87A-23. Health benefits plan supplemental to medicare
The board shall establish a health benefits plan, which takes into account benefits available to an employee-beneficiary and spouse under medicare, subject to the following conditions:
(1) There shall be no duplication of benefits payable
under medicare. The plan under this section, which shall be secondary to
medicare, when combined with medicare and any other plan to which the health
benefits plan is subordinate under the National Association of Insurance
Commissioners' coordination of benefit rules, shall provide benefits that
approximate those provided to a similarly situated beneficiary not eligible for
medicare;
(2) The State, through the
department of budget and finance, and the counties, through their respective
departments of finance, shall pay to the fund a contribution equal to an amount
not less than the medicare part B premium, excluding medicare income-related
monthly adjustment amounts for a retired employee hired after June 30, 2023,
and their spouse, for each of the following who are enrolled in the medicare
part B medical insurance plan: (A) an employee-beneficiary who is a retired
employee, (B) a spouse of an employee-beneficiary hired prior to July 1, 2023,
while the employee-beneficiary is living, and (C) an employee-beneficiary's
spouse, after the death of the employee-beneficiary, if the spouse qualifies as
an employee-beneficiary. If the amount reimbursed by the fund under this
section is less than the actual cost of the medicare part B medical insurance
plan, excluding medicare income-related monthly adjustment amounts for a
retired employee hired after June 30, 2023, and their spouse, due to an increase
in the medicare part B medical insurance plan rate, the fund shall reimburse
each employee-beneficiary and spouse of an employee-beneficiary hired prior to
July 1, 2023, for the cost increase within thirty days of the rate change.
Each employee-beneficiary and employee-beneficiary's spouse who becomes
entitled to reimbursement from the fund for medicare part B premiums after July
1, 2006, shall designate a financial institution account into which the fund
shall be authorized to deposit reimbursements. This method of payment may be
waived by the fund if another method is determined to be more appropriate. For
purposes of this section, a "retired employee" means retired members
of the employees' retirement system; county pension system; or a police,
firefighters, or bandsmen pension system of the State or a county as set forth
in chapter 88;
(3) The benefits available under this plan, when
combined with benefits available under medicare or any other coverage or plan
to which this plan is subordinate under the National Association of Insurance
Commissioners' coordination of benefit rules, shall approximate the benefits
that would be provided to a similarly situated employee-beneficiary not
eligible for medicare;
(4) All employee-beneficiaries or
dependent-beneficiaries who are eligible to enroll in the medicare part B
medical insurance plan shall enroll in that plan as a condition of receiving
contributions and participating in benefits plans under this chapter. This
paragraph shall apply to retired employees, their spouses, and the surviving
spouses of deceased retirees and employees killed in the performance of duty;
and
(5) The board shall determine which of the
employee-beneficiaries and dependent-beneficiaries, who are not enrolled in the
medicare part B medical insurance plan, may participate in the plans offered by
the fund.
[L 2001, c 88, pt of §1; am L 2003, c 111, §1; am L 2006, c 39, §1;
am L 2023, c 40, §2 and c 41, §2]
