Florida Administrative Code › 60 - DEPARTMENT OF MANAGEMENT SERVICES › 60P - Division of State Employees' Insurance › Chapter 60P-6 - GENERAL PROVISIONS AND DEFINITIONS › Section 60P-6.006 - Definitions

Current through Reg. 50, No. 138; July 16, 2024
Unless otherwise expressly stated whenever used in Chapter
				  60P-6, F.A.C., the following terms shall have the respective meaning
				  indicated:
(1) "Claim Filing Deadline"
				is April 15 following the participant's period of eligibility. All initial
				prior plan year claims filings must be postmarked or received, when not mailed,
				at the Department on or prior to this date to be considered for
				processing.
(2) "Claim filing
				run-out period" is the period during which the Department will accept
				documentation in support of claims filed within the claim filing deadline. This
				period will not extend beyond June 30 following the end of the prior plan
				year.
(3) "Dependent" means:
An individual for whom the participant is entitled to a tax
				  deduction under the Internal Revenue Code; requires full time care because of a
				  physical or mental incapacity; or is the spouse of the participant and is
				  physically or mentally incapable of caring for himself or
				  herself.
(4) "Dependent Care
				Expenses" means expenses incurred by a participant for the care of an eligible
				dependent as defined in applicable Internal Revenue Code to permit a
				participant and spouse, if any, to be gainfully employed.
(5) "Dependent care reimbursement account"
				means an account under which an employee may set aside money, on a pretax basis
				via salary reduction to pay for qualified daycare expenses.
(6) "Participant" means an employee who has
				enrolled in the Program for a period of coverage, and who has not become
				ineligible for participation at any time during the period of
				coverage.
(7) "Health care
				expenses" means any unreimbursed eligible expenses incurred by a participant or
				by a spouse or dependent of such participant for medical care.
(8) "Health care reimbursement account" means
				an account under which an employee may set aside money, on a pretax basis via
				salary reduction to pay for qualified health care expenses.
(9) "Period of coverage" means the Plan Year
				or that portion of the Plan Year during which coverage of benefits under the
				Plan is available to and elected by the participant.
(10) "Program" means the Florida Flexible
				Benefits Program established pursuant to Section 110.161, Florida
				Statutes.
(11) "Plan year" means a
				12-month period beginning January 1 and ending December 31.
(12) "Salary reduction agreement" means an
				agreement by and between the State and the employee, in which the employee
				elects to participate in the Program.
(13) "Qualifying status change (QSC) event"
				or "QSC event" means the change in employment status, for subscriber or spouse,
				family status or significant change in health coverage of the employee or
				spouse attributable to the spouse's employment.
Specific Authority
					 110.161(5) FS.
					 Law Implemented 110.161
					 FS.
New 8-3-89, Amended 4-17-91, Formerly 22FB-1.006, Amended
					 8-26-96, Repromulgated 4-25-02.