N.J. Admin. Code § 17:6-18.1

Current through Register Vol. 57, No. 1, January 6, 2025

Section 17:6-18.1 - Benefit

(a) The Group Disability Benefit Plan shall provide disability benefit coverage under a group policy or policies issued by one or more insurance company providers as shall be selected from time to time by the Treasurer. The benefit shall provide a monthly income if the participant becomes totally disabled (within the meaning of N.J.A.C. 17:6-18.3) from occupational or non-occupational causes for a period of at least six consecutive months following the effective date of the coverage. The monthly disability benefit may be paid by the insurance company so long as the participant remains disabled up to the participant's 70th birthday. The benefit shall terminate when the participant is no longer considered totally disabled or begins to receive his or her benefit under the Retirement Plan.

(b) A participant shall be deemed to be in service and covered by the Group Disability Benefit Plan for a period of no more than six months while on official leave of absence without pay if satisfactory evidence is presented to the Plan Administrator that such leave of absence without pay is due to illness and that the participant was not actively engaged in any gainful occupation during such period of leave of absence without pay.

(c) Disability benefit insurance provisions of the group policy or policies shall not cover disability resulting from or contributed to by pregnancy, act of war, intentionally self-inflicted injury, or attempted suicide whether or not sane. For purposes of such disability benefit coverage, the participant shall not be considered to be disabled while the participant is imprisoned or while outside the United States and its territories or possessions.

(d) If the participant has recovered from the total disability for which the participant had received benefits and again becomes totally disabled while insured, the later disability shall be regarded as a continuation of the prior one unless the participant has returned to full-time covered employment for at least six months. If the later absence is due to an unrelated cause and the participant had returned to full-time work, it shall be considered a new disability. The disability benefit insurance cannot be converted to an individual policy.

(e) No participant shall be covered by the disability benefit provision of the group policy or policies except upon the completion of one year of full-time continuous employment in a position eligible for participation in the Program. For an eligible employee who is a participant pursuant to N.J.A.C. 17:6-4.1(a)5, completion of one year of full-time continuous employment in a position eligible for membership in the Teachers' Pension and Annuity Fund, Police and Firemen's Retirement System, State Police Retirement System, or the Public Employees' Retirement System shall also be considered in determining if the participant met the requirements of this subsection.

N.J. Admin. Code § 17:6-18.1

Amended by 52 N.J.R. 802(a), effective 4/6/2020