RELATES TO:
KRS
16.505,
16.576(4),
61.505(1)(g),
61.510,
61.701,
61.702,
78.510,
78.5536,
26 U.S.C.
105(b),
106,
115,
213(d),
42 U.S.C.
300bb-8(3),
1395y(b),
Pub.L.
111-148
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
61.505(1)(g) authorizes the
Kentucky Public Pensions Authority to promulgate administrative regulations on
behalf of the Kentucky Retirement Systems and the County Employees Retirement
System that are consistent with
KRS
16.505 to
16.652,
61.510 to
61.705, and
78.510 to
78.852.
KRS
61.702 and
78.5536 provide for the systems
operated by the Kentucky Public Pensions Authority to offer hospital and
medical insurance coverage to recipients (including retired members and some
beneficiaries of deceased members), their spouses, and their disabled or
dependent children, and require the promulgation of administrative regulations
concerning requirements for medical insurance reimbursement programs. This
administrative regulation establishes procedures for the administration of the
hospital and medical insurance benefits provided by the Kentucky Retirement
Systems and the County Employees Retirement System, as well as establishes
eligibility requirements, necessary documentation for proof of insurance,
deadlines for filing for reimbursement, and forms.
Section 1. Definitions.
(1) "Agency" means:
(a) Prior to April 1, 2021, the Kentucky
Retirement Systems, which administered the State Police Retirement System, the
Kentucky Employees Retirement System, and the County Employees Retirement
System; and
(b) Beginning April 1,
2021, the Kentucky Public Pensions Authority, which is authorized to carry out
the day-to-day administrative needs of the Kentucky Retirement Systems
(comprised of the State Police Retirement System and the Kentucky Employees
Retirement System) and the County Employees Retirement System.
(2) "Boards" means the Board of
Trustees of the Kentucky Retirement Systems and the Board of Trustees of the
County Employees Retirement System.
(3) "Complete" means all required sections of
a form are filled out, the form has been fully executed by the recipient or the
recipient's legal representative, and all supporting documentation required by
the form is included with the form.
(4) "Dependent child" is defined by
KRS
16.505(17) and
78.510(49).
(5) "Eligible spouse and dependent children"
means spouses and dependent children who are eligible to receive all or a
portion of their premiums paid for by the boards in accordance with
KRS
61.702 and
78.5536.
(6) "File" means a form or document has been
received at the retirement office by mail, fax, secure email, in-person
delivery, or via Self Service on the Web site maintained by the agency (if
available).
(7) "MEM" means:
(a) A Medicare eligible member who is retired
and reemployed:
1. With a participating
employer that offers the member a hospital and medical insurance benefit;
or
2. By a participating employer
that is prevented from offering a hospital and medical benefit to the member as
a condition of reemployment under
KRS
70.293,
95.022, or
164.952; and
(b) A Medicare eligible member who
is retired and whose spouse meets the following criteria:
1. The spouse is also a member;
2. The spouse is reemployed with a
participating employer that offers the spouse a hospital and medical insurance
benefit, or by a participating employer that is prevented from offering a
hospital and medical benefit to the spouse as a condition of reemployment under
KRS
70.293,
95.022, or
164.952; and
3. The spouse's hospital and medical
insurance plan coverage is provided by the retired member's benefits pursuant
to KRS
61.702(2) and
78.5536(2).
(8) "Member" is defined
by KRS
16.505(21),
61.510(8), and
78.510(8).
(9) "Monthly contribution rate" means:
(a) The amount determined by the boards as
the maximum contribution the systems will pay toward the premium of a retired
member who began participating in the systems on or before June 30, 2003;
or
(b) For a retired member who
began participating in the system on or after July 1, 2003, the amount per
month earned by the retired member based on years of service as provided in
KRS
61.702(4)(e) and
78.5536(4)(e).
(10) "Premium" means the monthly
dollar cost required to provide hospital and medical insurance plan coverage
for a recipient, a recipient's spouse, or a disabled or dependent
child.
(11) "Provide", if used in
reference to a form or other document, means the agency makes a form or
document available on its Web site (if appropriate) or, upon request by a
recipient or other person, by mail, fax, secure email, or via Self Service on
the Web site maintained by the agency (if available).
(12) "Qualifying event" means a change in
life circumstances that:
(a) Meets the
agency's requirement for a member to alter an existing hospital and medical
insurance plan, or sign up for a new one outside of new or open enrollment if
the alteration is consistent with the change; and
(b) Is included on the list of qualifying
events provided annually to the members by the agency.
(13) "Recipient" is defined by
KRS
16.505(26),
61.510(27), and
78.510(26).
(14) "Retired member" is defined by
KRS
16.505(11),
61.510(24), and
78.510(23).
(15) "Retirement allowance" is defined by
KRS
16.505(12),
61.510(16), and
78.510(16).
(16) "Retirement office" is defined by
KRS
16.505(28),
61.510(31), and
78.510(29).
(17) "Systems" means the State Police
Retirement System, the Kentucky Employees Retirement System, and the County
Employees Retirement System.
(18)
"Wellness" or "wellbeing promise" means an annual health assessment or
screening that, if completed timely, provides a discounted insurance rate for
the following fiscal year's health insurance plan premium.
Section 2. Trust Fund.
(1) Pursuant to
KRS
61.701, fund assets shall be dedicated for
use toward health benefits, as provided in
KRS
61.702 and
78.5536, and as permitted under
26 U.S.C.
105 and
106 of the United States Internal
Revenue Code, to retired recipients and employees of employers participating in
the systems. Certain dependents or beneficiaries shall be included, such as
qualified beneficiaries as described in
42 U.S.C.
300bb-8(3) of the
United States Public Health Service Act.
(2) The boards may adopt a trust agreement
and take all action authorized by
KRS
61.701(6).
Section 3. Contribution Rates.
(1)
(a) The
boards shall adopt monthly contribution rates as follows:
1. Medicare eligible coverage;
2. Non-Medicare eligible coverage;
and
3. MEM coverage.
(b) The boards may choose to adopt
a monthly contribution rate for MEM coverage that is separate from the monthly
contribution rate the boards adopt for Medicare and non-Medicare eligible
coverage, or may choose to adopt a monthly contribution rate that is the same
for Non-Medicare eligible coverage and MEM coverage.
(2) The boards shall adopt a contribution
plan for each monthly contribution rate in subsection (1) of this
section.
(3) The boards may adopt
separate contribution rates for:
(a) Tobacco
and non-tobacco users; and
(b)
Wellness or wellbeing promise completion and incompletion.
Section 4. Payments by the Boards.
(1) The monthly contribution rate paid by the
boards towards premiums for a recipient or eligible spouse or dependent child
shall not exceed the monthly contribution rate to which the recipient is
entitled under KRS
61.702 and
78.5536.
(2) For a retired member who retired based on
reciprocity with any other state-administered retirement system, the boards
shall not pay more than a portion of the single monthly contribution rate for
the hospital and medical insurance plan chosen by the retired member based on
the retired member's service credit with the systems.
(3)
(a) A
retired member who is not Medicare eligible or is a MEM may cross-reference
health insurance coverage with a spouse enrolled in the same hospital and
medical insurance plan.
(b) A
retired member identified in paragraph (a) of this subsection who has hazardous
service and a membership date prior to July 1, 2003 may be able to use any
unused portion of the monthly contribution rate the retired member is entitled
to receive toward the premium cost attributable to the spouse, if the spouse's
portion of the premium is not fully paid by the boards pursuant to
KRS
61.702 and
78.5536.
(4) Pursuant to
KRS
61.702(4)(d),
61.702(4)(e)
5., 78.5536(4)(d), and 78.5536(4)(e)5., funds from the insurance trust fund or
the 401(h) accounts provided for in
KRS
61.702(3)(b) and
78.5536(3)(b)
shall be used to pay a percentage of the monthly contribution rate for family
coverage for eligible spouses and dependent children as defined in
KRS
16.505(17) and
78.510(49).
(5)
(a)
Members not eligible for Medicare who began participation in the system on or
after July 1, 2003 and have accrued an additional full year of service as a
participating employee beyond his or her career threshold may receive an
additional five (5) dollar contribution toward monthly hospital and medical
insurance premiums in accordance with
KRS
61.702(4)(e) 6.b. and
78.5536(4)(e)6.b.
(b)
1. If a member who is eligible for an
additional five (5) dollar contribution pursuant to paragraph (a) of this
subsection has service in multiple systems operated by the agency, each system
in which the member participates that meets the requirements of
KRS
61.702(4)(e) 6.b.iii. and
78.5536(4)(e)6.b.iii shall pay a portion of the additional five (5) dollar
contribution based on the percentage of the member's service in each
system.
2. If a member who is
eligible for an additional five (5) dollar contribution pursuant to paragraph
(a) of this subsection has service in multiple systems operated by the agency,
and not all of the systems in which the member participates meet the
requirements of KRS
61.702(4)(e) 6.b.iii. and
78.5536(4)(e)6.b.iii, only those systems that meet the requirements of
KRS
61.702(4)(e) 6.b.iii. and
78.5536(4)(e)6.b.iii shall pay a portion of the additional five (5) dollar
contribution based on the percentage of the member's service in each
system.
Section
5. Premiums Paid by Recipient.
(1) Any premium amount that is not paid or
payable by the insurance trust fund established under
KRS
61.701 or a 401(h) account in accordance
KRS
61.702 and
78.5536 shall be deducted from
the monthly retirement allowance of the recipient.
(2)
(a) If
the amount of a premium is not fully paid by the insurance trust fund
established under KRS 61.701, a 401(h) account,
and the recipient's monthly retirement allowance, then the recipient shall pay
the balance of the premium monthly by electronic transfer of funds by filing a
complete Form 6131, Bank Draft Authorization for Direct Pay Accounts, at the
retirement office.
(b) If a
complete Form 6131, Bank Draft Authorization for Direct Pay Accounts, is
required and is not filed at the retirement office, then the recipient, the
recipient's spouse, and any disabled or dependent children shall not be
enrolled in a hospital and medical insurance plan established pursuant to
KRS
61.702 and
78.5536.
(c)
1. If
the electronic transfer of funds based on a complete Form 6131, Bank Draft
Authorization for Direct Pay Accounts, on file at the retirement office fails,
then the agency shall provide an invoice to the recipient.
2. If a recipient fails to remit the balance
of the premium by the date provided on the invoice, then the enrollment of the
recipient, the recipient's spouse, and any disabled or dependent children in
the hospital and medical insurance plan shall be cancelled the month after the
last month the recipient paid the premium.
(d) If the hospital and medical insurance
plan coverage of a recipient, the recipient's spouse, or any disabled or
dependent children is cancelled pursuant to this subsection, the recipient
shall not be eligible to enroll in a hospital and medical insurance plan
established pursuant to
KRS
61.702 and
78.5536 until the next open
enrollment period for hospital and medical insurance plan coverage.
Section 6. Eligibility
to Participate in Hospital and Medical Insurance Plans.
(1) A person shall not be eligible to
participate in the hospital and medical insurance plans established pursuant to
KRS
61.702 and
78.5536 until the person is a
recipient of a monthly retirement allowance, except as provided in
KRS
16.576(4).
(2) A person who retires under disability
retirement shall not be eligible to participate in the hospital and medical
insurance plans established pursuant to
KRS
61.702 and
78.5536 until the month the
person receives his or her first monthly retirement allowance
payment.
(3) A recipient's spouse,
disabled child, or dependent child shall not be eligible to participate in the
hospital and medical insurance plans established pursuant to
KRS
61.702 and
78.5536 unless the recipient is
participating in the hospital and medical insurance plans established pursuant
to KRS
61.702 and
78.5536.
(4) An alternate payee shall not be eligible
for participation in the hospital and medical insurance plans established
pursuant to KRS
61.702 and
78.5536.
Section 7. Participation in a Hospital and
Medical Insurance Plan.
(1) A recipient,
spouse, or disabled or dependent child who is Medicare eligible, except
individuals identified in subsection (2) of this section, shall participate in
the hospital and medical insurance plan established for Medicare eligible
recipients pursuant to
KRS
61.702 and
78.5536.
(2) MEMs, and spouses of MEMs and disabled or
dependent children of MEMs who are Medicare eligible, shall participate in the
group hospital and medical insurance plan established for MEMs pursuant to
KRS
61.702(2)(b) 3.b. and
78.5536(2)(b)3.b..
(3) A recipient,
spouse, or disabled or dependent child who is not Medicare eligible shall
participate in a non-Medicare eligible group hospital and medical insurance
plan established pursuant to
KRS
61.702 and
78.5536.
(4) If a recipient, spouse, or disabled or
dependent child is eligible for Medicare but the other persons enrolled in a
group hospital and medical insurance plan are not, then the recipient, spouse,
or disabled or dependent child who is not eligible for Medicare may continue to
participate in the non-Medicare eligible group hospital and medical insurance
plan established pursuant to
KRS
61.702 and
78.5536.
(5) Members identified in subsections (1)
through (4) of this section may waive enrollment in the hospital and medical
insurance plan by filing:
(a) A completed KPPA
Health Plans for Medicare Eligible Persons form, for Medicare eligible
recipients; or
(b) A completed
Retiree Health Insurance Enrollment/Change Form, for MEMs and non-Medicare
eligible recipients.
(6)
Members identified in subsections (1) through (4) of this section who do not
enroll in or waive the hospital and medical insurance plan shall be
automatically enrolled in an appropriate default plan in accordance with
Section 9 of this administrative regulation.
Section 8. Required Forms.
(1) If the boards use the group hospital and
medical insurance provided by the Kentucky Department of Employee Insurance to
provide health insurance coverage for its non-Medicare eligible recipients,
spouses, disabled or dependent children, and MEMs, then the agency shall
provide these recipients and MEMs with the Retiree Health Insurance
Enrollment/Change Form, required for enrollment, waiver, or changes to the
group hospital and medical insurance plan.
(2) On behalf of the boards, the agency shall
arrange hospital and medical insurance coverage for Medicare eligible
recipients, spouses, and disabled or dependent children, except MEMs. The
agency shall provide these recipients with the KPPA Health Plans for Medicare
Eligible Persons form, required for enrollment, waiver, or changes to the
hospital and medical insurance plans.
(3) The agency shall provide the Form 6256,
Designation of Spouse and/or Dependent Child for Health Insurance
Contributions, for recipients to complete to receive health insurance
contributions toward an eligible spouse and dependent children who are between
the ages of eighteen (18) and twenty-two (22).
Section 9. Default Plans.
(1) The boards shall adopt a default plan for
new retired members upon initial enrollment, and for recipients who do not file
a complete insurance enrollment form during annual open enrollment, if
required.
(2) The boards shall
adopt a default plan for retired members and recipients who are Medicare
eligible, and a default plan for retired members and recipients who are
non-Medicare eligible and recipients who are subject to
42 U.S.C.
1395y.
Section 10. Initial and Annual Enrollment and
Qualifying Events.
(1)
(a) The recipient shall file complete
insurance enrollment forms as described in Section 8 of this administrative
regulation at the retirement office by the last day of the month the initial
retirement allowance is paid.
(b)
If the recipient fails to file the complete insurance enrollment forms as
required by paragraph (a) of this subsection, the retired member shall be
automatically enrolled in the appropriate default plan adopted by the boards as
described in Section 9 of this administrative regulation.
(c) If the recipient identified in paragraph
(a) of this subsection files the completed insurance enrollment forms as
described in Section 8 of this administrative regulation by the last day of the
month in which he or she receives his or her initial retirement allowance
payment, the retired member shall be enrolled in the selection indicated on the
form effective the first day of the following month.
(2) If a recipient has a qualifying event,
the recipient shall file the complete insurance enrollment forms as described
in Section 8(1) or (2) of this administrative regulation at the retirement
office within the time period prescribed by state and federal law and the
health insurance plan documents.
(3)
(a) If
enrollment is mandatory:
1. The recipient
shall file the complete insurance enrollment forms as described in Section 8 of
this administrative regulation at the retirement office by the last day of the
month of the annual open enrollment period.
2. If the recipient fails to file the
complete insurance enrollment forms as required by subparagraph 1. of this
paragraph, the recipient shall be automatically enrolled in the default plan
adopted by the boards as described in Section 9 of this administrative
regulation.
(b) If
enrollment is not mandatory:
1. The recipient
may file the complete insurance enrollment forms as described in Section 8 of
this administrative regulation at the retirement office by the last day of the
month of the annual open enrollment period.
2. If the recipient does not file the
complete insurance enrollment forms as required by subparagraph 1. of this
paragraph, the recipient, and the recipient's spouse and disabled or dependent
children as applicable, shall remain on the same plan with the same level of
coverage as the previous plan year.
(4)
(a)
1. In order to receive health insurance
contributions toward an eligible spouse or a dependent child who is between the
ages of eighteen (18) and twenty-two (22), the recipient shall file a complete
Form 6256, Designation of Spouse and/or Dependent Child for Health Insurance
Contributions, by November 30th of the calendar year prior to the calendar year
in which coverage is effective, regardless of whether enrollment is mandatory
or not mandatory.
2. If a
qualifying event results in a new eligible spouse or dependent child, in order
to receive health insurance contributions toward the eligible spouse or a
dependent child who is between the ages of eighteen (18) and twenty-two (22),
the recipient shall file a complete Form 6256, Designation of Spouse and/or
Dependent Child for Health Insurance Contributions.
(b)
1. If
the recipient does not file a complete Form 6256, Designation of Spouse and/or
Dependent Child for Health Insurance Contributions, in accordance with
paragraph (a) of this subsection, health insurance contributions shall not be
paid toward the premiums for an eligible spouse or dependent children unless a
complete Form 6256 is filed at the retirement office in the calendar year in
which coverage is in effect.
2. If
the recipient files a complete Form 6256, Designation of Spouse and/or
Dependent Child for Health Insurance Contributions, between December 1 and
December 31 of the calendar year prior to the calendar year in which coverage
is effective, then health insurance contributions may be paid for an eligible
spouse or a dependent child who is between the ages of eighteen (18) and
twenty-two (22) as of January of the calendar year in which coverage is
effective. If the health insurance contributions are not paid for an eligible
spouse or a dependent child as of January of the calendar year in which
coverage is effective, then health insurance contributions shall be paid
starting in February of the calendar year in which coverage is effective and
the recipient shall also be reimbursed for the January health insurance
contributions for the eligible spouse or dependent child.
3. If the recipient files a complete Form
6256, Designation of Spouse and/or Dependent Child for Health Insurance
Contributions, prior to December 31 of the calendar year in which coverage is
in effect, health insurance contributions shall be paid toward premiums for an
eligible spouse or a dependent child who is between the ages of eighteen (18)
and twenty-two (22) in any month in the calendar year in which coverage is
effective after the Form 6256 is filed at the retirement office. If a complete
Form 6256 is filed at the retirement office prior to December 31 of the
calendar year in which coverage is in effect, the recipient shall also be
reimbursed for up to three (3) months of health insurance contributions for the
eligible spouse and dependent children.
Section 11. Changes in Spouse and
Disabled or Dependent Child Eligibility.
(1)
Recipients, spouses, and disabled or dependent children shall notify the agency
of any change that may affect the eligibility of the spouse, disabled child, or
dependent child to enroll in a hospital and medical insurance plan offered by
the agency or the eligibility of the spouse or dependent child to have all or a
portion of their premiums paid for by the boards in accordance with
KRS
61.702 and
78.5536.
(2)
(a) The
recipient shall repay any premiums that were paid by the boards after the
spouse or dependent child ceased to be eligible to have all or portion of their
premiums paid in accordance with
KRS
61.702 and
78.5536.
(b) If the agency is unable to recover from
the recipient the full amount of premiums paid in accordance with paragraph (a)
of this subsection, the agency may withhold any remaining amount from the
recipient's monthly retirement allowance payment.
(c) If the agency is not able to recover the
full amount of the premiums paid in accordance with paragraphs (a) and (b) of
this subsection, the agency may recover any remaining amount from the spouse or
dependent child.
Section
12. Medical Insurance Reimbursement Plan for Recipients Living
Outside of Kentucky.
(1) A recipient may
participate in the medical insurance reimbursement plan pursuant to
KRS
61.702(6) and
78.5536(6) if
the recipient lives in an area outside of the coverage of the group hospital
and medical insurance plans offered by the agency.
(2) The medical insurance reimbursement plan
shall be available in any month the recipient:
(a) Resides outside of Kentucky;
(b) Is not eligible for the same level of
hospital and medical benefits as recipients who resided inside of Kentucky with
the same Medicare status; and
(c)
Has paid hospital and medical insurance plan premiums capable of being
reimbursed.
(3)
Recipients eligible to participate in the medical insurance reimbursement plan
shall be reimbursed up to the applicable monthly contribution rate for premiums
paid for hospital and medical coverage less any premiums paid by the
recipient's employer.
(4)
(a) In order to receive the applicable
reimbursement, an eligible recipient shall file a Form 6240, Application for
Out of State Reimbursement for Medical Insurance, and as applicable Form 6256,
Designation of Spouse and/or Dependent Child for Health Insurance
Contributions, at the retirement office with one (1) or more of the following
as proof of coverage and payment of premiums for hospital and medical insurance
that covers the entire time period for the requested reimbursement:
1. Form 6241, Employer Certification of
Health Insurance for Health Insurance Reimbursement Plan, completed by the
employer;
2. Form 6242, Insurance
Agency/Company Certification of Health Insurance for Health Insurance
Reimbursement Plan, completed by the insurance agency or company;
3. A signed statement from the employer
listing individuals covered, dates of hospital and medical insurance coverage,
amount of premiums deducted from wages, and the cost of the single coverage;
or
4. A signed statement or invoice
from the insurance company listing individuals covered, the dates and cost of
single hospital and medical insurance coverage, along with proof of payment
such as a receipt or bank statement clearly indicating payment for the
statement or invoice provided.
(b)
1. If
any provided documentation is deemed insufficient by the agency, the agency may
request additional proof of medical and hospital insurance coverage or
payment.
2. The agency may verify
the recipient's eligibility for reimbursement for hospital and medical
insurance by requesting verification of coverage and payments directly from the
insurance company indicated on the Form 6240, Application for Out of State
Reimbursement for Medical Insurance.
(5) An eligible recipient may file for
reimbursement quarterly each calendar year in accordance with subsection (4) of
this section.
(6) If the eligible
recipient files for reimbursement in accordance with subsection (4) of this
section, the eligible recipient shall be reimbursed on the following schedule:
(a) In February, if all documentation is
filed at the retirement office by January 20;
(b) In May, if all documentation is filed at
the retirement office by April 20;
(c) In August, if all documentation is filed
at the retirement office by July 20; or
(d) In November, if all documentation is
filed at the retirement office by October 20.
(7) The agency shall not reimburse an
eligible recipient for premiums for a calendar year in which the eligible
recipient failed to file a request for reimbursement in accordance with
subsection (4) of this section by March 20 of the following calendar
year.
(8)
(a) If a recipient receives a payment from
the agency that does not qualify as a premium reimbursement, the recipient
shall return the payment to the agency at the retirement office.
(b) If the recipient fails to return the
payment, the agency may withhold the payment from the recipient's monthly
retirement allowance payment.
Section 13. Dollar Contribution Medical
Insurance Reimbursement Plan for Recipients Hired on or after July 1, 2003.
(1) Beginning January 1, 2023, a recipient
with a hire date on or after July 1, 2003 may participate in the hospital and
medical insurance dollar contribution reimbursement plan pursuant to
KRS
61.702(6) and
78.5536(6), if
the recipient chooses to purchase a hospital and medical insurance plan not
provided by the systems.
(2)
Recipients eligible to participate in the dollar contribution medical insurance
reimbursement plan shall be reimbursed up to the applicable monthly
contribution rate for premiums paid for hospital and medical coverage less any
premiums paid by the recipient's employer.
(3)
(a) In
order to receive the applicable reimbursement, an eligible recipient shall file
a Form 6280, Application for Dollar Contribution Reimbursement for Medical
Insurance, at the retirement office with one (1) or more of the following as
proof of payment of premiums for hospital and medical insurance coverage that
covers the entire time period for the requested reimbursement:
1. Form 6281, Employer Certification of
Health Insurance for Dollar Contribution Reimbursement Plan, completed by the
employer;
2. Form 6282, Insurance
Agency/Company Certification of Health Insurance for Dollar Contribution
Reimbursement Plan, completed by the insurance agency or company;
3. A signed statement from the employer
listing individuals covered, dates of hospital and medical insurance coverage,
amount of premiums deducted from wages, and the cost of the single coverage;
or
4. A signed statement or invoice
from the insurance company listing the individuals covered, dates, and cost of
single hospital and medical insurance coverage; along with proof of payment
such as a receipt or bank statement clearly indicating payment for the
statement or invoice provided.
(b)
1. If
any provided documentation is deemed insufficient by the agency, the agency may
request additional proof of medical and hospital insurance coverage or
payment.
2. The agency may verify
the recipient's eligibility for reimbursement for hospital and medical
insurance by requesting verification of coverage and payments directly from the
insurance company indicated on the Form 6280, Application for Dollar
Contribution Reimbursement for Medical Insurance.
(4) An eligible recipient may file
for reimbursement in accordance with subsection (3) of this section, quarterly
each calendar year.
(5) If the
eligible recipient files a request for reimbursement in accordance with
subsection (3) of this section, the eligible recipient shall be reimbursed on
the following schedule:
(a) In February, if
all documentation is filed at the retirement office by January 20;
(b) In May, if all documentation is filed at
the retirement office by April 20;
(c) In August, if all documentation is filed
at the retirement office by July 20; or
(d) In November, if all documentation is
filed at the retirement office by October 20.
(6) The agency shall not reimburse an
eligible recipient for premiums for a calendar year in which the eligible
recipient failed to file a request for reimbursement in accordance with
subsection (3) of this section by March 20 of the following calendar
year.
(7)
(a) If a recipient receives a payment from
the agency that does not qualify as a premium reimbursement, the recipient
shall return the payment to the agency at the retirement office.
(b) If the recipient fails to return the
payment, the agency may withhold the payment from the recipient's monthly
retirement allowance payment.
Section 14. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) Form 6131, "Bank Draft
Authorization for Direct Pay Accounts", April 2021;
(b) "KPPA Health Plans for Medicare Eligible
Persons", September 2022;
(c)
"Retiree Health Insurance Enrollment/Change Form", September 2022;
(d) Form 6240, "Application for Out of State
Reimbursement for Medical Insurance," September 2022;
(e) Form 6241, "Employer Certification of
Health Insurance for Health Insurance Reimbursement Plan", September
2022;
(f) Form 6242, "Insurance
Agency/Company Certification of Health Insurance for Health Insurance
Reimbursement Plan", September 2022;
(g) Form 6256, "Designation of Spouse and/or
Dependent Child for Health Insurance Contributions", September 2022;
(h) Form 6280, "Application for Dollar
Contribution Reimbursement for Medical Insurance", September 2022;
(i) Form 6281, "Employer Certification of
Health Insurance for Dollar Contribution Reimbursement Plan", September 2022;
and
(j) Form 6282, "Insurance
Agency/Company Certification of Health Insurance for Dollar Contribution
Reimbursement Plan", September 2022.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Kentucky Public
Pensions Authority, 1260 Louisville Road, Frankfort, Kentucky 40601, Monday
through Friday, 8 a.m. to 4:30 p.m., or on the agency's Web site at
kyret.ky.gov.