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Georgia - Compensation & Benefit Legislation

GEORGIA - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

GEORGIA - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children is included in state's newborn health care mandate.

 

Preventive care for children: Yes, to age 5.

 

(Georgia Code Ann. Sections 33-24-4.5, 33-24-22, 33-24-24, 33-24-28, 33,24,58 et seq.)

 

GEORGIA - ALCOHOLISM & DRUG ABUSE

Employer option.

 

Minimum yearly inpatient coverage: 30 days

 

Minimum yearly outpatient coverage: 45 visits

 

Minimum lifetime coverage: No less than lifetime coverage for physical illness. (Ga. Code Ann. 33-24-28.1)

 

GEORGIA - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: No. Follows FUTA.

 

GEORGIA - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

Death: Yes. (If surviving spouse is 60 or older.)

 

Job Termination: Yes. (Unless employee was terminated for cause, or failed to pay premium; 3 months minimum continuation of coverage.)

 

Reduction of Hours: No.

 

Divorce or Legal Separation: Yes. (If spouse is age 60 or older.)

 

Medicare Eligibility: No.

 

Other Provisions: Insured's coverage terminated for any other reason except non-payment by insured or discontinuance of group policy; 3 months minimum continuation coverage. Dependent child exceeding maximum age for dependent status is eligible for continuation coverage if in college or university, to age 25.

 

Early Termination of Continuation of Coverage: Becoming eligible for Medicare; becoming eligible under another policy; termination of group policy, failure to make a timely payment. (Georgia Code Ann. Sections 33-24-21.1, 33-24-21.2, 33-30-4)

 

GEORGIA - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits (effective 1/1/91). Based on 1987 National Association of Insurance Commissioner Rules Model. Includes joint custody provision. (Georgia. Admin. Comp. ch. 120-2-48)

 

GEORGIA - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

GEORGIA - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: Employees working for the state or contract workers who provide personal services for the state in high-risk jobs. Any applicant for state or public school employment.

 

Applicant Testing: Applicant testing is allowed for state or public school employment.

 

Employee Testing: Employee testing is allowed, but only an employee working in a high-risk job may be tested at random.

 

How Test Results are Used: Test results may be grounds for termination of employment or disqualification from employment.

 

Enforcement of Statutes: State has no statutory requirements.

 

Employee Remedies: State has no statutory requirements.

 

Employer Penalties: State has no statutory requirements.

 

Who Pays for Testing: The board of education of any county or independent school system may require that applicants for employment within the school system pay for the cost of pre-employment testing.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: State has no statutory requirements.

 

(Georgia Code Ann. Sections 45-20-90 thru 45-20-112.)

 

GEORGIA - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies providing family coverage must cover adopted children as of the date of the final decree of adoption. (Georgia Code Ann. Section 33-24-22.)

 

Bone Marrow Transplants: Insurers must make available to accident and sickness policyholders coverage for bone marrow transplants for breast cancer treatment. (HB369, 1995.)

 

Coverage Continuation and Conversion: Group policies must provide continuation rights of up to three months to persons whose coverage is terminated for themselves and their dependents. (Georgia Code Ann. Section 33-24-21.1.) Group policies also must allow members whose coverage expires to continue coverage for themselves or eligible dependents if the member was 60 years of age or older at the date of expiration. (Georgia Code Ann. Section 33-2421.2(b)(1).) Accident and health policies must provide conversion rights to spouses and dependents who cease to be eligible due to death of the insured or dissolution of marriage. (Georgia Code Ann. Sections 33-24-20, 21.)

 

Genetic Testing: Insurers including managed care organizations must not use information derived from genetic testing to deny access to accident and sickness insurance. Genetic testing may be conducted only with written approval of the individual tested, and information obtained must be used only for therapeutic or diagnostic purposes.

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while a child is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Georgia Code Ann. Section 33-24-28.)

 

Heart Transplants: Insurers must make available to accident and sickness policyholders coverage for human heart transplants. (Georgia Code Ann. Sections 33-29-3.1 and 33-30-4.1.)

 

Health Maintenance Organizations: Effective July 1, 1996, employers that only offer health coverage through HMOs must provide employees with a point-of-service option. Reasonable premiums and administrative costs may be charged to employees choosing that option. (HB14042, 1995) (Georgia Code Ann. Section 33-21-29.)

 

Joints: Insurers must make available to policyholders coverage for temporomandibular joint dysfunction. (Georgia Code Ann. Section 33-29-20.)

 

Mammography Screening, Pap Smears, and Prostate Specific Antigen Tests: Insurers must make available to accident and sickness policyholders coverage for mammograms, pap spears, and prostate specific antigen tests (PSATs). Mammograms shall be covered at least once as a baseline for women at least 35 but less than 40 years of age; once every two years for women at least 40 but less than 50 years of age; once every year for women at least 50 years of age; and when ordered by a physician for a woman at risk. Pap smears shall be covered once a year, or more often if ordered by a physician. Annual PSATs shall be covered for males 45 years of age or older, or for males 40 years or older if ordered by a physician. (Georgia Code Ann. Sections 33-29-3.2, 33-30-4.2.)

 

Maternity: Group policies that provide maternity benefits must cover complications of pregnancy as defined. (Georgia Code Ann. Section 33-24-24.)

 

Mental Health: Insurers must make available to accident and sickness policyholders coverage for treatment of mental disorders equal to that for physical illness generally, including a maximum of 30 days per year of inpatient treatment and 48 outpatient visits per year for an individual policy and 60 days/50 visits for group policies. (Georgia Code Ann. Section 33-24-28.1.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects and birth abnormalities. (Georgia Code Ann. Section 33-24-22.)

 

Outpatient surgery: Insurers must make available to accident and sickness policyholders with coverage for inpatient medical and surgical procedures optional coverage for such procedures rendered on an outpatient basis. (Georgia Code Ann. Section 33-24-28.2.)

 

Pharmaceutical Services: A group accident and sickness insurance policy may not be issued if it requires that insured individuals obtain pharmaceutical services exclusively from a mail-order pharmaceutical distributor. Those not utilizing a mail-order distributor shall not be subject to different conditions for the receipt of services from those utilizing a mail-order distributor. (Georgia Code Ann. Section 33-30-4.3(b).)

 

Pre-existing Conditions: Health insurers must enroll for immediate coverage eligible individuals or dependents who have had similar insurance coverage under another plan within the previous 90 days. Policies may include a limitation for pre-existing conditions of not to exceed 12 months following the effective date of coverage; policies may waive the pre-existing conditions limitation, however, during the period of time an individual had similar coverage under another plan. (616, 1995). Insurers including group disability plans must not limit or exclude payment of benefits for a disability resulting from a pre-existing condition if that disability occurs more than 24 months following the effective date of coverage. (S23, 1995) (Georgia Code Ann. Section 33-24-26.1.)

 

Providers: Psychologists and chiropractors: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the services is covered by the policy. (Georgia Code Ann. Section 33-24-27.) Hospital specializing in alcoholism and drug abuse treatment: Policies covering treatment of alcoholism or drug abuse may not exclude reimbursement to hospitals specializing in such treatment. (Georgia Code Ann. 33-24-28.3.) Optometrists: Costs for such services must be covered. (Georgia Code Ann. Section 33-24-27.1.)

 

GEORGIA - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

Eligibility Criteria: 2 - 50 employees, the majority within the state.

 

Restrictions on premiums: Yes.

 

Restrictions on cancellation: No statutory requirements.

 

Pre-existing Conditions: Coverage for named impairments may be waived.

 

Other: Coverage limits for mental illness must be no less than for physical illness.

 

(Ga. Code Section 33-24-29, 33-30-12)

 

GEORGIA - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: Yes.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: 2.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None. (Georgia Code Ann. Sections 33027-1, 33-27-3, 33-27-5)

 

GEORGIA - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving, Sunday. Other: All days designated as public and legal holidays by the federal government. Days as designated by the Governor. (Georgia Code Assn. Sections 1-4-1, 1-4-2, 1-4-5 through 1-4-10) (1990 revision).

 

GEORGIA - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

GEORGIA - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is liable for actual damages and reasonable attorney fees.

 

Other Requirements: Employee is entitled to actual salary while serving on jury duty. (Georgia Code Ann. Section 34-1-3.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes, if acting in response to a subpoena (but not if employee is a defendant in a criminal case.)

Remedies and Penalties: Actual damages and attorney fees.

 

Other Requirements: Employer may require reasonable notice of anticipated absence.

 

GEORGIA - LEAVES OF ABSENCE

State reports no statutory requirements.

 

See U.S. Federal Family and Medical Leave Act

 

GEORGIA - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

GEORGIA - MANDATED PROVIDERS

Optometrists, chiropractors, and psychologists. Mandatory coverage athletic trainers (Georgia Code Ann. Sections 33-24-27, 33-24-27.1, 33-24-27.2, 33-30-7)

 

GEORGIA - MENTAL HEALTH CARE

Employer option.

 

Minimum yearly inpatient coverage: 30 days.

 

Minimum yearly outpatient coverage: 48 days.

 

Minimum lifetime coverage: No less than lifetime maximum for physical illness.

 

(Georgia Code Ann. Section 33-24-28.1)

 

GEORGIA - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain agriculture employees, outside sales, and students. Handicapped workers in special environments may be exempt by authorizations. (Georgia Code Ann. 34-4-3, 34-4-4)

 

See U.S. Minimum Wage

 

GEORGIA - OVERTIME COMPENSATION REQUIREMENTS

State reports no statutory requirements.

 

GEORGIA - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: Employees paid for fewer than 350 hours during a continuous 4 month period, or who have gross earnings of less than $300 every month.

 

Form(s) to file: State form; employer may develop own report of W-4 form.

 

Filing deadline: Within 10 days of hire or rehire.

 

Employer information to be included: Name, address, employment security number, or unified business identifier number.

 

Employee information to be included: Name, address, SSN, and date of birth.

 

Penalty for failure to report: Written warning.

(Georgia Code Ann. Section 19-11-9.2)

 

GEORGIA - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: Yes, to age 5. (Georgia Code Ann. Sections 33-24-4.5, 33-24-22, 33-24-24, 33-24-28, 33,24,58 et seq.)

 

GEORGIA - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

GEORGIA - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, coverage for names impairments may be waived. (Georgia Code Ann. Section 33-30-12)

 

Health Insurance Portability & Accountability Act

 

GEORGIA - PROTECTED CLASSIFICATIONS

Age: Yes, between 40 and 70.

 

Race: Yes.

 

Color: Yes.

 

National Origin: Yes.

 

Ancestry: No specific law. State has expressed policy against discrimination.

 

Religion: Yes.

 

Sex: Yes.

 

Pregnancy: No specific law. State has expressed policy against discrimination.

 

Sexual Harassment: No specific law. State has expressed policy against discrimination.

 

(Ga. Code Ann. Sections 45-19-28, 45-19-29; apply to public employment only.)

 

GEORGIA - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

GEORGIA - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

GEORGIA - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Payday.

 

Date due if employee resigns: Payday

 

Wages: Yes.

 

Vacation Pay: No.

 

Holiday: No.

 

Sick leave: No.

 

Severance: No. (Georgia Code Ann. Section 34-7-5)

 

GEORGIA - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes.

 

(Georgia Code Ann. Sections 34-8-152, 34-8-155, 34-8-156.)

 

GEORGIA - VACATION PAY

State reports no statutory requirements.

 

GEORGIA - VOTING TIME OFF

Employer must give sufficient time to vote to any employee who does not have 2 hours off before work after polls are open or after work before polls close. (Georgia Code Ann. Sections 21-2-404, 21-2-567.)

 

GEORGIA - WORKERS' COMPENSATION

Private Employers: Mandatory coverage for employers with 3 or more employees. Coverage of active partners, sole proprietors, or farm employees is elective.

 

Public Employers: Mandatory as to state, county, municipal corporations, and political sub-divisions including school districts. Voluntary as to planning commissions.

 

Exceptions: Farm labor, domestic servants, employees of common carriers by railroad, casual labor and licensed real estate salespersons and brokers.

 

Special Coverage Provisions: Voluntary as to excepted employments. (U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)