Louisiana Administrative Code › Title 32 - EMPLOYEE BENEFITS › Part I - General Provisions › Chapter 3 - Uniform Provisions-Participation in the Office of Group Benefits › Section I-307 - Persons to be Covered

Current through Register Vol. 50, No. 6, June 20, 2024
A.
1. For the purpose of determining eligibility
				to participate in OGB health coverage and life insurance, the term employee
				shall refer to a full-time employee as defined by a participating employer and
				in accordance with federal and state law.
2. Covered Persons, Both Employees. No one
				may be enrolled simultaneously as an employee and as a dependent under an OGB
				plan, nor may a dependent be covered as a dependent of more than one employee.
				If a covered dependent is eligible for coverage as an employee, he/she may
				choose to be covered separately at a later OGB designated enrollment period.
				Coverage shall be effective as directed by the OGB designated enrollment
				period.
3. Effective Dates of
				Coverage, New Employee, Transferring Employee. Coverage for each employee who
				follows the OGB procedures for enrollment and agrees to make the required
				payroll contributions to his/her participating employer is effective as
				follows:
a. if employment begins on the first
				day of the month, coverage is effective on the first day of the following month
				(for example, if employment begins on July 1, coverage will begin on August
				1);
b. if employment begins on or
				after the second day of the month, coverage is effective on the first day of
				the second month following employment (for example, if employment begins on
				July 15, coverage will begin on September 1);
c. employee coverage will not become effective unless
				the employee completes an enrollment form within 30 days following the date
				employment begins;
d. an employee
				who transfers employment to another participating employer shall complete a
				transfer form within 30 days following the date of transfer to maintain
				coverage without interruption.
4. Effective Dates of Coverage, Existing
				Employee. Existing employees may only enroll in a plan during open enrollment
				or as otherwise specified by the OGB health plan document. Coverage for the
				employee will be effective on the first day of the new plan year or on the date
				set forth in the OGB health plan document.
5. Re-Enrollment Previous Employment for
				Health Benefits and Life Insurance
a. An
				employee whose employment terminated while covered who is re-employed within 12
				months of the date of termination will be considered a re-enrollment previous
				employment applicant.
b. If an
				employee acquires an additional dependent during the period of termination,
				that dependent may be covered if added within 30 days of
				re-employment.
6.
				Members of Boards and Commissions. Except as otherwise provided by law, members
				of boards or commissions are not eligible for participation in an OGB plan of
				benefits. This Section does not apply to members of school boards or members of
				state boards or commissions who are determined by the participating employer
				and in accordance with federal and state law to be full-time
				employees.
7. Legislative
				Assistants. Legislative assistants are eligible to participate in an OGB plan
				if they are determined to be full-time employees by the participating employer
				under applicable federal and state law or pursuant to
				R.S.
				24:31.5(C), either:
a. receive at least 60 percent of the total
				compensation available to employ the legislative assistant if a legislator
				employs only one legislative assistant; or
b. is the
primary legislative
				assistant
as defined in
				R.S.
				24:31.5(C) when a legislator
				employs more than one legislative assistant.