TN 8 (01-20)

SL 30001.303 Basic Section 218 Coverage Concepts

A. General rules for establishing coverage under a Section 218 Agreement

  • The Social Security Administration (SSA) administers the Social Security and Medicare coverage provisions under Sections 218 and 210 of the Act.

  • Each State's original Agreement incorporates the basic provisions, definitions, and conditions for coverage under the Agreement.

  • Coverage under a Section 218 Agreement is voluntary. The State must initiate voluntary coverage under Section 218 and must designate at least one official to act on the State's behalf in administering the State's Section 218 Agreement. Section 218 Agreements become legally binding and cannot be terminated after the State and SSA have executed the Agreement.

  • A Section 218 Agreement provides retirement, survivors, disability, and hospital insurance (HI) coverage for those groups of State and local government employees stipulated in the Agreement. A State can also provide Medicare HI-only coverage for certain individuals.

  • Employees in positions covered under a Section 218 Agreement have the same coverage and benefit rights as employees mandatorily covered for Social Security and Medicare.

  • If there is no voluntary coverage under a Section 218 Agreement, you must consider whether mandatory coverage under Section 210 applies.

B. State-specific rules for coverage under Section 218

The extent of coverage under a Section 218 Agreement varies from State to State. Therefore, it is important to know who the employer is, to identify the position, and to recognize key State and local coverage dates when determining coverage for an employee. The State must have authority under its own State law to enter into a Section 218 Agreement and to expand coverage through Modifications to that Agreement. The types and extent of coverage that a State may provide under its Agreement must be consistent with the authority given to the State by both Federal and State laws.

C. Coverage groups

  • Section 218 Agreements and Modifications generally do not cover individuals. They cover the services performed within positions by employees, e.g., teachers or bus drivers.

  • Coverage is extended to a group of positions, collectively known as a “coverage group.” The State decides which positions to cover and the effective date of coverage, subject to Federal and State laws. To have a coverage group, actual employees must occupy the intended coverage group’s positions. There are two types of employee groupings for coverage purposes:

    • Absolute coverage groups (Section 218(b)(5); SL 30001.315), composed of positions not under a retirement system and

    • Retirement system coverage groups (Section 218(d); SL 30001.320), composed of positions under a retirement system.

  • There are exceptions to the general rule that Agreements and Modifications cover positions, and not individuals (see, e.g., SL 30001.334; SL 30001.395; SL 50001.501; SL 50001.510).

D. Required and optional exclusions

Certain services are required to be excluded from Section 218 coverage. Some services, however, may either be excluded or covered under the State's Section 218 Agreement at the State’s option (see SL 30001.356 and SL 30001.357 for details).

When an absolute or retirement system coverage group is covered under an Agreement, the services of all employees who are members of the coverage group are covered unless they are required to be or are optionally excluded from coverage under the State’s Agreement.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/1930001303
SL 30001.303 - Basic Section 218 Coverage Concepts - 12/18/2003
Batch run: 01/29/2020
Rev:12/18/2003