Provides health care benefits to disabled members of TPAF and PERS.
What changed between versions
New Section 1 provides free health coverage under the School Employees Health Benefits Program for disabled TPAF members (and PERS members of boards of education or county colleges) who were already receiving benefits before January 1, 2027, with no employee contribution requirement.
New Section 5 creates a framework for disabled TPAF and PERS (board of education/county college) members who begin receiving benefits on or after January 1, 2027: non-Medicare-eligible members may enroll in the NJ Educators Health Plan or Garden State Health Plan but must pay monthly contributions calculated using their disability benefit as base salary; Medicare-eligible members must switch to the School Employees Health Benefits Program and also pay contributions.
New Section 6 creates a parallel framework for disabled PERS State employees who begin receiving benefits on or after January 1, 2027: non-Medicare-eligible members may enroll in PPO or Tiered Network plans paying contributions based on the rate applicable to retirees with 25 years of service; Medicare-eligible members must enroll in the State Health Benefits Program.
New Section 1(b) and 2(b) require the program to refund premiums actually paid by eligible disabled members on or after January 1, 2024 but before the bill's effective date while they were receiving disability benefits.
The destination of the insurance company's payment of the employee contribution amount changed: it is now paid 'to the insurer or insurers for the member's retirement annuity' rather than 'into the Teachers' Pension and Annuity Fund' (or PERS).
New Sections 5(e) and 6(c) establish a non-payment enforcement mechanism: the Division of Pensions and Benefits must notify the member, allow 30 days to pay, then issue a termination notice. Coverage terminates on the last day of the month for which premiums were paid.
The appeals process in both Section 10(j) and Section 11(j) was expanded from covering only disputes about ability to return to employment and physical examinations to also cover eligibility for disability insurance coverage and eligibility for health care benefits coverage including required contributions.
In both Section 10(f) (TPAF) and Section 11(f) (PERS), the phrase 'other than health insurance' was removed from the list of periodic benefits that reduce the monthly disability benefit. This means health insurance costs can now reduce the amount of the disability benefit a member receives.
The provision stating 'For pension purposes, the member shall be considered as if the member was in active service for the duration of the time the disability benefit is received' was removed from both Section 10(f) and Section 11(f). Disabled members will no longer accrue service credit during their disability period.
Section 10(i) was rewritten so that disabled members who begin receiving benefits on or after January 1, 2027 no longer automatically receive free state-provided health coverage. Instead they must enroll under the School Employees Health Benefits Program in accordance with Section 5 of this bill, which requires them to pay contributions.
Section 11(i) was restructured into two subsections: non-State PERS employees keep employer-provided health coverage (same as retirees), while State PERS employees who begin benefits on or after January 1, 2027 must enroll in the State Health Benefits Program under Section 6 of this bill and pay contributions.
