Code of Maine Rules
94 - INDEPENDENT AGENCIES
411 - MAINE PUBLIC EMPLOYEES RETIREMENT SYSTEM (MAINEPERS)
Chapter 601 - GROUP LIFE INSURANCE
Section 411-601-4 - TERMINATION AND REINSTATEMENT OF COVERAGE

Universal Citation: 94 ME Code Rules ยง 411-601-4

Current through 2024-38, September 18, 2024

1. Coverage on any participant or dependent will cease at the end of the last period for which premiums for that participant or dependent are paid to the Maine Public Employees Retirement System, subject to a 31-day grace period.

2. Coverage for a participant who, during a period of unpaid military leave of absence, does not continue coverage as provided in Section 3, subsection 2, paragraph D, must be reinstated to the levels of coverage in effect immediately prior to the unpaid military leave. A request for reinstatement by the employee must be made within 31 days of the employee's return to work following unpaid military leave. An employee who wants to be reinstated and who does not apply for reinstatement within 31 days of the employee's return to work from unpaid military leave must produce evidence of insurability at the employee's own expense and in accordance with the requirements of the insurance underwriter.

3. Coverage of an unmarried dependent child having attained a maximum age as provided in 5 M.R.S.A. §§18056(3)(A), and 18656(3)(A), shall be continued if:

A. due proof is furnished prior to the 31st day after the applicable termination date, and each year thereafter, indicating that the unmarried, dependent child is permanently disabled as set forth in 5 M.R.S.A. §17001(12)(B); or

B. due proof is furnished prior to the 31st day after the applicable termination date, and each year thereafter, indicating that the unmarried dependent child is under 22 years of age and a full-time student.

C. Coverage for a disabled child shall continue while the Policy remains in force and the child's condition remains unchanged. "Substantially gainful employment" shall mean any work activity that is consistent with the individual's training, education and experience (including self-employment) and which, taking into consideration information about the state labor market, could be expected to generate an annual amount of gross earnings which equals or exceeds the state minimum hourly wage multiplied by 2080.

4. Whenever the Executive Director determines that an employee lacks coverage or has a lapse in coverage due to error on the part of the employer or MainePERS, coverage may be implemented or reinstated as follows:

A. Participant, or employer in the case of employer-paid premiums, pays back premiums from the date of eligibility or the date of last payment to the present;

B. Participant files Evidence of Insurability with coverage effective on the first day of the month following one month of additional employment in an eligible position beyond the date approved by the insurer under contract with MainePERS.

In the event that the insurer denies coverage based on Evidence of Insurability, the participant may restore coverage under the provisions of paragraph A.

Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.