TITLE 36
Public Officers and Employees

CHAPTER 36-12
Insurance Benefits

SECTION 36-12-1


§ 36-12-1 Definitions.

The following words, as used in §§ 36-12-1 – 36-12-14, shall have the following meanings:

(1) "Employer", means the state of Rhode Island.

(2) "Employee", means all persons who are classified employees as the term "classified employee" is defined under § 36-3-3, and all persons in the unclassified and non-classified service of the state; provided, however, that the following shall not be included as "employees" under §§ 36-12-1 – 36-12-14:

(i) Part-time personnel whose work week is less than twenty (20) hours a week and limited period and seasonal personnel;

(ii) Members of the general assembly, its clerks, doorkeepers, and pages.

(3) "Dependents" means an employee's spouse, domestic partner and unmarried children under nineteen (19) years of age. Domestic partners shall certify by affidavit to the benefits director of the division of personnel that the (i) partners are at least eighteen (18) years of age and are mentally competent to contract, (ii) partners are not married to anyone, (iii) partners are not related by blood to a degree which would prohibit marriage in the state of Rhode Island, (iv) partners reside together and have resided together for at least one year, (v) partners are financially interdependent as evidenced by at least two (2) of the following: (A) domestic partnership agreement or relationship contract; (B) joint mortgage or joint ownership of primary residence, (C) two (2) of: (I) joint ownership of motor vehicle; (II) joint checking account; (III) joint credit account; (IV) joint lease; and/or (D) the domestic partner has been designated as a beneficiary for the employee's will, retirement contract or life insurance. Misrepresentation of information in the affidavit will result in an obligation to repay the benefits received, and a civil fine not to exceed one thousand dollars ($1000) enforceable by the attorney general and payable to the general fund. The employee will notify the benefits director of the division of personnel by completion of a form prescribed by the benefits director when the domestic partnership ends.

(4) "Retired employee", means all persons retired from the active service of the state, who, immediately prior to retirement, were employees of the state as determined by the retirement board under § 36-8-1, and also all retired teachers who have elected to come under the employees' retirement system of the state of Rhode Island.

(5) "State retiree", means all persons retired from the active service of the state who, immediately prior to retirement, were employees of the state as determined by the retirement board under § 36-8-1.

(6) "Teacher retiree", means all retired teachers who have elected to come under the employees' retirement system of the state of Rhode Island.

(7) "Long-term health care insurance", means any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for not less than twelve (12) consecutive months for each covered person on an expense incurred, indemnity, prepaid, or other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting other than an acute care unit of a hospital. The term includes: group and individual policies or riders whether issued by insurers, fraternal benefit societies, nonprofit health, hospital, and medical service corporations; prepaid health plans, health maintenance organizations; or any similar organization. Long-term health care insurance shall not include: any insurance policy which is offered primarily to provide basic medicare supplement coverage; basic hospital expense coverage; basic medical-surgical expense coverage; hospital confinement indemnity coverage; major medical expense coverage; disability income protection coverage; accident only coverage; specified disease or specified accident coverage; or limited benefit health coverage. This list of excluded coverages is illustrative and is not intended to be all inclusive.

(8) "Non-Medicare-eligible retiree health care insurance", means the health benefit employees who retire from active service of the state (subsequent to July 1, 1989), who immediately prior to retirement were employees of the state as determined by the retirement board pursuant to § 36-8-1, shall be entitled to receive until attaining Medicare eligibility. This health care insurance shall be equal to semi-private hospital care, surgical/medical care and major medical with a one hundred seventy-five dollar ($175) calendar year deductible. The aforementioned program will be provided on a shared basis in accordance with § 36-12-4.

(9) "Medicare-eligible retiree health care insurance", means the health benefit employees who retire from active service of the state (subsequent to July 1, 1989), who immediately prior to retirement were employees of the state as determined by the retirement board pursuant to § 36-8-1, shall have access to when eligible for Medicare. This health care insurance shall include plans providing hospital care, surgical/medical services, rights and benefits which, when taken together with their federal Medicare program benefits, 42 U.S.C. § 1305 et seq., shall be comparable to those provided for retirees prior to the attainment of Medicare eligibility.

(10) "Health reimbursement arrangement", or "HRA" means an account that:

(i) Is paid for and funded solely by state contributions;

(ii) Reimburses a Medicare-eligible state retiree for medical care expenses as defined in § 213(d) of the Internal Revenue Code of 1986, as amended, which includes reimbursements for health care insurance premiums;

(iii) Provides reimbursements up to a maximum dollar amount for a coverage period; and

(iv) Provides that any unused portion of the maximum dollar amount at the end of a coverage period is carried forward to increase the maximum reimbursement amount in subsequent coverage periods.

History of Section.
(P.L. 1960, ch. 136, § 1; P.L. 1967, ch. 105, § 1; P.L. 1988, ch. 433, § 1; P.L. 1989, ch. 227, § 2; P.L. 1989, ch. 542, § 88; P.L. 2001, ch. 110, § 1; P.L. 2013, ch. 144, art. 2, § 1.)