3307:1-11-03 Health care services - cost.

 

 

 

3307:1-11-03               Health care services - cost.

 

 

 

(A)  An enrollee's cost to participate in the medical plan will be determined as follows:

 

(1)   Costs shall be based upon service credit, the effective date of benefits, and such other factors as the state teachers retirement board may find relevant. The state teachers retirement board shall annually review costs and premiums charged for participation in the medical plan and shall establish a schedule for determining or calculating enrollee costs and premiums.

 

(2)    Enrolled benefit recipients shall pay all costs or premiums through benefit deduction unless the amount of a benefit will not cover such costs. In that case, the benefit recipient will be billed directly by the state teachers retirement system. Participation in and coverage under the medical plan may be terminated in the event payment is not made within thirty days.

 

(3)   The state teachers retirement board will not waive any portion of the cost for:

 

(a)     Service benefit recipients with less than fifteen years of Ohio-valued service credit with an effective date of benefits before January 1, 2004.

 

(b)   Spouses or dependents of service and disability benefit recipients.

 

(c)    Any service benefit recipient who retires or who makes application to retire on or after March 17, 1989 and:

 

(i)    Who has purchased service credit under section 3307.73, 3307.741 or 3307.78 of the Revised Code in order to become eligible for benefits under section 3307.58 of the Revised Code; or for whom service credit has been purchased under section 145.297, 145.298,

3307.54 or 3309.33 of the Revised Code in order for the member to become eligible for retirement effective on or after September 1, 1996.

 

(ii)      Until such time as the service benefit recipient is eligible for benefits under section 3307.58 of the Revised Code without regard to service credit purchased under such sections, the benefit recipient and all eligible dependents are eligible for participation in the health coverage program only by paying all premium and associated costs. At such time as the benefit recipient becomes eligible for service retirement benefits under section 3307.58 of the Revised Code without regard to service credit purchased under  such  sections,  the  state  teachers  retirement  board  may

 

 

 

waive a portion of the cost for a benefit recipient with fifteen or more years of Ohio-valued service.

(4)

(a)   If benefits have been granted under section 3307.60 of the Revised Code and the effective date of the benefit recipient's monthly benefits is before January 1, 2004, for the later of five years from January 1, 2004 or the effective date of survivor benefits as defined under the above section, costs for the survivor benefit recipients and dependents shall be calculated based upon the member's years of service and other factors as the state teachers retirement board may find relevant. After the five year period, the state teachers retirement board will not waive any portion of the cost.

(b)   If benefits have been granted under section 3307.60 of the Revised Code and the effective date of the benefit recipient's monthly benefits is on or after January 1, 2004, the member must have had fifteen or more years of service credit for the survivor and dependents to qualify for the five year subsidy period. In the event the benefit recipient named multiple beneficiaries under section 3307.60 (A)(4) of the Revised Code, the percent subsidy for which the benefit recipient was eligible will be allocated equally among the surviving beneficiaries for the five year subsidy period. After the five year period, the state teachers retirement board will not waive any portion of the cost.

(5)

(a)   If benefits have been granted under division (C)(1) of section 3307.66 of the Revised Code as the result of the death of a member eligible for service retirement, and the effective date of survivor benefits is before January 1, 2004, for the later of five years from January 1, 2004 or the effective date of survivor benefits as defined under the above section, costs for the survivor benefit recipients and dependents shall be calculated based upon the member's years of service and other factors as the state teachers retirement board may find relevant. After the five year period, the state teachers retirement board will not waive any portion of the cost.

(b)   If benefits have been granted under division (C)(1) of section 3307.66 of the Revised Code as the result of the death of a member eligible for service retirement, and the effective date of survivor benefits is on or after January 1, 2004, the member must have had fifteen or more years

of service credit for the survivor and dependents to qualify for the five year subsidy period unless the member was receiving state teachers retirement system disability benefits at the time of death. If the member was receiving disability benefits at the time of death, the effective date of disability benefits is used for determining whether the member had fifteen or more years of service to qualify for the five year subsidy.

(c)    If benefits are granted under division (C)(2) of section 3307.66 of the Revised Code as the result of the death of a member, for the later of five years from January 1, 2004 or the effective date of survivor benefits as defined under the above section, costs shall be calculated based upon the greater of the member's years of service or fifteen years and other factors as the state teachers retirement board may find relevant. After the five year period, the state teachers retirement board will not waive any portion of the cost.

(B)     An  enrollee's  cost  to  participate  in  the  ancillary  plans  shall  be  the  full  cost  of coverage as specified by the state teachers retirement board.

Effective:                                                     10/27/2006

R.C. 119.032 review dates:                         03/01/2009

CERTIFIED ELECTRONICALLY

Certification

09/18/2006

Date

Promulgated Under:                           111.15

Statutory Authority:                           3307.04

Rule Amplifies:                                  3307.39, 3307.60, 3307.61

Prior Effective Dates:                         12/23/76, 11/28/77, 3/17/89 (Emer.), 6/1/89, 9/23/91

(Emer.), 5/28/92, 6/22/92 (Emer.), 9/10/92, 2/13/93, 9/1/96, 7/3/97, 9/16/98 (Emer.), 11/27/98, 5/25/00,

7/1/01 (Emer.), 9/17/01, 9/17/02, 1/1/04 (Emer.),

3/22/04