Section 11-91A-3 Employee, Retiree, and Dependent Coverage; Premiums; Summary Documents.
The board must set coverage rules and premiums for the program, employer participants must provide required information and premium payments, covered employees and retirees are entitled to coverage and certain dependent coverage, and a summary document must be provided; it may be electronic at the board’s discretion.
(a) All full-time employees, elected officials, and retirees of employer participants who are eligible for health care benefits for themselves or their dependents under the provisions of the program shall be entitled to coverage and benefits as designated by the board. (b) Each employee and retiree shall be entitled to have his or her spouse and dependent children, as those persons are defined by the board, included in the coverage under rules and regulations promulgated by the board upon agreeing to pay the employee’s contribution of the health care premium for the dependents. The board shall adopt rules and regulations governing the discontinuance and resumption of coverage for dependents by the employees and retirees. The board shall adopt rules governing the discontinuance and resumption of coverage for dependents by the employees and retirees. (c) The board shall establish premiums required for employee, retiree, and dependent coverage to be paid by each employer participant in the program pursuant to rules adopted by the board. Employer participants shall provide to the board any information deemed necessary by the board for the determination of premium or other program matters. Employer participants shall submit all premium payments and any other information required pursuant to rules adopted by the board. Any portion of the premium to be paid for the full-time employees, elected officials, and retirees and their dependents pursuant to this section may be paid by the employer participant. (d) During any period in which an employee or an employee’s dependents are covered under this chapter, the employee’s contribution to the health care premium may be deducted from payroll by his or her employer on a pretax basis as permitted under Section 125 of the federal Internal Revenue Code or its successor. (e) Each employee and retiree who is covered under the program shall be provided a summary document setting forth the benefits to which the employee, retiree, and dependents are entitled, to whom such benefits shall be payable, to whom claims shall be submitted, and a summary of the provisions of the program as they affect the employee, retiree, and dependents. The summary document may be provided in electronic format at the discretion of the board.