Florida Regulations 60P-6.0068: Change in Participation, Termination, and Continuation of Participation
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(1) A participant’s salary reduction amount shall be increased or decreased automatically to correspond to any changes in employee contributions where, during the Plan Year, there has been a change in the cost of the premium under the State Health Insurance Program.
(2) An election made under the Pretax Premium Plan shall be irrevocable during the Plan Year except when a participant experiences a QSC event.
(3) A participant may revoke an existing election and make a new benefit election for the remaining period of coverage when a QSC event is or has been experienced, provided that the new election is consistent with the event and the request for such a change is made within thirty-one (31) calendar days of the event’s occurrence by submission of an application to the Department. Such application shall be required in addition to any insurance applications that may be required to comply with Fl. Admin. Code Chapter 60P-2 The Department shall determine if the requested benefit change is consistent with the change in status. Documentation of the occurrence of the change in status is required.
(4) Retirees under the State University System Phased Retirement Program who elect to continue their coverage shall be treated as having taken an unpaid leave of absence upon returning to employment, if they return during the same Plan Year.
(5) A participant may revoke an existing election if employment is terminated during the Plan Year. However, the participant may not make a new benefit election for the remaining portion of the Plan Year. A participant who fails to make the required contributions to the Medical Reimbursement Account in accordance with the salary reduction agreement at any time during the coverage period will have benefit payments suspended, regardless of account balance, until payment of required contributions resumes.
(6) Contributions under any pretax plan shall not be discontinued, except in the event of termination of participation as provided in this section. Any contribution made under any Plan may not be refunded to the participant. Reimbursements made under any Reimbursement Plan shall not be considered refunds of contributions.
(7) A participant shall continue to participate in any pretax plan until the earlier of the following dates:
(a) The date the participant ceases to be an eligible employee, unless the participant elects to continue coverage in the Medical Reimbursement Account by continuing payment of contributions, or
(b) The date on which the coverage period ends due to non-payment of contributions for a Medical Reimbursement Account, or
(c) The date the Plan Year ends.
(8) Upon subsequent employment with the State, an eligible employee who has terminated participation in the Plan shall be entitled to recommence participation as follows:
(a) If the participant is rehired as an eligible employee within 31 calendar days of termination and during the same Plan Year in which employment terminated, the participant shall not be allowed to make any new benefit elections under the Plan and will have the same level of benefits as were in effect immediately prior to the termination of employment unless there has been a Qualifying Status Change other than the termination and rehire.
(b) If reemployment as an eligible employee occurs during the same Plan Year in which employment terminated but occurs more than 31 calendar days after termination, and the participant has revoked his earlier benefit election, the participant shall not be entitled to recommence participation until the following Plan Year. However, the employee will be entitled to elect insurance coverage under the State Group Health Insurance Program on an after-tax basis, in accordance with Fl. Admin. Code Chapter 60P-2
(c) If reemployment occurs during a Plan Year subsequent to the one in which termination occurred, the employee shall be entitled to recommence participation upon reemployment and can make new benefit elections for the new Plan Year in accordance with rules and procedures established for newly-hired and newly-eligible employees.
(9) Upon termination of employment, the participant may desire to continue in the Medical Reimbursement Account and satisfy his or her annual election. The participant must notify the Department of his or her desire to continue no later than sixty (60) calendar days from the later of:
(a) The employment termination date;
(b) The date the participant is notified by the Department of his or her eligibility to continue participation.
(10) Continuation in the Medical Reimbursement Account requires that the participant satisfy his or her annual election by one of the following methods:
(a) Arranging, in advance of termination, to have all or part of the remaining balance deducted from his or her payment for annual or sick leave through payroll deduction on a pretax basis. Any amount needed to satisfy the annual election after this deduction is taken must be paid by personal check or money order within forty-five (45) calendar days of the participant’s election to continue participation;
(b) Making a single after-tax payment by check or money order for 100% of the remaining balance due within forty-five (45) calendar days of the participant’s election to continue participation;
(c) Making monthly after-tax payments by check or money order for the required monthly contribution made as an active employee. Such payments must be made no later than the first of each month. The first payment must be made within forty-five (45) calendar days of the participant’s election to continue participation.
Rulemaking Authority Florida Statutes § 110.161(5). Law Implemented Florida Statutes § 110.161. History-New 8-26-96, Repromulgated 4-25-02, Amended 3-2-17.
(3) A participant may revoke an existing election and make a new benefit election for the remaining period of coverage when a QSC event is or has been experienced, provided that the new election is consistent with the event and the request for such a change is made within thirty-one (31) calendar days of the event’s occurrence by submission of an application to the Department. Such application shall be required in addition to any insurance applications that may be required to comply with Fl. Admin. Code Chapter 60P-2 The Department shall determine if the requested benefit change is consistent with the change in status. Documentation of the occurrence of the change in status is required.
(4) Retirees under the State University System Phased Retirement Program who elect to continue their coverage shall be treated as having taken an unpaid leave of absence upon returning to employment, if they return during the same Plan Year.
(5) A participant may revoke an existing election if employment is terminated during the Plan Year. However, the participant may not make a new benefit election for the remaining portion of the Plan Year. A participant who fails to make the required contributions to the Medical Reimbursement Account in accordance with the salary reduction agreement at any time during the coverage period will have benefit payments suspended, regardless of account balance, until payment of required contributions resumes.
(6) Contributions under any pretax plan shall not be discontinued, except in the event of termination of participation as provided in this section. Any contribution made under any Plan may not be refunded to the participant. Reimbursements made under any Reimbursement Plan shall not be considered refunds of contributions.
(7) A participant shall continue to participate in any pretax plan until the earlier of the following dates:
(a) The date the participant ceases to be an eligible employee, unless the participant elects to continue coverage in the Medical Reimbursement Account by continuing payment of contributions, or
(b) The date on which the coverage period ends due to non-payment of contributions for a Medical Reimbursement Account, or
(c) The date the Plan Year ends.
(8) Upon subsequent employment with the State, an eligible employee who has terminated participation in the Plan shall be entitled to recommence participation as follows:
(a) If the participant is rehired as an eligible employee within 31 calendar days of termination and during the same Plan Year in which employment terminated, the participant shall not be allowed to make any new benefit elections under the Plan and will have the same level of benefits as were in effect immediately prior to the termination of employment unless there has been a Qualifying Status Change other than the termination and rehire.
(b) If reemployment as an eligible employee occurs during the same Plan Year in which employment terminated but occurs more than 31 calendar days after termination, and the participant has revoked his earlier benefit election, the participant shall not be entitled to recommence participation until the following Plan Year. However, the employee will be entitled to elect insurance coverage under the State Group Health Insurance Program on an after-tax basis, in accordance with Fl. Admin. Code Chapter 60P-2
(c) If reemployment occurs during a Plan Year subsequent to the one in which termination occurred, the employee shall be entitled to recommence participation upon reemployment and can make new benefit elections for the new Plan Year in accordance with rules and procedures established for newly-hired and newly-eligible employees.
(9) Upon termination of employment, the participant may desire to continue in the Medical Reimbursement Account and satisfy his or her annual election. The participant must notify the Department of his or her desire to continue no later than sixty (60) calendar days from the later of:
(a) The employment termination date;
(b) The date the participant is notified by the Department of his or her eligibility to continue participation.
(10) Continuation in the Medical Reimbursement Account requires that the participant satisfy his or her annual election by one of the following methods:
(a) Arranging, in advance of termination, to have all or part of the remaining balance deducted from his or her payment for annual or sick leave through payroll deduction on a pretax basis. Any amount needed to satisfy the annual election after this deduction is taken must be paid by personal check or money order within forty-five (45) calendar days of the participant’s election to continue participation;
(b) Making a single after-tax payment by check or money order for 100% of the remaining balance due within forty-five (45) calendar days of the participant’s election to continue participation;
(c) Making monthly after-tax payments by check or money order for the required monthly contribution made as an active employee. Such payments must be made no later than the first of each month. The first payment must be made within forty-five (45) calendar days of the participant’s election to continue participation.
Rulemaking Authority Florida Statutes § 110.161(5). Law Implemented Florida Statutes § 110.161. History-New 8-26-96, Repromulgated 4-25-02, Amended 3-2-17.