Premium Benefit Documentation

R2-8-205. Premium Benefit Documentation A. Every year, prior to the effective date of Coverage, a n Employer shall report to the ASRS all the Coverage plans an d premium rates the Employer offers to its retired or Disable d employees. B. An Employer shall inform the ASRS of any changes to th e Annui- retired member’s, Disabled member’s, or Contingent tant’s Coverage, including enrollment in Coverage, maintaine d through the Employer within 30 days of the changes takin g effect. C. Using the Employer’s secure ASRS website account, or another ASRS approved method, an Employer shall submit th e Supp. Administrative Code ADMINISTRATION RETIREMENT SYSTEM BOARD following health insurance enrollment, change, and/or deletio n information pursuant to subsection (B): 1. The retired member’s, Disabled member’s, or Contingent Annuitant’s Social Security number or U.S. Tax Identification number; 2. The retired member’s, Disabled member’s, or Contingent Annuitant’s full name; 3. The retired member’s, Disabled member’s, or Contingent Annuitant’s date of birth; 4. The Coverage in which the retired member, Disable d member, or Contingent Annuitant is enrolling; 5. The type of change that is being made to the Coverage; 6. The following information for each dependent enrolle d in, or to be enrolled in, or removed from, Coverage: a. First and last name; b. Social Security number or U.S. Tax Identificatio n number; c. Date of birth; and d. Medicare number, if applicable. 7. The old and new premium amounts for Coverage; enroll- 8. The effective date of the change, deletion, and/or ment; 9. The Employer’s name and telephone number; 10. A certification by the Employer representative’s date d signature that the information is current and correct. Historical Note New Section made by final rulemaking at 10 A.A.R. 1962, effective May 4, 2004 (Supp. 04-2). Section expired under A.R.S. § 41-1056(E) at 16 A.A.R. 1765, effective July 14, 2010 (Supp. 10-3). New Section made by final rulemaking at 23 A.A.R. 1414, effective July 3, 2017 (Supp. 17-2). Amended by final expedited rulemaking at 27 A.A.R. 479, with an immediate effective of rulemak- March 5, 2021 (Supp. 21-1). Amended by final ing at 30 A.A.R. 739 (April 12, 2024), effective May 17, 2024 (Supp. 24-1).