurate or incorrect statement made on the medicare part "B" reimbursement statement, OP& F reserves all rights to recover monies associated with a covered person's failure to comply with such provisions.

(C) In accordance with divisions (C) and (D) of section 742.45 of the Revised Code, OP& F shall not reimburse the medicare part "B" premium to a benefit recipient who is receiving or should be receiving reimbursement for this premium from any other source and the member or benefit recipient shall be deemed to consent to the recovery of any overpayment by deduction from his/her monthly pension or benefit. If another Ohio retirement system is responsible to provide health care to such recipient, OP& F shall not be responsible to pay the medicare part "B" reimbursement. No retroactive payment shall be given.

(D) The recipient of the medicare part "B" reimbursement shall be deemed to consent to the recovery of any overpayment by deduction from his/her monthly pension or benefit. The monthly deduction shall be an amount equal to the greater of:

(1) The monthly amount determined by dividing the amount of the overpayment by the time period over which the overpayment occurred;

(2) The monthly amount of OP& F's medicare part "B" reimbursement on the month in which deductions are to commence; or

(3) The monthly amount agreed to in writing by the recipient.

(E) Effective January 1, 2002, the reimbursement of medicare part "B" payments made by OP& F to eligible beneficiaries under section 742.45 of the Revised Code shall not be considered "benefits" under division of property orders and child and spousal support orders since these payments are reimbursement of expenses incurred by such beneficiary.

Five Year Review (FYR) Dates: 05/26/2017 and 04/06/2022
Promulgated Under: 111.15
Statutory Authority: 742.10, 742.45
Rule Amplifies: 742.45
Prior Effective Dates: 07/15/94, 02/17/98, 01/29/01, 11/30/01 (Emer.), 02/22/02, 03/14/02 (Emer.), 05/31/02, 10/06/03, 12/23/04, 12/20/2006 (Emer.), 03/19/2007, 05/17/2012

742-7-10 Long-term care insurance program.

(A) The terms of the long-term care program offered pursuant to section 742.53 of the Revised Code shall be outlined in plan document prepared by the vendor chosen by OP& F's board of trustees and upon terms and conditions in a form acceptable to OP& F. For any changes after January 1, 2004, the plan committee designated in the health care plan and referenced in paragraph (B) of rule 742-7-13 of the Administrative Code shall have authority to approve such changes, subject to prior board approval only for any changes in the vendor or for the determination of the"members of the family" who are eligible to participate in the program.

(B) The vendor chosen by OP& F's board of trustees to offer the long-term care coverage shall be responsible for providing a summary plan description to the appropriate individuals.

(C) For purposes of section 742.53 of the Revised Code, "members of their families" shall mean the spouse of the OP& F member or benefit recipient, the parent(s) of the OP& F member or benefit recipient, the parent(s) of the spouse of the OP& F member or benefit recipient, or the adult children of the OP& F member or benefit recipient, subject to certain limitations outlined in the governing plan document.

(D) If the long-term care program is established jointly with another retirement system, the plan shall separately establish the terms and conditions for participation for OP& F members, benefit recipients, and eligible members of their families, as defined in paragraph (C) of this rule.

(E) Contributions for the cost of long-term care coverage shall be paid directly by the eligible participant to the vendor consistent with the governing plan provisions.

(F) OP& F shall not subsidize or underwrite the cost of this program.

Five Year Review (FYR) Dates: 10/24/2014 and 10/24/2019
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.45, 742.53
Prior Effective Dates: 10/06/2003

742-7-11 Responsibility for health care coverage.

(A) For the purpose of this rule:

(1) "Age and service retirant" means a former member who is receiving a retirement allowance pursuant to division (C) of section 742.37 of the Revised Code.

(2) "Cost paid by the benefit recipient" means the amount equal to the percentages as of January 1, 2004 paid by the benefit recipient multiplied by the system's cost per benefit recipient.

(3) "Dependent" means an eligible spouse or child of an eligible benefit recipient.

(4) "Disability benefit recipient" means a member who is receiving a benefit or allowance pursuant to section 742.38 or former division (C)(2), (C)(3), or (C)(4) of section 742.37 of the Revised Code.

(5) "Effective benefit date" means the effective date of retirement, as outlined in rule 742-3-01 of the Administrative Code or the effective date of the survivor benefits.

(6) "Eligible benefit recipient" means an age and service retirant, disability or survivor benefit recipient who is eligible for health care coverage.

(7) "Health care coverage" means the benefit under the health care plan sponsored by OP&F including, but not limited to, the medical coverage, dental and the vision coverage, the prescription drug coverage, and the medicare part B premium reimbursement.

(8) "Ohio retirement system" means public employees retirement system, state teachers retirement system, school employees retirement system, or highway patrol retirement system.

(9) "Survivor benefit recipient" means a beneficiary receiving a benefit pursuant to division (D), (E), or (F) of section 742.37 of the Revised Code.

(B) Except as otherwise provided in this rule, this retirement system shall be the system responsible for health care coverage for eligible benefit recipients who receive a benefit or allowance from this system.

(C) This retirement system shall not be the system responsible for health care coverage for eligible benefit recipients in the following situations.

(1) Where an eligible benefit recipient who is an age and service retirant of this system also is an eligible benefit recipient receiving an age and service benefit from another Ohio retirement system and the effective benefit date in this system is later than the effective benefit date in the other system.

(2)

(a) Where an eligible recipient who is a disability benefit recipient of this system also is an eligible benefit recipient receiving an age and service benefit from another Ohio retirement system.

(b) Where an eligible benefit recipient who is a survivor benefit recipient of this system also is an eligible benefit recipient receiving an age and service benefit or a disability benefit from another Ohio retirement system.

(3) Where an eligible benefit recipient who is a disability benefit recipient of this system also is an eligible benefit recipient receiving a disability benefit from another Ohio retirement system and the effective benefit date of the benefit from this system is later than the effective date in the other system.

(4) Where an eligible benefit recipient who is a survivor benefit recipient of this system also is an eligible benefit recipient receiving a survivor benefit from another Ohio retirement system and the effective benefit date of the benefit from this system is later than the effective date in the other system.

(5)

(a) Where the effective benefit dates for an eligible benefit recipient in the situation described in paragraph (C)(1), (C)(3) or (C)(4) of this rule are the same in each system, and the benefit recipient has less service credit in this system than in the other system.

(b) Where an effective date and service credit for an eligible benefit recipient in the situation described in paragraph (C)(1), (C)(3) or (C)(4) of this rule are the same in each system, and the employee contributions in the account upon which the benefit in this system is based are less than the employee contributions in the account upon which the benefit in the other system was based.

(D)

(1)

(a) Where this system is responsible for health care coverage pursuant to this rule, an eligible benefit recipient of this system who also is an eligible benefit recipient of another Ohio retirement system may irrevocably waive such health care coverage in order to be covered by the other Ohio retirement system, if the other system has agreed in writing to offer such coverage. Such recipient shall waive such coverage in writing to this system. Health care coverage in this system shall cease beginning the first of the month following receipt of the waiver by this system.

(b) In the event a recipient has waived health care coverage as provided in paragraph (D)(1)(a) of this rule, this system shall:

(i) Promptly notify the other Ohio retirement system that the benefit recipient has waived health care coverage and the effective date of such non-coverage; and

(ii) For covered benefit recipients and dependents transfer to the other system annually for each month covered an amount equal to the sum of:

(a) The lesser of this system's average monthly medical including health maintenance organization cost per benefit recipient less the cost paid by the benefit recipient, or the other system's average monthly medical including health maintenance organization cost per benefit recipient.

(b) The lesser of this system's average monthly cost of the prescription drug program per benefit recipient, or the other system's average monthly cost of the prescription drug program per benefit recipient.

(c) The lesser of the monthly cost of the medicare part B premium that would be reimbursed by the system for the benefit recipient or the monthly cost of the medicare part B premium that would be reimbursed by the other system for the benefit recipient.

(d) This system shall transfer the amounts due pursuant to paragraph (D)(1)(b)(ii) of this rule no later than the last business day of February each year for the preceding calendar year after the following occur:

(i) This system receives from the other system a list containing the names of benefit recipients and the number of months during which the recipients were covered by the other system for the preceding calendar year; and

(ii) This system prepares an itemized accounting of the amount transferred for each such benefit recipient.

(2)

(a) Where this system is not responsible for health care coverage pursuant to this rule, an eligible benefit recipient of another Ohio retirement system who also is an eligible benefit recipient or dependent of an eligible benefit recipient of this system may irrevocably waive health care coverage in the other system to be covered by this system as a benefit recipient or dependent if otherwise eligible. Health care coverage in this system shall be effective the first of the month following the termination of coverage in the other system.

(b) Where an eligible benefit recipient or dependent of an eligible benefit recipient of this system has waived health care coverage in another Ohio retirement system, this system shall be responsible to provide health care coverage only if this system:

(i) Is promptly notified by the other system that the benefit recipient or dependent has waived health care coverage and the effective date of termination of coverage; and

(ii) For covered benefit recipients and dependents the other system pays annually to this system for each month covered an amount equal to the sum of:

(a) The lesser of this system's average monthly medical including health maintenance organization cost per benefit recipient less the cost paid by the benefit recipient, or the other system's average monthly medical including health maintenance organization cost per benefit recipient.

(b) The lesser of this system's average monthly prescription drug program per benefit recipient, or the other system's average monthly cost of the prescription drug program per benefit recipient.

(c) The lesser of the monthly cost of the medicare part B premium that would be reimbursed by the system for the benefit recipient or the monthly cost of the medicare part B premium that would be reimbursed by the other system for the benefit recipient.

(E)

(1) Not later than three years from the effective date of this rule this system shall contact the other Ohio retirement systems to review the adequacy of the transfer of funds described in paragraph (D) of this rule.

(2) If there is a material change in this system's plan or circumstances, this system shall notify the other Ohio retirement systems ninety days prior to the effective date of such change to discuss the impact of such change on this rule.

(F) The waiver program outlined in paragraphs (D) and (E) of this rule shall cease with the state teachers retirement system for the plan year beginning on January 1, 2008, and the waiver program with the Ohio public employees retirement system and the school employees retirement system has been discontinued in accordance with the dates established by these respective retirement systems. The highway patrol retirement system has never participated with OP&F in the waiver program outlined in this rule. Notwithstanding the discontinuation of the waiver program, any OP&F benefit recipient who irrevocably waived OP&F healthcare coverage as outlined in this rule shall remain in effect.

Effective: 3/22/2015
Five Year Review (FYR) Dates: 01/05/2015 and 03/22/2020
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.45
Prior Effective Dates: 7/11/1997, 12/30/2004, 7/19/2007

742-7-12 Health care discount program.

(A) OP&F may offer a discount in the non-subsidized portion of the health care contributions established by OP&F's board of trustees for eligible members or eligible survivors who meet the criteria established by OP&F's board of trustees. If such a discount is offered, eligible members or eligible survivors requesting the discount must file the appropriate form with OP&F's third party administrator for healthcare. The request must be filed prior to the date published on the form in order to be eligible for the discount for the applicable period. If an eligible member or eligible survivor fails to file the appropriate request form by the deadline date, no discount for that year, including a retroactive discount established by OP&F's board of trustees.

To be eligible for any discount in the non-subsidized portion of the health care contributions offered by the OP&F board of trustees, a member or survivor shall have a total household income equal to or less than a percentage, which shall be annually established by the board, of the poverty level established annually by the United States department of health and human services.

(B) The discount amount established by the board of trustees shall be effective on January first of each year through and including December thirty-first of that year.

(C) OP&F's third party administrator for healthcare will provide a written notice to the applicant on whether or not the discount has been granted.

(D) If the discount has been granted by OP&F's third party administrator for healthcare, a change in the household income of that eligible member or eligible survivor shall not impact the discount granted to that person for the discount period provided the person originally met the criteria at the time the discount request form was filed . If the discount has not been granted by OP&F and a decline in the household income of that eligible member or eligible survivor occurs from and after the deadline date referenced in paragraph (A) of this rule, the eligible member or eligible survivor shall not be allowed to enroll or receive the discount.

(E) By filing the discount request form, the eligible member or survivor authorizes OP&F to recover any discount granted as a result of a false or inaccurate statement made by the eligible member or eligible survivor or their authorized representative and OP&F reserves the right to request additional information for verification purposes only.

(F) For purposes of this rule, a "member of the household" shall include any eligible child, as defined in the health care plan referenced in rule 742-7-13 of the Administrative Code.

Effective: 12/26/2013
R.C. 119.032 review dates: 10/11/2013 and 12/26/2018
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.45
Prior Effective Dates: 1/29/01, 4/9/01 (Emer.), 6/24/01, 8/30/01, 6/26/02 (Emer.), 9/13/02, 10/6/2003

742-7-13 Health care program.

(A) For purposes of the health care program referenced in section 742.45 of the Revised Code, the board of trustees of the police and fire pension fund (OP&F) shall initially establish the terms of a health care plan, which will address the following, among other things:

(1) Health are/prescription drug coverage through contracts with third party administrators;

(2) Schedule of benefits;

(3) Supplemental dental and vision benefits;

(4) Medicare part B, as more fully described in rule 742-7-09 of the Administrative Code;

(5) Eligibility criteria;

(6) Coverage provisions;

(7) Enrollment rights;

(8) Termination of coverage;

(9) Contributions and the provision for the payment of any excess contributions due;

(10) The subsidy offered by OP& F;

(11) The right to continue coverage upon the occurrence of certain events;

(12) Coordination with medicare and other plans and benefits;

(13) Administration of the program;

(14) Claims procedures;

(15) Subrogation rights;

(16) Excluded coverage; and

(17) Mandated coverage.

(B) The terms of the health care plan that outlines the eligibility criteria and OP&F subsidy may only be changed/amended by OP&F's board of trustees, which is intended to serve as an amendment to the health care plan. With the exception of the eligibility criteria, OP&F subsidy, and designation of third party administrators, which may only be changed/amended by OP&F's board of trustees, the plan committee, which consists of OP&F's executive director, director of member services and general counsel, may approve any other amendments to the health care plan for plan .

(C) OP&F's board of trustees shall annually establish the amount of OP&F's subsidy for that plan year, consistent with OP&F's health care funding policy.

(D) OP&F shall communicate a summary of the health care plan to its eligible participants. Nothing in the summary is meant to interpret, extend or change in any way the rules set forth in the health care plan.

Effective: 12/26/2013
R.C. 119.032 review dates: 10/11/2013 and 12/26/2018
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.45
Prior Effective Dates: 10/6/2003

742-7-14 Recognition of pick-up of contributions.

(A) For reporting and tax purposes, the Ohio police and fire pension fund ("OP& F") will recognize any payment of a member's contributions under section 742.32 of the Revised Code or amounts designated by the member's employer for the purchase of service credit by payroll deduction with picked-up contributions if the member's employer has adopted and filed with OP& F a resolution authorizing the deduction and payment of contributions or service credit purchases for its employees with amounts designated as picked-up contributions under section 414(h)(2) of the Internal Revenue Code, in such form approved by OP& F's board of trustees, including an effective date (the "approved resolution"). The resolution must be filed at least thirty days prior to submitting contributions to OP& F as picked-up.

(B) The employer's reporting requirement under section 742.32 of the Revised Code shall also include the reporting of picked-up contributions consistent with the terms of this rule.

(C) To be compliant for reporting purposes under section 742.32 of the Revised Code and rule 742-9-10 of the Administrative Code, the employer must meet the following criteria:

(1) Timely file with OP& F a resolution authorizing the payment of contributions or purchase of service credit for its employees with amounts designated as picked-up contributions under section 414(h)(2) of the Internal Revenue Code in accordance with the deadline outlined in paragraph (A) of this rule;

(2) Timely report the amount of picked-up contributions by member as part of section 742.32 of the Revised Code and rule 742-9-10 of the Administrative Code and consistent with the applicable approved resolution on file with and approved by OPandF;

(3) Timely file a separate resolution for police and fire and then by unit/division, if applicable, or clearly outline the pick-up by unit/division;

(4) Timely file any changes to any approved resolution, which needs to be reviewed and approved by OP& F as if it were an originally-filed approved resolution;

(D) Applicable penalties and interest will apply for employers who fail to:

(1) Timely file a resolution for picked-up contributions with OP& F in accordance with the deadlines of this rule; and

(2) Timely report picked-up contributions under section 742.32 of the Revised Code.

(E) If OP& F receives an employer report under rule 742-9-10 of the Administrative Code that does not conform to the resolution on file with OP& F, OP& F shall send a written notice to the employer of the non-conforming nature of the resolution or reporting and allow the employer to have an opportunity to take corrective actions noted in the notice within thirty days of OP& F's written notice. OP& F shall not assess further penalties and interest under section 742.35 of the Revised Code until the expiration of this grace period for those employers who fail to take the corrective action noted by OP& F's written notice.

(F) For those employers who file an approved resolution and report contributions as picked-up, but fail to provide an effective date, this shall not be deemed to be non-compliant. In this case, the effective date will be the date of authorized signature or other supporting documentation provided by the employer, which is acceptable to OP& F.

(G) The requirements of this rule shall also apply to any changes or modifications to picked-up contributions and they will be treated as if they are a new resolution.

Five Year Review (FYR) Dates: 11/02/2015 and 11/02/2020
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.32
Prior Effective Dates: 11/25/03 (Emer.), 2/9/04, 7/19/04, 9/26/05, 10/4/10

742-7-15 Delinquent employers payment plan.

(A) For outstanding fines and penalties due under sections 742.352 and/or 742.353 of the Revised Code, OP& F shall offer a delinquent employer a payment plan if the employer meets the following criteria:

(1) The employer has no past due employee contributions; and

(2) The employer has satisfied any pre-existing payment plan promissory note; and

(3) The employer meets one of the following criteria:

(a) Employers on fiscal watch or fiscal emergency, as defined by the auditor of state, and who have past due contributions or have accrued reporting and/or pre-employment penalties and interest; or

(b) Employers who have accrued reporting and/or pre-employment penalties and interest which exceed the dollar amount of past due employer contributions, which have been past due for three or more quarters; or

(c) Employers who are inactive and have past due employer contributions, penalties, or interest; or

(d) Employers who have employer contributions that are three or more quarters past due and have no ability to pay (based on the financial formulas outlined below).

(i) Penalties and interest exceed 25% of general fund revenues; or

(ii) Penalties and interest exceed 80% of general fund ending fund balance; or

(iii) Penalties and interest exceed 50% of general fund receipt over expenditures.

(B) The offering of this plan of payment by OP& F will precede any actions taken by OP& F to certify the amount due from the employer in accordance with section 742.35 of the Revised Code.

(C) The plan of payment shall be offered to the employers who meet the criteria outlined in paragraph (A) of this rule in accordance with the following provisions:

(1) OP& F will review the eligibility of certain employers who may be able to take advantage of a payment plan. OP& F will notify those employers of the program and request that such employers contact OP& F for additional information.

(2) For any inquiries received from employers, OP& F will notify such employers of their eligibility to participate in a payment plan.

(3) OP& F shall designate a deadline by which the employer must elect to participate in the payment plan and sign the required documentation and if the employer fails to meet the deadlines, the payment plan will not be available to the employers and penalties and interest will continue to accrue.

(4) The employer will have several payment term options in order to permit the employer to choose the best option within the employer's budget considerations, but in no event will the term exceed fifteen years.

(5) The employer must sign a promissory note and agreement that will require signature by the designated authorities/officers of the municipality.

(6) As a condition to participating, the employer must pay in full all past accumulated interest incurred to date to OP& F. Should the employer be unable to remit the interest accrued in full, and all other conditions are met, the board will permit the employer to enter into the payment plan, however the employer's payments will be first applied to the accrued interest portion and then to the past due balance related to contributions and penalties. Interest on those past due balances and penalties will apply until the remaining balance is fully satisfied and based on the repayment term. The total repayment term is limited to the provisions otherwise outlined in paragraph C (4) of this rule.

(7) Upon OP& F's receipt of the required documents from the employer, further penalties will be suspended in exchange for the time certain repayment of funds due to OP& F made on a regular, periodic basis (monthly) as outlined on the payment schedule.

(8) For active employers who are participating in full compliance with the payment plan, the payment for regular quarterly bills will continue as normal and the billing statement will remove any reference to the unpaid penalties and interest covered under this arrangement unless the employer defaults.

(9) Interest will be calculated on accumulated penalty balance based on payment term selected. The balance due (penalty and interest) is to be amortized and repaid within the terms of the promissory note at the actuarial assumed rate of interest, which is currently 8.25 % and subject to change.

(10) The employer will be given strict payment dates with a fifteen day grace period for late payments. Further, each employer will only be allowed two late payments in any twelve calendar months. Employers will be notified of their late payment and failure to conform to promissory note terms on each occurrence may trigger a default covered by paragraph (D) of this rule.

(D) Failure to comply with the terms of the signed promissory note and agreement as described in paragraph (C) of this rule will put the employer in default status and OP& F shall terminate the agreement, at its option, and re-establish penalties retroactively back to the effective date of the promissory note, with a reduction of penalties for all payments of principal and interest made under the promissory note. The exercise of OP& F's right to declare a default shall be determined by OP& F's executive director.

(1) Upon default, the employer will be notified of the employer's failure to conform 742-7-15 2 to the terms of the promissory note and agreement as well as OP& F's decision to terminate the agreement.

(2) OP& F will initiate the certification process with the county where the employer resides to collect the balance of funds due to OP& F.

(E) All payments due under a payment plan shall be made as follows:

(1) Payments shall be due on the first of each month.

(2) Payments for active employers shall be sent to OP& F separately and not commingled with normal employer and employee contribution, which are paid quarterly.

(3) There is no prepayment penalty; excess amounts will be applied to principal.

(4) At the end of the term, any overpayments due to prepayment will be refunded back to the employer.

(5) Bounced checks will be charged back to employers with fees consistent with normal OP& F practices.

Five Year Review (FYR) Dates: 11/02/2015 and 11/02/2020
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.352, 742.353
Prior Effective Dates: 10/22/2004, 7/27/05 (Emer.), 10/13/2005, 10/04/2010

742-7-16 Guardianship.

(A) Except as provided in paragraph (E) of this rule, guardianship of the estate shall be required to do any of the following on behalf of a member or benefit recipient who has a legal disability, as defined in division (B) or (D) of section 2131.02 of the Revised Code:

(1) Apply for retirement or other benefits or payments on behalf of the member or benefit recipient;

(2) Elect an annuity payment plan and designate a beneficiary or beneficiaries, but only upon providing a court order approving the selection of the annuity payment plan and beneficiary designation; and

(3) Elect, or make any changes to, the payment of benefits or other monies that are due or become due to the member or benefit recipient, but only with a court order authorizing the release of funds or comparable order from another state that directs the payment of the benefits or other monies to be paid to the guardian or to a specific account at a financial institution.

(B) A guardian of the person is eligible to receive the account information of a member or benefit recipient, but may not make any changes regarding the account.

(C) A guardian of the estate, the person, or both shall provide OP&F with a copy of the "Letters of Guardianship" issued by the probate court showing his or her appointment as guardian.

(D) In lieu of guardianship, a court of competent jurisdiction may issue a limited order pursuant to section 2111.02, 2111.021, 2111.05 or 2111.131 of the Revised Code or comparable law from another state that directs OP&F to issue a member or benefit recipient's payment to a specific person or entity, and specifies the address and direct deposit routing and account numbers for the financial institution to receive such payment.

(E) Any benefits or payments that are due a benefit recipient who is a minor may be issued to the natural parent caring for the benefit recipient or the legal custodian of the benefit recipient. After the age of eighteen, payments shall be issued directly to the benefit recipient unless the benefit recipient is subject to an ongoing guardianship.

Effective: 12/21/2017
Five Year Review (FYR) Dates: 12/11/2022
Promulgated Under: 111.15
Statutory Authority: 742.10
Rule Amplifies: 742.26, 742.63, 742.58, 742.50, 742.446, 742.444, 742.39, 742.38, 742.3714, 742.3711, 742.37