§ 3.87.050. Eligibility for active municipal police or fire health insurance plan.

A.

Within 31 days of appointment to retirement, a member may elect to continue participation in the active police or fire health insurance plan. If a member elects to continue participation at such time, proof of insurability shall not be required and preexisting condition clauses shall not apply. The required active insurance premium for such coverage must be paid from the member's HRA account as a qualified payment. To the extent that the amount credited to the member's premium account is not sufficient to pay the full required active insurance premium, the member shall be required to contribute the balance of the required active insurance premium to the active municipal police or fire health insurance plan. This may be by voluntarily electing to take the payment from the member's retirement benefit from the police and fire retirement system, or other forms of payment deemed acceptable by the Municipality of Anchorage, including but not limited to the authorized deduction from the member's spouse that is also a member of the program.

1.

The Municipality shall provide a monthly discount form the stated premium to all members purchasing municipal health insurance. This monthly discount will be equal to the high deductible health plan monthly premium minus the monthly Class 1 contribution.

a.

Members who purchase municipal health insurance are not restricted to the high deductible health plan. The member may elect another eligible health plan and still receive the benefit of the monthly discount.

2.

Disability.

a.

In the event that a member's permanent occupational disability benefits are awarded retroactively, the member shall have 31 days from the date of the police and fire retirement board's decision to grant permanent disability benefits to elect to participate in the active police or fire health insurance plan without being subject to proof of insurability or preexisting condition clauses. However, such participation will be effective on the first of the month following such election; coverage is not retroactive.

B.

A member who does not elect to participate in the active municipal police or fire health insurance plan at the time of retirement shall be eligible to commence participation at other times in accordance with the following:

1.

A member may elect to enroll himself/herself, his/her spouse, and his/her dependents during an annual enrollment period. However, such enrollment is subject to the member and his/her spouse and dependents submitting proof of insurability. The requirement that proof of insurability be submitted shall be waived during the sixth annual enrollment period following a member's appointment to retirement, and during every fifth annual enrollment period thereafter.

2.

Special open enrollment periods may be scheduled periodically and a member may elect to enroll himself/herself, his/her spouse, and his/her dependents during such an enrollment period. Such enrollment is not subject to the member and his/her spouse and dependents submitting proof of insurability.

3.

A member and his/her spouse and dependents who enroll during an open or annual enrollment period shall be subject to the terms and conditions of the active municipal police or fire health insurance plan, including for example any pre-existing condition provisions of such plan.

4.

A member and his/her spouse and dependents who declined coverage when initially eligible because other coverage was available to him/her may elect to enroll in the plan within 31 days of losing such coverage, and having exhausted all COBRA rights, without being subject to the requirement to submit proof of insurability. This late entrant enrollment is subject to the terms and requirements of the municipality's insurance contract, however, no pre-existing conditions limitation will apply to such enrollees.

C.

If the spouse and dependents of a member are participating in the active municipal police or fire health insurance plan upon the death of the member, the surviving spouse and dependents may continue participation in the plan until funds in the member's account are exhausted or until attaining age 65, whichever is later. However, the surviving spouse and dependents are ineligible for the monthly discount described in 3.87.050 A.1.

D.

If the spouse and dependents of a member are not participating in the active municipal police or fire health insurance plan upon the death of the member, the surviving spouse and dependents may enroll in the plan during the annual open enrollment period immediately following the member's date of death, provided that there are funds in the member's account or the surviving spouse has not attained age 65, or the dependents would still qualify as the member's dependents if the member was alive. However, the surviving spouse and dependents are ineligible for the monthly discount described in section 3.87.050.A.1. The surviving spouse and dependent shall submit proof of insurability.

E.

Members who elect to participate in the active municipal police or fire health insurance plan shall be included in the public safety employee rating group, unless state or federal law requires the use of another rating methodology. Members shall be required to pay the active insurance premium amount. In the event that either public safety bargaining unit is removed, or removes itself, from the municipal insurance plan, the active insurance premium rate charged to members will be a rate computed as if the active group continued to participate in the municipal insurance plan.

F.

Should the active insurance premium established by the insurance carrier for the coming year be questioned by APDEA, IAFF or the board of trustees, then the municipality and APDEA or IAFF or the board shall jointly select and utilize the services of a third party consulting firm, qualified to review and determine appropriate insurance premiums, to assist in a review of the established rate. The review conducted by the third party shall be limited to a review of the submission of the parties. Following the report of the independent consulting firm, any unresolved issues shall be submitted to the municipal internal auditor for resolution. Costs incurred in connection with the third party consulting services shall be shared equally by the parties participating in the review.

(AO No. 94-222(S-1), § 1, 12-28-94; AO No. 97-104, § 4, 8-19-97; AO No. 2003-141, § 1, 10-21-03; AO No. 2005-153, § 2, 11-8-05; AO No. 2008-100(S), § 2, 1-10-10)

Note— Formerly § 3.87.060.