Fla. Admin. Code R. 60P-3.009

Current through Reg. 50, No. 235-239, December 10, 2024

Section 60P-3.009 - Contributions, Underpayments, and Overpayments

(1) Payment of Employee Contributions.

(a) Employee contributions are due in advance of each month's coverage.

(b) Payroll deductions for insurance coverage should always be made in such a manner that a full month's employee contribution has been deducted prior to the first day of the following month's coverage using authorized payroll procedures.

(c) Personal checks or money orders shall only be used for the correction of employee contributions, payment while off the payroll or when payroll deductions cannot be made for initial enrollment; otherwise, employee contributions shall be made by payroll deductions.

(d) The agency shall submit all personal checks or money orders to the Department. Each such check or money order shall be transmitted in a manner to be received by the Department prior to the first day of the month for which the employee contribution is being paid. Late payments for employees on leave without pay, Workers' Compensation, disability leave, layoff or suspension status, will be accepted if they are received by the Department on or before the last day of the coverage month for which premiums are being paid; however, payment will not be accepted after such date and coverage will be terminated except as provided in subsection 60P-3.015(6), F.A.C.

(2) Underpayment of Contributions.

(a) For employees or retiree's on the payroll:

1. When it has been determined that an employee's or retiree's contribution has been underpaid, the Department shall notify the employee or retiree of the underpayment by certified letter and shall send a copy of such notification to the employee's agency. This notice will advise the employee or retiree of the following provisions:

a. If the full amount of the underpayment is not received by the Department within thirty (30) calendar days from the date of the notification of the underpayment or if approval is not granted in accordance with sub-subparagraph (2)(a)1.b., or if an administrative hearing is not requested in accordance with sub-subparagraph (2)(a)1.c., the retiree's coverage shall be terminated. With respect to the employee, the Department will request the Department of Banking and Finance initiate involuntary wage deductions where applicable.

b. If the underpayment involves more than one coverage period, the Department may approve an installment payment program, provided a written request for such program is received from the employee or retiree within thirty (30) calendar days from the date of notification of underpayment. However, any such installment payment program is subject to approval of the Department of Banking and Finance in accordance with Section 17.04, F.S. Payroll deductions must be used whenever the employee is receiving a state payroll warrant issued by the Department of Banking and Finance. The period of payment shall not extend beyond two (2) years from the date of approval.

c. The employee or retiree may request an administrative hearing pursuant to Section 120.57, F.S., provided such request is received by the Department within twenty-one (21) calendar days from the date of receipt of the notification of underpayment.

2. When it has been determined that an agency has underpaid its contribution, the Department shall notify the agency of the underpayment in writing. Such notice will advise the agency that the full amount of the underpayment must be received by the Department within forty-five (45) calendar days from the date of the letter. The agency shall take appropriate action to ensure that future premium payments are correct. Should any state agency become more than sixty (60) days delinquent in payment of this obligation, the Department shall certify the amount due and request the Department of Banking and Finance recover such underpayment in accordance with Section 17.04, F.S.

(b) For employees or retirees off the payroll:

1. When it has been determined that none of the required contribution has been paid by the end of the coverage month, an employee's coverage will be canceled and a retiree's coverage will be terminated effective the first day of that month.

2. If some, but not all of the required contribution has been paid, the retiree, employee and the employee's agency will be notified as described in subparagraph (2)(a)1.

(c) An employee whose coverage is canceled in accordance with paragraph (2)(b) may only apply for reenrollment in the Life Plan by settling all underpayments and submitting an application during the open enrollment period. A retired employee whose coverage is terminated in accordance with paragraph (2)(a) or (2)(b) may not reenter the Plan.

(d) Underpayments which are detected beyond the period provided by law shall be deemed uncollectible.

(3) Overpayment of Premiums.

(a) Whenever the employee's agency becomes aware of a premium payment that is more than the amount required for the type of coverage selected, the agency shall take appropriate action to request a refund for the overpayment and ensure that future state or employee contributions are correct. The Department shall take corrective action for retired employees.

(b) Requests for refunds of any employee and or state contribution overpayments for active employees must be submitted by the employing agency. The Department shall initiate refunds for retired employees.

(4) State Contributions. Any state officer, full-time employee, or part-time employee participating in the Plan shall receive the state contribution or prorated state contribution if any of the following conditions exist:

(a) The employee is at work or on approved leave for a minimum of one day in the month previous to the month of coverage.

(b) The employee is either on academic contract or if regularly employed for less than twelve (12) months, provided the employee has worked at least eight (8) months during the prior consecutive twelve (12) month period. Such employee shall receive the state contribution for the entire twelve (12) months.

(c) The employee is on Workers' Compensation disability leave.

(d) The employee successfully appeals a suspension and receives full back pay. In such cases, the employee shall receive the state contribution for the period of suspension provided the employee continued coverage under the Life Plan during the period of suspension and was receiving the state contribution at the time of suspension.

(e) The employee successfully appeals a dismissal and receives full back pay. In such cases, the employee shall receive the state contribution for the period of the dismissal: provided the employee was receiving the state contribution at the time of dismissal and, upon reinstatement, pays all back employee contributions in order to have continuous coverage under the Life Plan.

Fla. Admin. Code Ann. R. 60P-3.009

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS.

New 8-12-80, Formerly 22K-1.48, 22K-1.048, 22K-1.306, Amended 8-26-96, Repromulgated 1-31-02, Amended by Florida Register Volume 43, Number 030, February 14, 2017 effective 3/2/2017.

New 8-12-80, Formerly 22K-1.48, 22K-1.048, 22K-1.306, Amended 8-26-96, Repromulgated 1-31-02, Amended 3-2-17.