N.J. Admin. Code § 17:9-5.5

Current through Register Vol. 56, No. 24, December 18, 2024

Section 17:9-5.5 - Medicare refunds

(a) Where the State, directly or indirectly, reimburses the retiree for the Medicare Part B charges:

1. The amount of the reimbursements made for Medicare Part B shall be determined by law or, through a collective bargaining agreement or contract, but in no case shall it exceed the standard monthly cost of Medicare Part B.

2. As Medicare Part B premium reimbursements are dependent upon sufficient annual appropriations from the Legislature, eligible reimbursements for Medicare Part B premiums will include only those premiums that have been paid for the period up to 12 months immediately preceding receipt of proof of Medicare and not those paid prior to the 12 months immediately preceding receipt of proof of full Medicare entitlement.

3. Wherever possible, the reimbursement will be added directly to the retirement allowance.

4. Where the reimbursement cannot be added to the retirement allowance, a separate check for the reimbursement will be mailed to the retiree annually for the Medicare Part B payments paid in the previous year; for ABP members, the reimbursement is mailed monthly. All reimbursements made for Medicare Part B shall be made payable to the retiree.

(b) Where authorized by law, a participating local employer paying for the cost of coverage for enrollment in an SHBP Plan for a retiree may reimburse the retiree for all or part of the cost of Part B of the Federal Medicare program for the retiree and enrolled spouse or eligible domestic or civil union partner, as appropriate. The participating local employer is responsible for the payment of such reimbursements.

(c) All reimbursements made pursuant to (b) above shall be made payable to the retiree constituting the most timely payment for Medicare Part B coverage. The amount of the reimbursement shall be determined by law or, through a collective bargaining agreement or contract, but in no case shall it exceed the standard monthly cost of Medicare Part B. The reimbursement shall be made as frequently as determined by the participating local employer, but not less frequently than annually. As with the State, local employers are limited by budget allocations; therefore, retroactive refunds are limited to one year.

(d) In no event shall duplicate reimbursements be made to any retiree for the retiree or the retiree's spouse or eligible domestic or civil union partner. If the spouse or eligible partner of a retiree receives reimbursement for Medicare Part B by the State in their retirement allowances, then the spouse or partner shall only be eligible for the Medicare Part B reimbursement based upon their employment and not the retiree's employment. Spouses or partners reimbursed directly by their employer and not through the State must submit proof that they have waived that other Medicare Part B reimbursement in order to be reimbursed as a spouse or partner of the retiree. In addition, the retiree is not eligible to receive reimbursement for the difference between the amounts reimbursed to a spouse or partner from another Medicare Part B reimbursement and the amounts reimbursed to the retiree under the SHBP.

(e) Any overpayment of Medicare Part B premiums by the State shall be deducted from the retiree's retirement allowance or from any retirement or death benefit due the retiree's beneficiary or estate.

N.J. Admin. Code § 17:9-5.5

Amended by 48 N.J.R. 2387(a), effective 11/7/2016