New Jersey Administrative Code
Title 17 - TREASURY - GENERAL
Chapter 9 - STATE HEALTH BENEFITS PROGRAM
Subchapter 6 - RETIREMENT
Section 17:9-6.1 - Retired employee defined
Current through Register Vol. 56, No. 6, March 18, 2024
(a) "Retired employee" means a person who is eligible for coverage under the SHBP's retiree group. This "retired employee" status, once established, shall continue in effect even if the employer is subsequently disbanded and no successor agency is created upon the dissolution of such employer.
(b) The definition of "retired employee" also includes the following classes of retired employees who are eligible for coverage:
(c) "Retired employee" also means an employee whose coverage terminated prior to retirement, if that employee is awarded a disability retirement allowance under the PFRS, SPRS, or JRS, or under the PERS or TPAF, if enrolled prior to May 21, 2010. Eligibility for retired coverage in the SHBP shall begin on the employee's retirement date, but should the approval of the retirement allowance be delayed, coverage shall not be retroactive for more than one year.
(d) The definition of "retired employee" shall include the spouse or eligible domestic or civil union partner of an active or retired employee, provided the spouse or eligible partner was covered as a dependent under the SHBP immediately preceding the death of the active or retired employee, and further provided that in the case of death of an active employee, the spouse or eligible partner is receiving a periodic pension or survivorship benefit from a State or locally administered retirement system or plan.
(e) The definition of "retired employee" shall also include the spouse or eligible partner of the employee, provided the spouse or partner was eligible for coverage immediately preceding retirement and is enrolled for coverage when the employee retires or is added to coverage pursuant to 17:9-6.3(a).
(f) The definition of "retired employee" shall include an employee who is eligible to receive a Federal pension based upon employment with the Cooperative Extension service staff of Rutgers University. This coverage is contingent upon the employee applying for and receiving a Federal pension immediately following the cessation of employment and further provided that the pension to which the employee is entitled is being granted by reason of age or disability and coverage based on employment with Rutgers University.
(g) The definition of "retired employee" shall also include an employee who is eligible to receive a monthly annuity or long-term disability benefits based on the employee's participation in the New Jersey Alternate Benefit Program, provided the employee who is receiving a monthly annuity applied for and began receiving the annuity immediately following the termination of employment in a position covered by the Alternate Benefit Program.
(h) The definition of "retired employee" shall also include an employee who enrolled in the PERS or TPAF on or after May 21, 2010, and who is approved for long-term disability benefits under P.L. 2010, c. 3, provided the member meets all other eligibility requirements.
(i) The definition of "retired employee" shall include any former employee, who retired from a State or locally administered retirement system or the spouse or eligible partner of the former employee of an employer who becomes a participating employer if the employee, spouse or eligible partner:
(j) The definition of "retired employee" shall include an employee who is eligible for continuation of coverage in the SHBP at the time of retirement who waives coverage at that time, or at a later date, because the employee has health benefit coverage (active or retired) through an employer or eligible retiree association as a dependent or as an active employee and who applies for continuation of coverage within 60 days after termination of coverage as a dependent or active employee. An eligible retiree association is an association whose membership is limited based on the employment of the employee or the employee's dependent. A certificate of continued coverage or employer or association letter certifying when coverage terminated must accompany the retiree application.
(k) The definition of "retired employee" shall not include an employee who on cessation of employment, elects a vested, deferred retirement benefit under which payments begin at a future date unless that employee is eligible for coverage under the provisions of P.L. 1987, c. 384 or P.L. 1992, c. 126 (52:14-17.3 2f and 52:14-17.3 2f1).
(l) The employer liability for payments on behalf of eligible retired employees, which includes those employees who are eligible to receive long-term disability benefits, is payable in accordance with the provisions of 52:14-17.32 , 52:14-17.38, 18A:66-39.1, and 43:15A-42.1.