Virginia Administrative Code › Title 1 - ADMINISTRATION › Agency 55 - DEPARTMENT OF HUMAN RESOURCE MANAGEMENT › Chapter 20 - COMMONWEALTH OF VIRGINIA HEALTH BENEFITS PROGRAM › Part III - Local Employer Participation › Section 1VAC55-20-240 - Payment of contributions

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				  Contributions due. It is the sole responsibility of the local employer to remit
				  local employer and local employee contributions to the department or its
				  designee. The local employer is responsible for remitting such contributions
				  for active, retired, and COBRA-participating employees. Health benefits program
				  contributions are to be made monthly, in advance, and are due at the department
				  on the first of each month. If the first day of the month falls on a weekend or
				  holiday, the payment is due at the department on the first business day of the
				  month.
B. Nonpayment of
				  contributions. A 10-day grace period for the nonpayment of contributions is
				  hereby provided. If the full and complete payment of contributions is not
				  received by the 10th of the month, a notice will be sent to the local employer
				  by the department or its designee. Additionally, there shall be imposed an
				  interest penalty of 12% per annum of the outstanding balance unpaid as of the
				  10th.
In the event that payment is not received by the 20th of
					 the month, the department shall place a notice of nonpayment of contributions
					 in a newspaper of general circulation in the locality of the local employer
					 notifying the employees of such local employer that claims incurred after the
					 end of the current month will not be paid until all outstanding contributions
					 and interest have been paid.
Furthermore, the department reserves the right to collect
					 from a local employer the greater of the monthly contribution or any amounts
					 incurred for claims during a period of nonpayment as well as any other costs
					 related thereto.
C.
				  Nonpayment as breach. The nonpayment of contributions by a local employer shall
				  constitute a breach of the adoption agreement and the local employer may be
				  obligated to pay damages. In the event that the local employer terminates
				  participation, such termination can only be prospective and the employer shall
				  be obligated to pay the greater of past contributions or actual claims incurred
				  during such period and any interest and damages that may be associated with
				  such nonpayment.
D. Coverage and
				  contribution period. Except as noted here, coverage elections including those
				  made by new employees are made on a prospective basis, that is, effective the
				  first of the month coinciding with or following the receipt of the election
				  form. However, if an election form is received from a new employee on the first
				  business day of the month, coverage for the employee will commence on the first
				  day of that month, (see
				  1VAC55-20-370 ). Coverage elections
				  made for newborns, adoption or placement for adoptions are effective the date
				  the child is born, adopted or placed for adoption, so long as the employee
				  makes the coverage election within 31 days of the event. Coverage terminations
				  are effective the end of the month following receipt of an election notice,
				  except for terminations that are required by the plan. Coverage terminations
				  required by the plan are effective the end of the month that the event takes
				  place. Examples of coverage terminations required by the plan are such things
				  as a divorce, termination of employment or a dependent child losing
				  eligibility.
Contributions shall always be for full calendar months.
					 Local employees who terminate employment within a calendar month shall have
					 coverage through the end of the month in which they terminate. In the event
					 that a terminating local employee becomes covered under an accident or health
					 plan of another employer prior to the end of the month in which the local
					 employee terminates, this health benefits program shall be a secondary payor to
					 the former local employee's new coverage.
Statutory Authority: § 2.2-2818 of the Code of
						Virginia.