CALIFORNIA STATUTES AND CODES
SECTIONS 22800-22826
GOVERNMENT CODE
SECTION 22800-22826
22800. (a) An employee or annuitant is eligible to enroll in an
approved health benefit plan, in accordance with this part and the
regulations of the board.
(b) Regulations may provide for the exclusion of employees on the
basis of the nature, conditions, and type of their employment,
including, but not limited to, short-term appointments, seasonal or
intermittent employment, and employment of a like nature. However, no
employee may be excluded solely on the basis of the hazardous nature
of the employment.
22802. (a) An annuitant whose retirement allowance is not
sufficient to pay his or her required contribution for the health
benefit plan in which he or she is enrolled may only remain enrolled
if the annuitant pays to the board the balance of the contributions
plus the related administrative costs, as determined by the board.
(b) (1) The annuitant shall pay the complementary annuitant
premium by remitting to the board quarterly payments in advance, or
by alternative monthly payment as determined by the board.
(2) The board may charge each annuitant who elects to pay the
complementary annuitant premium an initial setup charge and a monthly
maintenance charge, in amounts sufficient to ensure the ongoing
support of the complementary annuitant premium program.
(3) If payments are not received by the 10th of the month for the
following month, coverage shall be terminated and may not be resumed
until the next open enrollment period.
(c) Upon receipt of a written application, the benefits provided
by this section shall commence on the first day of the month
following receipt of the application and the payment required by the
board.
(d) The board has no duty to identify, locate, or notify any
annuitant who may be eligible for the benefit provided by this
section.
(e) Any complementary annuitant premium or any balance of unpaid
health benefit plan premiums that accrues and remains unpaid at the
time of the death of an annuitant shall be paid in accordance with
the sequence prescribed in Section 21506.
(f) All moneys received pursuant to this section shall be
deposited in the Public Employees' Contingency Reserve Fund in the
account provided by subdivision (e) of Section 22910.
22803. An out-of-state employee shall be eligible for enrollment,
in accordance with reasonable rules as the board may prescribe, to
receive the benefits provided by this part.
22805. An employee receiving full-time service credit pursuant to
Section 20900 may continue enrollment in a health benefit plan.
22806. (a) With respect to state officers and employees, a
permanent intermittent employee who has an appointment of more than
six months and works at least half-time shall be eligible to enroll
in a health benefit plan within 60 calendar days after having been
credited with a minimum of 480 paid hours within a designated
six-month period. The designated six-month periods are January 1 to
June 30, inclusive, and July 1 to December 31, inclusive, of each
calendar year. To continue benefits, a permanent intermittent
employee must be credited with a minimum of 480 paid hours in a
designated six-month period or 960 paid hours in two consecutive
periods.
(b) Permanent intermittent employees who are represented by State
Bargaining Unit 6 may enroll in a health benefit plan within 60
calendar days following graduation from the academy of the Department
of Corrections or the Department of the Youth Authority. To continue
benefits, a permanent intermittent employee must be credited with a
minimum number of hours, as provided in subdivision (a).
22807. (a) Notwithstanding subdivision (b) of Section 22772, a
contracting agency may, by resolution filed with the board, deem all
permanent or regular employees, except members of the State Teachers'
Retirement Plan, who have an appointment of six months or longer but
are employed less than half-time, to be employees subject to this
part.
(b) Notwithstanding subdivision (b) of Section 22772, a
contracting agency with employees who are members of the State
Teachers' Retirement Plan may, by resolution filed with the board,
deem any of the following to be employees subject to this part:
(1) Regular, permanent, probationary, or temporary employees or
substitutes who have an appointment for at least a semester, for six
months, or for half of the school year, but are employed less than
half-time.
(2) Substitutes who have an appointment for 100 days or more in
the school year.
22808. An employee enrolled in a health benefit plan under this
part shall be entitled to have his or her coverage and the coverage
of any family members continued for the duration of a leave of
absence, upon his or her application and upon assuming payments of
the contributions otherwise required of the employer, if any of the
following apply:
(a) A leave of absence is granted to the employee without pay
under the State Civil Service Act and the rules or regulations of the
Department of Personnel Administration, or other comparable leave.
(b) The employee is laid off and has not yet obtained other
employment, for a period of up to one year.
(c) The employee is employed by the California State University
and is granted a leave of absence for more than half-time.
22809. An employee of a contracting agency and his or her family
members may continue enrollment in a health benefit plan under this
part if the employee is granted a leave of absence by the contracting
agency for military duty. The coverage may continue for up to one
year.
22810. A Member of the Legislature may enroll in a health benefit
plan. The contributions of the member shall be the total cost of his
or her coverage and the coverage of any family members, less the
amount contributed pursuant to Section 8901.6 by the state.
22811. Notwithstanding any other provision of this part, a former
Member of the Legislature who has served six or more years as a
Member of the Legislature may elect, within 60 days after permanent
separation from state service, to enroll or continue enrollment in a
health benefit plan and dental care plan provided to annuitants. Upon
that election, the former member shall pay the total premiums
related to that coverage and an additional 2 percent thereof for the
administrative costs incurred by the board and the Department of
Personnel Administration in administering this section.
The health and dental benefits shall be provided without
discrimination as to premium rates or benefits coverage. A person who
subsequently terminates his or her coverage under this section may
not reenroll pursuant to this section.
22812. (a) A former legislative employee who separates from
employment while enrolled in a health benefit plan provided by his or
her employer, by reason of layoff, involuntary termination, or
retirement may enroll in a health benefit plan within 60 days of
separation from employment and, thereupon, shall be deemed to have
been enrolled on the date of the separation from employment.
(b) An eligible survivor of a legislative employee who was
enrolled in a health benefit plan provided by the employer at the
time of death may, within 60 days of the death of the employee,
enroll in a health benefit plan and, thereupon, shall be deemed to
have been enrolled on the date of the employee's death.
22814. (a) A judge who retires pursuant to Chapter 11 (commencing
with Section 75000) of Title 8, but is not yet receiving a pension,
may continue his or her coverage and the coverage of any family
members for the duration of the leave of absence, upon his or her
application and upon assuming payment of the contributions otherwise
required of the employer.
(b) (1) A judge who leaves judicial office pursuant to subdivision
(b) of Section 75521 and has not attained 65 years of age may
continue his or her coverage and the coverage of any family members
upon assuming payment of the contributions otherwise required of the
employer. The judge shall also pay an additional 2 percent of the
premium amount to cover administrative expenses incurred by the
system or the Department of Personnel Administration.
(2) An election to continue coverage under this subdivision shall
be made within 60 days of permanent separation. A retired judge who
cancels that coverage may not reenroll.
(3) Upon attaining 65 years of age, a retired judge who has
continuous and uninterrupted coverage pursuant to this subdivision
shall be entitled to the applicable employer contribution.
22815. (a) The following persons are eligible for enrollment as
provided in this section:
(1) A Member of the Legislature or an elective officer of the
state whose office is provided by the California Constitution who
meets all of the following conditions:
(A) Has at least eight years of credited service.
(B) Permanently separates from state service on or after January
1, 1988, and more than 10 years before his or her minimum age for
service retirement, or is an inactive member of the Legislators'
Retirement System pursuant to Section 9355.2.
(C) Elects to remain a member of a state retirement system
supported in whole or in part by state funds, other than the
University of California Retirement System.
(2) An exempt employee who meets all of the following conditions:
(A) Has at least 10 years of credited state service that includes
at least two years of credited service while an exempt employee.
(B) Permanently separates from state service on or after January
1, 1988, and more than 10 years before his or her minimum age for
service retirement.
(C) Elects to remain a member of a state retirement system
supported in whole or in part by state funds, other than the
University of California Retirement System.
(b) During the period he or she is not yet receiving a retirement
allowance, a person described by subdivision (a) may continue
enrollment in a health benefit plan or dental care plan without
discrimination as to premium rates or benefit coverage, upon assuming
payment of the contributions otherwise required of the former
employer on account of his or her enrollment and the employee
contribution. The person shall also pay an additional 2 percent of
the premium amount to cover administrative expenses incurred by the
system or the Department of Personnel Administration. An election to
continue coverage under this section shall be made within 60 days of
permanent separation.
(c) A person who receives coverage pursuant to this subdivision,
and subsequently terminates that coverage, may not be allowed to
reenroll and may not enroll as an annuitant pursuant to subdivision
(d).
(d) Upon retirement and receipt of a retirement allowance, a
person described in subdivision (b) may elect to continue enrollment
in a health benefit plan or dental care plan without discrimination
as to premium rates or benefit coverage, at which time the state
shall assume payment of the employer contribution and the person
shall thereafter be deemed an annuitant.
(e) The board has no duty to locate or notify any person who may
be eligible to enroll pursuant to this section.
22816. (a) A person who meets all of the criteria of an annuitant,
as defined in subdivision (f) or (g) of Section 22760, other than the
condition of receiving a retirement allowance under a retirement
system supported in whole or in part by state funds, may continue
enrollment in a health benefit plan or dental care plan provided to
annuitants without discrimination as to premium rates or benefits
coverage, upon assuming payment of the contributions otherwise
required of the former employer on account of his or her enrollment
and the employee contribution. The person shall also pay an
additional 2 percent of the premium amount to cover administrative
expenses incurred by the system or the Department of Personnel
Administration. An election to continue coverage under this section
shall be made within 60 days of permanent separation.
(b) A person who receives coverage pursuant to this subdivision
who subsequently terminates that coverage may not reenroll. However,
termination under this subdivision does not affect an annuitant's
rights under Section 22817. The benefits authorized by Section 22817
and this section are separate and distinct benefits.
(c) The board has no duty to locate or notify any person who may
be eligible to enroll pursuant to this section.
22817. (a) An annuitant, as defined in subdivision (f) or (g) of
Section 22760, may, upon assuming payment of the employee
contribution, enroll in a health benefit plan or dental care plan
without discrimination as to premium rates or benefit coverage, at
which time the state shall assume payment of the employer
contribution.
(b) The board has no duty to locate or notify any person who may
be eligible to enroll pursuant to this section.
22818. (a) In order to receive any benefit provided by this part,
an employee or annuitant shall provide, upon request of the board,
any of the following:
(1) Proof in a manner designated by the board that the employee or
annuitant and his or her domestic partner have filed a valid
Declaration of Domestic Partnership pursuant to Section 298.5 of the
Family Code or have established a valid domestic partnership, as
defined by his or her contracting agency in accordance with
subdivision (b) of Section 22771.
(2) A marriage certificate.
(3) A signed statement indicating that the employee or annuitant
agrees that he or she may be required to reimburse the employer, the
health benefit plan, and the system for any expenditures made for
medical claims, processing fees, administrative expenses, and
attorney's fees on behalf of the family member, if any of the
submitted documentation is found to be inaccurate or fraudulent.
(b) The employee or annuitant shall notify the employer or the
board when a marriage is dissolved or a domestic partnership has
terminated, as required by subdivision (c) of Section 299 of the
Family Code, or as required by his or her contracting agency in
accordance with subdivision (b) of Section 22771.
22819. (a) A family member of a deceased employee of a contracting
agency who is validly enrolled or is eligible for enrollment
hereunder on the date of the employee's death is deemed to be an
annuitant under Section 22760, pursuant to regulations prescribed by
the board.
(b) A contracting agency shall remit the amounts required under
Section 22901 as well as the total amount of the premium required
from the employer and enrollees hereunder in accordance with
regulations of the board. Enrollment of the annuitant and eligible
family members shall be continuous following the death of the
employee, or the effective date of enrollment, so long as the
surviving family members meet the eligibility requirements of Section
22775 and regulations pertinent thereto. Failure to timely pay the
required premiums and costs or the cancellation of coverage by the
annuitant shall terminate coverage without the option to reenroll.
The contracting agency may elect to require the family members to pay
all or any part of the employer premium for enrollment.
(c) This section shall apply to a contracting agency only upon the
filing with the board of a resolution of its governing board
electing to be subject to this section.
22819.1. (a) A family member of a deceased annuitant who retired
from a contracting agency prior to the effective date of the agency's
contract to provide health coverage under this part, and who was
validly enrolled in the agency's health plan on the day prior to the
effective date of the contract under this part, but who does not
receive an allowance in place of the annuitant, is deemed to be an
annuitant for purposes of Section 22760, pursuant to regulations
prescribed by the board.
(b) A contracting agency shall remit the amounts required under
Section 22901 as well as the total amount of the premium required
from the employer and enrollees in accordance with regulations of the
board. Enrollment of the eligible family members shall be continuous
following the death of the annuitant, or the effective date of
enrollment, as applicable, so long as the surviving family members
meet the eligibility requirements of Section 22775 and any
regulations promulgated with respect to that section. Either a
failure to timely pay the required premiums and associated costs of
the coverage or the cancellation of coverage shall terminate the
coverage without the option to reenroll. The contracting agency may
elect to require the family members to pay all or any part of the
employer premium for enrollment.
(c) This section shall apply to a contracting agency only upon the
filing with the board of a resolution of its governing board
electing to be subject to this section.
22820. (a) Upon the death, on or after January 1, 2002, of a
firefighter employed by a county, city, city and county, district, or
other political subdivision of the state, a firefighter employed by
the Department of Forestry and Fire Protection, a firefighter
employed by the federal government who was a resident of this state
and whose regular duty assignment was to perform firefighting
services within this state, or a peace officer as defined in Section
830.1, 830.2, 830.3, 830.31, 830.32, 830.33, 830.34, 830.35, 830.36,
830.37, 830.38, 830.39, 830.4, 830.5, 830.55, or 830.6 of the Penal
Code, if the death occurred as a result of injury or disease arising
out of and in the course of his or her official duties, the surviving
spouse or other eligible family member of the deceased firefighter
or peace officer, if uninsured, is deemed to be an annuitant under
Section 22760 for purposes of enrollment. All eligible family members
of the deceased firefighter or peace officer who are uninsured may
enroll in a health benefit plan of the surviving spouse's choice.
However, an unmarried child of the surviving spouse is not eligible
to enroll in a health benefit plan under this section if the child
was not a family member under Section 22775 and regulations pertinent
thereto prior to the firefighter's or peace officer's date of death.
The employer of the deceased firefighter or peace officer shall
notify the board within 10 business days of the death of the employee
if a spouse or family member may be eligible for enrollment in a
health benefit plan under this section.
(b) Upon notification, the board shall promptly determine
eligibility and shall forward to the eligible spouse or family member
the materials necessary for enrollment. In the event of a dispute
regarding whether a firefighter's or peace officer's death occurred
as a result of injury or disease arising out of and in the course of
his or her official duties as required under subdivision (a), that
dispute shall be determined by the Workers' Compensation Appeals
Board, subject to the same procedures and standards applicable to
hearings relating to claims for workers' compensation benefits. The
jurisdiction of the Workers' Compensation Appeals Board under this
section is limited to the sole issue of industrial causation and this
section does not authorize the Workers' Compensation Appeals Board
to award costs against the system.
(c) (1) Notwithstanding any other provision of law, and except as
otherwise provided in subdivision (d), the state shall pay the
employer contribution required for enrollment under this part for the
uninsured surviving spouse of a deceased firefighter or peace
officer for life, and the other uninsured eligible family members of
a deceased firefighter or peace officer, provided the family member
meets the eligibility requirements of Section 22775 and regulations
pertinent thereto.
(2) The contribution payable by the state for each uninsured
surviving spouse and other uninsured eligible family members shall be
adjusted annually and be equal to the amount specified in Section
22871.
(3) The state's contribution under this section shall commence on
the effective date of enrollment of the uninsured surviving spouse or
other uninsured eligible family members. The contribution of each
surviving spouse and eligible family member shall be the total cost
per month of the benefit coverage afforded him or her under the plan
less the portion contributed by the state pursuant to this section.
(d) The cancellation of coverage by an annuitant, as defined in
this section, shall be final without option to reenroll, unless
coverage is canceled because of enrollment in an insurance plan from
another source.
(e) For purposes of this section, "surviving spouse" means a
spouse who was married to the deceased firefighter or peace officer
on the deceased's date of death and either was married for a
continuous period of at least one year prior to the date of death or
was married to the deceased prior to the date the deceased
firefighter or peace officer sustained the injury or disease
resulting in death.
(f) For purposes of this section, "uninsured" means that the
surviving spouse is not enrolled in an employer-sponsored health plan
under which the employer contribution covers 100 percent of the cost
of health care premiums.
(g) The board has no duty to identify, locate, or notify any
surviving spouse or eligible family member who may be or may become
eligible for benefits under this section.
22822. No person is eligible for enrollment in a health benefit
plan pursuant to this part as a family member if he or she becomes a
family member of a surviving spouse of a deceased member of the
system after the date of the member's death.
22823. (a) Notwithstanding Section 10270.5 of the Insurance Code,
an employee who is enrolled in a board-approved health benefit plan
sponsored by an employee organization that is the exclusive
representative pursuant to the Ralph C. Dills Act (Chapter 10.3
(commencing with Section 3512) of Division 4 of Title 1) and who
terminates his or her membership in the respective employee
organization shall become ineligible for enrollment in the health
benefit plan.
(b) Notwithstanding subdivision (a), the employee may continue
enrollment in the employee organization health benefit plan until he
or she is notified by the employee organization of the loss of
eligibility. Upon notification of the loss of eligibility, the
employee within 60 days may change his or her enrollment to another
health benefit plan for which the employee is eligible.
22825. (a) An annuitant is not eligible to participate in a health
benefit plan offered by the California Association of Highway
Patrolmen unless the annuitant was enrolled in the California Highway
Patrolmen Health Benefits Trust for a minimum of five years as an
active employee.
(b) Notwithstanding subdivision (a), an annuitant that retires for
disability before becoming eligible for service retirement may
enroll in a health benefit plan offered by the California Association
of Highway Patrolmen if otherwise eligible.
(c) Former members of the California State Police are eligible to
participate in a health benefit plan offered by the California
Association of Highway Patrolmen, pursuant to subdivision (a) or (b).
Former members of the California State Police who transferred to the
California Highway Patrol and retired before January 1, 2003, are
exempt from the five-year requirement.
(d) This section only applies to persons who first became
employees of the California Highway Patrol on or after January 1,
1994.
22826. For purposes of this part, service credit shall be
determined according to the rules of the retirement system provided
by the employer in which the employee participates. In the case of
elected officials not eligible for participation in a retirement
system, service credit shall be determined according to the number of
years in office. In the elected official's final year of office, a
completed term of office shall be sufficient to earn one year of
service credit for that final year of office.