New York Codes, Rules and Regulations
Chapter V - Regulations Of The Department Of Civil Service (president's Regulations)
Part 76 - Managerial/confidential Group Accident And Sickness Insurance Plan
Section 76.2 - Eligibility

Current through Register Vol. 44, No. 38, September 21, 2022

(a) Employees.

(1) An employee shall be eligible for coverage under the plan subject to the provisions of this Part and to the plan.

(2) Coverage for any employee shall cease without notice upon termination of his status as an employee as defined in section 76.1 of this Part. The status of any person as an employee shall be deemed to terminate upon his severance from the payroll, except that for the purpose of continuing his coverage under the plan, the status of such person as an employee shall be deemed to continue during any period of authorized leave without pay.

(b) Cessation of eligibility. Upon the termination of the plan by the State, or by employee by reason of default in the payment of premiums or by withdrawal or expulsion or otherwise, the coverage shall cease as of the last day for which the required premiums have been paid to the carrier.

(c) Disqualification. The president may disqualify from participation in the plan any employee who has secured or attempted to secure participation in the plan for himself or another by fraud, deception or a false statement of a material fact. No employer shall be disqualified or denied benefits pursuant to this subdivision until he is given a written statement by the president of the reasons therefor and afforded an opportunity to make an explanation to be submitted to the president by the employee not later than 10 days following the issuance of the notice by the president required by this subdivision. Such employee may be restored to the plan only on the approval of the president and subject to such conditions as may be imposed by the president.

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