N.J. Admin. Code § 6A:23A-11.3

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

Section 6A:23A-11.3 - Adjustment for an increase in health care costs

(a) For the purposes of calculating the adjustment for health care costs, health care costs shall include medical insurance and prescription drug insurance consistent with the coverage provided under the SEHBP.

(b) A district board of education may increase its adjusted tax levy pursuant to N.J.S.A. 18A:7F-38.d.

1. For the purpose of this calculation, the health care cost for the prebudget year shall equal the projected cost of medical and prescription drug insurance from the original budget of the prebudget year.

(c) A district board of education shall submit to the executive county superintendent supporting documentation for this adjustment as follows:

1. A written verification or estimate, as applicable, of the rate increases for medical and prescription drug insurance from the insurance broker or insurer;

2. A summary schedule of invoices for the 12 months or four quarters ended, as applicable, prior to the fiscal year for which the adjustment request for medical and prescription drug insurance is being requested;

3. The actual cost, if available, or estimated cost of medical and prescription drug insurance for the budget year;

4. A summary schedule of medical and prescription drug insurance for the prebudget year and budget year including:

i. Plan type (for example, traditional, HMO, or PPO);

ii. Cost by coverage category (single, parent and child(ren), or family); and

iii. The number of employees in each plan by category;

5. Reimbursement required by employees;

6. A written assurance that health benefit invoices are reviewed at least quarterly or that personnel and payroll systems contain controls to ensure coverage and payments are made only for current eligible employees; and

7. For school districts that do not participate in the SEHBP:

i. A detailed analysis documenting the cost savings achieved from the current provider(s) as compared to participation in the SEHBP; and

ii. Documentation that the cost of health care insurance and alternative insurers, including group plans and consortiums, were examined at least once in the last three years and the school district participates in the most cost effective plan available pursuant to N.J.S.A. 18A:55-3.a given the requirements of the existing collective bargaining agreement(s).

N.J. Admin. Code § 6A:23A-11.3

Amended by 49 N.J.R. 1038(a), effective 5/1/2017

Amended by 56 N.J.R. 2141(a), effective 11/4/2024