New Jersey Administrative Code
Title 17 - TREASURY - GENERAL
Chapter 9 - STATE HEALTH BENEFITS PROGRAM
Subchapter 6 - RETIREMENT
Section 17:9-6.9 - Eligibility for State payment of retiree coverage under P.L. 1997, c. 330
Current through Register Vol. 56, No. 6, March 18, 2024
(a) For the purposes of this section, "qualified retiree" means a person who:
(b) Pursuant to P.L. 1997, c. 330 (52:14-17.32i et seq.), a qualified retiree and his or her eligible dependents, as defined in section 2 of P.L. 1961, c. 49 (52:14-17.26 ), but not survivors, are eligible to participate in the SHBP in accordance with the laws and rules governing the program, regardless of whether the retiree's employer participated in the program, and for State payment of an amount of the premium or periodic charges for the category of coverage elected by the qualified retiree equal to 80 percent of the premium or periodic charges for that category of coverage under the least expensive premium for a State-managed care plan or health maintenance organization, which provides services in the 21 counties of the State.
(c) The following persons are not eligible for benefits under P.L. 1997, c. 330 (52:14-17.3 2i et seq.).
(d) A qualified retiree who is ineligible for benefits under 52:14-17.3 2i et seq. because of employer payment for retiree coverage under (c)4 above or receipt of health benefits coverage in connection with employment after retirement under (c)5 above, shall be eligible for the benefits after termination of employer payment for retiree coverage or employer coverage if the retiree applies to the SHBP for the benefits within 60 days after the effective date of termination of employer payment or coverage. A certificate of continued coverage or employer letter certifying when coverage terminated must accompany the retiree application.
(e) The surviving spouse or eligible partner of a retiree who was eligible or was enrolled for benefits under 52:14-17.3 2i et seq., shall be eligible to continue coverage, at full cost, in the SHBP. If the deceased retiree would have been eligible for such coverage but was not enrolled due to active health benefit coverage as an employee or dependent, the surviving spouse or eligible partner may enroll in the SHBP, on a prospective basis, within six months after the retiree's death. The surviving spouse or eligible partner must inform the SHBP that they wish to enroll for coverage and must fill out an enrollment form and pay the required premiums before coverage may become effective.
(f) A qualified retiree who waives coverage at retirement, or at a later date, due to health benefit coverage (active or retired) through an employer as a dependent shall be eligible for the benefits after termination of dependent coverage if the retiree applies to the SHBP for the benefits within 60 days after the effective date of termination of dependent coverage. A certificate of continued coverage or employer letter certifying when coverage terminated must accompany the retiree application.
(g) A qualified retiree is required to make a minimum contribution of 1.5 percent of the retiree's monthly retirement allowance.
(h) Employers are not permitted to reimburse an eligible retired member for the member's share of the Chapter 330 coverage costs; members who receive such a reimbursement will be disqualified from receiving coverage under 52:14-17.32i .