SENATE, No. 2334
STATE OF NEW JERSEY
INTRODUCED DECEMBER 1, 1997
By Senators KYRILLOS and KENNY
An Act concerning health benefits coverage under the State Health Benefits Program of certain retired members of the Police and Firemen's Retirement System of New Jersey and the Public Employees' Retirement System of New Jersey and supplementing P.L.1961, c.49 (C.52:14-17.25 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. A qualified retiree from the Police and Firemen's Retirement System of New Jersey (C.43:16A-1 et seq.), and a qualified retiree from the Public Employees' Retirement System of New Jersey (C.43:15A-1 et seq.) whose service was as a law enforcement officer as defined in section 1 of P.L.1955, c.257 (C.43:15A-97) or as a policeman as defined in section 1 of P.L.1944, c.255 (C.43:16A-1), and dependents of a qualified retiree, including surviving dependents, are eligible to participate at any time in a State managed care plan for retirees in the program, regardless of whether the retiree's employer participated in the program.
A qualified retiree is a retiree who:
(1) retired on a benefit based on 25 or more years of service credit; or
(2) retired on a disability retirement based on fewer years of service credit.
A retiree who elected deferred retirement is not a qualified retiree.
b. A State managed care plan for retirees is a State managed care plan which:
(1) provides services in the 21 counties in the State through a network of doctors and other providers, with no deductible for services provided in the network; and
(2) provides for payment or reimbursement for services and supplies obtained outside the network.
The program shall reimburse a qualified retiree, or a surviving dependent of a qualified retiree, who participates in the State managed care plan for retirees in the program for the premium charges under Part B of the federal Medicare program for the retiree and the retiree's spouse.
A qualified retiree, or a surviving dependent of a qualified retiree, shall pay 20 percent of the premium or periodic charges of the State managed care plan for retirees for benefits provided to a qualified retiree and the dependents of the retiree, or surviving dependents, as the case may be. The State shall pay 80 percent of the premium or periodic charges of the State managed care plan for retirees for benefits provided to a qualified retiree and the dependents of the retiree, or surviving dependents, as the case may be, and the full cost for reimbursement of Medicare premiums.
If a qualified retiree, or a surviving dependent of a qualified retiree, shall elect to participate in the traditional plan of the program, the retiree or surviving dependent shall pay, in addition to the amount specified above, the amount of the difference between the cost of the premium or periodic charges for the traditional plan and the premium or periodic charges of the State managed care plan for retirees.
c. The State Health Benefits Commission shall annually certify to the State the cost for providing health benefits coverage to qualified retirees and their dependents, or surviving dependents, as the case may be, under this section. The State shall annually remit to the commission the amount certified at a time specified by the State Treasurer.
d. The provisions of this section shall not apply to (1) a retired State employee whose premium or periodic charges for benefits under the program are paid by the State pursuant to section 8 of P.L.1961, c.49 (C.52:14-17.32) or section 6 of P.L.1996, c.8 (C.52:14-17.28b); (2) a retiree whose premium or periodic charges for benefits under the program are paid by an employer other than the State pursuant to section 7 of P.L.1964, c.125 (C.52:14-17.38); (3) a retiree whose health care benefits are paid by an employer other than the State pursuant to N.J.S.40A:10-23; and (4) a retiree whose health care benefits were paid by an employer other than the State pursuant to section 7 of P.L.1964, c.125 (C.52:14-17.38) or N.J.S.40A:10-23 commencing prior to January 1, 1997, and are so paid on the effective date of P.L. , c. (C. ) (now pending before the Legislature as this bill).
2. The commission shall enter into a contract under the "New Jersey State Health Benefits Program Act," P.L.1961, c.49 (C.52:14-17.25 et seq.) for a State managed care plan for retirees in the program pursuant to section 1 of P.L. , c. (C. ) (now pending before the Legislature as this bill), for which the premium or periodic charges shall not be greater than the average of the premiums or periodic charges of the State managed care plans of the program.
3. This act shall take effect on the first day of the fourth month following enactment.
STATEMENT
This bill provides post-retirement health care benefits in a State managed care plan for retirees in the State Health Benefits Program (SHBP) to a qualified retiree from the Police and Firemen's Retirement System, and a qualified retiree from the Public Employees' Retirement System whose service was in law enforcement, and dependents of a qualified retiree, including surviving dependents, at any time, regardless of whether the retiree's employer participated in the program.
The bill defines a qualified retiree as a retiree who (1) retired on a benefit based on 25 or more years of service credit; or (2) retired on a disability retirement based on fewer years of service credit. A retiree who elected deferred retirement is not a qualified retiree. A State managed care plan for retirees is defined as a State managed care plan which provides services in the 21 counties in the State through a network of doctors and other providers, with no deductible for services provided in the network, and provides for payment or reimbursement for services and supplies obtained outside the network.
The bill provides that (1) a qualified retiree, or a surviving dependent of a qualified retiree, shall pay 20 percent of the premium or periodic charges of the State managed care plan for retirees; (2) SHBP shall reimburse a qualified retiree, or a surviving dependent of a qualified retiree, for Part B Medicare premium charges; and (3) the State shall pay 80 percent of the premium or periodic charges of the State managed care plan for retirees and the full cost for reimbursement of Medicare premiums. The bill also provides that if a qualified retiree, or a surviving dependent of a qualified retiree, shall elect to participate in the SHBP traditional plan, the retiree or surviving dependent shall pay, in addition, the amount of the difference between the cost of the premium or periodic charges for the traditional plan and the premium or periodic charges of the State managed care plan for retirees.
The provisions of this bill, however, shall not apply to (1) a retired State employee whose premium or periodic charges for benefits under the program are paid by the State pursuant to N.J.S.A.52:14-17.32 or N.J.S.A.52:14-17.28b; (2) a retiree whose premium or periodic charges for benefits under the program are paid by an employer other than the State pursuant to N.J.S.A.52:14-17.38; (3) a retiree whose health care benefits are paid by an employer other than the State pursuant to N.J.S.A.40A:10-23; and (4) a retiree whose health care benefits were paid by an employer other than the State pursuant to N.J.S.A.52:14-17.38 or N.J.S.A.40A:10-23 commencing prior to January 1, 1997 and are so paid on the effective date of the bill.
The bill requires that SHBP enter into a contract for a State managed care plan for retirees for which the premium or periodic charges shall not be greater than the average of the premiums or periodic charges of the other SHBP State managed care plans.
Provides contributory SHBP managed care plan to certain PFRS and PERS retirees.