N.Y. Comp. Codes R. & Regs. tit. 4 § 73.7

Current through Register Vol. 46, No. 51, December 18, 2024

Section 73.7 - Effective date of coverage

(a) Upon the approval of the application of any authority, corporation, district, agency, subdivision, or organization for the inclusion of its employees and/or prior retirees in the plan, it shall become a participating employer, and the president shall thereupon fix an effective date for the commencement of coverage of such employees and/or prior retirees, as the case may be. Such effective date shall be fixed with due regard to a reasonable time allowance needed for educational, promotional and enrollment purposes and other administrative requirements. The president may, in his discretion, fix a schedule of effective dates of coverage with respect to newly approved participating employers on a quarterly basis or at such other time intervals as he may deem appropriate.

(b) Notwithstanding such effective date for coverage as may be fixed by the president and except as provided in this subdivision, coverage shall not become effective with respect to the employees of a participating employer unless 75 percent of all persons eligible for coverage as employees of such participating employer shall enroll for such coverage. If a participating employer provides coverage for only a class of its employees designated by it in accordance with paragraph (a) of subdivision 2 of section 221 of the Insurance Law, the coverage shall not become effective until 75 percent of the class shall enroll for such coverage. If two or more classes of employees are covered simultaneously, the 75 percent requirement shall apply to the total of such two or more classes which shall be considered one group. If a class of employees not initially covered is subsequently extended the opportunity to enroll, then 75 percent of the employees of that class must enroll for coverage before such coverage can become effective for that class. If two or more classes not initially covered are subsequently and simultaneously extended the opportunity to enroll, then the 75 percent requirement shall apply to the total of such two or more classes which shall be considered one group. For the purposes of this subdivision, the prior retirees of a participating employer are deemed to be a class. The president shall make the final administrative determination whether any purported class set forth in an application for coverage is a class permitted by law. No coverage shall become effective until the employer and employee contributions therefor have been paid into the Health Insurance Fund.

N.Y. Comp. Codes R. & Regs. Tit. 4 § 73.7