Section .0100 ‑ General Provisions

Link to law: http://reports.oah.state.nc.us/ncac/title 20 - state treasurer/chapter 02 - retirement systems/subchapter d/subchapter d rules.html
Published: 2015

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SUBCHAPTER 2D –DISABILITY SALARY CONTINUATION PLAN

 

SECTION .0100 ‑ GENERAL PROVISIONS

 

20 NCAC 02D .0101          GENERAL INFORMATION

 

History Note:        Authority G.S. 135‑6(f); 135‑32;

135‑34;

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Amended Eff. December 1, 1982; October 29, 1979;

Repealed Eff. August 1, 1988.

 

 

20 NCAC 02D .0102          PURPOSES:

FUNCTIONS: AND DUTIES

20 NCAC 02D .0103          AUTHORITY TO APPOINT ADVISORY

COMMITTEE

 

History Note:        Authority G.S. 135‑6(f); 135‑33;

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Repealed Eff. December 1, 1982.

 

 

 

 

SECTION .0200 ‑ DISABILITY SALARY CONTINUATION PLAN

 

 

20 NCAC 02D .0201          DEFINITIONS

20 NCAC 02D .0202          MEMBERSHIP

20 NCAC 02D .0203          CONTRIBUTIONS

20 NCAC 02D .0204          BENEFITS

20 NCAC 02D .0205          REHABILITATION

20 NCAC 02D .0206          PHYSICAL EXAMINATION

20 NCAC 02D .0207          PAYMENT OF CLAIMS

20 NCAC 02D .0208          ASSIGNMENT

20 NCAC 02D .0209          MANAGEMENT OF FUNDS

 

History Note:        Authority G.S. 135‑34; 135‑6(f);

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Amended Eff. October 29, 1979;

Repealed Eff. August 1, 1988.

 

 

 

20 NCAC 02D .0210          TERMINATION OF THE PLAN

 

History Note:        Authority G.S. 135‑34; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

20 NCAC 02D .0211          AGREEMENT

20 NCAC 02D .0212          EMPLOYEE DISABILITY FUND

20 NCAC 02D .0213          FORMS

20 NCAC 02D .0214          INSTRUCTIONS FOR USE OF FORMS

 

History Note:        Authority G.S. 135‑34; 135‑6(f);

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Repealed Eff. August 1, 1988.

 

 

 

 

SECTION .0300 ‑ HOSPITAL AND MEDICAL CARE BENEFITS

 

 

20 NCAC 02D .0301          CONTRACT

20 NCAC 02D .0302          PROGRAM PROVISIONS

 

History Note:        Authority G.S. 135‑6(f); 135‑33;

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Amended Eff. October 29, 1979; July 1, 1978;

Repealed Eff. December 1, 1982.

 

 

 

20 NCAC 02D .0303          EFFECTIVE DATES

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

20 NCAC 02D .0304          CONTRIBUTION RATE

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Repealed Eff. July 1, 1978.

 

 

 

20 NCAC 02D .0305          TYPES OF COVERAGE

20 NCAC 02D .0306          SPLIT CONTRACT

 

History Note:        Authority G.S. 135‑6(f); 135‑33;

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Repealed Eff. December 1, 1982.

 

 

 

20 NCAC 02D .0307          SUPPLEMENTARY PLANS

20 NCAC 02D .0308          RETIREMENT

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

20 NCAC 02D .0309          PAYMENT

20 NCAC 02D .0310          ELIGIBILITY

 

History Note:        Authority G.S. 135‑6(f); 135‑33;

135‑33.1; 135‑36;

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Amended Eff. October 29, 1979;

Repealed Eff. December 1, 1982.

 

 

 

20 NCAC 02D .0311          OPEN ENROLLMENT

20 NCAC 02D .0312          AGENT

20 NCAC 02D .0313          CHANGES: BENEFIT PLANS

20 NCAC 02D .0314          ENROLLMENT AND ADMINISTRATION

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

20 NCAC 02D .0315          FILING OF CLAIMS

20 NCAC 02D .0316          CHANGES IN FAMILY STATUS

20 NCAC 02D .0317          SEPARATION FROM SERVICE

20 NCAC 02D .0318          LEAVE OF ABSENCE

 

History Note:        Authority G.S. 135‑6(f); 135‑33;

Eff. February 1, 1976;

Readopted Eff. September 21, 1977;

Repealed Eff. December 1, 1982.

 

 

 

20 NCAC 02D .0319          DOCUMENTS ATTACHED

20 NCAC 02D .0320          TERMINATION

20 NCAC 02D .0321          TERMINATION OF CERTIFICATES

20 NCAC 02D .0322          PREVIOUS CONTRACT

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .0400 ‑ EXPERIENCE RATING AGREEMENT

 

 

20 NCAC 02D .0401          BENEFIT ADMINISTRATION

20 NCAC 02D .0402          RETENTION

20 NCAC 02D .0403          INCURRED CLAIMS EXPENSE

20 NCAC 02D .0404          PROJECTED EXPENSE RATIO

20 NCAC 02D .0405          STABILIZATION RESERVES

20 NCAC 02D .0406          RATING PROCEDURES

20 NCAC 02D .0407          ACCOUNTING

20 NCAC 02D .0408          AGREEMENT INTENT

20 NCAC 02D .0409          ANNUAL REPORTS

20 NCAC 02D .0410          RETENTION

20 NCAC 02D .0411          INCOME AND CLAIMS EXPERIENCE

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .0500 ‑ COORDINATION OF BENEFITS

 

 

20 NCAC 02D .0501          BENEFITS PROVISION

20 NCAC 02D .0502          DEFINITIONS

20 NCAC 02D .0503          EFFECT ON BENEFITS

20 NCAC 02D .0504          IMPLEMENTATION

20 NCAC 02D .0505          FACILITY OF PAYMENT

20 NCAC 02D .0506          RIGHT OF RECOVERY

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .0600 ‑ INPATIENT HOSPITAL BENEFITS

 

 

20 NCAC 02D .0601          DAYS AVAILABLE

20 NCAC 02D .0602          BENEFITS IN CONTRACTING HOSPITALS

20 NCAC 02D .0603          BENEFITS: NONCONTRACTING HOSPITALS

20 NCAC 02D .0604          BENEFITS IN OUT‑OF‑STATE

HOSPITALS

20 NCAC 02D .0605          GENERAL PROVISIONS

20 NCAC 02D .0606          SKILLED NURSING FACILITY

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .0700 ‑ OUTPATIENT BENEFITS

 

 

20 NCAC 02D .0701          BENEFIT PROVISION

20 NCAC 02D .0702          ACCIDENTAL INJURY

20 NCAC 02D .0703          MEDICAL EMERGENCIES

20 NCAC 02D .0704          HOSPITAL OPERATIONS

20 NCAC 02D .0705          RADIATION THERAPY

20 NCAC 02D .0706          PATHOLOGICAL EXAMINATION

20 NCAC 02D .0707          TESTS AND PROCEDURES

20 NCAC 02D .0708          GENERAL PROVISIONS

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .0800 ‑ SURGICAL BENEFITS

 

 

20 NCAC 02D .0801          SCOPE OF SERVICES

20 NCAC 02D .0802          BASIS OF BENEFIT ALLOWANCES

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .0900 ‑ INPATIENT MEDICAL BENEFITS

 

 

20 NCAC 02D .0901          SCOPE OF SERVICES

20 NCAC 02D .0902          DURATION OF BENEFITS

20 NCAC 02D .0903          BASIS OF BENEFIT ALLOWANCES

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .1000 ‑ MAJOR MEDICAL BENEFITS

 

 

20 NCAC 02D .1001          MAXIMUM BENEFITS

20 NCAC 02D .1002          DEDUCTIBLE AMOUNTS

20 NCAC 02D .1003          BENEFIT PERIOD

20 NCAC 02D .1004          BENEFITS

20 NCAC 02D .1005          LIMITATIONS AND EXCLUSIONS FOR MAJOR

MEDICAL BENEFITS

20 NCAC 02D .1006          GENERAL PROVISIONS

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.

 

 

 

 

SECTION .1100 ‑ TERMS AND CONDITIONS

 

 

20 NCAC 02D .1101          DEFINITIONS

20 NCAC 02D .1102          MATERNITY PROVISIONS

20 NCAC 02D .1103          EXCLUSION: BASIC AND MAJOR MEDICAL

BENEFITS

20 NCAC 02D .1104          MISREPRESENTATION

20 NCAC 02D .1105          TERMINATION OF GROUP COVERAGE

20 NCAC 02D .1106          MODIFICATION

20 NCAC 02D .1107          TERMINATION UPON DEATH

20 NCAC 02D .1108          TERMINATION UPON MARRIAGE: AGE LIMIT

20 NCAC 02D .1109          TERMINATION WITHOUT CLAIM PREJUDICE

20 NCAC 02D .1110          CONVERSION FROM GROUP TO NONGROUP

COVERAGE

20 NCAC 02D .1111          NONGROUP TO GROUP COVERAGE

20 NCAC 02D .1112          COVERAGE CHANGE APPLICATION

20 NCAC 02D .1113          EXTENDED MATERNITY BENEFITS

20 NCAC 02D .1114          GENERAL PROVISIONS

20 NCAC 02D .1115          WAITING PERIODS

 

History Note:        Authority G.S. 135‑33; 135‑6(f);

Eff. February 1, 1976;

Repealed Eff. September 21, 1977.