New Jersey Administrative Code
Subchapter 2 - COVERAGE
Section 17:9-2.2 - Enrollment form

Universal Citation: NJ Admin Code 17:9-2.2

Current through Register Vol. 55, No. 48, December 18, 2023

(a) Within 60 days of the time an employee first becomes eligible to apply for coverage, the employee shall file a completed enrollment form indicating the employee's election to enroll or not to enroll for coverage on the employee's own behalf; and the employee's election to enroll or not to enroll any eligible dependents for coverage under one of the SHBP options. A dependent must be listed on the enrollment form to be enrolled for coverage. Appropriate legal documentation, as described in 17:9-3.3(a) , verifying the dependent's relationship with the subscriber is required before enrollment is approved. If more than 60 days have passed since first eligible for enrollment, then the enrollment form shall not be processed and will be returned to the employer. The employee may then file the enrollment form during the next open enrollment period with coverage to be effective according to the schedule for that open enrollment period.

(b) For Chapter 375 dependents, enrollment shall also occur in accordance with 17:9-13.2 .

(c) For overage dependents with disabilities, enrollment shall also occur in accordance with 17:9-3.4 .

Amended by 48 N.J.R. 2387(a), effective 11/7/2016

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