A. An individual has “current employment status” if he or she is actively working
as an employee, is the employer (including a self-employed individual), or is associated
with the employer in a business relationship.
An individual also has “current employment status” if he or she is not actively working,
but meets all of the following conditions:
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retains employment rights in the industry;
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the employer has not terminated the individual’s employment or the employee organization
providing the coverage has not terminated the individual’s membership in the employee
organization;
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is not receiving disability benefits from an employer for more than 6 months;
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is not receiving Social Security disability benefits; and
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has employment-based GHP coverage that is not COBRA continuation coverage.
Persons who retain employment rights include, but are not limited to:
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those who are on strike, furloughed, temporarily laid off, or who are on sick leave;
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teachers and seasonal workers who normally do not work throughout the year; and
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individuals age 65 and older who have health coverage that extends beyond or between
periods of active employment; for example, based on an hours’ bank arrangement.
Active union members in certain trades and industries (e.g., construction) often have
“hours’ bank” coverage.
For SEP Enrollments for hours’ bank arrangements see HI 00805.278.
B. The following information defines “current employment status” for specific situations:
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1.
Individual covered under a retirement GHP is rehired
A group health plan based on former employment becomes a GHP based on “current employment
status” if the:
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employer who is furnishing the retirement GHP rehires the individual, and
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amount of work the individual performs is sufficient to earn coverage from the employer
had the individual not retired.
The individual who meets the requirements in this section has GHP coverage based on
current employment status. This is true even if the employer deducts payment for the
GHP coverage from a pension or annuity payment.
If employed by an employer other than the one providing the group health plan coverage
the GHP is a retirement plan and the employee does not have GHP coverage based on
current employment status.
2. Employment Status of Senior Judges
Senior Federal judges are retired judges of the U.S. court system or the Tax Court.
They may continue to adjudicate cases, but they are entitled to full salary as a retirement
benefit whether or not they perform judicial services for the government. The remuneration
they receive as senior judges are not wages and do not count as earnings for Social
Security retirement test purposes.
Since senior judges are considered retired for Social Security purposes, they are
not considered to have current employment status for purposes of the SEP and premium-surcharge
rollback.
3. Clergy and members of religious orders
We consider members of religious orders who have not taken a vow of poverty to have
current employment status with the order if the:
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religious order pays FICA taxes on behalf of that member; or
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individual receives remuneration from the order for services furnished, regardless
of whether the order pays FICA taxes on behalf of that member.
We do not consider members of religious orders who have taken a vow of poverty to
have current employment status if the services performed as a member of the order
are considered employment for Social Security purposes only because the order elected
Social Security coverage under 3121(r) of the Internal Revenue Code.
4. Individuals serving as volunteers
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