S1755 1R

An Act concerning eligibility for participation in small employer health benefits plans ¹[and] ,¹ amending ¹[P.L.1992, c.162] various sections of law, and repealing N.J.S.40A:10-32¹.

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

Section 1 of P.L.1992, c.162 (C.17B:27A-17) is amended to read as follows:

1. As used in ¹[this act] P.L.1992, c.162 (C.17B:27A-17 et seq.)¹:

"Actuarial certification" means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the commissioner that a small employer carrier is in compliance with the provisions of section 9 of P.L.1992, c.162 (C.17B:27A-25), based upon examination, including a review of the appropriate records and actuarial assumptions and methods used by the small employer carrier in establishing premium rates for applicable health benefits plans.

"Anticipated loss ratio" means the ratio of the present value of the expected benefits, not including dividends, to the present value of the expected premiums, not reduced by dividends, over the entire period for which rates are computed to provide coverage. For purposes of this ratio, the present values must incorporate realistic rates of interest which are determined before federal taxes but after investment expenses.

"Board" means the board of directors of the program.

"Carrier" means any entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including an insurance company authorized to issue health insurance, a health maintenance organization, a hospital service corporation, medical service corporation and health service corporation, or any other entity providing a plan of health insurance, health benefits or health services. The term "carrier" shall not include a joint insurance fund established pursuant to State law. For purposes of this act, carriers that are affiliated companies shall be treated as one carrier, except that any insurance company, health service corporation, hospital service corporation, or medical service corporation that is an affiliate of a health maintenance organization located in New Jersey or any health maintenance organization located in New Jersey that is affiliated with an insurance company, health service corporation, hospital service corporation, or medical service corporation shall treat the health maintenance organization as a separate carrier.

"Church plan" has the same meaning given that term under Title I, section 3 of Pub.L.93-406, the "Employee Retirement Income Security Act of 1974" (29 U.S.C.s.1002(33)).

"Commissioner" means the Commissioner of Banking and Insurance.

"Community rating" or "community rated" means a rating methodology in which the premium charged by a carrier for all persons covered by a policy or contract form is the same based upon the experience of the entire pool of risks covered by that policy or contract form without regard to age, gender, health status, residence or occupation.

"Creditable coverage" means, with respect to an individual, coverage of the individual under any of the following: a group health plan; a group or individual health benefits plan; Part A or part B of Title XVIII of the federal Social Security Act
(42 U.S.C. s.1395 et seq.); Title XIX of the federal Social Security Act (42 U.S.C. s.1396 et seq.), other than coverage consisting solely of benefits under section 1928 of Title XIX of the federal Social Security Act (42 U.S.C.s.1396s); chapter 55 of Title 10, United States Code (10 U.S.C. s.1071 et seq.); a medical care program of the Indian Health Service or of a tribal organization; a state health benefits risk pool; a health plan offered under chapter 89 of Title 5, United States Code (5 U.S.C. s.8901 et seq.); a public health plan as defined by federal regulation; a health benefits plan under section ¹[5(e)] 2504(e)¹ of the "Peace Corps Act" (22 U.S.C. s.2504(e)); or coverage under any other type of plan as set forth by the commissioner by regulation.

Creditable coverage shall not include coverage consisting solely of the following: coverage only for accident or disability income insurance, or any combination thereof; coverage issued as a supplement to liability insurance; liability insurance, including general liability insurance and automobile liability insurance; workers' compensation or similar insurance; automobile medical payment insurance; credit only insurance; coverage for on-site medical clinics; coverage, as specified in federal regulation, under which benefits for medical care are secondary or incidental to the insurance benefits; and other coverage expressly excluded from the definition of health benefits plan.

"Department" means the Department of Banking and Insurance.

"Dependent" means the spouse, domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3), civil union partner as defined in section 2 of P.L.2006, c.103 (C.37:1-29), or child of an eligible employee, subject to applicable terms of the health benefits plan covering the employee.

"Eligible employee" means a full-time employee who works a normal work week of 25 or more hours. The term includes a sole proprietor, a partner of a partnership, or an independent contractor, if the sole proprietor, partner, or independent contractor is included as an employee under a health benefits plan of a small employer, but does not include employees who work less than 25 hours a week, work on a temporary or substitute basis or are participating in an employee welfare arrangement established pursuant to a collective bargaining agreement. For the purposes of P.L.1992, c.162 ¹(C.17B:27A-17 et seq.)¹, "eligible employee" shall also mean members of a volunteer fire company ¹, volunteer fire department,¹ or an incorporated volunteer first aid, emergency, rescue, or ambulance squad rendering service generally throughout the municipality who are eligible to receive any of the benefits ¹[under] authorized pursuant to¹ N.J.S.40A:10-26 through N.J.S.40A:10-32 ¹, or members of a volunteer fire company or volunteer fire department affording protection to a fire district who are eligible to receive any of the benefitsauthorized pursuant to N.J.S.40A:14-37 and 40A:14-38¹.

"Enrollment date" means, with respect to a person covered under a health benefits plan, the date of enrollment of the person in the health benefits plan or, if earlier, the first day of the waiting period for such enrollment.

"Financially impaired" means a carrier which, after the effective date of this act, is not insolvent, but is deemed by the commissioner to be potentially unable to fulfill its contractual obligations or a carrier which is placed under an order of rehabilitation or conservation by a court of competent jurisdiction.

"Governmental plan" has the meaning given that term under Title I, section 3 of Pub.L.93-406, the "Employee Retirement Income Security Act of 1974" (29 U.S.C.s.1002(32)) and any governmental plan established or maintained for its employees by the Government of the United States or by any agency or instrumentality of that government.

"Group health plan" means an employee welfare benefit plan, as defined in Title I of section 3 of Pub.L.93-406, the "Employee Retirement Income Security Act of 1974" (29 U.S.C. s.1002(1)), to the extent that the plan provides medical care and including items and services paid for as medical care to employees or their dependents directly or through insurance, reimbursement or otherwise.

"Health benefits plan" means any hospital and medical expense insurance policy or certificate; health, hospital, or medical service corporation contract or certificate; or health maintenance organization subscriber contract or certificate delivered or issued for delivery in this State by any carrier to a small employer group pursuant to section 3 of P.L.1992, c.162 (C.17B:27A-19). For purposes of this act, "health benefits plan" shall not include one or more, or any combination of, the following: coverage only for accident or disability income insurance, or any combination thereof; coverage issued as a supplement to liability insurance; liability insurance, including general liability insurance and automobile liability insurance; workers' compensation or similar insurance; automobile medical payment insurance; credit-only insurance; coverage for on-site medical clinics; and other similar insurance coverage, as specified in federal regulations, under which benefits for medical care are secondary or incidental to other insurance benefits. Health benefits plan shall not include the following benefits if they are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of the plan: limited scope dental or vision benefits; benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof; and such other similar, limited benefits as are specified in federal regulations. Health benefits plan shall not include hospital confinement indemnity coverage if the benefits are provided under a separate policy, certificate or contract of insurance, there is no coordination between the provision of the benefits and any exclusion of benefits under any group health benefits plan maintained by the same plan sponsor, and those benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor. Health benefits plan shall not include the following if it is offered as a separate policy, certificate or contract of insurance: Medicare supplemental health insurance as defined under section 1882(g)(1) of the federal Social Security Act (42 U.S.C.s.1395ss(g)(1)); and coverage supplemental to the coverage provided under chapter 55 of Title 10, United States Code (10 U.S.C. s.1071 et seq.); and similar supplemental coverage provided to coverage under a group health plan.

"Health status-related factor" means any of the following factors: health status; medical condition, including both physical and mental illness; claims experience; receipt of health care; medical history; genetic information; evidence of insurability, including conditions arising out of acts of domestic violence; and disability.

"Late enrollee" means an eligible employee or dependent who requests enrollment in a health benefits plan of a small employer following the initial minimum 30-day enrollment period provided under the terms of the health benefits plan. An eligible employee or dependent shall not be considered a late enrollee if the individual: a. was covered under another employer's health benefits plan at the time he was eligible to enroll and stated at the time of the initial enrollment that coverage under that other employer's health benefits plan was the reason for declining enrollment, but only if the plan sponsor or carrier required such a statement at that time and provided the employee with notice of that requirement and the consequences of that requirement at that time; b. has lost coverage under that other employer's health benefits plan as a result of termination of employment or eligibility, reduction in the number of hours of employment, involuntary termination, the termination of the other plan's coverage, death of a spouse, or divorce or legal separation; and c. requests enrollment within 90 days after termination of coverage provided under another employer's health benefits plan. An eligible employee or dependent also shall not be considered a late enrollee if the individual is employed by an employer which offers multiple health benefits plans and the individual elects a different plan during an open enrollment period; the individual had coverage under a COBRA continuation provision and the coverage under that provision was exhausted and the employee requests enrollment not later than 30 days after the date of exhaustion of COBRA coverage; or if a court of competent jurisdiction has ordered coverage to be provided for a spouse or minor child under a covered employee's health benefits plan and request for enrollment is made within 30 days after issuance of that court order.

"Medical care" means amounts paid: (1) for the diagnosis, care, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body; and (2) transportation primarily for and essential to medical care referred to in (1) above.

"Member" means all carriers issuing health benefits plans in this State on or after the effective date of this act.

"Multiple employer arrangement" means an arrangement established or maintained to provide health benefits to employees and their dependents of two or more employers, under an insured plan purchased from a carrier in which the carrier assumes all or a substantial portion of the risk, as determined by the commissioner, and shall include, but is not limited to, a multiple employer welfare arrangement, or MEWA, multiple employer trust or other form of benefit trust.

"Plan of operation" means the plan of operation of the program including articles, bylaws and operating rules approved pursuant to section 14 of P.L.1992, c.162 (C.17B:27A-30).

"Plan sponsor" has the meaning given that term under Title I of section 3 of Pub.L.93-406, the "Employee Retirement Income Security Act of 1974" (29 U.S.C.s.1002(16)(B)).

"Preexisting condition exclusion" means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for that coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before that date. Genetic information shall not be treated as a preexisting condition in the absence of a diagnosis of the condition related to that information.

"Program" means the New Jersey Small Employer Health Benefits Program established pursuant to section 12 of P.L.1992, c.162 (C.17B:27A-28).

"Small employer" means, in connection with a group health plan with respect to a calendar year and a plan year, any person, firm, corporation, partnership, or political subdivision that is actively engaged in business that employed an average of at least two but not more than 50 eligible employees on business days during the preceding calendar year and who employs at least two employees on the first day of the plan year, and the majority of the employees are employed in New Jersey. All persons treated as a single employer under subsection (b), (c), (m) or (o) of section 414 of the Internal Revenue Code of 1986 (26 U.S.C.s.414) shall be treated as one employer. Subsequent to the issuance of a health benefits plan to a small employer and for the purpose of determining continued eligibility, the size of a small employer shall be determined annually. Except as otherwise specifically provided, provisions of P.L.1992, c.162 (C.17B:27A-17 et seq.) that apply to a small employer shall continue to apply at least until the plan anniversary following the date the small employer no longer meets the requirements of this definition. In the case of an employer that was not in existence during the preceding calendar year, the determination of whether the employer is a small or large employer shall be based on the average number of employees that it is reasonably expected that the employer will employ on business days in the current calendar year. Any reference in P.L.1992, c.162 (C.17B:27A-17 et seq.) to an employer shall include a reference to any predecessor of such employer. For the purposes of determining the size of an employer, members of a volunteer fire company or an incorporated volunteer first aid, emergency, rescue, or ambulance squad rendering service generally throughout a municipality who are eligible to receive any of the benefits ¹[under] authorized pursuant to¹ N.J.S.40A:10-26 through N.J.S.40A:10-32 ¹, or members of a volunteer fire company or volunteer fire department affording protection to a fire district who are eligible to receive any of the benefits authorized pursuant to N.J.S.40A:14-37 and 40A:14-38,¹ shall not be counted as employees of the employer.

"Small employer carrier" means any carrier that offers health benefits plans covering eligible employees of one or more small employers.

"Small employer health benefits plan" means a health benefits plan for small employers approved by the commissioner pursuant to section 17 of P.L.1992, c.162 (C.17B:27A-33).

"Stop loss" or "excess risk insurance" means an insurance policy designed to reimburse a self-funded arrangement of one or more small employers for catastrophic, excess or unexpected expenses, wherein neither the employees nor other individuals are third party beneficiaries under the insurance policy. In order to be considered stop loss or excess risk insurance for the purposes of P.L.1992, c.162 (C.17B:27A-17 et seq.), the policy shall establish a per person attachment point or retention or aggregate attachment point or retention, or both, which meet the following requirements:

a. If the policy establishes a per person attachment point or retention, that specific attachment point or retention shall not be less than $20,000 per covered person per plan year; and

b. If the policy establishes an aggregate attachment point or retention, that aggregate attachment point or retention shall not be less than 125% of expected claims per plan year.

"Supplemental limited benefit insurance" means insurance that is provided in addition to a health benefits plan on an indemnity non-expense incurred basis.

(cf: P.L.2009, c.293, s.2)

¹2. N.J.S.40A:10-27 is amended to read as follows:

In addition to the insurance required pursuant to the provisions of chapter 15 of Title 34 of the Revised Statutes and the coverage provided in N.J.S.40A:10-26, the governing body of a municipality, in which an incorporated volunteer first aid, emergency, rescue, or ambulance squad or squads exist rendering service generally throughout the municipality, may:

a. Effect and maintain group accidental death and dismemberment, hospitalization, medical, surgical, major medical expenses, or health and accident insurance with any insurance company authorized to do business in New Jersey, or with a nonprofit hospital service or medical service corporation with respect to the benefits which they are authorized to provide, which is determined to be necessary or desirable for the protection, safety, and welfare of the members of an incorporated volunteer first aid, emergency, rescue, or ambulance squad that are eligible to receive benefits pursuant to N.J.S.40A:10-28;

b. Effect and maintain a contract or contracts to provide drug prescription or other health care benefits which are determined to be necessary or desirable for the protection, safety and welfare of the members of an incorporated volunteer first aid, emergency, rescue, or ambulance squad;

c. In the discretion of the governing body of the municipality, [appropriate and pay all or any] the municipality may assume a portion of the cost of such insurance or contract, or both. At minimum, a volunteer member eligible, pursuant to N.J.S.40A:10-28, to receive the benefits authorized pursuant to this section shall be required to contribute towards the cost thereof according to the following schedule:

(1) individual coverage or its equivalent: 4.5 percent of the cost of the benefit;

(2) volunteer plus child coverage, or volunteer plus spouse or partner coverage, or its equivalent: 3.5 percent of the cost of the benefit; or

(3) family coverage or its equivalent: three percent of the cost of the benefit.

In the discretion of the governing body of the municipality, the volunteer member may be required to pay the entirety of the cost of benefits authorized pursuant to this section, or a greater portion of the cost than the minimum required pursuant to this subsection.

d. The governing body of the municipality shall have the discretion to offer only individual coverage or its equivalent to a volunteer member eligible, pursuant to N.J.S.40A:10-28, to receive benefits authorized pursuant to this section.¹

(cf: N.J.S.40A:10-27)

¹3. N.J.S.40A:10-28 is amended to read as follows:

a. For the purposes of N.J.S.40A:10-28:

"Active emergency service" means participation in the volunteer first aid, emergency, rescue, or ambulance squad on a consistent and uniform basis, and accumulating a minimum number of credits that are granted in accordance with a schedule adopted by the governing body of the municipality pursuant to subsection d. of this section.

"Active volunteer member" means a person who has been designated by the governing board of an incorporated volunteer first aid, emergency, rescue, or ambulance squad and who is faithfully and actually performing volunteer service in that organization.

"Standby" means a line of duty activity of the volunteer first aid, emergency, rescue, or ambulance squad that lasts for no less than four hours and is not classified as another activity specified in the schedule adopted pursuant to subsection d. of this section.

b. A member of any incorporated volunteer first aid, emergency, rescue, or ambulance squad shall not be ineligible to receive any of the benefits under N.J.S.40A:10-26 and N.J.S.40A:10-27 because [he] the member may otherwise receive any form of compensation or salary from the municipality, except that a volunteer member shall not be eligible if such benefits are otherwise provided as part of the member’s employment with the municipality.

c. To be eligible to receive any of the benefits authorized pursuant to N.J.S.40A:10-27, a member of an incorporated volunteer first aid, emergency, rescue, or ambulance squad shall be required to be an active volunteer member and have provided active emergency service during the previous 12-month period.

d. Credits shall be granted to individuals who are members of volunteer first aid, emergency, rescue, or ambulance squads for activities designated by the governing body of the municipality, which may include the following:

(1) training courses;

(2) drills or training exercises;

(3) sleep-in or standby;

(4) completion of a one-year elected or appointed position in the organization;

(5) election as a delegate to an emergency service convention;

(6) attendance at official meetings of the municipal governing body;

(7) participation in emergency responses; or

(8) miscellaneous activities, designated by the governing body, including participation in other non-emergency first aid or rescue activities not otherwise enumerated.

If a municipality has established a length of service award program, as defined in section 2 of P.L.1997, c.388 (C.40A:14-184), the schedule adopted by governing body for the purposes of length of service award program eligibility shall serve as the schedule for establishing eligibility to receive benefits authorized pursuant to N.J.S.40A:10-27 unless the governing body adopts a more stringent schedule for purposes of receiving benefits authorized pursuant to N.J.S.40A:10-27.

e. For purposes of establishing eligibility to receive benefits authorized pursuant to N.J.S.40A:10-27, an incorporated volunteer first aid, emergency, rescue, or ambulance squad shall annually furnish to the municipality a certified list of all volunteer members, which shall identify active volunteer members having provided active emergency service during the previous 12-month period. The municipality shall review the annual certification list and approve the final annual certification. The approved list of certified active volunteer members shall be returned to each respective incorporated volunteer first aid, emergency, rescue, or ambulance squad and posted in a public area within the building used by the incorporated volunteer first aid, emergency, rescue, or ambulance squad for no less than 30 days for review by all volunteer members of the incorporated volunteer first aid, emergency, rescue, or ambulance squad.

f. The volunteer first aid, emergency, rescue, or ambulance squad shall maintain all records upon which the annual certification list is based in such a form as may be prescribed by the municipality and the Director of the Division of Local Government Services. Records maintained pursuant to this subsection, along with any other information concerning the annual certification list, shall be provided to the municipality or the director upon written request.

g. A member whose name does not appear on the approved certification list of a volunteer first aid, emergency, rescue, or ambulance squad may appeal in writing to the municipal clerk within 30 days of posting of the list. The municipality shall investigate a member’s appeal. The decision of a volunteer first aid, emergency, rescue, or ambulance squad shall be subject to appropriate judicial review.

h. Notwithstanding the provisions of this section, an active volunteer member may, in writing to the municipal clerk, waive benefits authorized pursuant to N.J.S.40A:10-27. A waiver shall remain in effect until withdrawn in writing to the municipal clerk and coverage is established. The municipal clerk shall maintain a list of active volunteer members that have waived benefits authorized pursuant to N.J.S.40A:10-27 as an addendum to the annual certification list required to be submitted pursuant to subsection e. of this section. No active volunteer members shall be eligible to receive payment in exchange for a waiver of benefits.

i. Notwithstanding the provisions of this section, the governing body of a municipality may require a new active volunteer member to provide active emergency service for a period of greater than 12 months before becoming eligible to receive benefits authorized pursuant to N.J.S.40A:10-27.

j. In addition to any other penalties provided by law, any volunteer member who knowingly misrepresents their eligibility to receive benefits authorized pursuant to N.J.S.40A:10-27, any person who knowingly misrepresents the credit earned, pursuant to subsection d. of this section, by a volunteer, or who knowingly includes an individual on an annual certification list, as required to be submitted pursuant to subsection e. of this section, who is not an active volunteer member who provided active emergency service during the previous 12 months, shall forfeit all benefits to which the member may be entitled pursuant to P.L. , c. (pending before the Legislature as this bill) and P.L.1997, c.388 (C.40A:14-183 et seq.), and be prohibited from serving in a volunteer or paid position within any emergency service organization, as defined in section 2 of P.L.1997, c.388 (C.40A:14-184), in this State.¹

(cf: N.J.S.40A:10-28)

¹4. N.J.S.40A:10-30 is amended to read as follows:

In addition to the insurance required pursuant to the provisions of chapter 15 of Title 34 of the Revised Statutes and the coverage provided in N.J.S.40A:10-29, a municipality maintaining a volunteer fire department or in which there are one or more incorporated volunteer fire companies may:

a. Effect and maintain group accidental death and dismemberment, hospitalization, medical, surgical, major medical expenses, or health and accident insurance with any insurance company authorized to do business in New Jersey, or with a nonprofit hospital service or medical service corporation with respect to the benefits which they are authorized to provide, which is determined to be necessary or desirable for the protection, safety and welfare of the members of the volunteer fire department or the members of the incorporated volunteer fire companies that are eligible to receive benefits pursuant to N.J.S.40A:10-31;

b. Effect and maintain a contract or contracts to provide drug prescription or other health care benefits which is determined to be necessary or desirable for the protection, safety and welfare of the members of the volunteer fire department or members of an incorporated volunteer fire company;

c. In the discretion of the governing body of the municipality, [appropriate and pay all or any] the municipality may assume a portion of the costs of such insurance or contract, or both. At minimum, a volunteer member eligible, pursuant to N.J.S.40A:10-28, to receive benefits authorized pursuant to this section shall be required to contribute towards the cost thereof pursuant to the following schedule:

(1) individual coverage or its equivalent: 4.5 percent of the cost of the benefit;

(2) volunteer plus child coverage or volunteer plus spouse or partner coverage, or its equivalent: 3.5 percent of the cost of the benefit; or

(3) family coverage or its equivalent: three percent of the cost of the benefit.

In the discretion of the governing body of the municipality, the volunteer member may be required to pay the entirety of the cost of the benefits authorized pursuant to this section, or a greater portion of the cost than the minimum required pursuant to this subsection.

(cf: N.J.S.40A:10-30)

¹5. N.J.S.40A:10-31 is amended to read as follows:

a. For the purposes of N.J.S.40A:10-31:

"Active emergency service" means participation in the volunteer fire department or incorporated volunteer fire company on a consistent and uniform basis, and accumulating a minimum number of credits that are granted in accordance with a schedule adopted by the governing body of the municipality pursuant to subsection d. of this section.

"Active volunteer member" means a person who has been designated by the governing board of a volunteer fire department or incorporated volunteer fire company and who is faithfully and actually performing volunteer service in that organization.

"Standby" means a line of duty activity of the volunteer fire department or incorporated volunteer fire company that lasts for no less than four hours and is not classified as another activity specified in the schedule adopted pursuant to subsection d. of this section.

b. A volunteer [fireman] firefighter shall not be ineligible to receive any of the benefits under N.J.S.40A:10-29 and N.J.S.40A:10-30 because [he] the firefighter may otherwise receive any form of compensation or salary from the municipality, except that a volunteer member shall not be eligible if the benefits are otherwise provided as part of the member’s employment with the municipality.

c. To be eligible to receive any of the benefits authorized pursuant to N.J.S.40A:10-30, a volunteer firefighter is required to have been an active volunteer member and have provided active emergency service during the previous 12-month period.

d. Credits shall be granted to individuals who are members of a volunteer fire department or incorporated volunteer fire company for activities designated by the governing body of the municipality, which activities may include the following:

(1) training courses;

(2) drills;

(3) sleep-in or standby;

(4) completion of a one-year elected or appointed position in the organization;

(5) election as a delegate to a firefighter convention;

(6) attendance at official meetings of the municipal governing body;

(7) participation in emergency responses; or

(8) miscellaneous activities including participation in other non-emergency fire activities not otherwise listed.

If a municipality has established a length of service award program, as defined in section 2 of P.L.1997, c.388 (C.40A:14-184), the schedule adopted by governing body for the purposes of length of service award program eligibility shall serve as the schedule for establishing eligibility to receive benefits authorized pursuant to N.J.S.40A:10-30 unless the governing body adopts a more stringent schedule for purposes of receiving benefits authorized pursuant to N.J.S.40A:10-30.

e. For purposes of establishing eligibility to receive benefits authorized pursuant to N.J.S.40A:10-30, a volunteer fire department or incorporated volunteer fire company shall furnish, annually, to the municipality a certified list of all volunteer members, which shall identify active volunteer members having provided active emergency service during the previous 12-month period. The municipality shall review the annual certification list and approve the final annual certification. The approved list of certified active volunteer members shall then be returned to each volunteer fire department or incorporated volunteer fire company and posted in a public area within the building used by the volunteer fire department or incorporated volunteer fire company for no less than 30 days for review by all volunteer members of the department or company.

f. The volunteer fire department or incorporated volunteer fire company shall maintain all records upon which the annual certification list is based in such a form as may be prescribed by the municipality and the Director of the Division of Local Government Services. Records maintained pursuant to this section, along with any other information concerning the annual certification list, shall be provided to the municipality or the director upon written request.

g. A member whose name does not appear on the approved certification list of a volunteer fire department or incorporated volunteer fire company may appeal in writing to the municipal clerk within 30 days of posting of the list. The municipality shall investigate a member’s appeal. The decision of a volunteer fire department or incorporated volunteer fire company shall be subject to appropriate judicial review.

h. Notwithstanding the provisions of this section, an active volunteer member may, in writing to the municipal clerk, waive benefits authorized pursuant to N.J.S.40A:10-30. A waiver shall remain in effect until withdrawn in writing to the municipal clerk and coverage is established. The municipal clerk shall maintain a list of active volunteer members that have waived benefits authorized pursuant to N.J.S.40A:10-30 as an addendum to the annual certification list required to be submitted pursuant to subsection e. of this section. No active volunteer members shall be eligible to receive payment in exchange for a waiver of benefits.

j. In addition to any other penalties provided by law, any volunteer member who knowingly misrepresents their eligibility to receive benefits authorized pursuant to N.J.S.40A:10-30, any person who knowingly misrepresents the credit earned, pursuant to subsection d. of this section, by a volunteer, or who knowingly includes an individual on an annual certification list, as required to be submitted pursuant to subsection e. of this section, who is not an active volunteer member who provided active emergency service during the previous 12 months, shall forfeit all benefits to which they may be entitled pursuant to P.L. , c. (pending before the Legislature as this bill) and P.L.1997, c.388 (C.40A:14-183 et seq.), and be prohibited from serving in a volunteer or paid position within any emergency service organization, as defined in section 2 of P.L.1997, c.388 (C.40A:14-184), in this State.¹

(cf: N.J.S.40A:10-31)

¹6. N.J.S.40A:14-38 is amended to read as follows:

a. For purposes of N.J.S.40A:14-38:

"Active emergency service" means participation in the volunteer fire department or incorporated volunteer fire company on a consistent and uniform basis, and accumulating a minimum number of credits that are granted in accordance with a schedule adopted by the board of fire commissioners pursuant to subsection d. of this section.

b. In any fire district in this State maintaining a volunteer fire department, or wherein there shall exist one or more incorporated volunteer fire companies affording fire protection to said fire district, it shall be lawful for the board of commissioners of such fire district, in addition to the insurance provided in N.J.S.40A:14-37, to effect, maintain and continue any and all forms of insurance covering the members of said volunteer fire department or incorporated volunteer fire company or companies, including group accidental death and dismemberment, hospitalization, medical, surgical, major medical expenses, or health and accident insurance with any insurance company authorized to do business in New Jersey, or with a nonprofit hospital service or medical service corporation with respect to the benefits which they are authorized to provide, a contract or contracts to provide drug prescription or other health care benefits, which the board of fire commissioners may determine to be necessary or desirable for the protection, safety and welfare of the members, and for the protection and safety of the equipment and apparatus of said volunteer fire department, or incorporated volunteer fire company or companies, or for the protection of said fire district, or against liability for its negligence and that of its officers, employees or servants, whether or not compensated or part-time, who is authorized to perform any act or service, but not including an independent contractor within the limitations of the "New Jersey Tort Claims Act" (C.59:1-1, et seq.), and by resolution, to appropriate from time to time, and pay, such sums of money as may be required to cover such portion of the premiums and costs of said insurance[, or such portion of the same] as said board of fire commissioners, in its discretion, may consider proper and advisable subject to N.J.S.40A:14-39.

c. To be eligible to receive any of the benefits authorized pursuant to subsection b. of this section, a volunteer firefighter shall be required to have been an active volunteer member and have provided active emergency service during the previous 12-month period.

d. Credits shall be granted to volunteer firefighters for activities designated by the board of fire commissioners, which may include the following:

(1) training courses;

(2) drills;

(3) sleep-in or standby;

(4) completion of a one-year elected or appointed position in the organization;

(5) election as a delegate to a firefighter convention;

(6) attendance at official meetings of the municipal governing body;

(7) participation in emergency responses; or

(8) miscellaneous activities including participation in other non-emergency fire activities not otherwise listed.

If a fire district has established a length of service award program, as defined in section 2 of P.L.1997, c.388 (C.40A:14-184), the schedule adopted by governing body for the purposes of length of service award program eligibility shall serve as the schedule for establishing eligibility to receive benefits authorized pursuant to this section unless the board of fire commissioners adopts a more stringent schedule for purposes of receiving benefits authorized pursuant to this section.

e. For purposes of establishing eligibility to receive benefits authorized pursuant to subsection b. of this section, a volunteer fire department or incorporated volunteer fire company shall furnish, annually, to the fire district, a certified list of all volunteer members, which shall identify active volunteer members having provided active emergency service during the previous 12-month period. The fire district shall review the annual certification list and approve the final annual certification. The approved list of certified active volunteer members shall then be returned to each volunteer fire department or incorporated volunteer fire company and posted in a public area within the building used by the volunteer fire department or incorporated volunteer fire company for no less than 30 days for review by all volunteer members of the department or company.

f. The volunteer fire department or incorporated volunteer fire company shall maintain all records upon which the annual certification list is based in such a form as may be prescribed by the fire district and the Director of the Division of Local Government Services. Records maintained pursuant to this subsection, along with any other information concerning the annual certification list, shall be provided to the fire district or the Director of the Division of Local Government Services upon written request.

g. A member whose name does not appear on the approved certification list of a volunteer fire department or incorporated volunteer fire company may appeal in writing to the board of fire commissioners within 30 days of posting of the list. The decision of a volunteer fire department or incorporated volunteer fire company shall be subject to appropriate judicial review.

h. Notwithstanding the provisions of this section, an active volunteer member may, in writing to the board of fire commissioners, waive benefits authorized pursuant to subsection b. of this section. A waiver shall remain in effect until withdrawn in writing to the board of fire commissioners and coverage is established. The board of fire commissioners shall maintain a list of active volunteer members that have waived benefits authorized pursuant to N.J.S.40A:10-30 as an addendum to the annual certification list required to be submitted pursuant to subsection e. of this section. No active volunteer members shall be eligible to receive payment in exchange for a waiver of benefits.

i. At minimum, an active volunteer member eligible for the benefits authorized pursuant to subsection b. of this section shall be required to contribute towards the cost of such insurance or contract, or both, pursuant to the following schedule:

(1) individual coverage or its equivalent: 4.5 percent of the cost of the benefit;

(2) volunteer plus child coverage or volunteer plus spouse or partner coverage, or its equivalent: 3.5 percent of the cost of the benefit; or

(3) family coverage or its equivalent: three percent of the cost of the benefit.

In the discretion of the board of fire commissioners, the volunteer member may be required to pay the entirety of the cost of the benefits authorized pursuant to this section, or a greater portion of the cost than the minimum required pursuant to this subsection. The board of fire commissioners shall also have the discretion offer only individual coverage or its equivalent to a volunteer member eligible to receive benefits authorized pursuant to this section.

j. Notwithstanding the provisions of this section, the board of fire commissioners may require a new active volunteer member to provide active emergency service for a period of greater than 12 months before becoming eligible to receive benefits authorized pursuant to subsection b. of this section.

k. In addition to any other penalties provided by law, any volunteer member who knowingly misrepresents their eligibility to receive benefits authorized pursuant to subsection b. of this section, any person who knowingly misrepresents the credit earned by a volunteer according to the schedule adopted pursuant to subsection d. of this section or who knowingly includes an individual on an annual certification list, required to be submitted pursuant to subsection e. of this section, who is not an active volunteer member who provided active emergency service during the previous 12 months, shall forfeit all benefits to which they may be entitled pursuant to P.L. , c. (pending before the Legislature as this bill) and P.L.1997, c.388 (C.40A:14-183 et seq.), and be prohibited from serving in a volunteer or paid position within any emergency service organization, as defined in section 2 of P.L.1997, c.388 (C.40A:14-184) in this State.¹

(cf: P.L.1979, c.230, s.3)

¹7. N.J.S.40A:14-39 is amended to read as follows:

No member of any volunteer fire department or of any incorporated volunteer fire company shall be considered ineligible to receive [said] insurance benefits because [he] the member may otherwise receive any form of compensation, wages, or salary from the municipality or fire district for any services rendered, except that a member shall not be eligible if the benefits are otherwise provided as part of the member’s employment with the fire district.¹

(cf: N.J.S.40A:14-39)

¹8. (New section) The Director of the Division of Local Government Services in the Department of Community Affairs may, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), update or adopt regulations to effectuate the provisions of P.L. , c. (pending before the Legislature as this bill).¹

¹9. N.J.S.40A:10-32 is repealed.¹

¹[2.] 10.¹ This act shall take effect immediately.