A 5330 — Permits Director of Division of Pensions and Benefits to initiate temporary transfer of funds in certain circumstances.

2026, c.028 (A5330) §2CHAPTER C.52:14-17.46.9a28   P.L.An Act concerning the School Employees’ Health Benefits Program and amending and supplementing P.L.2007, c.103.

2026, CHAPTER 28, approved June 30, 2026 Assembly, No.

5330     An Act concerning the School Employees’ Health Benefits Program and amending and supplementing P.L.2007, c.103.

  C.52:14-17.46.9  Obligations of employer for charges for benefits;

funds;

subaccount.

All such contributions shall be deposited in the fundfund, and the fund shall be used to pay the portion of the premium and periodic charges attributable to employee and dependent coverage.

[No] Except as permitted pursuant to section 2 of P.L.   P.L.2026, ,c.28 c.   (C.52:14-17.46.9a), (C.        ) (pending before the Legislature as this bill), no person shall use or authorize the use of the assets in the subaccount, or the investment earnings thereon, for any purpose other than for the provision of benefits in accordance with the terms of the School Employees' Health Benefits Program and for defraying the reasonable costs of administering the subaccount. subaccount.          A third-party medical claims reviewer, procured pursuant to section 2 of P.L.2019, c.143 (C.52:14-17.30b), shall, in the performance of services for the program, act in the best interests of the State, participating employers, and covered employees and their enrolled eligible dependents.

     The third-party medical claims reviewer shall collect, storestore, and maintain a secure archive of medical and prescription drug claims data and other health services payment information and provide such data and other reports in compliance with applicable State and federal laws, including the "Health Insurance Portability and Accountability Act of 1996," Pub.L.104-191, to document the cost and nature of claims incurred, demographic information on the covered population, emerging utilization and demographic trends, and such other information as may be available to assist in the governance of the program and in timely response to any requests from the Governor, the State Treasurer, the Division of Pensions and Benefits, the School Employees' Health Benefits Commission, the School Employees' Health Benefits Plan Design Committee, the President of the Senate, and the Speaker of the General Assembly.

     e.     Notwithstanding any law to the contrary and except as provided by amendment by P.L.2010, c.2, and by P.L.2011, c.78, the payment in full of premium or periodic charges for eligible retirees and their dependents pursuant to section 3 of P.L.1987, c.384 (C.52:14-17.32f), section 2 of P.L.1992, c.126 (C.52:14-17.32f1), or section 1 of P.L.1995, c.357 (C.52:14-17.32f2) shall be continued without alteration or interruptioninterruption, and there shall be no premium sharing or periodic charges for certain school employees in retirement once they have met the criteria for vesting for pension benefits, which criteria for purposes of this subsection only shall mean the criteria for vesting in the Teachers' Pension and Annuity Fund.

(cf:C.52:14-17.46.9a  Temporary transfer of available funds.

P.L.2019, c.143, s.6)        2.    (New Section)  a.  If the available funds in the health benefits fund established pursuant to section 39 of P.L.2007, c.103 (C.52:14-17.46.9) fall to a level that is insufficient to cover 10 days of anticipated payments from the fund, including, but not limited to, any portion of premiums, claims, and other periodic charges, provided that claims for medical, prescription, and dental expenses are based on an average over the past six months, then the Director of the Division of Pensions and Benefits may initiate a temporary transfer of available funds from the health benefits fund established pursuant to section 49 of P.L.2007, c.103 (C.52:14-17.46a) to the health benefits fund established pursuant to section 39 of P.L.2007, c.103 (C.52:14-17.46.9).(C.52:14-17.46.9).  The Director of the Division of Pensions and Benefits shall notify the commission within 30 days of the transfer.  The amount transferred pursuant to this subsection shall not exceed the amount necessary to cover 30 days of anticipated payments from the fund, including, but not limited to, any portion of premiums, claims, and other periodic charges, provided that claims for medical, prescription, and dental expenses are based on an average over the past six months and any other anticipated payment or charge in the next 30 days.

 The amount transferred pursuant to this subsection shall be reimbursed from the health benefits fund established pursuant to section 39 of P.L.2007, c.103 (C.52:14-17.46.9) on or before the 120th day next following the date of the transfer unless the Director of the Division of Pensions and Benefits shalldetermines notifythat an extension of the commissionreimbursement withindate 30is daysnecessary ofto ensure that sufficient funding is available to pay claims incurred by active covered employees and their eligible dependents, provided, however, in no case shall the transfer.reimbursement date be extended for more than an additional 365 days.

 The amount transferred pursuant to this subsection shall not exceed the amount necessary to cover 30 days of anticipated payments from the fund, including, but not limited to, any portion of premiums, claims, and other periodic charges, provided that claims for medical, prescription, and dental expenses are based on an average over the past six months and any other anticipated payment or charge in the next 30 days.  The amount transferred pursuant to this subsection shall be reimbursed from the health benefits fund established pursuant to section 39 of P.L.2007, c.103 (C.52:14-17.46.9) on or before the 120th day next following the date of the transfer unless the Director of the Division of Pensions and Benefits determines that an extension of the reimbursement date is necessary to ensure that sufficient funding is available to pay claims incurred by active covered employees and their eligible dependents;

provided, however, in no case shall the reimbursement date be extended for more than an additional 365 days.

       3.   3. This act shall take effect immediately.

    STATEMENT        This billact establishesshall atake mechanismeffect toimmediately. provide necessary funds if the available funds in the health benefits fund for active education employees and their dependents falls to a level that is insufficient to cover days of anticipated payments from the fund.

 The  bill     permitsApproved theJune Director30, of2026. the Division of Pensions and Benefits to initiate a temporary transfer of available funds from the health benefits fund for qualified local education retirees and their dependents to the health benefits fund for active education employees and their dependents.  The bill requires the Director of the Division of Pensions and Benefits to notify the School Employees’ Health Benefits Commission within 30 days of the transfer.

     Under the bill, the amount transferred must not exceed the amount necessary to cover 30 days of anticipated payments from the fund.

 The amount transferred is to be reimbursed from the active education employee and dependent fund on or before the 120th day next following the date of the transfer unless the Director of the Division of Pensions and Benefits determines that an extension of the reimbursement date is necessary to ensure that sufficient funding is available to pay claims incurred by employees of local education employers and their dependents;

provided, however, in no case will the reimbursement date be extended for more than an additional 365 days.

     The bill requires the Director of the Division of Pensions and Benefits to provide to the State Treasurer a monthly accounting of any transfers initiated in the prior 30 days, the outstanding balances of all transfers initiated, any repayments for past transfers received, and the current balance of the active education employee and dependent health benefits fund.

                                            Permits Director of Division of Pensions and Benefits to initiate temporary transfer of funds in certain circumstances.