N.J. Admin. Code § 17:9-8.1

Current through Register Vol. 56, No. 23, December 2, 2024

Section 17:9-8.1 - Employee Prescription Drug Plan

(a) The Employee Prescription Drug Plan was established under the provisions of 52:14-17.2 9(F).

(b) Separate election shall be required for enrollment and for a change in, or a termination of, coverage in the Employee Prescription Drug Plan.

(c) The rules for eligibility and for determining the effective dates of coverage are the same as those of the SHBP as administered by the Commission in accordance with the provisions of 52:14-17.25 et seq., with the following exceptions:

1. Except under the provisions of the Federal COBRA law, prescription drug coverage is not continued in the event of death or other termination of the group coverage;

2. Employers, other than the State of New Jersey, may offer to their employees and eligible dependents enrollment in the State Employee Prescription Drug Plan, or another free-standing prescription drug plan, or elect to have prescription drug coverage under the offering of their SHBP medical plans.

i. If the employer elects to offer the State Employee Prescription Drug Plan, the employee's share of the cost for this prescription drug plan may be determined by a formula different from that used to determine the employee's share of the cost of health coverage. The employee may pay a share of the cost of prescription drug coverage for the employee and for the employee's covered dependents as required by a bargaining unit agreement. The employer may establish by ordinance or resolution, rules for the employee's share of the cost for those employees not covered under a bargaining agreement.

ii. If an employer, other than the State of New Jersey, offers a free-standing prescription drug plan other than the State Employee Prescription Drug Plan, this plan must be comparable in design, as determined by the Commission, to the State Employee Prescription Drug Plan. If an employee declines the employer's offering of a prescription drug plan, no reimbursement for prescription drugs will be provided under the SHBP medical plan in which the member is enrolled; and

3. Prescription drug classifications that are not eligible for coverage under the employer's prescription drug plan are also not eligible for coverage under the SHBP medical plans except as Federally or State mandated.

N.J. Admin. Code § 17:9-8.1

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