7 Colo. Code Regs. § 1107-1.3

Current through Register Vol. 47, No. 20, October 25, 2024

Section 7 CCR 1107-1.3 - Individuals Electing Coverage

1. Individuals electing coverage may elect coverage under C.R.S. § 8-13.3-514 for an initial period of coverage of three years.

A. The individual electing coverage must create a My FAMLI+ Employer account and must submit their notice of election of coverage via My FAMLI+ Employer. For self-employed individuals, the notice of election must include a copy of their most recent tax transcript, and no communication from a self-employed individual will constitute a notice of election without it.

B. Elective coverage becomes effective on:

1. The date of filing the notice of election; or

2. If the individual so chooses, the first day of one of the five most recent closed calendar quarters.

C. A period of coverage is defined as:

1. The three years following the first day of elective coverage or any gap in coverage; and

2. Each subsequent year.

D. Any individual electing coverage may file a notice of withdrawal within thirty calendar days after the end of a period of coverage.

E. The notice of withdrawal must include an effective date of the withdrawal, which must be no sooner than thirty days after the filing of the notice of withdrawal.

F. A notice of withdrawal from coverage must be submitted to the Division online or in another format approved by the Division.

G. Upon termination of coverage, due and unpaid premiums must be paid, as well as any interest or fines assessed.

2. Provisions specific to self-employed individuals electing coverage:

A. When the Division receives a completed notice of election from a self-employed individual, it will review the tax transcript to confirm gross income from self-employment.

B. If the tax transcript includes gross income from self-employment:

1. The Division will presume that the tax transcript reflects four quarters of gross income from self-employment.

2. The Division will determine prospective quarterly gross income from self-employment by dividing the tax transcript's total gross income from self-employment by four.

3. If the individual submits evidence sufficient for the Division to conclude that the tax transcript reflects fewer than four quarters of gross income from self-employment, the Division will adjust its calculation accordingly in order to determine prospective quarterly gross income from self-employment. For example, if the Division concludes that an individual's tax transcript reflects only two quarters of gross income from self-employment, then the Division will determine prospective quarterly gross income from self-employment by dividing the tax transcript's total gross income from self-employment by two.

4. The individual's premium liability and wage replacement benefits will be based on the prospective quarterly gross income from self-employment until the individual submits subsequent tax transcripts in accordance with these rules, at which point the Division will make any necessary adjustments to prior premium liability and wage replacement benefits, and will recalculate prospective quarterly gross income from self-employment for the following year.

C. If the tax transcript does not include gross income from self-employment, then the individual's premium liability and wage replacement benefits will be based on actual gross income reported quarterly in accordance with these rules. The individual must submit invoices, payment records, and bank records to verify actual gross income reported. After the individual submits subsequent tax transcripts in accordance with these rules, the individual's premium liability and wage replacement benefits will be based on prospective gross income from self-employment, calculated by the Division in accordance with these rules.

D. In addition to the tax transcript required in the notice of election, a self-employed individual electing coverage must annually submit to the Division a tax transcript by June 1 or within fourteen (14) days after filing their income tax return with the IRS, whichever is later. The Division may accept a tax transcript outside of these timeframes upon a showing of good cause by a self-employed individual.

3. All individuals electing coverage must report wages and remit premium payments no later than the last day of the month immediately following the end of the calendar quarter for which the premiums have accrued. The Division may require additional information or documentation from any individual electing coverage when such information is necessary to accurately calculate and administer premiums obligations and benefit entitlements.

7 CCR 1107-1.3

44 CR 23, December 10, 2021, effective 1/1/2022

45 CR 23, December 10, 2022, effective 12/30/2022

46 CR 17, September 10, 2023, effective 1/1/2024