Public Employees Retirement System - Health Care Coverage - Dental and vision coverage.


Published: 2021-01-01

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(A) The public employees retirement system may offer dental or vision coverage that is administered by a third party administrator(s) to individuals who are receiving a benefit from the system and eligible dependents. For purposes of this rule, "benefit" includes monthly amounts paid to an individual pursuant to section 145.32, 145.33, 145.331, 145.332, 145.35, 145.36, 145.361, 145.37, 145.384, 145.45, or 145.46 of the Revised Code, or section 9.02, article X, or article XI of the combined plan document.

(B) The dental and vision coverage offered by the system shall be administered consistent with health care coverage as follows: enrollment in the coverage as described in paragraphs (B), (D), and (E) of rule 145-4-30 of the Administrative Code and paragraph (D) of rule 145-4-62 of the Administrative Code; effective dates of coverage as described in rule 145-4-32 of the Administrative Code; and enrollment of dependents as described rules 145-4-30, 145-4-34, 145-4-36, 145-4-62, 145-4-62, and 145-4-66 of the Administrative Code; and payment of charges and disenrollment for nonpayment as described in rule 145-4-17 of the Administrative Code.

(C) The following provisions also apply to the dental and vision coverage offered by the system:

(1) The coverage shall be in effect for a calendar year.

(2) An individual enrolled in dental or vision coverage can voluntarily terminate the individual's enrollment in the coverage or a dependent's enrollment in the coverage only at the end of each calendar year by filing the notice of cancellation in a form and manner approved by the system during the annual open enrollment period.

(3) The system may require the automatic withholding of coverage premiums from the benefit paid to the enrolled individuals or, if necessary, may require the direct payment of premiums by the individual to the system or the third party administrator(s).

(D) The retirement system shall offer continuation coverage, as applicable, in accordance with the requirements of the Consolidated Omnibus Budget and Reconciliation Act of 1985 ("COBRA"), 42 U.S.C.A. 300gg-1.

Last updated September 30, 2021 at 9:13 AM