§ 21-5-415 - Nonpayment of premiums and failure to file reports by agency or school district.
21-5-415. Nonpayment of premiums and failure to file reports by agency or school district.
(a) (1) If any participating agency or school district does not remit insurance premiums and required monthly reports to the Employee Benefits Division of the Department of Finance and Administration by the last calendar day of each billing month, the division shall impose a penalty of two dollars ($2.00) per insured member or one hundred dollars ($100), whichever is greater.
(2) Penalties will be assessed and invoiced based on the actual number of members included on the monthly billing report that is past due. Invoices will be processed at the beginning of the month following the infraction.
(3) Penalties shall be payable to the Employee Benefits Division and must be received by the division no later than the last calendar day of the month following invoicing.
(4) If payment is not received by the division by the due date, the following collection methods may be used:
(A) (i) The Chief Fiscal Officer of the State may cause the amount sought to be transferred to the division from:
(a) Funds the agency or school district has on deposit with the Treasurer of State; or
(b) Any funds the agency or school district is due from the state.
(ii) If a transfer must be made, a transfer penalty of twenty dollars ($20.00) per transfer shall be assessed each agency or school district fund and included in the transfer;
(B) The agency director or school district superintendent may be required to appear before the State and Public School Life and Health Insurance Board to report the reasons for nonpayment or incorrect reporting; and
(C) The Chief Fiscal Officer of the State may use his or her powers outlined in 19-4-301 et seq. to aid in collection.
(5) Nonpayment of premiums could also result in a lapse of health and life insurance coverage for employees of the school district, agency, or the agency assuming responsibility for paying health and life claims for its employees.
(b) (1) If any participating agency or school district fails to follow established policy and procedures set by the executive director, including but not limited to notifying the division of an insured's leave without pay, family medical leave, or military leave status or if any participating agency or school district provides incorrect benefit information or processes unauthorized benefit changes, including system entries that result in unreimbursed expenses to the State Employees Benefits Trust Fund or Public School Employees Insurance Trust Fund, the division shall have the right to:
(A) Require the agency to pay the total amount of the insured's premium; and
(B) Impose a penalty of fifty dollars ($50.00) per insured.
(2) Penalties will be assessed and invoiced based on the actual number of violations. Invoices will be processed at the beginning of the month following discovery of the infraction.
(3) Penalties shall be payable to the Employee Benefits Division and must be received by the last calendar day of the month following invoicing.
(4) The Chief Fiscal Officer of the State may cause the amount sought to be transferred from:
(A) Funds the agency or school district has on deposit with the Treasurer of State; or
(B) Any funds the agency or school district is due from the state.
(5) If a transfer is made, a transfer penalty of twenty dollars ($20.00) per transfer shall be assessed each agency or school district fund and included in the transfer.
(c) The division may correct any error regarding an insured's benefits according to existing documentation without authorization or prior notification to the agency or school district.