Ariz. Admin. Code § 2-6-106

Current through Register Vol. 31, No. 2, January 10, 2025

Section R2-6-106 - Effective Date of Coverage

A. If an individual enrolls in an insurance plan made available by the Department or provides notice of a qualified life event within the time specified in R2-6-105, the Department shall ensure that the insurance coverage becomes effective on the following dates:

1. Newly hired employee or officer. The date determined by the Director following submission of a properly completed enrollment form and supporting documentation;

2. Retiree, former elected official, surviving dependent, or surviving spouse. The first day of the first pay period following the end of active coverage or the first day of the first month following submission of a properly completed enrollment form and supporting documentation, whichever is applicable;

3. Qualified life event change other than a change in the number of dependents due to birth, adoption, legal placement for adoption, or grant of legal guardianship:

a. Non-university employee or officer. The first day of the first pay period following submission of a properly completed enrollment form and supporting documentation;

b. University employee. The date determined by the Director; and

c. Retiree, former elected official, surviving dependent, or surviving spouse. The first of the month following submission of a properly completed enrollment form and supporting documentation; and

4. Change in the number of dependents due to birth, adoption, legal placement for adoption, or grant of legal guardianship. On the date of birth, adoption, legal placement for adoption, or grant of legal guardianship if a properly completed enrollment form and supporting documentation are submitted.

B. If a retiree, former elected official, eligible dependent, surviving dependent, or surviving spouse becomes eligible for Medicare, the retiree, former elected official, eligible dependent, surviving dependent, or surviving spouse may cancel or reduce coverage under the health plan made available by the Department. If a retiree, former elected official, eligible dependent, surviving dependent, or surviving spouse ceases to be eligible for Medicare, the retiree, former elected official, eligible dependent, surviving dependent, or surviving spouse may enroll or increase coverage under the health plan made available by the Department. A change made under this subsection becomes effective on the first day of the first month following submission of a properly completed enrollment form and supporting documentation if the enrollment form and supporting documentation are submitted within 31 days of the change in Medicare eligibility.

C. If a member experiences one of the following changes in coverage, the member may make a corresponding change to the member's coverage under the health plan made available by the Department by submitting a properly completed enrollment form and supporting documentation within 31 days of the change. A change made under this subsection becomes effective on the first day of the first pay period or first month, as applicable, following submission of a properly completed enrollment form and supporting documentation:

1. Elected coverage provided under the plan is significantly restricted or eliminated,

2. Non-elected coverage provided under the plan is significantly improved,

3. The member's spouse makes a change in the coverage provided by the spouse's employer,

4. The member or an eligible dependent loses coverage under another group health plan sponsored by a governmental or educational entity, or

5. The member becomes subject to a QMCSO or another person becomes subject to a QMCSO that requires the other person to provide health insurance for the member's eligible dependent.

Ariz. Admin. Code § R2-6-106

Adopted effective August 31, 1984 (Supp. 84-4). Former Section R2-6-106 renumbered to R2-6-206, new Section R2-6-106 adopted effective September 16, 1997 (Supp. 97-3). Section expired under A.R.S. § 41-1056(E) at 8 A.A.R. 5017, effective September 30, 2002 (Supp. 02-4). New Section made by final rulemaking at 15 A.A.R. 258, effective March 7, 2009 (Supp. 09-1). Amended by final rulemaking at 23 A.A.R. 1719, effective 6/6/2017.