Permits members of Legislature to enroll in SHBP.

A1151

ASSEMBLY, No. 1151

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblyman JOE DANIELSEN

District 17 (Middlesex and Somerset)

SYNOPSIS

���� Permits members of Legislature to enroll in SHBP.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act

concerning membership in the New Jersey State
Health Benefits Program by members of the Legislature and amending P.L.1961,
c.49

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.� Section 2 of P.L.1961,
c.49 (C.52:14-17.26) is amended to read as follows:

���� 2.��� As used in P.L.1961,
c.49 (C.52:14-17.26 et seq.):

���� (a)�� The term
"State" means the State of New Jersey.

���� (b)�� The term
"commission" means the State Health Benefits Commission, created by
section 3 of P.L.1961, c.49

(C.52:14-17.27).

���� (c)�� (1) The term
"employee" means an appointive or elective officer, a full-time
employee of the State of New Jersey, or a full-time employee of an employer
other than the State who appears on a regular payroll and receives a salary or
wages for an average of the number of hours per week as prescribed by the
governing body of the participating employer which number of hours worked shall
be considered full-time, determined by resolution, and not less than 20.

���� (2)�� After the effective date
of P.L.2010, c.2, the term "employee" means: (i) a full-time
appointive or elective officer whose hours of work are fixed at 35 or more per
week, a full-time employee of the State, or a full-time employee of an employer
other than the State who appears on a regular payroll and receives a salary or
wages for an average of the number of hours per week as prescribed by the
governing body of the participating employer which number of hours worked shall
be considered full-time, determined by resolution, and not less than 25; (ii)
an appointive or elective officer, an employee of the State, or an employee of
an employer other than the State who has or is eligible for health benefits
coverage provided under P.L.1961, c.49 (C.52:14-17.25 et seq.) or sections 31
through 41 of P.L.2007, c.103 (C.52:14-17.46.1 et seq.) on that effective date
and continuously thereafter, provided the officer or employee is covered by the
definition in paragraph (1) of this subsection; or (iii) every commissioner
appointed to the New Jersey Maritime Pilot and Docking Pilot Commission
pursuant to R.S.12:8-1.� Any hour or part thereof, during which an employee
does not work due to the employee's participation in a voluntary or mandatory
furlough program shall not be deducted in determining if a person's hours of
work are fixed at fewer than 35 or 32 per week, as appropriate, for the purpose
of eligibility for health benefits coverage provided under P.L.1961, c.49
(C.52:14-17.25 et seq.), provided the employee continues to pay contributions
for coverage during the period of furlough.� If the pay of a furloughed
employee is insufficient to withhold the entirety of the employee's
contribution, then the employee shall remit the portion of the contribution not
withheld from the employee's pay to the Division of Pensions and Benefits in
the Department of the Treasury in a manner determined by the division, except
that no deduction for the payment of such contributions shall be made from the
unemployment compensation benefits of the employee.

����
(3) After the effective
date of P.L.��� , c.��� (C.��� ) (pending before the Legislature as this bill),
the term �employee� shall include a member of the Legislature.

���� For the purposes of this act,
an employee of Rutgers, The State University of New Jersey, shall be deemed to
be an employee of the State, and an employee of the New Jersey Institute of
Technology shall be considered to be an employee of the State during such time
as the Trustees of the Institute are party to a contractual agreement with the
State Treasurer for the provision of educational services.� The term
"employee" shall further mean, for purposes of this act, a former
employee of the South Jersey Port Corporation, who is employed by a subsidiary
corporation or other corporation, which has been established by the Delaware
River Port Authority pursuant to subdivision (m) of Article I of the compact
creating the Delaware River Port Authority (R.S.32:3-2), as defined in section
3 of P.L.1997, c.150 (C.34:1B-146), and who is eligible for continued
membership in the Public Employees' Retirement System pursuant to subsection j.
of section 7 of P.L.1954, c.84 (C.43:15A-7).

���� For the purposes of this act
the term "employee" shall not include persons employed on a
short-term, seasonal, intermittent or emergency basis, persons compensated on a
fee basis, persons having less than two months of continuous service or persons
whose compensation from the State is limited to reimbursement of necessary
expenses actually incurred in the discharge of their official duties, provided,
however, that the term "employee" shall include persons employed on
an intermittent basis to whom the State has agreed to provide coverage under
P.L.1961, c.49 (C.52:14-17.25 et seq.) in accordance with a binding collective
negotiations agreement.� An employee paid on a 10-month basis, pursuant to an
annual contract, will be deemed to have satisfied the two-month waiting period
if the employee begins employment at the beginning of the contract year.� The
term "employee" shall also not include retired persons who are
otherwise eligible for benefits under this act but who, although they meet the
age or disability eligibility requirement of Medicare, are not covered by
Medicare Hospital Insurance, also known as Medicare Part A, and Medicare
Medical Insurance, also known as Medicare Part B.� A determination by the
commission that a person is an eligible employee within the meaning of this act
shall be final and shall be binding on all parties.

���� (d) (1) The term
"dependents" means an employee's spouse, partner in a civil union
couple or an employee's domestic partner as defined in section 3 of P.L.2003,
c.246 (C.26:8A-3), and the employee's unmarried children under the age of 23
years who live with the employee in a regular parent-child relationship.�
"Children" shall include stepchildren, legally adopted children and
children placed by the Division of Child Protection and Permanency in the
Department of Children and Families, provided they are reported for coverage
and are wholly dependent upon the employee for support and maintenance.� A
spouse, partner in a civil union couple, domestic partner or child enlisting or
inducted into military service shall not be considered a dependent during the military
service.� The term "dependents" shall not include spouses, partners
in a civil union couple or domestic partners of retired persons who are
otherwise eligible for the benefits under this act but who, although they meet
the age or disability eligibility requirement of Medicare, are not covered by
Medicare Hospital Insurance, also known as Medicare Part A, and Medicare
Medical Insurance, also known as Medicare Part B.

���� (2)�� Notwithstanding the
provisions of paragraph (1) of this subsection to the contrary and subject to
the provisions of paragraph (3) of this subsection, for the purposes of an
employer other than the State that is participating in the State Health
Benefits Program pursuant to section 3 of P.L.1964, c.125 (C.52:14-17.34), the
term "dependents" means an employee's spouse or partner in a civil
union couple and the employee's unmarried children under the age of 23 years
who live with the employee in a regular parent-child relationship.�
"Children" shall include stepchildren, legally adopted children and
children placed by the Division of Child Protection and Permanency in the
Department of Children and Families provided they are reported for coverage and
are wholly dependent upon the employee for support and maintenance.� A spouse,
partner in a civil union couple or child enlisting or inducted into military
service shall not be considered a dependent during the military service.� The
term "dependents" shall not include spouses or partners in a civil
union couple of retired persons who are otherwise eligible for benefits under
P.L.1961, c.49 (C.52:14-17.25 et seq.) but who, although they meet the age or
disability eligibility requirement of Medicare, are not covered by Medicare
Hospital Insurance, also known as Medicare Part A, and Medicare Medical
Insurance, also known as Medicare Part B.

���� (3)�� An employer other than
the State that is participating in the State Health Benefits Program pursuant
to section 3 of P.L.1964, c.125 (C.52:14-17.34) may adopt a resolution
providing that the term "dependents" as defined in paragraph (2) of
this subsection shall include domestic partners as provided in paragraph (1) of
this subsection.

���� (e)�� The term
"carrier" means a voluntary association, corporation or other
organization, including a health maintenance organization as defined in section
2 of the "Health Maintenance Organizations Act," P.L.1973, c.337
(C.26:2J-2), which is lawfully engaged in providing or paying for or
reimbursing the cost of personal health services, including hospitalization,
medical and surgical services, under insurance policies or contracts,
membership or subscription contracts, or the like, in consideration of premiums
or other periodic charges payable to the carrier.

���� (f)�� The term
"hospital" means (1) an institution operated pursuant to law which is
primarily engaged in providing on its own premises, for compensation from its
patients, medical diagnostic and major surgical facilities for the care and
treatment of sick and injured persons on an inpatient basis, and which provides
such facilities under the supervision of a staff of physicians and with
24-hour-a-day nursing service by registered graduate nurses, or (2) an
institution not meeting all of the requirements of (1) but which is accredited
as a hospital by the Joint Commission on Accreditation of Hospitals.� In no
event shall the term "hospital" include a convalescent nursing home
or any institution or part thereof which is used principally as a convalescent
facility, residential center for the treatment and education of children with
mental disorders, rest facility, nursing facility or facility for the aged or
for the care of drug addicts or alcoholics.

���� (g)�� The term
"State-managed care plan" means a health care plan under which
comprehensive health care services and supplies are provided to eligible
employees, retirees, and dependents: (1) through a group of doctors and other
providers employed by the plan; or (2) through an individual practice
association, preferred provider organization, or point of service plan under
which services and supplies are furnished to plan participants through a
network of doctors and other providers under contracts or agreements with the
plan on a prepayment or reimbursement basis and which may provide for payment
or reimbursement for services and supplies obtained outside the network.� The
plan may be provided on an insured basis through contracts with carriers or on
a self-insured basis, and may be operated and administered by the State or by
carriers under contracts with the State.

���� (h)�� The term
"Medicare" means the program established by the "Health
Insurance for the Aged Act," Title XVIII of the "Social Security
Act," Pub.L.89-97 (42 U.S.C. s.1395 et seq.), as amended, or its successor
plan or plans.

���� (i)��� The term
"traditional plan" means a health care plan which provides basic
benefits, extended basic benefits and major medical expense benefits as set
forth in section 5 of P.L.1961, c.49 (C.52:14-17.29) by indemnifying eligible
employees, retirees, and dependents for expenses for covered health care
services and supplies through payments to providers or reimbursements to
participants.

���� (j)��� The term
"successor plan" means a State-managed care plan that shall replace
the traditional plan and that shall provide benefits as set forth in subsection
(B) of section 5 of P.L.1961, c.49 (C.52:14-17.29) with provisions regarding
reimbursements and payments as set forth in paragraph (1) of subsection (C) of
section 5 of P.L.1961, c.49 (C.52:14-17.29).

(cf: P.L.2021, c.418, s.4)

���� 2.� The State Health Benefits
Commission shall establish a 60-day special open enrollment period, to begin on
the effective date of this act, P.L.��� , c.��� (C.��� ) (pending before the
Legislature as this bill), during which members of the Legislature then
serving, and their dependents, may be enrolled in the State Health Benefits
Program.

���� 3.� This act shall take effect
immediately.

STATEMENT

���� This bill permits members of the
Legislature to enroll in the New Jersey State Health Benefits Program.