N.J. Admin. Code § 17:9-6.7

Current through Register Vol. 56, No. 21, November 4, 2024

Section 17:9-6.7 - Coverage for PFRS and SPRS accidental death benefit recipients

(a) For the purposes of this section, "eligible person" means the surviving spouse, eligible partner pursuant to 17:1-5.5 and child, as defined in 43:16A-1, of a member of the Police and Firemen's Retirement System, to or for whom an accidental death benefit is payable under 43:16A-10, and the surviving spouse, eligible partner and child, as defined in 53:5A-3, of a member of the State Police Retirement System, to or for whom an accidental death benefit is payable under 53:5A-14.

(b) An eligible person may participate in the SHBP regardless of whether the member's employer is a participating employer. The premiums for the coverage shall be paid by the State of New Jersey, as provided in P.L. 1989, c. 271.

(c) Persons eligible to participate in the program under this section shall participate in the retiree group. If there is a surviving spouse or eligible partner, eligible children shall participate as dependents of the surviving spouse or partner. If there is no surviving spouse or partner, eligible children shall participate as members of the program, and their eligibility to participate shall continue, as long as they qualify as children under the laws governing the retirement system of the deceased member.

(d) An eligible person, as defined in (a) above, shall be eligible for coverage under the program as of February 1, 1990, or the effective date for an accidental death benefit under the retirement system of the deceased member, whichever is later. An eligible person shall receive a refund for premiums paid for health insurance coverage comparable to that provided under the program for the period from the date of eligibility for coverage under this section and the effective date of enrollment, but the refund shall not exceed the cost of the coverage under the program. An eligible person who is covered under Part B of the Federal Medicare program shall receive a refund for the amount paid for Part B. While an application for an accidental death benefit is pending, an eligible person enrolled in the program may continue coverage on a direct payment basis. If an accidental death benefit is granted, the eligible person shall receive a refund of the payments made.

N.J. Admin. Code § 17:9-6.7

New Rule, R.1990 d.481, effective 10/1/1990.
See: 22 N.J.R. 1903(b), 22 N.J.R. 3158(c).
Amended by R.2003 d.437, effective 11/3/2003.
See: 35 N.J.R. 2587(a), 35 N.J.R. 5149(a).
In (a), substituted "surviving spouse" for "widow or widower" preceding "and child"; in (c), deleted references to widow or widower.
Amended by R.2005 d.187, effective 6/20/2005.
See: 37 N.J.R. 397(a), 37 N.J.R. 2212(b).
In (a), substituted "surviving spouse, eligible domestic partner pursuant to N.J.A.C. 17:1-5.5 and child" for "surviving spouse and child" preceding ", as defined in N.J.S.A. 43:16A-1" and inserted "eligible domestic partner" preceding "and child, as defined in N.J.S.A. 53:5A-3"; in (c), inserted references to domestic partners following references to spouses throughout.
Amended by R.2009 d.150, effective 5/4/2009.
See: 41 N.J.R. 101(a), 41 N.J.R. 2037(a).
In (a) and (c), deleted "domestic" preceding "partner" throughout; in (b), substituted "SHBP" for "State Health Benefits Program" and "c. 271" for "c.271"; and in (c), inserted a comma following "continue".