PERMANENT RULES
Date of Adoption: November 28, 2001.
Purpose: Adds a new section WAC 182-12-118 which defines insurance eligibility and establishes rules for participation for surviving dependents of emergency service personnel killed in the line of duty as enacted by the 2001 legislature.
Citation of Existing Rules Affected by this Order: Adds a new section WAC 182-12-118.
Statutory Authority for Adoption: RCW 41.05.160.
Other Authority: RCW 41.05.065.
Adopted under notice filed as WSR 01-21-142 on October 24, 2001.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 1, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making:
New 0,
Amended 0,
Repealed 0;
Pilot Rule Making:
New 0,
Amended 0,
Repealed 0;
or Other Alternative Rule Making:
New 1,
Amended 0,
Repealed 0.
Effective Date of Rule:
Thirty-one days after filing.
November 29, 2001
Melodie Bankers
Rules Coordinator
OTS-5286.1
NEW SECTION
WAC 182-12-118
Insurance eligibility for surviving
dependents of emergency service personnel killed in the line of
duty.
Surviving dependents of emergency service personnel who
were killed in the line of duty on or after January 1, 1998, are
eligible to participate in medical and dental coverage
administered by the health care authority and sponsored by the
public employee's benefits board.
(1) This rule applies to the dependents of emergency service personnel "killed in the line of duty" as determined consistent with Title 51 RCW by the department of labor and industries.
(2) "Emergency service personnel" is defined as law enforcement officers, fire fighters and reserve officers, fire fighters as defined in RCW 41.26.030 and 41.24.010.
(3) "Surviving dependent" is defined as:
(a) A lawful spouse or ex-spouse as defined in RCW 41.26.162; and
(b) Dependent children. The term "children" includes unmarried natural children, stepchildren and legally adopted children under the age of twenty or under the age of twenty-four for a dependent student attending high school or an accredited secondary school full-time. Disabled dependents as defined in RCW 41.26.020(7) are eligible at any age.
(4) Premium rates will be subsidized consistent with rates established by the health care authority for non-Medicare retirees under RCW 41.05.022 and for Medicare-eligible retirees under RCW 41.05.085.
(5) Surviving dependents that are Medicare-eligible must enroll in both parts A and B of Medicare.
(6) The surviving dependent must send a completed enrollment application to the health care authority no later than sixty days after:
(a) The last day of any coverage extended by the employing agency of the emergency service employee who died in the line of duty; or
(b) The last day of coverage extended through the Consolidated Omnibus Budget Reconciliation Act (COBRA) from any employing agency.
(7) Surviving dependents must choose one of the following two options for maintaining eligibility for participation under public employee's benefits board sponsored medical and dental coverage:
(a) Enroll in coverage:
(i) Enrollment in a medical plan is required.
(ii) Enrollment in dental coverage is optional. Once enrolled in dental the member must maintain enrollment in a dental plan for a minimum of two years before dental can be dropped.
(iii) Dental only coverage is not available.
(b) Waive enrollment:
(i) Surviving dependents may waive enrollment in public employee's benefits board sponsored medical and dental coverage if they are enrolled in employer sponsored medical through their employment.
(ii) Surviving dependents may enroll in public employee's benefits board sponsored medical and dental when their employer sponsored coverage ends. Proof of their continuous enrollment in employer sponsored coverage must be submitted with their application for enrollment to the health care authority within sixty days of the date that their coverage ended.
(8) Enrollees may change their medical or dental plan selection during the annual open enrollment period held by the health care authority. In addition to the annual open enrollment period, enrollees may change plans if they move out of their plan's service area or into a service area where a plan that was not previously offered is now available.
(9) Surviving dependents will forfeit their right to enroll in public employee's benefits board sponsored medical and dental coverage if they:
(a) Do not make application to the health care authority before the date specified in subsection (6) of this section; or
(b) Do not maintain continuous medical coverage during the waiver period enrollment for public employee's benefits board sponsored medical, as provided in subsection (7)(a)(ii) of this section.
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