7 Colo. Code Regs. § 1107-1.3

Current through Register Vol. 47, No. 24, December 25, 2024

Section 7 CCR 1107-1.3 - Individuals Electing Coverage

1. Individuals electing coverage may elect coverage under C.R.S. § 8-13.3-514 for an initial period of coverage of three years.

A. The individual electing coverage must create a My FAMLI+ Employer account and must submit their notice of election of coverage via My FAMLI+ Employer. For self-employed individuals, the notice of election must include a copy of their most recent tax transcript, as well as copies of any IRS Form W-2 issued to the individual by the individual's business or businesses for the same tax year reflected by the tax transcript. No communication from a self-employed individual will constitute a notice of election without the required tax transcript and W-2 forms.

B. Elective coverage becomes effective on the date of filing the notice of election.

C. A period of coverage is defined as:

1. The three years following the first day of elective coverage or any gap in coverage; and

2. Each subsequent year.

D. Any individual electing coverage may file a notice of withdrawal within thirty calendar days after the end of a period of coverage.

E. The notice of withdrawal must include an effective date of the withdrawal, which must be no sooner than thirty days after the filing of the notice of withdrawal.

F. A notice of withdrawal from coverage must be submitted to the Division online or in another format approved by the Division.

G. Upon termination of coverage, due and unpaid premiums must be paid, as well as any interest or fines assessed.

H. Throughout a period of coverage, individuals electing coverage as a self-employed individual, and individuals electing coverage as an employee of a local government that has declined participation pursuant to C.R.S. § 8-13.3-522, must report wages, pay premiums, and otherwise comply with the FAMLI Act and its implementing regulations. This includes submitting wage reports for quarters in which no relevant wages are paid and submitting documentation as required by the FAMLI Act, its implementing regulations, or the Division.

I. If, during a period of coverage, an individual becomes no longer employed by a local government that has declined participation pursuant to C.R.S. § 8-13.3-522, or becomes no longer self-employed in Colorado, their coverage period does not end, and they must still comply with the FAMLI Act and its implementing regulations with regard to elective coverage. However, they may contact the Division and request a waiver of their quarterly wage reporting obligations, and the Division in its sole discretion may grant the waiver. The Division may revoke the waiver at any time.

2. Provisions specific to self-employed individuals electing coverage:

A. Starting with the second calendar quarter of 2025, self-employed individuals must submit supporting documentation with their quarterly wage reports except for quarters in which they receive no gross income from self-employment. The supporting documentation must substantiate the amount of wages reported. Supporting documentation may include bank account statements, invoices, pay statements, reports, receipts, or other relevant documentation. Wage reports without supporting documentation may be considered untimely and subject to fines.

B. If the documentation submitted does not clearly support the reported wages, or if other information available to the Division undermines the reliability of the reported wages, then the Division may revise the wage amount to reflect the Division's reasonable estimate of gross income from self-employment. A reasonable estimate may be, but is not limited to:

1. A prior quarter's wages; or

2. A prorated amount of gross income from self-employment reflected by the individual's tax transcripts and W-2 forms.

C. If the Division revises a wage amount pursuant to Section 1.3.2.B above, and the self-employed individual wants to challenge that revision, they must first request a reconsideration of that revision within forty-nine (49) days of the date of the revision. The deadline to request a reconsideration may be extended by up to a maximum of forty-nine (49) days for good cause. The self-employed individual may appeal the outcome of the reconsideration pursuant to 7 CCR 1107-9.

D. In addition to the tax transcript required in the notice of election, a self-employed individual electing coverage must annually submit to the Division the prior year's tax transcript and W-2 forms by December 1.

1. If the transcript and W-2 forms-prorated as appropriate-show a total amount of gross income from self-employment that is lower than the total the self-employed individual reported for that year, then the Division may evenly decrease each of that year's quarterly wage reports proportionate to the difference and adjust premium obligations and benefits payments accordingly.

2. If the transcript and W-2 forms-prorated as appropriate-show a total amount of gross income from self-employment that is higher than the total the self-employed individual reported for that year, then the self-employed individual may request the Division to evenly increase each of that year's quarterly wage reports proportionate to the difference and adjust premium obligations and benefits payments accordingly. Such a request must be received by December 1 of the following year. The Division may increase quarterly earnings pursuant to this rule regardless of whether it received a request to do so.

3. If the self-employed individual fails to submit complete and accurate tax transcripts and W-2 forms by November 1 as required by these rules, then the Division may:

a. Remove their gross income from self-employment from any active claim;

b. Exclude gross income from self-employment from new claims for the entire period of time the tax transcripts and W-2 forms are due and absent; and

c. Assess a fine against the individual in an amount up to $500.00.

4. If the Division imposes a consequence described in Section 1.3.2.D.3 above, it shall withdraw that consequence if it receives the required tax transcripts and W-2 forms by December 1 of the following year.

3. All individuals electing coverage must report wages and remit premium payments quarterly, no later than the last day of the month immediately following the end of the calendar quarter for which the premiums have accrued. The Division may require additional information or documentation from any individual electing coverage in order to determine or verify wages or other information.

7 CCR 1107-1.3

44 CR 23, December 10, 2021, effective 1/1/2022

45 CR 23, December 10, 2022, effective 12/30/2022

46 CR 17, September 10, 2023, effective 1/1/2024

47 CR 23, December 10, 2024, effective 1/1/2025