Rule 111-4-1-.05 - Effective Date of Coverage(1)Upon Employment. The Employee's Coverage under the SHBP shall become effective on the first of the month following employment for the full preceding calendar month if the Employee has not terminated employment on or before that date. Coverage for a transferring Employee shall be effective the first of the month following the end of Coverage under a previous Employing Entity. Coverage for eligible Dependents will become effective on the date the Employee's Coverage is effective.(2)Upon Change in Coverage. If the Member changes Coverage to include eligible Dependents based upon acquisition of Dependent(s), Coverage for the Dependents shall become effective on the later of the first of the month following the request for Coverage, or subject to guidelines for acquisition of Dependent(s).(3)Upon Open Enrollment Change or Enrollment. The effective date for enrollments or changes in Coverage election to add eligible dependents shall be January 1st unless the Member no longer meets the definition of an Active Employee on or before that date. The termination date for Open Enrollment discontinuation of Coverage shall be December 31st. Subject to the provisions of Section 111-4-1-.06 of these regulations, Coverage elections shall be binding upon the Member for the duration of the Plan Year.(4)Upon Return from Leave Without Pay. The effective date for re-enrollments following an Approved Leave of Absence Without Pay shall be the first of the month following the return to work. The effective date for re-enrollments following a military leave without pay shall be the first of the month following the return to work or the date employment is reinstated. In all instances, the appropriate Premiums must be deducted and remitted by the Employing Entity.(5)Upon Acquisition of a Dependent. The effective date of Coverage for acquired Dependents is subject to the requirements as outlined for the Member and shall be the later of the first of the month following the request for Coverage or: (a)Legally Married Spouse. The effective date of Coverage shall be no earlier than the first of the month of marriage to the Member. The Plan is not responsible for payment of the Spouse's medical services incurred prior to the actual date of the marriage.(b)Natural Children. The effective date of Coverage shall be the date of birth.(c)Stepchildren. The effective date of Coverage shall be no earlier than the date of marriage of the Member and the natural parent of the children.(d)Adopted Children. The effective date of Coverage shall be no earlier than the date of legal placement for adoption.(e)Other Children. The effective date of Coverage shall be no earlier than the date that sole legal guardianship is established.(6)Premium. The Administrator shall terminate Coverage of Enrolled Members and Covered Dependents for which the Plan has not received full payment of the required Premium prior to the first day of the Coverage month. Terminated Coverage will be reactivated upon receipt of full payment of the required monthly Premium.Ga. Comp. R. & Regs. R. 111-4-1-.05
O.C.G.A. Secs. 20-2-881, 20-2-911, 45-18-2, Health Insurance Portability and Accountability Act (HIPAA), Internal Revenue Code Section 125, Uniformed Services Employment and Reemployment Act 5. Patient Protection and Affordable Care Act (PPACA)
Original Rule entitled "Effective Date of Coverage" adopted. F. Apr. 18, 2005; eff. May 8, 2005.Repealed: New Rule of same title adopted. F. Jan. 22, 2007; eff. Feb. 11, 2007.Amended: F. May 25, 2007; eff. June 14, 2007.Amended: F. Jan. 26, 2011; eff. Feb. 16, 2011.