Program Operations Manual System (POMS)
SL 30001.303 Basic Section 218 Concepts
Coverage under a Section 218 Agreement is voluntary. The initiative for securing coverage under Section 218 is with the State.
Coverage is obtained through a formal written agreement between the State and SSA.
There must be authority under Federal and State law (State’s enabling legislation) to enter into a Section 218 Agreement and to extent coverage under an agreement. Types and extent of coverage provided under an agreement must be consistent with Federal and State laws.
Each State's original agreement incorporates the basic provisions, definitions and conditions for coverage under the agreement.
Additional coverage is provided by modifications to the original agreement extended by the State and SSA. Each modification, like the original agreement, is a legal document.
There must be authority under Federal and State laws (State enabling legislation) to enter into an agreement and to extend coverage under an agreement.
Coverage is extended to groups of employees known as “coverage groups" – not on an individual basis.
Generally, an agreement may be modified to increase the extent of coverage but not to reduce the amount of coverage.
With certain exceptions, once coverage is provided, it continues and cannot be terminated.
Employees covered under a Section 218 Agreement have the same coverage and benefit rights as employees mandatorily covered for Social Security and Medicare.
Each State is required to designate an official(s) to act on the State’s behalf in administering the State’s Section 218 Agreement.
SSA administers the Social Security and Medicare coverage provisions under Sections 218 and 210 of the Act.