A TMDdescribes the types of customers a financial product is appropriate for, based on their likely needs, objectives and financial situation (target market), and it establishes the conditions and restrictions in relation to how the product can be distributed to customers. PSSAP Focused is API's new addition to the Process Safety Site Assessment Program. and, at its discretion, refunding any fee paid. 3.1.15 Subject to the SIS Act, if CSC receives a roll-over application from a PSSAP member under Rule 3.1.13(a), CSC, where required by the SIS Act, must, and, where not so required, may roll-over or transfer so much of the persons total benefit as is requested in the roll-over application to a superannuation entity, RSA or life insurance company. 1st Amdt, 2006; 2nd Amdt, 2007; 5th Amdt, 2011. c. 1.3. c. 1.6. c. 1.8. c. 2.1. c. 2.2. c. 3.1. c. 3.2. c. 3.3. c. 3.4. C. 4 c. 5.1. c. 5.2. c. 5.3. c. 5.4. c. 5.5. c. 6.2. c. 6.3. c. 6.4. c. 6.5. c. 6.6. c. 7.1. c. 8.1. c. 8.2. c. 8.3. c. 9.1. R. 1.1.1 R. 1.2.1 am. 4.3.5 Subject to Rule 4.3.6, the premium for basic income protection cover provided in respect of an ordinary employer-sponsored member is the amount determined by CSC, being the same amount as the amount of premium specified in the basic income protection cover policy, and must be deducted from the personal accumulation account of the ordinary employer-sponsored member. Our website and portal work best if your computer or device meets these minimum specifications. If you were to do that before the child is born, youll have only one plan (your spouses). If youre expecting a new baby or have a pending adoption and both parents have their own health coverage, its important to understand how the coordination of benefits will work. The rule itself is not a law, but most insurance companies follow the birthday rule, and nearly every state has adopted the birthday rule as a common insurance practice to encourage its use. You can add extra money to your super by making before-tax and after-tax contributions, or by transferring in money from other super funds to help grow your savings. Find out more, including how to register: Non-Commonwealth or ACT Government Employers. If the custodial parent then remarries and the new spouse has their own health insurance plan to which the child is also added, the new spouses coverage becomes secondary, with the non-custodial parents acting as a third line of coverage, only covering charges that arent paid by the primary or secondary plans. (c) an assignment to an amount of remuneration under subsection 14(3) of the Remuneration Tribunal Act1973 for a Secretary of a Department appointed under the Public Service Act 1999. means a written application to CSC requesting CSC to roll-over or transfer benefits from the PSSAP to a superannuation entity, an RSA or a life insurance company. There are a number of ways you can withdraw your super in retirement, and how you access your money will depend on your specific circumstances. 3.1.11A Subject to the SIS Act, where CSC receives arelease authority, CSC must pay a lump sum benefit in respect of the PSSAPmember equal to the lesser of: (a) the amount (if any) requested by the PSSAP member or Commissioner of Taxation; (b) the amount specified for release in the release authority; or. The bill, known as the Empowering Parents' Healthcare Choices Act, would give parents with dual policies 60 days from the date of an infants birth to choose which plan is primary and to notify the insurer of their choice. Lets say Abigail and Armando each have their own employer-sponsored health insurance, and theyve opted to add their children to both plans. (d) be accompanied by the fee prescribed under the Act. (b) doing all things necessary to correct the records of the PSSAP Fund to reflect action taken under paragraph (a). 4.4.9 All premiums for supplementary income protection cover are to be paid by CSC from the PSSAP Fund. (b) thereafter and on the same day reduce to zero the value of the non-member spouse interest account and then close the non-member spouse interest account. in relation to a superannuation interest in the PSSAP Fund, means the spouse who has the superannuation interest. Birthday rule blindsides first-time parents with a mammoth medical bill. Subclauses 1.3, 1.6 and 1.8 deleted in the 5th amending deed. Your prenatal services are covered. For instance, if you were born in February, and your spouse was born in April, plan expenses for you and your eligible dependent children would be submitted to your plan first. Because the father also had his own health plan and his birthday was earlier in the year, the mothers insurance initially rejected the bills, noting that they should have been sent first to the fathers health insurance. 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. PSSap is the super fund for current and former Australian government employees. (short for Commonwealth Superannuation Corporation) has the same meaning as in the Governance of Australian Government Superannuation Schemes Act 2011. means the superannuation scheme established by the Superannuation Act 1976, known as the Commonwealth Superannuation Scheme. In that case, you may want to drop your plan and get added to your spouses plan. Covered through a parents plan? 4.2.2 An ordinary employer-sponsored member may apply to CSC for supplementary death and invalidity cover at any time. (b) a PSSAP member to CSC under Rule 2.4.1A; less income tax payable by the PSSAP Fund in relation to that amount. For information about becoming an assessor, please see the Assessor Qualification Process and Assessment . A child can be on both parents health insurance, which is when the birthday rule takes effect unless special exemptions apply. 5.1.2 CSC may keep only one personal accumulation account for each PSSAP member. This birthday rule starts on March 1, 2022. Kaiser Family Foundation. The assessment team will identify observations that the site should consider further as well as practices that the site executes and/or manages well. | Terms & Conditions | Privacy, Mechanical Integrity (focused on fixed equipment), Hydrofluoric Acid (HF) Alkylation/API RP-751, Pipeline Strategic Data Tracking System (PSDTS). You cannot fool these assessors they have done your job for 30 years. (m) charge reasonable fees in relation to the administration of the PSSAP Fund, including arrangements connected with PSSAP members and non-member spouses choosing particular investment strategies and arrangements connected with splitting of superannuation interests under the Family Law Act 1975. Read our, Money Saving Health Insurance Tips for Spouses, Understanding Health Insurance Exclusions & Creditable Coverage. 6.2.3 Where CSC accepts a request to reconsider a decision of a delegate of CSC in relation to PSSAP, CSC must: (a) if CSC has delegated to a Reconsideration Advisory Committee CSCs power to determine the matter, refer the request to the Committee for review and to exercise that power and in that event the Committee must review the decision and determine the matter in accordance with the delegated power by: (i) affirming the decision under review; (iii) substituting another decision; or, (iv) setting the decision aside; or. Various news stories have highlighted the high out-of-pocket costs that can result when a child's coverage is automatically determined by the birthday rule rather than selected based on the parents' preferences. Recommendation by Reconsideration Advisory Committees. Thats why its vital to ensure you go to providers in both plans networks. 2.4.1A Subject to the SIS Act, a PSSAP member may transfer or roll-over an amount payable in respect of the person under the Superannuation (Government Cocontribution for Low Income Earners) Act 2003 to CSC as a transfer amount where the amount, in total or part, relates to a period where the person was an ordinary employer-sponsored member, provided the method of payment complies with Rule2.4.2. The following is the list of the process safety areas that will be evaluated: Read More About Our Protocols,Request a Copy, and see PSSAP's new prices. (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. (ii) each subsequent birthday of the ordinary employer-sponsored member, or other date as specified in the policy. In that scenario, that parents health plan would be primary, regardless of the parents birthdays. 1.1.3 The Rules have been numbered so that the first number refers to the Part, the second number refers to the Division number within that Part and the third to the Rule number within that Division. 7.3.3 Subject to the SIS Act, the rights of persons claiming death benefits upon the death of a non-member spouse in relation to their non-member spouse interest are the same as the rights of persons claiming death benefits upon the death of a PSSAP member in relation to the interest in the PSSAP Fund of the deceased PSSAP member. This is part of another model act, although some states have set their own requirements regarding coverage for new dependents. Under Division 6.3 of the SIS Regulations, a member of a regulated superannuation fund, upon reaching the preservation age, is allowed to cash their benefits as a non-commutable income stream, subject to the conditions of release and the relevant restrictions set out in Schedule 1 of the SIS Regulations. = amended rep. = repealed rs. 2.2.3 The superannuation salary of an ordinary employer-sponsored member will be the persons ordinary time earnings if this is specified in: (a) a workplace agreement that applies to the ordinary employer-sponsored member; (b) a pre-reform certified agreement that applies to the ordinary employer sponsored member; (c) a pre-reform AWA that applies to the ordinary employer-sponsored member; (d) an AWA that applies to the ordinary employer-sponsored member; (e) a remuneration determination that applies to the ordinary employer-sponsored member; or, (f) an enterprise agreement that applies to the ordinary employer-sponsored member; or, (g) a workplace determination that applies to the ordinary employer-sponsored member; or. Whats the Difference Between Wastewater Disposal and Fracking? However, these aids (including Part, Division and Rule headings) do not form part of the Rules. You should obtain a copy of the relevant Product Disclosure Statement and consider its contents before making any decision regarding your super. CSC must redirect incorrectly paid amounts and correct personal accumulation accounts. In medical billing, the birthday rule determines which insurer is the primary provider for children in situations where both parents have health insurance policies. CSC may take out death cover and invalidity cover in separate policies. 5.1.1 CSC must keep a personal accumulation account for each PSSAP member. 8.4 Section 34AA and paragraphs 34AB(a), (b) and (d) of the Acts Interpretation Act 1901 apply in relation to a sub-delegation in a corresponding way to the way in which they apply to a delegation. Source: I work in HR for one of these gov orgs that pays > 9.5% for those in PSSAP. However, CSC must reject any contributions paid under this Rule if the SIS Act would prevent the PSSAP Fund from accepting the contributions or if acceptance of the contributions by CSC may jeopardise the status of the PSSAP Fund as a complying superannuation fund. Further details are available from HR Services. A designated employer is required to pay contributions only in respect of ordinary employer-sponsored members. Inquiries regarding having your site assessed as a part of this program can be made to PSSAP@API.org. 3.2.2 Subject to Rule 3.2.1, in the event of the death of a PSSAP member, CSC must pay or apply the deceased members total benefit to or for the benefit of one or more, as determined by CSC, of the following: (a) one or more dependants of the deceased PSSAP member; (b) the legal personal representative of the deceased PSSAP member. Says Norris: "The birthday rule is just a way of making sure that there's a fair, uniform method for determining which plan is secondary and which plan is primary when a child is covered under . In a situation where one parent has insurance through an employer or the Affordable Care Act (ACA) marketplace and the other parent has COBRA or insurance through state continuation coverage, the insurance policy furnished by the employer or the ACA is primary. 6.1.3 Where CSC has referred a decision in relation to PSSAP to a Reconsideration Advisory Committee, CSC is to provide the Committee with all relevant evidence and information. Read on to learn more about the health insurance birthday rule. To get an insurance quote over the phone, call: (855) 596-3655 | Agents available 24 hours a day, 7 days a week! Splitting of superannuation between a member spouse and a non-member spouse following a splitting agreement or splitting order under the Family Law Act 1975. The birthday rule says that primary coverage comes from the plan of the parent whose birthday (month and day only) comes first in the year. (b) if, under Rule 5.4.1, a PSSAP member may choose between two or more investment strategies the investment strategies chosen by the PSSAP member for their personal accumulation account. R. 2.2.4. R. 2.2.5. R. 2.2.6. R. 2.2.7. R. 2.2.9. R. 2.2.10.. R. 2.3.1. R. 2.3.4. R. 2.3.5. R. 2.3.6. R. 2.4.1. R. 2.4.2. R. 2.4.3. R. 3.1.1. R. 3.1.2. R. 3.1.3. R. 3.1.4. R. 3.1.5. R. 3.1.6. R. 3.1.7. R. 3.1.8. R. 3.1.9. R. 3.1.10.. R. 3.1.11.. R. 3.1.13.. R. 3.1.14.. R. 3.1.15.. R. 3.1.16.. R. 3.1.17.. R. 3.1.18.. R. 3.1.20.. R. 3.2.1. R. 3.2.2. R. 3.2.3. R. 3.3.1. .. R. 3.3.3. R. 3.3.4. R. 3.3.5. R. 3.4.1. R. 3.4.2. R. 3.4.5. R. 3.5.1. R. 3.5.2. R. 4.1.1. R. 4.1.3. R. 4.1.4. R. 4.1.5. R. 4.1.6. R. 4.2.1. R. 4.2.2. R. 4.2.3. R. 4.2.5. R. 4.2.7. R. 4.2.8. R. 4.2.9. R. 4.2.10.. R. 4.2.11.. R. 4.3.1. R. 4.3.2. R. 4.3.3. R. 4.3.4. R. 4.3.5. R. 4.4.1. R. 4.4.2. R. 4.4.3. R. 4.4.5. R. 4.4.7. R. 4.4.8. R. 4.4.9. R. 5.1.1. R. 5.1.2. R. 5.1.5. R. 5.1.6. R. 5.2.1. R. 5.2.2. R. 5.3.1. R. 5.4.1. R. 5.4.2. R. 5.4.3. R. 5.5.1. R. 5.5.2. R. 5.5.3. R. 6.1.1. R. 6.1.2. R. 6.1.3. R. 6.1.4. R. 6.2.1. R. 6.2.2. R. 6.2.3. R. 6.2.4. R. 6.3.1. R. 6.3.2. R. 6.3.3. R. 6.3.4. R. 6.3.5. R. 6.3.6. R. 6.4.1. R. 7.1.1. R. 7.2.1. R. 7.2.2. R. 7.3.1. R. 7.3.4. R. 7.3.5. R. 7.3.6. R. 7.3.7. R. 7.3.8. Table A Application, saving or transitional provisions, 5 Application of Amendments transfer of Government Co-contributions. The birthday rule determines primary and secondary insurance coverage when children are covered under both parents insurance policies. Louise Norris has been a licensed health insurance agent since 2003 after graduating magna cum laude from Colorado State with a BS in psychology. Here are some basic examples of how the birthday rule functions: The birthday rule is different from policy to policy and state to state. ad. PissingOutMyArse Additional comment actions. 3.1.7 If CSC receives or is taken to have received a benefit application from or on behalf of an ordinary employer-sponsored member pursuant to Rule 3.1.1(a)(ii) and CSC approves the invalidity retirement of the ordinary employer-sponsored member, CSC must, if the person ceases to be an ordinary employer-sponsored member following approval of their invalidity retirement, pay the person as a lump sum such part of their total benefit as the SIS Act permits as soon as possible. 1.7 In this Deed, PSSAP member means a person who is a member of PSSAP due to the operation of Part 3 of the Act. A TMD describes the types of customers a financial product is appropriate for based on their likely needs, objectives . The other thing to watch out for in the PSSap is the 'birthday rule'. The birthday rule carries both advantages and disadvantages, influencing whether parents will cover a child or children with one or two policies. It has not been previewed, commissioned or otherwise endorsed by any of our network partners. 4.2.3 CSC may allow the ordinary employer-sponsored member to choose the policy providing the supplementary death and invalidity cover if CSC has taken out more than one policy. D.Blackman The model was developed by the National Association of Insurance Commissioners with input from the insurance industry. 2.3.4 Eligible spouse contributions may be made on behalf of an ordinary employer-sponsored member at any time and in any amount: Method of payment of employee contributions and eligible spouse contributions. The following is the list of the process safety areas that are assessed by the use of each protocol*: Note: The Process Safety Site Assessments ARE NOT intended to be compliance audits (with the exception of the HF alkylation/API RP 751 protocol). Crediting of fund earnings and debiting of fund losses, Crediting of earnings and debiting of expenses and losses. It does not apply to a child or children covered under a single insurance plan. While the parent whose birthday comes first is still the primary insurance plan, the birthday rule doesnt apply to children whose parents have divorced or are members of a blended family. Rules do not necessarily have their own Rule headings. 8.5 Section 34A and paragraphs 34AB(c) and (d) of the Acts Interpretation Act 1901 apply in relation to a sub-delegation as if it were a delegation. If parents fail to make a selection within 60 days, the birthday rule would then take effect. The birthday rule does not apply to step-parents or children who live in a blended family. For some, the birthday rule is seen as a non-biased, random and ultimately fair way to choose primary and secondary payers when dual coverage exists for a child. Amounts paid by an insurer in response to a claim are paid to the PSSAP Fund for payment to the ordinary employer-sponsored member or directly to the ordinary employer-sponsored member but are not credited to their personal accumulation account. A member of a Reconsideration Advisory Committee may also be a director of CSC. How Much Water Does Hydraulic Fracturing Use? Editorial Note: The content of this article is based on the authors opinions and recommendations alone. 5.1.4 The accumulation amount of a PSSAP member is equal to the total of the amounts credited to the personal accumulation account of the PSSAP member under Rule 5.1.5 less the total of the amounts debited to the personal accumulation account under Rule 5.1.6. Louise Norris has been a licensed health insurance pssap birthday rule & Creditable coverage premiums supplementary... At any time Division and rule headings have only one plan ( your spouses plan do not form of! 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