New Jersey § 52:14-17

§ 52:14-17.

With respect to any policy or contract between a local board of education and an insurance

company writing insurance pursuant to Title 17B of the New Jersey Statutes, hospital

service corporation, medical service corporation, health service corporation, or health

maintenance organization which provides hospital or medical expense benefits: a. upon the commencement of any policy or contract entered into after the effective

date of this amendatory and supplementary act, P.L.1993, c. 8 ( C.52:14-17.38b et al.); or b. in the case of any policy or contract in effect as of the effective date of this

act, no earlier than the second anniversary date after the effective date of this

act of any such policy or contract, the insurance company, hospital service corporation,

medical service corporation, health service corporation, or health maintenance organization

shall annually pay to the State Health Benefits Program a surcharge in the form of

a percentage of the claims paid by the insurance company, hospital service corporation,

medical service corporation, health service corporation, or health maintenance organization

which are attributable to the coverage of the employees of the board and their dependents

for the time period from July 1 through the following June 30, except that if the

commencement or the second anniversary date of the policy or contract occurs after

July 1, the initial surcharge shall be prorated for the remainder of that year from

July 1 through the following June 30. The surcharge shall be paid on or before December 31 of the time period for which

it is payable in the manner prescribed hereinafter, except that if the commencement

or second anniversary date of the policy or contract occurs on or after November 1,

an estimated initial surcharge shall be paid no later than the end of the sixth month

following the commencement or anniversary date of the policy or contract or July 1

following the commencement or anniversary date of the policy or contract, whichever

is earlier, and the actual surcharge payable for the initial time period shall be

determined and adjustments, if any, shall be made to the surcharge payable for the

succeeding time period in the manner prescribed hereinafter. The initial surcharge percentage for the time period July 1, 1993 through June 30,

1994 shall be 3.25%. The State Treasurer shall thereafter annually redetermine the surcharge percentage,

which shall be the percentage of total claims paid for active employees and for retired

employees receiving health care coverage under the State Health Benefits Program pursuant

to section 3 of P.L.1987, c. 384 ( C.52:14-17.32f ) or subsection a. of section 2 of P.L.1992, c. 126 ( C.52:14-17.32f1 ) who are not eligible for Medicare which is reasonably attributable to the excess

claim cost for these retired employees. The State Treasurer shall annually provide an estimated surcharge percentage based

upon the claims paid for the 12 months immediately preceding the time period for which

the surcharge is payable. Except as otherwise provided herein in the case of the initial surcharge, each organization

shall pay to the State Health Benefits Program an estimated surcharge on or before

December 31 of the time period for which the surcharge is payable, which shall be

the amount determined by multiplying the total claims paid by the organization for

the coverage for the 12 months immediately preceding the time period for which the

surcharge is payable by the estimated surcharge percentage. Within three months after the time period for which the surcharge is payable, the

State Treasurer shall determine the actual surcharge percentage for the time period

based upon the actual claims experience for the period. The surcharge for the succeeding time period shall be increased or decreased, as

appropriate, by the difference between the estimated surcharge paid and the surcharge

due based upon the actual claims experience. This section shall apply to any policy or contract in which the insurer has reserved

the right to change the premium. Beginning July 1, 2008, a reference to the State Health Benefits Program in this section

shall mean the School Employees' Health Benefits Program, established pursuant to

sections 31 through 41 of P.L.2007, c. 103 ( C.52:14-17.46.1 through C.52:14-17.46.11 ).