N.J. Admin. Code § 17:9-3.4
Current through Register Vol. 56, No. 23, December 2, 2024
Section 17:9-3.4 - Children with disabilities age 26 or older; determination of eligibility for continuation of coverage(a) The determination as to the continuation of certain children with disabilities as "dependents" as defined by 17:9-3.1 shall be made by the SHBP's medical advisors. A form requesting continuance of enrollment for an eligible dependent with disabilities must be submitted to the SHBP no later than January 31 of the year following the calendar year in which the child attained the age of 26.(b) Children with disabilities who are age 26 or older at the time their parents obtain coverage under the SHBP who are determined by the SHBP's medical advisors to be incapable of self-sustaining employment by reason of mental or physical disabilities and who meet the requirements of "dependents" as defined by 17:9-3.1, shall not be enrolled for coverage as "dependents" as defined by N.J.A.C. 17:9- 3.1, unless: 1. They were covered as dependents under a public employer's group plan immediately preceding that employer's entrance into the SHBP; or2. They were covered as dependents under a public employer's group plan immediately preceding their parents' entrance into the SHBP under the provisions of 52:14-17.3 2f (qualified retirees of the Teachers' Pension and Annuity Fund), 52:14-17.3 2f1 (qualified retirees of the Public Employees' Retirement System who retired from boards of education or county colleges), 52:14-17.3 2i (qualified firefighter or law enforcement retirees from the Police and Firemen's Retirement System, Public Employees' Retirement System and Consolidated Police and Firemen's Pension Fund) or the provisions of the Intergovernmental Transfer Program (established under 11A:2-11) .(c) SHBP or SEHBP coverage for an overage child with disabilities must be continuous. If the member waives coverage or removes the child from coverage for any reason, the child may not be added again at a later date. This includes cases where an employee waives active coverage and resumes coverage as a retiree.N.J. Admin. Code § 17:9-3.4
Amended by 48 N.J.R. 2387(a), effective 11/7/2016