La. Admin. Code tit. 4 § III-114

Current through Register Vol. 50, No. 11, November 20, 2024

Section III-114 - Statewide Vendor Requirements and Responsibility

A. Any statewide vendor applicant for deduction, domestic or foreign, regulated by the Department of Insurance shall meet the minimum requirements set forth in R.S. 42:455.

B. Statewide vendor applicants for deductions not regulated by the Department of Insurance shall:

1. possess appropriate license or other required certification for providing the particular product or service for a fee;

2. have been doing business in this state for not less than five years providing the product and/or services anticipated to be offered state employees;

3. be in compliance with all requirements of any regulatory and/or supervisory office or board charged with such responsibility by state statute or federal regulations;

4. provide to the Commissioner of Administration within 30 days of approval an irrevocable letter of credit in the amount of $100,000, or an irrevocable pledge of a certificate of deposit in the amount of $100,000 to protect the state and any officer or employee from loss arising out of participation in the program or plan offered by the vendor.

C. Vendors shall:

1. provide annual renewal application as set forth in §106 of this rule;

2. maintain the requirements set forth in A. and B. of this Section;

3. maintain individual product (product categories as defined by OSUP) participation levels that meet or exceed 100 employees paid through the LaGov HCM payroll system. Vendors will be allowed 12 months after initial product approval to meet the minimum product participation requirements;

4. solicit employees for payroll deduction only:

a. after notification to the vendor and state department/agencies from OSUP that the product has been approved;

b. upon written authorization and within the solicitation policy established by the department/agency; and

c. for those products, policy forms or service plans submitted and approved in the annual renewal or new application process;

5. provide and use the standard deduction authorization form (SED-4) authorized by OSUP using the guidelines below;

a. deduction form is not authorized to be submitted from an employee for the purpose of transmitting any part of that deduction to a non-approved vendor;

b. deduction form shall not be submitted which lists any product or service for which a product code has not been approved;

c. deduction form may include additional information provided that such information shall not represent a disclaimer or escape clause(s) in favor of the vendor. The authorization shall not stipulate any "contract" or "term of participation" requirements;

d. the authorization must specify product name, IRC §125 eligibility, monthly premium or fee, and the semi-monthly (24 annually) premium or fee. Statewide vendor deductions in the LaGov HCM payroll system must be semi-monthly deduction amounts only (to the second decimal place). Payroll systems outside of the LaGov HCM payroll system which permit monthly deductions may continue same;

e. an employee shall have only one deduction authorization (which may cover more than one product/policy) for a single vendor effective at any one time. Total current deduction amount and each component amount that make up that total must be reflected on any successive form(s);

f. vendor shall be responsible for completing authorization forms prior to obtaining employee signature and for submitting forms to the appropriate payroll office designated by each employing department/agency;

g. deduction forms must contain appropriate agency number to support monthly reconciliation process;

h. deduction authorization shall not be processed for any employee which is intended to provide a benefit for any party for whom the employee has no insurable interest;

i. employee deduction authorization shall not be transferred by an approved vendor to another vendor without special approval from the Commissioner of Administration;

j. an employee may discontinue a voluntary statewide vendor policy/service at any time by following OSUP and department/agency policy. Any deduction amount that is committed for participation in a current FBP year will continue to be deducted, but will be paid to the state of Louisiana;

6. follow procedures established by OSUP policy when refunding payroll deducted and remitted premiums to employees and § 112 for requesting changes to existing products;

7. use invoice/billing identification structure that is compatible with payroll agency numbers to facilitate the monthly reconciliation;

8. be responsible for preparing a reconciliation of monthly payroll deduction/remittances to vendor's monthly premium due;

a. monthly reconciliation shall include total monthly premium due amount, each product amount and code as assigned by OSUP that makes up the total amount of premium due, total remittance amount, and a listing of all exceptions between the premium due and deduction/remittance by employee within billing/payroll agency numbers;

b. monthly reconciliation exception listing shall identify the employee by Social Security number and payroll agency number and shall be grouped within payroll agency numbers for LaGov HCM payroll system agencies and similarly for payroll systems outside of the LaGov HCM payroll system;

9. furnish evidence of reconciliation to OSUP as requested by that office. Like verification may be required by other payroll systems outside of the LaGov HCM payroll system;

10. provide written notification within ten days of any change in the name, address, entity status, principal officers, designated administrative coordinator, appointed Louisiana sales coordinator and appointed billing coordinator to OSUP;

11. provide written notification of the dismissal of any vendor representative participating in state deduction to OSUP. Any vendor representative who has been debarred by a vendor from state participation shall not be allowed to represent any vendor for deduction for a minimum of two years thereafter.

D. Vendor administrative coordinator shall:

1. be responsible for obtaining solicitation authorization and department policy from the department head or his designee;

2. appoint a vendor representative, if preferred, to be the "Louisiana sales coordinator" to handle the areas of solicitation and educational responsibilities;

3. be responsible for dissemination of information such as the requirements of this rule and department/agency policy and procedures to vendor representatives;

4. act as liaison for the vendor with any administrative contract (or) and the state relative to FBP participation;

5. be the primary contact for resolution of billing, refund, and reconciliation problems; and resolving claims problems for employee;

6. appoint a vendor representative, if preferred, to be the "billing coordinator" to handle the areas of billing, refunds and reconciliation problems.

E. Vendors, applicants, and any representatives thereof shall be prohibited from any action intended to influence the opinion or recommendation of any EPBC member.

F. Vendors may be debarred by a department/agency from solicitation within that department/agency for violation of this section or OSUP policy.

G. Vendors may be debarred from solicitation statewide by OSUP for violation of this section or OSUP policy.

H. Unethical conduct or practices of the vendor will result in the termination of payroll deduction authority for that vendor. Unethical or unprofessional conduct of any vendor representative shall result in that individual being debarred from participation in state deduction for any vendor.

I. Deduction authority shall be revoked for any vendor that fails to maintain compliance with provisions of R.S. 42:455 or the requirements of this rule.

La. Admin. Code tit. 4, § III-114

Promulgated by the Office of the Governor, Division of Administration, Office of State Uniform Payroll, LR 32:87 (January 2006), amended LR 38:798 (March 2012).

AUTHORITY NOTE: Promulgated in accordance with R.S. 42:455.