§18058. Insurance; automatic application

Link to law: http://legislature.maine.gov/legis/statutes/5/title5sec18058.html
Published: 2015

§18058. Insurance; automatic application








1. Employees insured. 
Each employee shall complete an application for insurance coverage within 31 days
of becoming eligible. Each employee who completes an application and is found eligible for basic insurance under this subchapter is insured for the amount of basic coverage applicable under this subchapter, beginning on the first day of
the month following one month of employment after the employee becomes eligible.





A. The employee shall indicate the types of coverage elected. [1991, c. 480, §6 (NEW).]










B. If the employee elects coverage within 31 days of the employee's first becoming eligible
and elects coverage in addition to basic, that additional coverage becomes effective on the first day of the month following one month of employment
after the employee becomes eligible. [2011, c. 449, §10 (AMD).]










C. If the employee does not elect coverage within 31 days of the employee's first becoming eligible, the employee may subsequently
apply for insurance coverage but must produce evidence of insurability at the employee's own expense and in accordance
with the requirements of the insurance underwriter. [2011, c. 449, §10 (AMD).]










D. The employee may designate in writing the name and address of a 3rd party to whom
notice must be provided as required in subsection 6. [2015, c. 61, §1 (NEW).]







[
2015, c. 61, §1 (AMD)
.]








2. Employees not wanting to be insured. 
Any employee not wanting to be insured under this subchapter, at the time the employee
first becomes eligible, shall, on the application form, give written notice to the
employee's employing officer and to the retirement system that the employee does not
want to be insured.





A. If after being insured, the employee wishes to cancel or reduce coverage, written
notice must be given by the employee to the employee's employing officer and to the
retirement system. [1991, c. 480, §6 (AMD).]










B. The employee's insurance coverage must cease or be reduced at the end of the month
in which the notice is received by the employing office. [1991, c. 480, §6 (AMD).]










C. Any employee who does not want to be insured or who cancels insurance coverage may
subsequently apply for insurance, but must produce evidence of insurability at the
employee's own expense and in accordance with the requirements of the insurance underwriter. [1991, c. 480, §6 (AMD).]










D. [2011, c. 449, §11 (RP).]







[
2011, c. 449, §11 (AMD)
.]








3. Dependent coverage. 
An employee may apply for coverage for a dependent in the application provided in
subsection 1. If an employee has no dependents at the time the application provided
in subsection 1 is completed and if application is made for coverage within 31 days
of acquiring a dependent, coverage becomes effective the first day of the month following
the month in which the application is received by the employing office. An employee
who does not apply for dependent coverage within 31 days may subsequently apply for
dependent coverage but must produce evidence of insurability at the employee's own
expense. Coverage for subsequently acquired dependents is effective immediately.


[
1991, c. 480, §6 (NEW)
.]








4. Evidence of insurability. 
When the insurance underwriter approves an application for coverage or increase
in coverage with which evidence of insurability has been filed as provided under subsection
1, paragraph C or subsection 2, paragraph C, the coverage or increased coverage becomes
effective as of the first day of the first month following completion of one month
of employment after the date of approval.


[
1991, c. 480, §6 (NEW)
.]








5. Employee on leave of absence. 
Insurance coverage for an employee on an authorized leave of absence is governed
as follows.





A. An employee who, during a period of an unpaid leave of absence, continues to pay premiums
due for the period of the leave continues to be covered. Coverage for an employee
who, during the period of the leave, does not pay the premiums due ceases at the end
of the period covered by the last premium paid. [2011, c. 449, §12 (NEW).]










B. Notwithstanding paragraph A, an employee who, during a period of unpaid military leave
of absence, does not continue coverage while on unpaid military leave must be reinstated
to the levels of coverage in effect immediately prior to the unpaid military leave.
A request for reinstatement by the employee must be made within 31 days of the employee's
return to work following unpaid military leave. An employee who wants to be reinstated
and who does not apply for reinstatement within 31 days of the employee's return to
work from unpaid military leave must produce evidence of insurability at the employee's
own expense and in accordance with the requirements of the insurance underwriter. [2011, c. 449, §12 (NEW).]







[
2011, c. 449, §12 (NEW)
.]








6. Notice to employee and 3rd party prior to lapse or termination. 
Coverage for an employee may not be terminated for nonpayment of premium unless,
at least 14 days prior to the lapse or termination of coverage, the board has mailed
a notice of cancellation to the employee and any 3rd party designated by the employee
by name and address in writing pursuant to subsection 1, paragraph D.


[
2015, c. 61, §2 (NEW)
.]





SECTION HISTORY

1985, c. 801, §§5,7 (NEW).
1991, c. 480, §6 (AMD).
1993, c. 386, §3 (AMD).
2007, c. 17, §1 (AMD).
2007, c. 17, §3 (AFF).
2009, c. 236, §§1, 2 (AMD).
2009, c. 474, §§ 24, 25 (AMD).
2011, c. 449, §§10-12 (AMD).
2015, c. 61, §§1, 2 (AMD).
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