Louisiana Administrative Code › Title 32 - EMPLOYEE BENEFITS › Part I - General Provisions › Chapter 3 - Uniform Provisions-Participation in the Office of Group Benefits › Section I-323 - Employer Responsibility

Current through Register Vol. 50, No. 6, June 20, 2024
A. It is
				the responsibility of the participating employer to submit timely enrollment
				and coverage changes using OGBs electronic enrollment system or other approved
				submission method, and to review and certify all necessary documentation to OGB
				on behalf of its employees. Employees of a participating employer will not, by
				virtue of furnishing any documentation to OGB be considered agents of OGB, and
				no representation made by any participating employer at any time will change
				the provisions of an OGB plan of benefits.
B. A participating employer shall immediately
				inform OGB when a retiree with OGB coverage returns to benefit-eligible
				employment. The enrollee shall be placed in the re-employed retiree category
				for premium calculation. The re-employed retiree premium classification applies
				to retirees with and without Medicare. The premium rates applicable to the
				re-employed retiree premium classification shall be identical to the premium
				rates applicable to the classification for retirees without Medicare. If the
				re-employed retiree suspends retirement benefits and returns to
				benefit-eligible employment with the agency from which the re-employed retiree
				originally retired, the employee portion of the premium shall be withheld by
				payroll deduction and the employing agency shall remain responsible for the
				employer portion of the premium. If the re-employed retiree suspends retirement
				benefits and returns to benefit-eligible employment with an OGB participating
				agency other than the agency from which the re-employed retiree originally
				retired, the employee portion of the premium shall be withheld by payroll
				deduction, and the employing agency shall be responsible for the employer
				portion of the premium throughout the duration of employment. If the
				re-employed retiree returns to benefit-eligible employment, yet does not
				suspend retirement benefits as allowed by law, the employee portion of the
				premium shall be withheld by payroll deduction, and the employing OGB
				participating agency shall be responsible for the employer portion of the
				premium throughout the duration of employment. When the re-employed retiree
				separates from employment with the OGB participating employer, the employer
				shall notify OGB of such separation within 30 days. After the re-employed
				retiree again separates from employment with an OGB participating employer, the
				agency from which the re-employed retiree originally retired shall again be
				responsible for the employer portion of the premium.
C. A participating employer that receives a Medicare
				secondary payer (MSP) collection notice or demand letter shall deliver the MSP
				notice to OGB within 15 days of receipt. If timely forwarded, OGB will assume
				responsibility for medical benefits, interest, fines and penalties due to
				Medicare for a plan participant. If not timely forwarded, OGB will assume
				responsibility only for covered plan benefits due to Medicare for a plan
				participant. The participating employer will be responsible for interest,
				fines, and penalties due.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  42:801(C) and
				  802(B)(1).