New Jersey Administrative Code
Title 17 - TREASURY - GENERAL
Chapter 9 - STATE HEALTH BENEFITS PROGRAM
Subchapter 3 - DEPENDENTS
Section 17:9-3.4 - Children with disabilities age 26 or older; determination of eligibility for continuation of coverage
Current through Register Vol. 56, No. 6, March 18, 2024
(a) The determination as to the continuation of certain children with disabilities as "dependents" as defined by 17:9-3.1 shall be made by the SHBP's medical advisors. A form requesting continuance of enrollment for an eligible dependent with disabilities must be submitted to the SHBP no later than January 31 of the year following the calendar year in which the child attained the age of 26.
(b) Children with disabilities who are age 26 or older at the time their parents obtain coverage under the SHBP who are determined by the SHBP's medical advisors to be incapable of self-sustaining employment by reason of mental or physical disabilities and who meet the requirements of "dependents" as defined by 17:9-3.1 , shall not be enrolled for coverage as "dependents" as defined by N.J.A.C. 17:9- 3.1, unless:
(c) SHBP or SEHBP coverage for an overage child with disabilities must be continuous. If the member waives coverage or removes the child from coverage for any reason, the child may not be added again at a later date. This includes cases where an employee waives active coverage and resumes coverage as a retiree.