D.C. Mun. Regs. tit. 6, r. 6-B2214

Current through Register Vol. 71, No. 44, November 1, 2024
Rule 6-B2214 - TERMINATION AND CONVERSION OF DCEGLI COVERAGE
2214.1

The basic insurance of an employee and any optional insurance elected by the employee shall stop at the end of the day on which the employee separates, subject to a thirty-one-day (31-day) extension of coverage at no cost to the employee or the District.

2214.2

The thirty-one-day (31-day) extension of insurance coverage provided in Subsection 2214.1 of this section shall not be extended beyond thirty-one days (31-days), nor is it contingent upon timely issuance of notice of the right of conversion to an individual policy.

2214.3

After termination of group coverage for any reason other than voluntary cancellation, an employee may, upon application within the thirty-one-day (31-day) extension period and without medical examination, convert all or any part of his or her basic life insurance to an individual policy at rates determined by the insurance company.

2214.4

There shall be no thirty-one-day (31-day) extension of coverage when a voluntary cancellation occurs.

2214.5

An employee shall be eligible to convert to an individual policy only if he or she does not return, within three (3) calendar days from the termination event, to a position allowing coverage under the group plan.

2214.6

The employee, retiree, or annuitant shall be notified by the personnel authority of the loss of DCEGLI coverage as a group member and the right to convert to an individual policy either prior to or immediately following the event causing the loss of coverage.

2214.7

An employee, retiree, or annuitant who fails to exercise his or her right to convert to an individual policy during the thirty-one day (31-day) extension of coverage is deemed to have declined coverage under an individual policy, unless the Director of the DCHR, determines the failure was beyond the control of the employee.

2214.8

An employee, retiree, or annuitant seeking to convert to an individual policy after the thirty-one day (31-day) extension of coverage must apply to the Director of the DCHR, within six (6) months from the date that the coverage terminated.

2214.9

An employee who is removed or suspended without pay and later reinstated or restored to duty on the grounds that the adverse action was unwarranted or unjustified may, at his or her option, do either of the following:

(a) Enroll as a new employee; or
(b) Have coverage restored with appropriate adjustments made in contributions and claims to the same extent and effect as though the removal or suspension had not taken place.
2214.10

Except as provided in Subsection 2214.12 of this section, basic life insurance and optional life insurance of an insured employee continue without cost to the employee while he or she is in a non-pay status for up to three hundred sixty-five days (365 days), at which time it stops, subject to a thirty-one day (31-day) extension of insurance coverage.

2214.11

The three hundred sixty-five day (365-day) period described in Subsection 2214.10 of this section may be continuous or broken by periods of less than four (4) consecutive months in a pay status.

2214.12

If a claim is filed by a beneficiary or assignee, if any, in accordance with Subsections 2215.1 and 2215.2 of this chapter for an employee who is in a non-pay status at the time of death, the Director of the DCHR, shall determine the value of employee contributions not withheld from the employee during the preceding twelve (12) months because the employee was in a non-pay status and shall authorize the life insurance company selected in accordance with subsection 2218.1 of this chapter to withhold an amount equal to the value of those contributions. Any such amount shall be deducted from the payment due each beneficiary in proportion to the percentage of the total benefit being received by that beneficiary.

D.C. Mun. Regs. tit. 6, r. 6-B2214

Final Rulemaking published at 44 DCR 5368 (September 19, 1997); as amended by Final Rulemaking published at 60 DCR 11218 (August 2, 2013)
Authority: Mayor's Order 2008-92, dated June 26, 2008, and in accordance with the provisions of Chapter XXII of the District of Columbia Government Comprehensive Merit Personnel Act of 1978 (CMPA), effective March 3, 1979 (D.C. Law 2-139; D.C. Official Code § 1-622.01 et seq. (2012 Supp.)).