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<h2 class="fw4 ma0">Section 218 Agreements</h2>
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<a class="js-toggle-link
bg-ocean-blue-500 hover-teal white" href="#!">What is a Section 218 Agreement?</a><section class="js-toggle-content">
<p>A Section 218 Agreement is a voluntary agreement
between the State and the Social Security Administration (SSA) to provide Social Security and Medicare Hospital Insurance (HI) or Medicare HI-only
coverage for State and local government employees. These agreements are called "Section 218" Agreements because they are authorized by
<a href="https://www.ssa.gov/OP_Home/ssact/title02/0218.htm">Section 218 of the Social Security Act</a>. Section 218 Agreements are irrevocable.
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<a class="js-toggle-link
bg-ocean-blue-500 hover-teal white" href="#!">Who has a Section 218 Agreement?</a><section class="js-toggle-content">
<p>All States, including the 50 states, Puerto Rico, the Virgin Islands, and approximately 60 interstate instrumentalities have a Section 218 Agreement with SSA. These agreements allow the States, if they desire, to provide Social Security and Medicare Hospital Insurance (HI) or Medicare HI-only coverage for public employees.
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<a class="js-toggle-link
bg-ocean-blue-500 hover-teal white" href="#!">How are employees covered under a Section 218 Agreement?</a><section class="js-toggle-content">
<p>Section 218 Agreements cover positions not individuals. If the position is covered for Social Security and Medicare under a Section 218 Agreement, then any employee filling that position is subject to Social Security and Medicare taxes. Employees covered under a Section 218 Agreement have the same coverage and benefit rights as employees in the private sector. </p>
<p>Public employees are brought under a Section 218 Agreement in groups known as coverage groups. There are two basic coverage groups: absolute coverage groups and retirement system coverage groups. An absolute coverage group is composed of employees whose positions are not covered under a public retirement system. A retirement system coverage group is composed of employees whose positions are covered under a public retirement system. </p>
<p>A public retirement system may be covered under a Section 218 Agreement only after a referendum is held. All States are authorized to use the majority vote referendum process. If a majority of all the eligible members vote in favor of coverage, all current and future employees in positions under the retirement system will be covered. </p>
<p>In addition to the majority vote referendum procedure, certain States and all interstate instrumentalities are authorized to divide a retirement system based on whether the employees in positions under the retirement system want coverage. Under the divided vote referendum, only those employees who vote &quot;yes&quot; and all future employees who become members of the retirement system will be covered. Members who vote &quot;no&quot; are not covered as long as they maintain continuous employment in a position within the same public retirement system coverage group.</p>
<p>Although the referendum itself is a State matter, Section 218 of the Act requires that certain conditions be met. </p>
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<a class="js-toggle-link
bg-ocean-blue-500 hover-teal white" href="#!">Can a Section 218 Agreement exclude certain employees?</a><section class="js-toggle-content">
<p>Under the Act, certain employee services are mandatorily excluded from Social Security coverage under a Section 218 Agreement. In addition, certain services and positions may, if requested by the State, be excluded from Social Security coverage under the State's Section 218 Agreement (optional exclusions). The services that a State may optionally exclude are limited to those listed as optional exclusions in Section 218 of the Act.</p>
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<a class="js-toggle-link
bg-ocean-blue-500 hover-teal white" href="#!">Who is the State Social Security Administrator?</a><section class="js-toggle-content">
<p>Each State has a designated official, the <a href="state_ssa.htm">State Social Security Administrator</a>, who is responsible for administering the State's Section 218 Agreement and supervising the referendum process. The State Administrator provides public employers information and advice about Social Security and Medicare coverage for State and local government
employees. Contact the <a class="disclaimer" href="http://ncsssa.org/statessadminmenu.html">State Administrator for your State</a></p>
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<p>&#149; <a href="https://www.ssa.gov/OP_Home/ssact/title02/0218.htm">Section
218 of the Social Security Act</a><br>
&#149; <a href="https://www.ssa.gov/OP_Home/cfr20/404/404-1200.htm">SSA
Regulations 20 CFR 404.1200</a><br>
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