Compilation of Rules and Regulations of the State of Georgia › Department 478 - RULES OF THE STATE PERSONNEL BOARD › Chapter 478-2 - FLEXIBLE BENEFITS PROGRAM › Rule 478-2-.01 - Definitions

Current through Rules and Regulations filed through June 27, 2024
(1) "Act" means the
			 legislative act that authorized the establishment of a flexible employee
			 benefit plan and is designated in the Official Code of Georgia Annotated as
			 Article 3 of Chapter 18 of Title 45. (07-30-86/08-08-86)
(2) "Active" means that the employee is
			 receiving wages or salary through a department, school system, local employer,
			 employer, agency, authority, board, commission, county department of family and
			 children services, county department of health, or community service board and
			 for whom the employee's cost of the coverage is stated as a payroll deduction
			 or reduction. (03-27-97/04-09-97)
(3) "Administrator" means the State Personnel
			 Administrationor the Commissioner of Personnel Administration.
(4) "After-Tax Premium" or "After-Tax
			 Contribution" means the contract rate approved by the Council for a specific
			 benefit or health care spending account contribution transmitted directly to
			 the Flexible Benefits Program by the employee or extended beneficiary or the
			 contract rate for after-tax options that have been approved by the Council to
			 be offered through payroll deductions. (06-28-90/07-01-90)
(5) "After-Tax Option" means any benefit
			 option that is approved by the Council to be offered to employees through
			 payroll deductions and for which the cost of the option is not a reduction of
			 gross salary for the purposes of federal or state income taxes or FICA taxes.
			 (06-28-90/07-01-90)
(6) "Approved
			 Leave of Absence Without Pay" means a period of time approved by the
			 appropriate organizational official during which the employee is absent from
			 work and is not paid wages or salary. (03-27-97/04-09-97)
(7) "At Work" means that the employee is at
			 the employee's customary place of employment, on paid leave for conditions
			 other than illness or injury, or performing his normal duties at a place other
			 than the place of employment or in a non-scheduled work period, must be able to
			 perform normal duties on that day and cannot be hospitalized or otherwise
			 institutionalized. (03-27-97/04-09-97)
(8) "Annuitant" means a retired employee or
			 surviving spouse or dependent child who receives a monthly retirement benefit
			 from the Employees Retirement System, Legislative Retirement System, Superior
			 Court Judges Retirement System, District Attorney's Retirement System, Teachers
			 Retirement system, or Public School Employees Retirement System.
			 (03-27-97/04-09-97)
(9)
			 "Beneficiary" means the person, individual, trust, or estate named by the
			 employee to receive the value of the insurance proceeds at the employee's
			 death. (07-30-86/08-08-86)
(10)
			 "Benefit" or "benefits" means any of the types of offerings under the Flexible
			 Benefits Program. (07-30-86/08-08-86)
(11) "Benefit Salary" means the amount of
			 compensation used to calculate certain salary based coverages. This
			 compensation is intended to be normal, regular, non-temporary, and shall
			 include base salary and any special salary supplements that are intended to be
			 regular and not of short duration. This salary amount shall not exceed the
			 amount on which retirement contributions are calculated.
			 (03-27-97/04-09-97)
(12) "Cafeteria
			 Plan" means a plan which meets the requirements of the Regulations of the
			 Internal Revenue Service under Internal Revenue Code (IRC) 125.
			 (03-27-97/04-09-97)
(13)
			 "Commissioner" means the Commissioner of Personnel Administration as created by
			 the Official Code of Georgia Annotated 45-20-4. (07-30-86/08-08-86)
(14) "Community Service Board" means a public
			 community mental health, mental retardation, and substance abuse board
			 established pursuant to the Official Code of Georgia Annotated 37-2-6.
			 (03-27-97/04-09-97)
(15)
			 "Contractor" means a company or corporation approved to provide one or more
			 benefit types under the Flexible Benefits Program.
			 (07-30-86/08-08-86)
(16)
			 "Contribution" means the amount to be reduced by a salary agreement transferred
			 to the Administrator for the employee's health and/or dependent care spending
			 accounts. (03-27-97/04-09-97)
(17)
			 "Council" and "Employee Benefit Plan Council" are synonymous and mean the
			 governing body as created in O.C.G.A.
			  45-18-51.
			 (07-30-86/08-08-86)
(18)
			 "Department," "Employing Entity," and "agency" are synonymous and mean any of
			 the separate and distinct employing entities defined as a State Employer, an
			 Educational Institution, or a Community Service Board that employs an employee
			 as defined in these regulations. (03-27-97/04-09-97)
(19) "Dependent" means any eligible spouse,
			 dependent child, fulltime student under age 26, or disabled child and as more
			 specifically defined by the insurance option contracts and policies.
			 (03-27-97/04-09-97)
(20)
			 "Educational Institution" means any separate and distinct local school system,
			 regional educational services agency, and county or regional library whose
			 heads are legally authorized to appoint employees to positions and whose heads
			 have elected to participate in the Flexible Benefits Program administered by
			 the State Personnel Administration (O.C.G.A.
			  45-18-52)
			 (12-18-90/01-10-91)
(21) "Employee"
			 means a person eligible to participate in the Flexible Benefits Program.
			 (07-30-86/08-08-86)
(22) "Employer"
			 means the State of Georgia and the department, agency, or entity from which the
			 employee receives his compensation. (03-27-97/04-09-97)
(23) "Extended beneficiary" means the
			 individual who was covered as an active or retired employee or employee on
			 approved leave of absence without pay; or a person who was covered as a spouse
			 or eligible dependent of an active or retired employee or employee on approved
			 leave of absence without pay on the day the dental option or health care
			 spending account option was lost as a result of a qualifying event under the
			 requirements of federal law and regulation known as the Consolidated Omnibus
			 Budget Reconciliation Act (COBRA), as amended; and further defined and expanded
			 under the Health Insurance Portability and Accountability Act (HIPAA) of 1996
			 to include a child who is born to the covered person, adopted or placed for
			 adoption by a qualified beneficiary while on COBRA continuance. The applicable
			 regulations for the health option are outlined in the Regulations of the State
			 Personnel Board for the Health Benefit Plan. (03-27-97/04-09-97)
(24) "Extended coverage" means coverage
			 required to be made available by federal law or regulation to an extended
			 beneficiary under the dental option or the health care spending account option
			 of the Flexible Benefit Plan upon the occurrence of a qualifying event. The
			 applicable regulations for the health option are outlined in the Regulations of
			 the State Personnel Board for the Health Benefit Plan.
			 (12-20-88/01-19-89)
(25) "Flexible
			 Benefits Program" or "Flexible Benefit Plan" or "Plan" or "Program" means the
			 combination of approved benefits authorized for establishment by O.C.G.A.
			  45-18-52 and  offered to all eligible employees. Benefit options may be those authorized
			 in the Flexible Benefit Plan Document or authorized by the Council as an
			 After-Tax Option and incorporated in these Regulations. (03-27-97/
			 04-09-97)
(26) "Flexible Benefit
			 Plan Document" means the legal document required by the Regulations of the
			 Internal Revenue Service for a cafeteria plan under IRC 125. Statutory benefit
			 options as allowed by IRC 125 and authorized by the Council shall be
			 incorporated in the Flexible Benefit Plan Document.
			 (06-28-90/07-01-90)
(27) "Fund"
			 means any moneys received and accounted for on behalf of the Flexible Benefits
			 Program. (12-20-88/01-19-89)
(28)
			 "Health benefit option" means any self-insured or health maintenance
			 organization (HMO) option offered under the State Health Benefit Plan and which
			 is included in the Flexible Benefits Program. (03-27-97/04-09-97)
(29) "Insurance option" or "insurance" means
			 the life, dependent life, accidental death and dismemberment, disability,
			 dental, legal, and long-term care options and any other option for which a
			 contract for underwriting the risk has been or is to be approved by the
			 Council. (03-27-97/04-09-97)
(30)
			 "Option" means any specific benefit offering under the Flexible Benefits
			 Program. (12-20-88/01-19-89)
(31)
			 "Plan Year" means the twelve-month period beginning on July 1, and ending on
			 the following June 30. (06-28-90/07-01-90)
(32) "Premium" means the cost to the employee
			 for each insurance option offered under the Flexible Benefits Program.
			 (03-27-97/ 04-09-97)
(33)
			 "Qualifying event" means an event as defined by federal law or regulation that
			 authorizes eligibility for extended coverage under a health benefit plan.
			 Qualifying events include a change in employment or family status such as:
			 termination of employment (except for gross misconduct), employee layoff,
			 reduction of employee's hours below the minimum number required for coverage
			 eligibility as an active employee, end of twelve (12) month leave without pay
			 period, covered employee's death, divorce or legal separation from the covered
			 employee, or any reason for which a dependent child would otherwise become
			 ineligible for coverage under the applicable option.
			 (03-27-97/04-09-97)
(34) "Retired
			 Employee" means a former state employee, former teacher, or former public
			 school employee who met the eligibility criteria when active, and who receives
			 a monthly benefit from the Employees Retirement System, Legislative Retirement
			 System, Teachers Retirement System, Public School Employees Retirement System,
			 Superior Court Judges Retirement System, or District Attorney's Retirement
			 System. (03-27-97/04-09-97)
(35)
			 "Retiring Employee" means a covered employee who is eligible to receive an
			 immediate retirement benefit payment from the Employees Retirement System,
			 Legislative Retirement System, Teachers Retirement System, Public School
			 Employees Retirement System, Superior Court Judges Retirement System, or
			 District Attorney's Retirement System. (03-27-97/04-09-97)
(36) "Salary deduction" means an agreement
			 between the employee and the employer, on behalf of the Council, to deduct
			 amount from the employee's wages for the purpose of purchasing or contributing
			 to the purchase of benefits as allowed under federal and state laws.
			 (12-20-88/01-19-89)
(37) "Salary
			 reduction" means an agreement between the employee and the employer, on behalf
			 of the Council, to reduce the employee's wages for the purpose of purchasing
			 benefits as allowed under federal and state laws. (12-20-88/01-19-89)
(38) "Spending account option" means the
			 reimbursement accounts for eligible health or dependent care expenses as
			 defined by the Plan. (12-20-88/01-19-89)
(39) "Spouse" means an individual who is not
			 legally separated, who is of the opposite sex to the member and who is legally
			 married or who has submitted satisfactory evidence to the Administrator prior
			 to January 1, 1997 of common law marriage to the employee or retired employee.
			 (03-27-97/04-09-97)
(40) "State
			 Employer" means all separate and distinct divisions and subdivisions of state
			 governments, including authorities, county departments of family and children
			 services, or county departments of health, whose heads are legally authorized
			 to appoint employees to positions. (O.C.G.A.
			  45-18-50)
			 (03-27-97/04-09-97)
(41) "State
			 Personnel Board" or "Board" means the State Personnel Board established by
			 Article IV, Section III, Paragraph I of the Constitution of the State of
			 Georgia. (12-20-88/01-19-89) Authority O.C.G.A.
			  45-18-51(g).
(42) "Surviving Spouse" means the living
			 spouse of a deceased active or retired employee who was covered under the
			 dental option offered under the Flexible Benefits Program.
			 (03-27-97/04-09-97)
O.C.G.A. Secs.
				  45-18-51, 45-18-3.1.