New Jersey Administrative Code
Title 17 - TREASURY - GENERAL
Chapter 9 - STATE HEALTH BENEFITS PROGRAM
Subchapter 7 - TERMINATION
Section 17:9-7.3 - Continuation of coverage
Universal Citation: NJ Admin Code 17:9-7.3
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The coverage of an employee, and an employee's dependents, may be continued if:
1. The employee has an award pending or
received an award of periodic benefits under Workers' Compensation and the
employee is not otherwise covered as an employee or retiree under the SHBP. The
employee may continue coverage and the coverage of the employee's dependents,
provided that the employee shall pay to the employer in advance that portion,
if any, of the charges due from the employee to continue the
coverage;
2. The employee is on an
approved leave of absence without pay. The coverage of such employee and such
employee's dependents may be continued by such employee, provided that the
employee shall pay in advance the total charge required for the employee's
coverage and coverage of the employee's dependents during such period of
authorized leave of absence without pay; provided that no period of continued
coverage, as provided above, shall exceed a total of 20 biweekly payroll
periods, or nine months, during which the employee receives no pay. After the
20 biweekly payroll periods, or nine months, the employee may continue coverage
through COBRA for the remaining balance of the COBRA continuation period;
or
3. The employee is on an
approved State or Federal Family Leave.
i. The
State Family Leave Act (34:11B-1 et seq.)
entitles an employee to continue 12 weeks of SHBP coverage in any 24-month
period at the expense of their employer. This includes all health care
benefits, including Prescription Drug, Dental and Vision Care benefits if the
employer provides them. State Family Leave includes leave from employment to
provide care for the birth or adoption of a child, or the serious illness of a
child, parent, spouse or partner. It does not provide for a leave due to the
personal illness of the employee.
ii. The Federal Family Leave Act (Family and
Medical Leave Act of 1993,
29 U.S.C. §§
2601 et seq.) has benefits similar to the
State Family Leave Act with the exception that the Federal act also requires
that leave be permitted for the employee's own serious illness of up to 12
weeks in any 12-month period.
iii.
In cases where the employee on an approved Family Leave has a deduction, the
employer must make arrangements with the employee to receive direct payment for
the required employee contribution. If the SHBP does not receive full payment
from the employer, then the employee's benefit coverage will be terminated
under the termination provisions of the SHBP program.
iv. The time an employee spends on Federal or
State family leave shall not count as part of the COBRA eligibility period
should an employee receive approval from their employer to extend the
leave.
Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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