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Firefighter Cardiac Benefit Program Guidelines

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Approved by the DOLA Executive Director: March 7, 2017

As of July 1, 2014, the Department of Local Affairs (DOLA) is responsible for administering the Firefighter Heart and Circulatory Malfunction Benefits (FCB) Fund. Beginning January 1, 2015, DOLA will reimburse qualifying employers for the costs of maintaining insurance coverage or alternate plans to provide the benefits required by CRS 29-5-302 to qualifying covered individuals. Moneys in the FCB Fund will be used to reimburse employers for the direct costs of maintaining insurance coverage or alternate plans required by Senate Bill 14-172.

For as long as there are sufficient moneys in the FCB Fund, this program is designed to reimburse any qualifying employer that employs one or more qualifying covered individuals for the direct costs of maintaining an insurance coverage or alternate plan that provides the required heart and circulatory malfunction benefits. To obtain such a plan, the employer must participate in a multiple employer health trust except for those exempted by Senate Bill 24-089.

These Standard Operating Guidelines have been established to assist DOLA staff with administering the FCB Program. These Guidelines also provide guidance and instructions to employers when submitting reimbursement requests to DOLA via the e-filing portal.

Program Eligibility

The following entities are eligible to receive reimbursement as “employers” under the FCB Program:

  • A municipality that employs one or more covered individuals;
  • A special district that employs one or more covered individuals;
  • A fire authority that employs one or more covered individuals; or
  • A county improvement district that employs one or more covered individuals.

To be qualified as a “covered individual” for purposes of the FCB Program, an individual must:

  • Be an active employee of an employer;
  • Be a full-time, part-time, or volunteer employee of an employer who regularly works at least one thousand six hundred (1600) hours in any calendar year;
  • Perform duties that are directly involved with the provision of fire protection services; and
  • Have at least five years of continuous full-time, part-time or volunteer employment with an employer.

For each online reimbursement request, the employer is required to certify that it is seeking reimbursement for direct costs incurred to provide the benefits required by CRS 29-5-302 only to qualified covered individuals.

For each online reimbursement request, the employer is required to certify that the benefits offered to the qualified covered individual(s) meet all of the minimum requirements of CRS 29-5-302.

DOLA reserves the right to conduct onsite document review with employers to ensure reimbursements from the FCB Fund are provided to only those employers offering the benefits as required by CRS 29-5-302 to qualified covered individuals.

List of Stakeholders

  • Colorado Division of Fire Prevention & Control
  • Colorado Professional FF Association
  • Colorado State FF Association
  • Colorado State Fire Chiefs Association
  • Colorado Municipal League
  • Special District Association of Colorado
  • Colorado Counties Inc.
  • PRIMA –Colorado Chapter

Forms

FCB Reimbursement Instructions - Firefighter Heart and Circulatory Malfunction Benefits Fund W-9 - Request for Taxpayer Identification Number (TIN) Verification

Standard Operating Guidelines

Important Details

  • DOLA staff will review and evaluate online reimbursement requests submitted by qualified employers, process approved reimbursement payments, and assure adherence to these Standard Operating Guidelines. For purposes of administration, these Standard Operating Guidelines may be amended by Program staff with input from stakeholders and approval of the Executive Director of the Department of Local Affairs.
  • The FCB Fund does not pay individual firefighter’s insurance policies or claims.
  • Qualified firefighters with questions about their eligibility to collect benefits must speak with their employer. DOLA does not administer the actual benefits. Rather, DOLA only reimburses employers who are required to maintain insurance coverage or alternate plans to provide the benefits required by CRS 29-5-302 to qualifying firefighters.
  • The FCB Fund will reimburse employers for the direct costs of maintaining an insurance coverage or alternate plan required by CRS 29-5-302. For as long as there are sufficient moneys in the FCB Fund, this program is designed to reimburse any qualifying employer that employs one or more qualifying covered individuals for the direct costs of maintaining an insurance coverage or alternate plan that provides the required heart and circulatory malfunction benefits.
  • To obtain such a plan, the employer must participate in a multiple employer health trust. Senate Bill 24-089 exempts firefighter employers that are cities and counties or municipalities that have a population of 400,00 or more and, as of April 30, 2024, have enacted an ordinance to provide the required monetary benefits that remains in effect.
  • The FCB Program is not intended to pay for any insurance costs prior to the effective date of an insurance coverage or alternate plan that meets the minimum requirements of CRS 29-5-302(2).

Depleted Funds

If during the course of the State of Colorado’s fiscal year all of the moneys in the FCB Fund are depleted, then the insurance coverage or alternate plan required to be maintained by CRS 29-5-302 shall become optional pursuant to CRS 29-1-304.5. In such event, the employer may elect to obtain an insurance coverage or alternate plan to provide benefits for qualified firefighters after the date of depletion, but will not be reimbursed by DOLA for the costs of doing so. DOLA staff will post the up-to-date fund balance on the Firefighter Cardiac Benefit Program page.

Reimbursement Request

Proof of coverage must be provided for direct costs to be reimbursed and should accompany the online FCB reimbursement request. There must be an invoice for each insurance coverage or alternate plan purchased showing proof that includes the following:

  • the employer name
  • coverage or alternate plan name
  • coverage plan # and effective date
  • coverage period
  • description of insurance coverage or alternate plan type showing compliance with CRS 29-5-302(2)
  • dollar amount of benefits
  • # of qualified firefighters covered
  • cost to employer to provide benefits

Qualified employers are encouraged to submit a request for reimbursement within 90 days of the effective date of any insurance coverage or alternate plan purchased by the employer in order to increase the likelihood of funds being available for reimbursement.

Online FCB reimbursement requests may be submitted for insurance coverage or alternate plans with effective dates on or after July 1, 2014, however DOLA cannot reimburse employers for any direct costs incurred to obtain such plans until January 1, 2015.

DOLA will process completed online FCB reimbursement requests in the order that they are received. A reimbursement request is considered “completed” for purposes of processing by DOLA if no further clarifying information or supporting documentation is required by DOLA.

Application Timelines

DOLA will reimburse employers with moneys from the FCB Fund based on the State of Colorado’s fiscal year, which runs from July 1 to June 30 of the subsequent calendar year (e.g. July 1, 2016 through June 30, 2017). All completed online FCB reimbursement requests for any insurance coverage or alternate plan with an effective date during the prior state fiscal year must be submitted online to DOLA no later than July 10 of the following state fiscal year. Requests for reimbursements for the prior state fiscal year submitted after July 10 of the following state fiscal year will be declined and may not be resubmitted.

Online FCB reimbursement requests may be declined if paid invoices or paid receipts have not been provided by the employer. DOLA staff will contact the employer to request the appropriate documentation and will allow 30 days thereafter for submittal. If the requested information is not included with resubmission of the request, then DOLA’s staff will decline the employer’s request for reimbursement.

DOLA strongly recommends that employers submit all completed online FCB reimbursement requests for any insurance coverage or alternate plan with an effective date during the state fiscal year no later than May 1 of the same state fiscal year to avail themselves of the 30-day resubmission period, should their request be initially denied.

Employer’s Authorized Representative Requirements

For each online reimbursement request, the employer’s authorized representative is required to certify that the employer is either: (1) a municipality that employs one or more firefighters; (2) a special district that employs one or more firefighters; (3) a fire authority that employs one or more firefighters; or (4) a county improvement district that employs one or more firefighters.

For each online reimbursement request, the employer’s authorized representative is required to certify that the employer is seeking reimbursement for the direct costs of obtaining an insurance coverage or alternate plan that provides the benefits required by CRS 29-5-302 only to qualified covered individuals. If employers require qualified covered individuals to pay for a portion of the insurance coverage or alternate plan premium, then employers may seek reimbursement only for the employers’ portion of the insurance coverage or alternate plan premium. For example, if the premium to obtain an insurance coverage or alternate plan for each qualified covered individual is $150.00 total, the covered individual pays $75.00 and the employer pays $75.00, then the employer may seek reimbursement for only $75.00 per qualified covered individual covered by the plan.

For each online reimbursement request, the employer’s authorized representative is required to certify that the insurance coverage or alternate plan provides all of the minimum benefits required by CRS 29-5-302(2).

Each completed online FCB reimbursement request must be signed by the employer’s authorized representative using the DOLA ID credentials provided to employers.

Audits and Reviews

DOLA reserves the right to conduct onsite document review and audits of employers to ensure that reimbursements from the FCB Fund are provided to only qualified employers for the direct costs of obtaining insurance coverage or alternate plans that provide all of the minimum benefits required by CRS 29-5-302(2) to qualified covered individuals.

It is expected that the employer will maintain true and correct copies of any insurance coverage or alternate plan purchased and will be responsible for assisting DOLA staff as needed with the processing of any reimbursement requests. All records supporting a successful request for reimbursement must be kept and stored by the employer for a minimum of three years following the close of the state fiscal year during which the request was granted (e.g. if a reimbursement request was approved on 09/01/2015, records would need to be kept through June 30, 2019).

If an insurance coverage or alternate plan is canceled or terminated within the eligible coverage period, then the employer must notify DOLA immediately. Upon review, DOLA may request a refund for all, or a portion, of any reimbursement previously made to the employer.

Adherence to the timeframes set forth by these Standard Operating Guidelines is greatly encouraged.

Online Application Process

Electronic filing of FCB reimbursement requests is located on DOLA’s Firefighter Cardiac Benefit Program page. Please follow the online instructions and submit your reimbursement directly to DOLA via the e-filing system using the DOLA ID credentials provided in your letter. 

Contact Information

Please refer to the FCB program’s FAQs or contact:
Chris Ockwig
chris.ockwig@state.co.us
(720)795-8434