PSSAP Focused will help facilitate smaller refineries, petrochemical, and chemical facilities to take part in the program. Thats why its vital to ensure you go to providers in both plans networks. The birthday rule is a part of a set of rules called the coordination of benefits (COB) which collectively resolves questions about which health insurance policy provides coverage. 2.2.1 Each pay day the designated employer of an ordinary employer-sponsored member must pay as contributions to CSC an amount equal to 15.4% of the superannuation salary of the member on that day. in relation to a PSSAP member, means . 7.3.5 CSC may determine when and how a non-member spouse may make or change an election about their choice of investment strategy. 6.3.3 CSC must not proceed with a request for reconsideration of a decision of CSC in relation to PSSAP: (a) that does not include new evidence; or. Also covers the payment to CSC of contributions and transfer amounts in respect of an ordinary employer-sponsored member of PSSAP by designated employers and by or on behalf of employees and the transfer of amounts to the plan from other superannuation entities. 2. So in 1582, Pope Gregory XIII established the Gregorian calendar and introduced the century rule, Levine . 4.2.10 Any amount paid by a life insurance company to CSC in response to a claim against a policy providing supplementary death and invalidity cover must be paid into the PSSAP Fund and is credited to the persons personal accumulation account. Does Fracking Cause Flaming Water Faucets? 3.1.13 A roll-over application may be made to CSC, in accordance with the SIS Act, by: (a) a PSSAP member other than in their capacity as a transitional member applying under paragraph (b); or. Establishing Reconsideration Advisory Committees. 3.2.3 If, after making reasonable enquiries, CSC upon the death of a PSSAP member has not found either a legal personal representative or a dependant of the deceased PSSAP member, CSC will pay or apply the deceased members total benefit to or for the benefit of such one or more individuals as determined by CSC. Figure 1: PSSAP membership, 2011-12 to 2015-16 Our hand-picked assessors have an average of 35 years processsafety experiencein the refining and petrochemical industry, and are recognized as leading experts in their respective fields. They appear throughout the Rules in bold print to remind the reader that they have a special meaning. 3.1, 3.23.9: (a) Remainder: 26 June 2009. So, if your birthday is July 15, 1985, and your spouse is September 17, 1983, your health plan would be considered primary . The other parents health plan then provides secondary coverage. in relation to an ordinary employer-sponsored member, has the same meaning as in the Act. Establishment of the Public Sector Superannuation Accumulation Plan (PSSAP) and the PSSAP Fund. , under Rule 4.1.7, a premium payable for, (a) whether it is prepared to provide the cover for that, (b) if so, the cost of the premium, including any extra cost where the, must provide the responses to the questions in paragraphs (a) and (b) from the, (d) where, under Rule 4.2.13, a premium payable for, (e) the date the insurer ceases to provide, Subject to Rule 4.2.13, the cost of the premium for, (b) in accordance with the policy between, , under Rule 4.3.6, a premium payable for, may make a claim against a policy providing, insurer in response to a claim are paid to the, it is prepared to provide the cover for that, , the cost of the premium, including any extra cost where the, , under Rule 4.4.11, a premium payable for, Subject to Rule 4.4.11, the cost of the premium for, (e) the interest credited (if any) in respect of fund earnings on the persons, (h) any amount credited to the persons, (i) amount of any tax offset as determined by, If any or all of the following amounts are paid from the, payable under Rule 4.1.6, 4.2.12, 4.3.5 and 4.4.10 paid from the persons, in respect of fund losses on the persons, (d) any benefit paid to or in respect of the, In determining the amount referred to in Rule 5.2.1, (a) the charges, costs and expenses incurred in the investment of amounts in all, is subject to provisions relating to financial management of funds (including solvency and winding up of accumulation, possible surcharge assessments received in respect of surchargeable contributions made on or after 1 July 2005 (legislation has been introduced in Parliament to abolish the surcharge from 1 July 2005), Rule 5.3.1 will cover surcharge assessments received in relation to surchargeable contributions made before 1 July 2005 and transferred by, If any moneys paid to or withdrawn from the, (a) in the case of moneys paid by mistake refunding those moneys to the person who paid them to the, (b) in the case of moneys withdrawn by, taking all reasonable steps to recover the moneys and doing all things necessary to correct the records of the, all things necessary to correct the records of the. The other parent's policy will provide secondary . For example, if the mothers plan has covered the child longer than the fathers plan, then the mothers plan is the primary policy. (b) in accordance with the policy between CSC and the life insurance company, the company refuses to provide cover in respect of the ordinary employer-sponsored member. Share. For example, lets imagine that you are about to have a baby with your spouse. Note:Among other things, Rule 5.5.1 covers the situation where an amount transferred to CSC by the Australian Taxation Office under Rule 2.4.1(c) or (d) has been found, upon reassessment by the Commissioner of Taxation, to be more than the correct amount. in relation to a PSSAP member means the amount specified in Rule5.1.4. means, in respect of an ordinary employer-sponsored member, contributions made by the designated employer of that member under Rule 2.2.4. means an Agency within the meaning of the Public Service Act 1999. has the same meaning as in the Superannuation Contributions Tax (Assessment and Collection) Act 1997. means an AWA within the meaning of clause 1 of Schedule 7A to the Workplace Relations Act 1996, as continued in existence as a transitional instrument under the Fair Work (Transitional Provisions and Consequential Amendments) Act 2009. means insurance coverage provided in respect of an ordinary employer-sponsored member under Division 1 of Part 4 of the Rules for death and permanent invalidity. 5.2.1 CSC may determine the amounts to be credited or debited to a persons personal accumulation account under Rule 5.1.5(e) and 5.1.6(c) that reasonably reflects the after tax earnings or losses derived from the investment of the amount in the account. If a young adult has coverage under a parents plan and a spouses plan, the plan covering them for longer will typically be primary. 2.1.3 Where a person is an ordinary employer-sponsored member in respect of two or more concurrent employments, CSC may maintain one personal accumulation account for the member. (f) a PSSAP member or the Commissioner of Taxation, applying for the payment of a benefit pursuant to a release authority. CSC m not take out insurance policy for a non-member spouse. (b) the designated employer of the ordinary employer-sponsored member. In cases where a custodial parent remarries and a child is added to the new spouses insurance, the custodial parents insurance is primary. It states that the health plan of the parent whose birthday comes first in the calendar year will be designated as the primary plan. Its full name is Public Sector Superannuation Accumulation Plan, and it is defined as a 'non public offer Public Sector fund', meaning only some people can . 2.2 There is hereby established from 1July2005, and vested in CSC (formerly referred to as the Board), a fund for the purposes of PSSAP (to be known as the PSSAP Fund). Related to PSSap. Note:The PSSAP is subject to provisions relating to financial management of funds (including solvency and winding up of accumulation funds) set out at Part 9 of the SIS Regulations. The birthday rule is used to determine how coordination of benefits work when a child is covered by both parents' health insurance policies. D.Blackman In situations where each parent has their own health plan, a newborn or newly adopted child may end up in a coordination of benefits scenario, even if the parents dont intend to maintain more than one policy for the child. You should read your policy or membership agreement to see what procedure your health insurer has in place. 3.5.2 A person in receipt of benefits under Division 1 of this Part may use the benefits to purchase income products arranged by CSC. 6.6 CSC shall ensure that any investment manager engaged by CSC in relation to the PSSAP Fund: (a) operates within the investment powers of CSC and the investment strategy and policy as determined for the time being by CSC; and. = repealed and substituted, am. The assessors who make up our process safety site assessment teamshave an invaluable amount of experience, which results in "world class" assessments for your facilities. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. But its possible to have more than one, especially if a household has two parents whose jobs both offer employer-sponsored health coverage. The other parents plan provides secondary coverage. If the primary carrier pays 80% of the claim $800 the secondary insurer could then pay the remaining $200, provided, of course, that the services are covered and the deductible has been met. The Affordable Care Act requires health plans to allow young adultseven if theyre no longer tax dependentsto remain on their parents health coverage until age 26. Through multi-platform and multi-media eLearning, APIs Training Program offers comprehensive training developed by experts on API Standards and Recommended Practices. for the purposes of reconsidering decisions of CSC under Part6 of the Rules, includes: (a) making, suspending, revoking or refusing to make an order or determination; (b) giving, suspending, revoking or refusing to give a certificate, direction, approval, consent or permission; (c) issuing, suspending, revoking or refusing to issue an authority or other instrument; (d) imposing a condition or restriction; (e) making a declaration, demand or requirement; (f) retaining, or refusing to deliver up, an article; and. means any amounts payable in respect of an ordinary employer-sponsored member for insurance coverage under Part 4 of the Rules. (b) profit includes capital profit. (b) otherwise becomes aware that a PSSAP member has died; CSC must determine who is entitled to be paid the death benefits in accordance with Division2 of this Part and pay the total benefit to the person or persons so entitled in such shares as CSC determines. Centers for Medicare & Medicaid Services. in relation to a superannuation interest in the PSSAP Fund, means the spouse who has the superannuation interest. (d) be accompanied by the fee prescribed under the Act. The intent of the birthday rule is to prevent the double billing and overpayment of claims while ensuring that the child with dual coverage receives coordinated and . ABOUT US. Medicare: How it works with other insurance, Key difference between Medicare and Medicaid, Best home and auto insurance bundle companies, A complete guide to short-term health insurance, Guide to domestic partner health insurance, can you stay on your parents insurance after age 26. has the same meaning as in the Income Tax (Transitional Provisions) Act1997. has the same meaning as in the Governance of Australian Government Superannuation Schemes Act 2011. means contributions paid by an ordinary employer-sponsored member under Rule2.3.1. means the amount, if any, reported under Rule 2.2.10. means a enterprise agreement within the meaning of section 12 of the Fair Work Act 2009. means benefits payable under Division 4 of Part 3. means insurance cover provided in respect of an ordinary employer-sponsored member under Division 3 and Division 4 of Part 4 of the Rules. means a workplace agreement within the meaning of section 4 of the Workplace Relations Act 1996, as continued in existence as a transitional instrument under the Fair Work (Transitional Provisions and Consequential Amendments) Act 2009. means a workplace determination within the meaning of section12 of the Fair Work Act 2009. It does not apply to a child or children covered under a single insurance plan. 5.5.2 If any moneys paid to or withdrawn from the personal accumulation account of a PSSAP member were, in the opinion of CSC, paid into or withdrawn from the personal accumulation account by mistake (whether of law or of fact), CSC must take steps to correct the mistake, including: (a) withdrawing an amount from the personal accumulation account or paying an amount to the personal accumulation account; and. The model was developed by the National Association of Insurance Commissioners with input from the insurance industry. 5.1.3 The personal accumulation account records the accumulation amount of a PSSAP member. (b) engage in any hazardous occupation or pursuit. Although it would be nice, your health plans birthday rule doesnt refer to insurers sending you a special discount, benefit, or coupon for free ice cream to celebrate your birthday. The payment of a PSSAP member go to providers in both plans.! 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