Current through Register Vol. 47, No. 17, September 10, 2024
1. Private
plans must be approved by the Division prior to implementation. Private plans
in the form of an insurance policy issued by an insurer approved by the state
must first be submitted to the Colorado Division of Insurance for
approval.
2. To obtain approval of
a private plan, an employer must first submit a completed application for
private plan approval to the Division. Applications may be submitted at any
time, and the Division will review applications as they are received.
3. An application for private plan approval
must include:
A. The employer's federal
employer identification number ("EIN");
B. The employer's name;
C. The employer's business address;
D. The employer's mailing address;
E. A designated contact person, with that
person's name and contact information;
F. A copy of the employer's self-insured
private plan, or if the private plan is in the form of an insurance policy
provided by an insurer approved by the state, a copy of that insurance policy
form;
G. If the private plan is in
the form of self-insurance, a surety bond, issued by a surety company
authorized to transact business in Colorado, in an amount equal to one year of
total premiums calculated pursuant to C.R.S. §
8-13.3-507, along with payroll
documentation supporting the surety bond calculation;
H. If the private plan is in the form of
self-insurance, attestation that the employer has complied with the separate
account requirements at 7 CCR 1107-5 Section 5.3.6;
I. An attestation, completed by the employer,
that the employer understands, and the private plan satisfies, the requirements
set forth in the FAMLI Act and its implementing regulations;
J. An attestation, completed by the employer,
that the forms used by the employees and/or health care providers will be no
more onerous than the forms used by employees and/or health care providers
under the state plan;
K. A copy of
the posted notice required by 7 CCR 1107-5, Section 5.9.4;
L. Other information as required on the
application form; and
M. An
administration fee of:
1. $500.00 for private
plan applications received through 2024; and
2. For private plan applications received in
2025 and later, the amount determined by the Director pursuant to C.R.S. §
8-13.3-521(7), and
published on the Division's website.
4. Approved private plans must take effect no
earlier than sixty days after the date of application so that the Division has
sufficient time to review the application, and the employer has sufficient time
to provide notice to employees in accordance with 7 CCR 1107-5 Section
5.9.
5. The employer must submit to
the Division any forms to be used by employees and/or health care providers
under the approved private plan at least thirty (30) days prior to making them
available to employees for usage.
6. Employers remain liable to the FAMLI
Division for premiums on wages paid until the effective date of the approved
private plan, and remain entitled under C.R.S. §
8-13.3-507(5) to
withhold the employees' share of premiums from wages paid until the effective
date of the approved private plan. Throughout the duration of an approved
private plan, employers may withhold premiums deductions from employees in an
amount not to exceed the amount authorized by C.R.S. §
8-13.3-507(5), if
such a deduction is pursuant to the terms of the approved private
plan.
7. Employees remain eligible
for benefits under the FAMLI Act on and after January 1, 2024, and until the
effective date of the approved private plan.
8. Benefits awarded to an employee must be
paid by the plan that awarded the benefits for the full duration of the
employee's approved FAMLI benefits claim, pursuant to 7 CCR 1107-4 Section
4.9.1.A.
A. In the event of an approved
private plan failing to pay benefits due to an insurance carrier's insolvency,
if the policy is covered by an insurance guaranty association, the claims will
be paid by the insurance guaranty association pursuant to their rules and
procedures. If the policy is not covered by a guaranty association, then the
employer will become responsible for paying all claims approved by the private
plan prior to the date of insolvency. In either event, the employer shall
immediately notify the FAMLI Division of the insolvency, the notice
requirements under Section 5.14 of these rules are waived, and the employer
will be deemed covered under the state system.
B. If a self-insured employer fails to pay
benefits as awarded and private plan approval is withdrawn pursuant to Section
5.16 of these rules, the Division shall execute upon the surety bond and use
the proceeds and the remaining funds in the separate account established
pursuant to Section 5.3.6 of these rules to pay benefits due for claims arising
prior to the date of termination.
C. If an employer fails to pay benefits as
required by 5.4.8.A, or if the surety bond and remaining funds are insufficient
to pay the benefits under 5.4.8.B, those claims shall be paid by the FAMLI
Division. The employer is indebted to the Division for such amounts, and the
Division may pursue all legal means to collect such amounts from the
employer.
