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Group Legal Services Insurance Plan

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1501. GENERAL INFORMATION

The Group Legal Services Insurance Plan (Plan) is a voluntary, employee-paid plan that provides comprehensive legal coverage. The current plan administrator is ARAG(R) Insurance Company. The Plan is designed to meet the most common personal legal needs of an individual and their family. Some of the popular features includes: unlimited toll- free advice about personal legal matters - standard will preparation, living wills, codicils and advanced health care directives, follow-up calls, prepare documents or third party letters - powers of attorney, childcare authorizations, challenges to denial of credit and credit card inquiry.
 
There are no deductibles or discounted fees for in-office services when a network attorney is used for consumer protection, trial defense (i.e., civil actions and criminal misdemeanors), juvenile court proceedings, traffic charges (except DUI/DWI and parking tickets), real estate transactions, domestic matters, will preparation, adoptions, bankruptcy (including wage earner plan), conservatorship and guardianship, elder law rider, and habeas corpus. Several of the plan benefits have a six-month waiting period (divorce, motion to modify, personal bankruptcy, and defense of civil actions).
 
Plan members can use a Reduced Fee Network Attorney (RFNA) at a reduced rate of at least 25% for legal advice and representation for non-excluded services. The employee can also enlist the services of an attorney who is not a member of the network for covered benefits. ARAG will reimburse the employee for the non-network attorney fees up to a specified maximum (outlined in the plan member document aka Certificate of Insurance, Indemnity Coverage - Non-Network Attorney).
 
  •  The monthly premium is $10.19 for individual coverage and $17.74 for family coverage (employee and one or more eligible dependents); a $.85 administration service fee is included. Personnel offices, plan members, and other interested parties may contact ARAGs Customer Care Center toll-free 866-762-0972, or TTY (800) 383-4184 or 711 to reach a relay operator (Monday - Friday, 5:00 a.m. - 5:00 p.m., Pacific Standard Time [PST]) or via the ARAG Legal Center web site.  Use Access Code: 10202soc (Actives) 17642ret (Retirees) or linked through the CalHR web site.

Authority:

Government Code Section 19889.7 - 19849.10-13 for Excluded Employees and Memoranda of Understanding for Rank and File Employees
 

1502. ELIGIBILITY CRITERIA

Employee eligibility

Active employees who meet the following criteria are eligible to participate in the Plan:

  1. Permanent or probationary employees with a time base of half-time or more designated as Rank and File  and employees excluded from  collective bargaining, represented by one of the following designations;

    Managerial (M, E50, E79, E99, E59)

    Supervisory (S, E48, E58, E68, E78, E98)

    Confidential (C, E97)

    Excluded/Exempt (E88, E89, E92)

    E01 through E21, E67, or E77 due to middle management reductions. 

    California Exposition and State Fair (Cal Expo), California Fair Services Authority and Legislative Analyst Office are the direct pay departments which can elect to enroll if eligible.

  2. Permanent-Intermittent (PI) employees who worked a minimum of 480 paid hours each six month qualifying control period ending June 30 or December 31 or a total of 960 paid hours in two consecutive (prior and current) control periods (January through December).
    • Hours worked during a qualifying period in a permanent, temporary authorization (TAU) or limited-term (LT) appointment may be counted toward the 480 hours if the employee subsequently receives a PI appointment with no break in service.
    • An employee who permanently separated and reinstated as a PI employee must work the 480 hours in a qualifying control period to be eligible for coverage, regardless of the length of the break in service.
    • A PI employee who transitions into a LT position during a control period, with no break in service, may combine the hours worked as an LT with the PI hours to qualify for coverage at the end of that control period. The LT time base must be half-time or more.
    • An enrolled employee whose time base changes to PI will have coverage continued until the end of the next control period. At that time, the employee must re-qualify based on his or her PI status.
    • A cadet PI employee who attends Academies of the CA Highway Patrol or the Department of Corrections and Rehabilitation may count the hours worked for that control period.
  3. LT assignments (six months or more) are eligible to participate in the program if they have a mandatory right of return to a permanent civil service appointment and they work half time or more.

Dependent Eligibility

  1. A lawful spouse or domestic partner;*
  2. Any unmarried, dependent children under the age of 26 who have never been married;
    • Children include natural, stepchildren, adopted children, children for whom the employee is the legal guardian, and children of either domestic partner; and
    • Any economically dependent child, 26 years of age or over if she or he is incapable of self-support because of a physical disability or mental incapacity who has never been married and is chiefly dependent on the eligible employee for support and maintenance.
Family members who are not eligible include the eligible employee's parents and grandparents, children under the age of 26 who are married, or who have been married, and children over age 26, unless disabled as specified above. Employees are responsible for notifying the Personnel Office and completing the necessary paperwork when a child loses dependent eligibility (in accordance with the 60-calendar day permitting event criteria).
 
Enrolled members who fail to initiate the voluntary deletion within the permitting event date will not be reimbursed for the overpayment of premium nor will the carrier provide coverage for family members who no longer meet the eligibility requirement for dependents. Dependents can convert to an individual plan, if previously covered under the family plan.
 
*Domestic partner coverage is available to same-sex partners under the following circumstances:
  • Same-sex marriages contracted outside California and valid by the laws of the jurisdiction in which it was contracted before November 5, 2008.
  • If both partners are of the same sex, or if opposite sexes and one partner is at least 62 years old, then the employee may be eligible to register a domestic partnership with the Secretary of State (Declaration of Domestic Partnership Form NP/SF DP-1).

1503. OPEN ENROLLMENT

An annual open enrollment is conducted during the months of March through April. ARAG mails marketing materials to the home addresses of eligible employees not currently enrolled in the Plan. If the employee is off work or on an unpaid leave of absence, he or she will not be eligible to enroll in the program until he or she returns to active status.
 
Annually, CalHR distributes a Personnel Management Liaison (PML) memorandum to personnel offices.
 
During the open enrollment period current plan members may make additions or deletions of covered dependents or change their level of coverage, i.e., from single to family, family to single, and add/delete eligible dependents, Changes in Coverage regarding the permitting event qualification). Once enrolled in the Plan a member is not required to reenroll each year in order to continue coverage. Current Plan members receive a letter thanking them for their continued participation including notification of any Plan enhancements. There are three departments not on the SCO payroll system: CA Exposition and State Fair, CA Fair Services Authority and Legislative Analyst's Office. CalHR and ARAG will coordinate distribution of enrollment and communication materials to these departments.
 

Newly Eligible/Hires

Newly eligible employees have 60-calendar days from their effective date of eligibility/hire to complete a Plan Enrollment Authorization Form. These forms are included in the annual enrollment packets available from ARAG. Permanent Intermittent employees hired during/after the open enrollment period, may enroll in the Plan as newly eligible upon completion of the 480 paid hours in a qualifying control period. In this case, the "Remarks" in Section C.9 and the "Permitting event date" in Section C.10 must be documented.
 
Failure to complete Sections C-9 and 10 will result in the application form being returned to the department by the SCO.
 

Eligibility criteria

  • New appointments to state service in an eligible class;
  • Changes in time base that change an employee's status from ineligible to eligible (not less than half-time)/ or completion of a qualifying control period); or
  • Returning from an unpaid leave of absence.

Departmental Personnel Offices responsibilities

  • Providing the newly eligible employee with a copy of the open enrollment kit;
  • Designating the appropriate 60-calendar day enrollment period (the transaction keyed-in date, PAR turnaround date, or NOPA date may be used as the beginning date);
  • Providing employees who want to cancel his/her membership in the plan with a Plan application in a timely fashion; and
  • Advising the employee of the effective date coverage begins or the effective date the cancellation will occur.

Effective Dates of Coverage

The employee's effective date of coverage will begin on the first day of the pay period following the first premium (payroll) deduction.
 
State Controller's Office receives Group Legal enrollment form* by...
  • March 10: Employee's Group Legal coverage will be effective April 1
  • March 11 - April 10: Employee's Group Legal coverage will be effective May 1
  • April 11 - April 28:** Employee's Group Legal coverage will be effective June 1
 Timely processing is important. Because this is a pre-paid plan a payroll deduction must appear on the employee's paycheck before coverage is effective. The SCO will return any incorrectly completed forms to the Personnel Office for correction.
 
If requesting approval for a late or retroactive date of coverage, the department must submit a written/e-mail request to CalHR. These requests are subject to approval on a case-by-case basis.
 
*processed through departmental personnel offices
**if April 28 falls on a Saturday, Sunday or holiday, or if the envelope is postmarked "April 30" applications are to be accepted and processed by May 10 for an effective date of June 1.
 

1504. ORDERING OF ENROLLMENT AUTHORIZATION FORMS

CalHR does not maintain forms for distribution to departments. Personnel offices should maintain an adequate supply of enrollment materials for employees who have status changes (i.e., marriage, divorce, domestic partner, birth of a child or adoption, child reaching an ineligible age, etc.,) or for an employee who may wish to cancel plan coverage.
 
Personnel should call ARAG toll-free at 1-800-888-4184, Ext., 259 or if hearing impaired TTY (800) 383-4184, or 711 for a relay operator, or by e-mail at printdistribution@ARAGlegal.com (Monday - Friday, 5:00 a.m. - 5:00 p.m., PST).
 
Shipment is via UPS ground delivery and not deliverable to a P.O. Box. Staff should anticipate 5-10 business days for delivery. The request must include the:
  • Department name
  • Name of the contact person
  • Actual physical address
  • Zip code
  • Room number or mail station
  • Telephone number and extension
  • Quantity of Active or Retiree kits needed

1505. COMPLETION OF ENROLLMENT AUTHORIZATION FORMS

A PDF Fill and Print form on the ARAG web site - Use Access Code: 10202soc.

Section A (1-7) - to be completed by the employee
  1. A.1. Type of Action. Indicate whether (a) new enrollment, (b) change of coverage or (c) cancel coverage; and
  2. A.2-7. Employee completes his or her social security number, date of birth, full name, mailing address, and daytime telephone number (optional).
Section B (1-3) - completed by the employee
       1. B.1. Employee checks box to authorize automatic payroll deduction;
       1. B.1.a-b. Employee selects type of coverage: 1.a) individual or 1.b) family/registered domestic partner (if family or domestic coverage was selected lists the name[s] and date[s] of birth of dependents);
       2. B.1.a-c. Employee selects type of coverage: 1.a) individual; or 1.b) family; or 1.c) domestic partner (if family or domestic coverage was selected lists the name[s] and date[s] of birth of dependents);
       3. B.2.a. If employee checks box to cancel coverage he or she must complete Section A.1.c and numbers 2-5. Section B.2.b the reason for cancellation (is optional); and
       4. B.3. Employee signs and dates application.
 
Section C (3-13) - completed by agency personnel
       1. Personnel Offices verifies that employee is eligible based on time base and if he or she is a PI the qualifying control period (see C.9 and 10);
       2. C.3. Enter deduction amount: Individual Coverage $10.19 or Family/Registered Domestic Partner Coverage $17.74; and
       3. 3. C.4-13. Personnel Office completes all blank items before submission to the SCO. It's important to document in C.5., the date the application was received by the Personnel Office staff and not the date it was signed by the employee.
Section C.9, "Remarks"
  1. This information documents the type of change, i.e., time base change, new hire, return from LOA, PI control period, divorce or legal separation, deletion of an dependent (that results in a change of coverage) and is required on all enrollment forms, with the exception of cancellations and newly eligible employees during the annual two-month open enrollment period.
    • Failure to complete Section C-9 will result in the application form being returned to the department by the SCO.
Section C.10 "Permitting event date"
  1. This section is used to certify the date the event occurred, i.e., marriage, adoption, divorce, dependent losing eligibility, employee returning from a LOA, PI meeting control period, etc.; it is audited using the 60-calendar day control period criteria. During the annual two-month open enrollment period this requirement does not apply to a new enrollee unless he or she is a PI that recently meet the control period or an employee who returns from a LOA.
Department Personnel Offices are responsible for reviewing Sections A and B, completing Section C (3-13), certifying that the employee has submitted the form within the 60-calendar day permitting event. Employees should be informed that the change becomes effective the first day of the month following the pay period in which the payroll warrant reflects the premium change.
 

1506. CHANGES IN COVERAGE

Family Status Changes/Permitting Events

Plan members who experience certain status changes do not have to wait until open enrollment to make changes to their level of coverage. There are various types of qualifying events which may qualify the employee to change his/her coverage, such as:
  1. An employee who enrolled in individual coverage and subsequently marries during the plan year can resubmit a form to change his or her coverage from individual to family coverage;
  2. A single parent whose enrolled dependent child marries or an employee who divorces will need to change his or her coverage from family to individual coverage (if there are no other eligible dependents enrolled in the plan);
  3. A state employee (active) listed under dependent coverage may chose to enroll in the plan as a primary member, if his or her coverage is cancelled due to divorce, legal separation, or if the enrolled plan member leaves state service; or
  4. An enrolled plan member has filed a domestic partner certification with the Secretary of State.
The employee must submit an enrollment form within 60-calendar days of the qualifying event (e.g., divorce, legal separation, marriage, child losing eligibility due to age or marriage, death of a spouse or child, primary member leaves state service, or a new Domestic Partner Certification.
 
The employee completes:
Section A (1-7)
  1. A.1.b. Change of Coverage; and
  2. A.2-7. Employee completes his or her social security number, date of birth, full name, mailing address, and daytime telephone number (optional).
Section B (1-3)
  1. B.1. Employee checks box to authorize automatic payroll deduction;
  2. B.1.a-c. Employee selects type of coverage: 1.a) individual, 1.b) family or 1.c) Domestic Partner; and
  3. B.3. Employee signs and dates application.
If the dependent is changing to the primary subscriber, he or she would fill-out the application as a New Enrollee
 
Section A.(1-7)
  1. A.1.a. New Enrollment; and
  2. A.2-7. Employee completes his or her social security number, date of birth, mailing address, and daytime telephone number (optional).
Section B (1-3)
  1. B.1. Employee checks box to authorize automatic payroll deduction;
  2. B.1.a-c Employee selects type of coverage: 1.a) individual, 1.b) family or 1.c) Domestic Partner; and
  3. B.3. Employee signs and dates application.
Section C (3-13) - completed by agency personnel (see Section 1505, Completion of Enrollment Authorization Forms)
 

Mandatory Deletions

The state has a Mandatory Deletion that when an eligible dependent child marries or reaches age 26 (whichever is sooner) he or she is no longer eligible for coverage under the insured members plan. The member must complete a new enrollment form if he or she wishes to change to individual coverage when the dependent child loses eligibility.
 
The 60-calendar day permitting event date of the dependent child's marriage or age change is documented in Section C-10. Enrolled members who fail to initiate the voluntary deletion within the permitting event date will not be reimbursed for the overpayment of premium nor will the carrier provide coverage for family members who no longer meet the eligibility requirement for dependents.
 

1507. CANCELLATION

Enrolled employees are not required to remain in the Plan for a minimum period as cancellation of coverage can occur at any time. Employees should be aware that in order to receive certain covered services, (e.g., divorce, bankruptcy, and defense of civil actions) they must serve a 6-month waiting period. If an employee cancels the Plan and subsequently re-enrolls later, he or she will have to fulfill a new waiting period requirement in order to receive covered services with waiting periods.
 
For enrollment forms received at the SCO by the 10th of the month, the first effective date of cancellation would be the beginning of the next pay period, i.e., for the March paycheck, the effective date of cancellation will be April 1. The Plan can be cancelled in either of the following ways:
 
  1. The employee can complete the application form cancellation of coverage and submit it to their personnel office. The employee must complete Section A.1-7 and Section B.1-3 as follows:
    • Section A.1.c. Cancel coverage and complete items 2-5, (item 7 is optional);
    • Section B.2.a. Check I elect to cancel the Group Legal Service Insurance Plan;
    • Section B.2.b Reason for cancellation (Optional). Completion of this section will assist DPA in monitoring the effectiveness of the program; and
    • Section B 3.Sign and date application.
  2. The employee may submit a written request directly to the State Controller's Office - 300 Capitol Mall, 10th Floor, Attn: Misc./Deductions Unit, Sacramento, CA 95814. The request must include the employee's name, social security number, Deduction code (075), Organization code (081), Deduction amount, (Single $10.19 or Family $17.74) and be signed with an original signature authorizing the cancellation of the deduction and the date. The employee should also give a copy of any cancellation letter to their Personnel Office for back-up documentation.
 

1508. CONTINUATION OF COVERAGE UPON LOSS OF ELIGIBILITY

Transfer to Ineligible Time Base

The SCO conducts a monthly post-audit and will automatically cancel employees who lose their eligibility due to a time base change of less than half-time. Enrolled employees whose time base changes to PI will have coverage continued until the end of the next control period. At that time the employee must re-qualify based on his or her PI status. A PI employee who does not qualify during a control period must be administratively cancelled. The effective date of cancellation is February 1 for the December 31 control period, or August 1 for the June 30 control period.

Termination/Separation

An employee can convert to a plan with ARAG that is completely separate from the State's sponsored plan.
 

Retirement

There is a Retiree Group Legal Services Insurance Plan, which began April 1, 2011. Employees should be given an enrollment packet upon retiring. Personnel Offices may contact ARAG for these enrollment packets at (800) 888-4184, Extension 259 email your request to printdistribution@ARAGlegal.com or print out the form on the Group Legal Page. The retiree form is also on-line at the ARAG's website – Use Access Code: 17642ret. Personnel Office's need to complete Section C and return the form to the employee. Do not send enrollment forms to CalPERS. Employees have 60 days to elect to enroll after retiring. If not, they have to wait until the next open enrollment. They will need to enroll in the retiree plan, even if they are a current Plan member.

Death

Upon the death of a Plan member enrolled in the family option,  ARAG will continue coverage for the spouse and/or eligible dependents at no cost for the balance of certificate year. At the end of the certificate year the surviving spouse and/or eligible dependents are eligible to convert to the individual legal plan. Dependents can contact ARAG directly.

Disability

Premiums are deducted from non-disability leave (NDI) industrial disability leave/IDL checks as long as the employee has a qualifying pay period.

Unpaid Leave of Absence

An employee enrolled in the Plan who is taking an unpaid leave must contact ARAG in writing (address below) or at (866) 762-0972 within 45 days of the leave to make arrangements for direct payment if he or she wishes to continue coverage.

ARAG Legal Insurance
Accounts Payable – Leave of Absence
400 Locust St., Suite 480
Des Mines, IA 50309
 
Completed forms can be faxed to ARAG at (515) 246-8710, Attention Eligibility and Fulfillment Unit.
 
If the anticipated leave period is one year or less, the employee must pay the full premium amount in advance. If it is not possible for the employee to determine what the length of his or her leave will be, or if the leave will exceed one year, the premium can be submitted in monthly installments from a checking account. If an overpayment of the premium occurs, the carrier shall promptly refund the difference.
 
For employees who do not wish to make direct payments, the coverage will terminate until the employee returns to active pay status. When the payroll deduction restarts, the effective/coverage date will start anew. Consequently, the employee will have to fulfill a new six-month waiting period in order to receive covered services with a waiting period.
 
If an eligible employee is on an unpaid leave of absence (ULA)/disability leave such as NDI or temporary disability (TD) without supplementation during the annual open enrollment, the employee should be treated as a "newly eligible" employee upon return to active pay status and provided with a 60-calendar day permitting event in which to enroll in the Plan. Section C.9 "Remarks" of the application form should include a comment stating RTW from ULA or NDI etc., and the 60-calendar day permitting event date is documented in Section C.10.

Military Leave

ARAG will waive the premium for state employees enrolled in the Plan who are called to active duty. ARAG has provided the following information regarding administration of the Plan. "Should a named insured be called to active duty for a period of more than thirty (30) consecutive days for the purpose of military service or of responding to a declared national emergency, coverage for the spouse and the insured dependents will continue, without the payment of premium, for the length of the named insured's absence and for so long as the named insured remains eligible for benefits through the policyholder." To qualify for this benefit the employee must provide ARAG with a completed copy of the Military Leave Work Sheet and active orders. On the Military Leave Work Sheet, under Item 10, Discretionary State Payroll Deductions, add to "Other" Group Legal. Under Deduction and Organization Code add 075 and 081. For the Deduction Amount list the monthly premium rate. Because this deduction will continue through the SCO, ARAG will reimburse the employee.
 

The documents must be sent to:

 
ARAG Legal Insurance
Accounts Payable – Military Leave
400 Locust St., Suite 480
Des Moines, IA 50309 
  Updated: 2/19/2015
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