Bill Text: NJ A2185 | 2010-2011 | Regular Session | Introduced
Bill Title: Requires that public employees who are married, partners in civil union couples, or with domestic partners receive health care benefits from only one public employer.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2010-02-11 - Introduced, Referred to Assembly State Government Committee [A2185 Detail]
Download: New_Jersey-2010-A2185-Introduced.html
Sponsored by:
Assemblyman PAUL D. MORIARTY
District 4 (Camden and Gloucester)
SYNOPSIS
Requires that public employees who are married, partners in civil union couples, or with domestic partners receive health care benefits from only one public employer.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health care benefits provided by public employers to certain public employees, amending P.L.1961, c.49 and supplementing P.L.1979, c.391 (C.18A:16-12 et seq.) and chapter 10 of Title 40A of the New Jersey Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 7 of P.L.1961, c.49 (C.52:14-17.31) is amended to read as follows:
7. (a) The coverage provided solely for employees shall, subject to the provisions below, automatically become effective for all eligible employees from the first day on or after the effective date of the program on which they satisfy the definition of "employee" contained in this act. The commission shall establish the rules and regulations governing the enrollment and effective dates of coverage of dependents of employees it deems necessary or desirable. The rules and regulations shall not defer coverage with respect to any qualified dependent an employee has on the date the employee's employer becomes a participating employer, provided the employee was, immediately prior to the date, insured with respect to the dependent under a group major medical insurance plan of the employer which was in effect immediately prior to the date. Under the rules and regulations established by the commission, each employee shall be given the opportunity to enroll for coverage for dependents as of the earliest date the employee becomes eligible for enrollment. An employee may elect to enroll dependents for both basic coverage and major medical expense coverage but may not enroll for either coverage alone.
If, on the date coverage for an employee would become effective, the employee is not actively at work full-time at the customary place of employment or other location to which the employment requires the employee to travel, the employee shall not be covered until the employee is so actively at work, except the employee shall be covered, if on the date the employee's employer becomes a participating employer, the employee was, immediately prior to that date, insured under a group major medical insurance plan of the employer which was in effect immediately prior to that date.
In the event that the group major medical plan which covered an employee or dependents immediately prior to the date the employee's employer becomes a participating employer provides, after termination of coverage thereunder, any continuation of benefits for medical expenses for hospitalization, surgery, medical treatment or any related service or supply, or would so provide in the absence of coverage pursuant to this act, no coverage shall be afforded pursuant to this act for any such expenses (i) which are covered, or which would be covered in the absence of coverage pursuant to this act, in whole or in part, by the prior insurance plan or (ii) which may be used in satisfaction of any deductible requirement under the prior insurance plan to establish entitlement to the continuation of benefits.
Each employee shall furnish the Division of Pensions and Benefits, in the prescribed form, the information necessary on account of the employee's own coverage and necessary to enroll dependents. Any employee not desiring coverage at the time the employee first becomes eligible, shall give the division written notice of that fact in the form prescribed by the division. The employee may not enroll thereafter except at the times and under the conditions prescribed by the commission.
If an employee of an employer other than the State eligible for coverage has a spouse who is also an employee of an employer other than the State eligible for coverage, the spouse may elect single coverage as an employee and enroll as a dependent, in which event no coverage shall be provided for such spouse as an employee while covered as a dependent. The employee of an employer other than the State, who has enrolled such spouse, and who is required to pay the full cost of dependent coverage, may receive a refund from the State Division of Pensions and Benefits equivalent in amount to the employer's cost for an employee's coverage. When both husband and wife are covered as employees, only one may enroll for their children as dependents.
A similar refund shall be authorized pursuant to such rules and regulations as the commission deems necessary or desirable in the case of an employee of an employer other than the State who is paying the full cost of dependent coverage for a spouse who is an employee of the State and eligible for coverage.
If a husband and wife are both eligible for coverage under the program as employees:
a. each may elect coverage for himself or herself as an employee and for their qualified dependents, including the spouse, under the traditional plan or the State managed care plan, but only one may elect coverage for himself or herself and for their qualified dependents, including the spouse, in a participating health maintenance organization; and
b. each may elect single coverage in any participating health maintenance organization, provided that he or she is not covered under the participating health maintenance organization as a dependent of his or her spouse.
Any person employed as a substitute teacher by a school district and who provides evidence of coverage under another health benefits program may waive coverage for the current school year on or after the date on which the person becomes an employee eligible for coverage.
(b) Notwithstanding the provisions of subsection a. of this section or any other provision of law to the contrary, if an employee of the State or of an employer other than the State is otherwise eligible on or after the effective date of P.L. , c. (pending before the Legislature as this bill) to enroll for coverage but has a spouse, a partner in a civil union couple, or a domestic partner who is already enrolled as an employee of the State, a board of education or a local government unit or agency thereof for coverage under this program or under another health care benefits plan or program provided by the employer of the spouse, partner in a civil union couple, or domestic partner, the employee shall not be enrolled for coverage under this program for himself or herself as an employee of the State or of an employer other than the State as long as the spouse, partner in a civil union couple, or domestic partner is enrolled for coverage and enrollment of the employee as a dependent is an available option under the plan or program covering the spouse, partner in a civil union couple, and domestic partner. This provision shall apply without regard to any cost imposed upon the employee for such dependent coverage.
Commencing in the 25th month following the effective date of P.L. , c. (pending before the Legislature as this bill), an employee and the employee's spouse, partner in a civil union couple, or domestic partner who were enrolled before that effective date for health care benefits coverage as employees of the State, a board of education, or a local governmental unit or agency thereof shall be enrolled only for employee and dependent coverage in one plan or program provided by one public employer as required above, in accordance with procedures developed and implemented by the commission and the division.
(cf: P.L.2007, c.103, s.25)
2. (New section supplementing P.L.1979, c.391; C.18A:16-12 et seq.) If an employee of a board of education is otherwise eligible on or after the effective date of P.L. , c. (pending before the Legislature as this bill) to enroll for health care benefits coverage provided by the board as an employer but has a spouse, partner in a civil union couple, or domestic partner who is already enrolled as an employee of a board of education, the State, or a local government unit or agency thereof for health care benefits coverage under the State Health Benefits Program or under another plan or program provided by the employer of the spouse, partner in a civil union couple, or domestic partner, the employee shall not be enrolled for coverage for himself or herself as an employee of the board as long as the spouse, partner in a civil union couple, or domestic partner is enrolled for coverage and the enrollment of the employee as a dependent is an available option under the plan or program covering that spouse, partner in a civil union couple, or domestic partner. This provision shall apply without regard to any cost imposed upon the employee for such dependent coverage.
Commencing with the 25th month following the effective date of P.L. , c. (pending before the Legislature as this bill), an employee and the employee's spouse, partner in a civil union couple, or domestic partner who were enrolled before that effective date for health care benefits coverage as employees of a board of education, the State, or a local governmental unit or agency thereof shall be enrolled only for employee and dependent coverage in one plan or program provided by one public employer as required above, in accordance with procedures developed and implemented by the board of education.
3. (New section supplementing chapter 10 of Title 40A of the New Jersey Statutes) If an employee of a local government unit or agency thereof is otherwise eligible on or after the effective date of P.L. , c. (pending before the Legislature as this bill) to enroll for health care benefits coverage provided by the unit or agency as an employer but has a spouse, a partner in a civil union couple, or a domestic partner who is already enrolled as an employee of a local government unit or agency thereof, the State, or a board of education for health care benefits coverage under the State Health Benefits Program or under another plan or program provided by the employer of the spouse, partner in a civil union couple, or domestic partner, the employee shall not be enrolled for coverage for himself or herself as an employee of the unit or agency as long as the spouse, partner in a civil union couple, or domestic partner is enrolled for coverage and the enrollment of the employee as a dependent is an available option under the plan or program covering the spouse, partner in a civil union couple, or domestic partner.
Commencing with the 25th month following the effective date of P.L. , c. (pending before the Legislature as this bill), an employee and the employee's spouse, partner in a civil union couple, or domestic partner who were enrolled before that effective date for health care benefits coverage as employees of a local government unit or agency thereof, the State, or a board of education shall be enrolled only for employee and dependent coverage in one plan or program provided by one public employer as required above, in accordance with procedures developed and implemented by the unit or agency.
4. This act shall take effect on the first day of the second month following enactment, except that this act shall not be deemed to impair an obligation set forth in a collective negotiations agreement or an individual contract of employment in effect on the effective date.
STATEMENT
This bill prohibits the enrollment of a public employee, after the date on which the bill if enacted takes effect, for health care benefits coverage provided by the employing public entity if the employee has, at that time, a spouse, partner in a civil union couple, or domestic partner who is also a public employee already enrolled for health care benefits coverage through a public entity and the employee can be enrolled as a dependent of the spouse, partner in a civil union couple or domestic partner. Thus, married couples, partners in civil union couples, or domestic partners who are both public employees will receive health care benefits only on the basis of employee and dependent coverage through one public employer.
Public employees enrolled for health care benefits coverage as of the effective date will have 24 months to change coverage to meet the bill's requirement.
