§36-12-1  Definitions. –


Published: 2015

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TITLE 36

Public Officers and Employees

CHAPTER 36-12

Insurance Benefits

SECTION 36-12-1



   § 36-12-1  Definitions. –

The following words, as used in §§ 36-12-1 – 36-12-14, shall

have the following meanings:



   (1) "Employer", means the state of Rhode Island.



   (2) "Employee", means all persons who are classified

employees as the term "classified employee" is defined under § 36-3-3, and

all persons in the unclassified and non-classified service of the state;

provided, however, that the following shall not be included as "employees"

under §§ 36-12-1 – 36-12-14:



   (i) Part-time personnel whose work week is less than twenty

(20) hours a week and limited period and seasonal personnel;



   (ii) Members of the general assembly, its clerks,

doorkeepers, and pages.



   (3) "Dependents" means an employee's spouse, domestic partner

and unmarried children under nineteen (19) years of age. Domestic partners

shall certify by affidavit to the benefits director of the division of

personnel that the (i) partners are at least eighteen (18) years of age and are

mentally competent to contract, (ii) partners are not married to anyone, (iii)

partners are not related by blood to a degree which would prohibit marriage in

the state of Rhode Island, (iv) partners reside together and have resided

together for at least one year, (v) partners are financially interdependent as

evidenced by at least two (2) of the following: (A) domestic partnership

agreement or relationship contract; (B) joint mortgage or joint ownership of

primary residence, (C) two (2) of: (I) joint ownership of motor vehicle; (II)

joint checking account; (III) joint credit account; (IV) joint lease; and/or

(D) the domestic partner has been designated as a beneficiary for the

employee's will, retirement contract or life insurance. Misrepresentation of

information in the affidavit will result in an obligation to repay the benefits

received, and a civil fine not to exceed one thousand dollars ($1000)

enforceable by the attorney general and payable to the general fund. The

employee will notify the benefits director of the division of personnel by

completion of a form prescribed by the benefits director when the domestic

partnership ends.



   (4) "Retired employee", means all persons retired from the

active service of the state, who, immediately prior to retirement, were

employees of the state as determined by the retirement board under §

36-8-1, and also all retired teachers who have elected to come under the

employees' retirement system of the state of Rhode Island.



   (5) "State retiree", means all persons retired from the

active service of the state who, immediately prior to retirement, were

employees of the state as determined by the retirement board under §

36-8-1.



   (6) "Teacher retiree", means all retired teachers who have

elected to come under the employees ' retirement system of the state of Rhode

Island.



   (7) "Long-term health care insurance", means any insurance

policy or rider advertised, marketed, offered, or designed to provide coverage

for not less than twelve (12) consecutive months for each covered person on an

expense incurred, indemnity, prepaid, or other basis for one or more necessary

or medically necessary diagnostic, preventive, therapeutic, rehabilitative,

maintenance, or personal care services, provided in a setting other than an

acute care unit of a hospital. The term includes: group and individual policies

or riders whether issued by insurers, fraternal benefit societies, nonprofit

health, hospital, and medical service corporations; prepaid health plans,

health maintenance organizations; or any similar organization. Long-term health

care insurance shall not include: any insurance policy which is offered

primarily to provide basic medicare supplement coverage; basic hospital expense

coverage; basic medical-surgical expense coverage; hospital confinement

indemnity coverage; major medical expense coverage; disability income

protection coverage; accident only coverage; specified disease or specified

accident coverage; or limited benefit health coverage. This list of excluded

coverages is illustrative and is not intended to be all inclusive.



   (8) "Non-Medicare-eligible retiree health care insurance",

means the health benefit employees who retire from active service of the state

(subsequent to July 1, 1989), who immediately prior to retirement were

employees of the state as determined by the retirement board pursuant to §

36-8-1, shall be entitled to receive until attaining Medicare eligibility. This

health care insurance shall be equal to semi-private hospital care,

surgical/medical care and major medical with a one hundred seventy-five dollar

($175) calendar year deductible. The aforementioned program will be provided on

a shared basis in accordance with § 36-12-4.



   (9) "Medicare-eligible retiree health care insurance", means

the health benefit employees who retire from active service of the state

(subsequent to July 1, 1989), who immediately prior to retirement were

employees of the state as determined by the retirement board pursuant to §

36-8-1, shall have access to when eligible for Medicare. This health care

insurance shall include plans providing hospital care, surgical/medical

services, rights and benefits which, when taken together with their federal

Medicare program benefits, 42 U.S.C. § 1305 et seq., shall be comparable

to those provided for retirees prior to the attainment of Medicare eligibility.



   (10) "Health reimbursement arrangement", or "HRA" means an

account that:



   (i) Is paid for and funded solely by state contributions;



   (ii) Reimburses a Medicare-eligible state retiree for medical

care expenses as defined in § 213(d) of the Internal Revenue Code of 1986,

as amended, which includes reimbursements for health care insurance premiums;



   (iii) Provides reimbursements up to a maximum dollar amount

for a coverage period; and



   (iv) Provides that any unused portion of the maximum dollar

amount at the end of a coverage period is carried forward to increase the

maximum reimbursement amount in subsequent coverage periods.



History of Section.

(P.L. 1960, ch. 136, § 1; P.L. 1967, ch. 105, § 1; P.L. 1988, ch.

433, § 1; P.L. 1989, ch. 227, § 2; P.L. 1989, ch. 542, § 88;

P.L. 2001, ch. 110, § 1; P.L. 2013, ch. 144, art. 2, § 1.)

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