Cal. Code Regs. Tit. 2, § 599.501 - Coverage
(a) Each employee
or annuitant other than those excluded by subsections (b) or (c) below, is
eligible to be enrolled in a health benefits plan at the times and under the
conditions prescribed in this subchapter, provided however that no person shall
be enrolled in a supplemental plan who at the time of enrollment is not also
enrolled under Part A and Part B of Medicare. An eligible employee or annuitant
enrolled in both Parts A and B of Medicare, or who has a family member who is
so enrolled, may be enrolled in a basic plan contracted for by the Board with
respect to persons not enrolled in Parts A and B, and in a supplemental plan
with respect to all persons enrolled in Parts A and B.
(b) Employees in the following groups are not
eligible:
(1) Employees serving under:
(A) Intermittent appointments except where
employment is on a permanent basis.
(B) Appointments to positions for which
contributions are made by the employer to health and welfare programs providing
prepaid hospital and medical care in accordance with Sections
14876 and
19831 of
the Government Code, or other similar provisions; or appointments to positions
for which salary payment is made in lieu of payment to health and welfare
programs providing prepaid hospital and medical care; or
(C) Appointments to positions not exceeding
six months duration unless the employee is enrolled prior to beginning service
under such appointment or unless the appointment is in lieu of a permanent
appointment pending establishment of and certification from a list from which
the position may be filled.
(2) Inmates of institutions who are allowed
compensation for such services as they are able to perform.
(3) Persons employed as student assistants
and graduate assistants and as student aids in special schools in the State
Department of Education and Vocational Rehabilitation, and the public schools
of the State.
(4) Blind persons and
other persons with disabilities employed by the California Industries for the
Blind, or in opportunity centers for the blind by the Department of Education
who are not civil service employees.
(5) Persons serving at a State college solely
as a teacher in any summer session or intersession for which compensation is
specifically attributable to such service in summer session or
intersession.
(6) Any member of the
Veterans' Home of California who is employed by said Home, or by the Post
Exchange thereof or in other Post Fund activities, except as an employee of a
contracting agency.
(7) Any
employee paid wholly from funds not controlled by the employer or from
revolving or similar funds from which regular payroll deduction of the
insurance premium cannot be made.
(8) Employees of a contracting agency who are
not members of the Public Employees' Retirement System or the State Teachers'
Retirement System, except those employees defined in Government Code section
22772(a)(2).
(c) Annuitants whose effective date of
retirement is more than 120 days after their date of separation from employment
are not eligible.
(d) A disabled
child as described in section
599.500, subdivision (p), who is
age 26 or over is to be enrolled at the time of the initial enrollment of the
employee or annuitant provided that satisfactory evidence of such disability is
filed with the Board within 60 days of the initial enrollment.
(e) A disabled child, as described in section
599.500, subdivision (p), who
attains age 26 is to be continued in enrollment if he or she is enrolled at the
time he or she attains age 26, provided that satisfactory evidence of such
disability is filed with the Board during the period commencing 90 days before
and ending 60 days after the child's 26th birthday.
(f) The Board shall make determinations of
the applicability of this section to specific employees or annuitants, or
groups of employees or annuitants.
Notes
2. Amendment filed 6-15-79; designated effective 8-1-79 (Register 79, No. 24).
3. Amendment filed 6-27-80; designated effective 8-1-80 (Register 80, No. 26).
4. Amendment filed 6-9-86; effective thirtieth day thereafter (Register 86, No. 24).
5. Change without regulatory effect amending subsection (c) and NOTE filed 10-31-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 44).
6. Amendment of subsections (f) and (g) filed 2-15-2011; operative 2-15-2011 pursuant to Government Code section 11343.4 (Register 2011, No. 7).
7. Amendment of subsection (a) filed 5-15-2013; operative 7-1-2013 (Register 2013, No. 20).
8. Amendment of subsections (b)(1)(B), (b)(4) and (b)(8), repealer of subsections (c), (e) and (i), subsection relettering and amendment of newly designated subsection (e) filed 2-28-2020; operative 4-1-2020 (Register 2020, No. 9).
Note: Authority cited: Sections 22794, 22796, 22800, 22830, 22831, 22846 and 22860, Government Code. Reference: Sections 22760, 22775, 22800, 22819, 22830, 22831, 22832 and 22837, Government Code.
2. Amendment filed 6-15-79; designated effective 8-1-79 (Register 79, No. 24).
3. Amendment filed 6-27-80; designated effective 8-1-80 (Register 80, No. 26).
4. Amendment filed 6-9-86; effective thirtieth day thereafter (Register 86, No. 24).
5. Change without regulatory effect amending subsection (c) and Note filed 10-31-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 44).
6. Amendment of subsections (f) and (g) filed 2-15-2011; operative 2-15-2011 pursuant to Government Code section 11343.4 (Register 2011, No. 7).
7. Amendment of subsection (a) filed 5-15-2013; operative 7-1-2013 (Register 2013, No. 20).
8. Amendment of subsections (b)(1)(B), (b)(4) and (b)(8), repealer of subsections (c), (e) and (i), subsection relettering and amendment of newly designated subsection (e) filed 2-28-2020; operative
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