Search Rutgers Law Library N.J. Court Opinions

16 CYNTHIA MEEKINS v. STATE HEALTH BENEFITS COMMISSION - -- rank: 776

... New Jersey and of employers defined as State agencies in N.J.S.A. 52:14-17.26, who were eligible for coverage as active employees immediately ... prescribed by the Commission for continuance of coverage after retirement. N.J.S.A. 52:14-17.32. To be eligible to enroll in the SHBP in ... New Jersey and of employers defined as State agencies in N.J.S.A. 52:14- 17.26, who were eligible for coverage as active employees immediately ... she insists the A-3182-19 7 legislative intent of N.J.S.A. 52:14-17.32(c)(1) 1 is to provide health benefits to ... is part of the New Jersey Health Benefits Program Act, N.J.S.A. 52:14-17.24 to .45. A-3182-19 8 It is also ... PERS retiree's eligibility for SHBP coverage is governed by N.J.S.A. 52:14-17.32(c)(1), N.J.A.C. 17:9- ...

docket:	a3182-19
court:	NJ Superior Court Appellate Division
decided:	2021-12-06
status:	Unpublished
citation:
Document Size:	26231

17 IN THE MATTER OF JACOB MICHELETTI -- rank: 771

... created by the State Health Benefits Program Act of 1961, N.J.S.A. 52:14-17.25 to .45 (Act), which also spawned the State Health ... as exclusive jurisdiction to determine disputed matters under the plan. N.J.S.A. 52:14-17.27 to .28. In addition to basic benefits and stated ... L. 1999, c. 441 §2, was enacted and codified as N.J.S.A. 52:14-17.29e, with the stated purpose of requiring that the SHBC ... meets the medical necessity standard as established by the carrier. . . [ N.J.S.A. 52:14-17.29e.] The two statutes used the same language respecting coverage ... in the best interests of the State and its employees." N.J.S.A. 52:14-17.28. It asserts that the exclusion is in compliance with the clear and unambiguous statutory mandate of N.J.S.A. 52:14-17.29d and e because non-restorative treatment for conditions ...

docket:	a4418-05
court:	njappellate
decided:	2007-01-17
status:	published
citation:	389 N.J. Super. 510
Document Size:	32535

18 FRANK GRILLO v. STATE OF NEW JERSEY -- rank: 766

... and other public employees whose employers participate in the program. N.J.S.A. 52:14-17.25 to -17.46a. Appellants allege they should not be ... for remitting [any] Chapter 78 contributions for health benefits under N.J.S.A. 52:14-17.28c.' The trial court granted the State’s motion to ... to Grant Appellants Leave to Amend Their Complaint. Point III: N.J.S.A. 52:14-17.28c Is Void for Vagueness as Applied to Workers Compensation ... context of these A-1038-19 7 facts, comes from N.J.S.A. 52:14-17.28c. This statutory section establishes the 'amount of contribution to ... L. 2011, c. 78] . . . by public employees of the State . . . .' N.J.S.A. 52:14- 17.28c. Its language directing a public employee's health plan ... corresponding percentage] of the cost of [health care benefits] coverage.' N.J.S.A. 52:14-17.28c. This sentence is repeated forty-eight times in ...

docket:	a1038-19
court:	NJ Superior Court Appellate Division
decided:	2021-04-01
status:	Unpublished
citation:
Document Size:	26060

19 PATERSON POLICE PBA LOCAL NO. 1 v. CITY OF PATERSON -- rank: 761

... 2011, c. 78, §§ 39 and 41, codified at N.J.S.A. 52:14-17.28(c) and N.J.S.A. 18A:16-17 ... retired employees from participation in the SHBP. He explained that ' N.J.S.A. 52:14-17.36 requires uniformity between the health benefits offered through the ... to qualified State and local employees, retirees, and eligible dependents. N.J.S.A. 52:14-17.25 to -17.46a. The SHBP is not itself an ... through contracts negotiated between the SHB Commission and insurance carriers. N.J.S.A. 52:14-17.28. A-3937-19 26 Once a local government employer ... rules and regulations of the [SHB] [C]omission related thereto.' N.J.S.A. 52:14-17.37(a). 'In 2011, the Legislature enacted Chapter 78, making ... also L. 2011, c. 78, § 45(b) (codified at N.J.S.A. 52:14-17.27). One of the most significant changes to the ...

docket:	a3937-19
court:	NJ Superior Court Appellate Division
decided:	2021-04-19
status:	Unpublished
citation:
Document Size:	68496

20 IN THE MATTER OF RIDGEFIELD PARK BOARD OF EDUCATION -- rank: 756

... 78, §§ 39 and 41 (Chapter 78), codified at N.J.S.A. 52:14-17.28c and N.J.S.A. 18A:16-17.1 ... in accordance with section 39 of [L. ]2011, [c. ]78 ([ N.J.S.A.] 52:14-17.28c). [N.J.S.A. 18A:16-17.1(a ... c. ]78, to apply the contribution levels set forth in [N.J.S.A. 52:14-17.28c] until all affected employees are contributing the full amount ... reached full implementation of the premium share set forth in [N.J.S.A. 52:14-17.28c] shall conduct negotiations concerning contributions for health care benefits ...

docket:	a1694-17
court:	NJ Superior Court Appellate Division
decided:	2019-05-03
status:	Published
citation:	459 N.J.Super. 57 207 A.3d 787
Document Size:	38691

21 /usr/local/share/www/libweb/collections/courts/appellate/a4232-18.opn.html -- rank: 753

... 78, §§ 39 and 41 (Chapter 78), codified at N.J.S.A. 52:14-17.28c and N.J.S.A. 18A:16- 17.1 ... 2016). The Board asserts that based on the provisions of N.J.S.A. 52:14-17.28c it had the managerial right not to renew its ... not somehow negate the fact . . . it was [then] obligated by N.J.S.A. 52:14-17.28c to have the employees pay for their dental A ... NJPER 34 (2015). PERC acknowledged the Board's argument that N.J.S.A. 52:14-17.28c preempted the dispute because 'once it moved to a ... any other health care benefit, provided pursuant to [other statutes.] [ N.J.S.A. 52:14-17.28c (emphasis added).] PERC interpreted the statute's plain language ... Considering this, PERC held the primary issue is not 'whether N.J.S.A. 52:14-17.28c preempts[,]' but 'whether an employer's choice to ...

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Document Size:	26353

22 In the Matter of State and School Employees’ Health Benefits Commissions’ Implementation of I/M/O Philip Yucht -- rank: 741

... health services were contrary to the legislative policies expressed in N.J.S.A. 52:14-17.46.7. After the Appellate Division decision, the Commissions each ... member, the tiered reimbursement schedule was determined to have violated N.J.S.A. 52:14-17.46.7, which addresses the calculation of reimbursement rates for ... which approved the change for implementation. Significantly, for purposes of N.J.S.A. 52:14-17.46.7, neither Magellan nor Horizon are nationally recognized databases ... similar nationally recognized database of prevailing health care charges.” N.J.S.A. 52:14-17.46.7. An SEHBP member, Philip Yucht, who received behavioral ... health services were contrary to the legislative policies expressed in N.J.S.A. 52:14-17.46.7. In declaring the adjusted reimbursement rates arbitrary, capricious ... The Commissions argue that they were entitled to rely on N.J.S.A. 52:14-17.43 and N.J.A.C. 17:9-1. ...

docket:	a_21_17
court:	NJ Supreme Court
decided:	2018-05-08
status:
citation:
Document Size:	55825

23 NEW JERSEY EDUCATION ASSOCIATION v. FRED BEAVER -- rank: 726

... health benefits program for the school employees of the State, N.J.S.A. 52:14-17.46.3, -17.46.4; the State Health Benefits Commission ... a health benefits program for the employees of the State, N.J.S.A. 52:14-17.27; and Fred Beaver, the Director of the Division of ... serves ex-officio as the secretary of both the SHBC, N.J.S.A. 52:14-17.27, and the SEHBC, N.J.S.A. 52:14-17.46.4. The SEHBC was established in the School Employees ... L. 2007, c. 103, §§ 31-41 (codified at N.J.S.A. 52:14-17.46.1 to -17.46.11), and that Act made ... employees ineligible for participation in the State Health Benefits Program. N.J.S.A. 52:14-17.27. Previously, when school employees participated in the State ...

docket:	a3221-09
court:	NJ Superior Court Appellate Division
decided:	2011-04-20
status:	unpublished
citation:
Document Size:	25582

24 JOSEPH YAKUP v. DEPARTMENT OF THE TREASURY, DIVISION OF PENSIONS AND BENEFITS- -- rank: 723

... Yakup contends that he was entitled to these benefits under N.J.S.A. 52:14-17.28d(b)(3) because he had '[twenty] or more years ... of this coverage pursuant to a schedule set forth in N.J.S.A. 52:14-17.28c.3 Retired State employees are also eligible for subsidized ... 28, 2011, and ] . . . retire[d] on or after that . . . date . . . .' N.J.S.A. 52:14-17.28d(b)(2)(a). Like the active State employees, these ... of their benefits pursuant to the schedule set forth in N.J.S.A. 52:14- - 17.28c. See N.J.S.A. 52:14-17.28d(b)(1). However, N.J.S.A. 52:14- 17.28d(b)(3) provides an exception to the contribution ...

docket:	a0637-19
court:	NJ Superior Court Appellate Division
decided:	2021-03-30
status:	Unpublished
citation:
Document Size:	31880

25 IN THE MATTER OF CLEMENTON BOARD OF EDUCATION -- rank: 716

... 2011, c. 78, §§ 39 and 41, codified at N.J.S.A. 52:14-17.28c and N.J.S.A. 18A:16-17.1 ... and public employees shall remain bound by the provisions of [ N.J.S.A. 52:14-17.28c and N.J.S.A. 18A:16-17.1 ... reached full implementation of the premium share set forth in [ N.J.S.A. 52:14-17.28c] shall conduct negotiations concerning contributions for health care benefits ... by N.J.S.A. 18A:16-17.1 and N.J.S.A. 52:14-17.28c. On March 3, 2015, while the scope-of-negotiations ... negotiations under Section 77 of the statute involving State employees, N.J.S.A. 52:14-17.28e, and Section 79 of the statute involving county and ...

docket:	a0372-15
court:	NJ Superior Court Appellate Division
decided:	2016-09-30
status:	unpublished
citation:
Document Size:	33330

26 IN THE MATTER OF COUNTY OF ESSEX AND FOP LODGE 106, ET AL. -- rank: 688

... view of the governing statutory framework. Under the SHBP Act, N.J.S.A. 52:14-17.25 to -17.46, the SHBP offers health insurance to ... between the State Health Benefits Commission (SHBC) and insurance carriers. N.J.S.A. 52:14-17.28(a). When a local government employer elects to participate ... in accordance with the rules and regulations of the [SHBC].' N.J.S.A. 52:14-17.37(a). The SHBP's benefits and requirements are intended ... the PDC may create, modify, or terminate in its discretion. N.J.S.A. 52:14-17.27(b). The PDC has 'the sole discretion to set ... other such participant costs for all plans in the program.' N.J.S.A. 52:14-17.29(J). Accordingly, a participating employer cannot alter the healthcare ...

docket:	a3809-22
court:	appellate
decided:	2024-05-03
status:	Unpublished
citation:
Document Size:	61776

27 IRVIN B. BEAVER v. MAGELLAN HEALTH SERVICES INC. -- rank: 675

... by the New Jersey Health Benefits Program Act (the Act), N.J.S.A. 52:14-17.24 to -45. The purpose of the Program is "to ... 373 N.J. Super. 408 , 413 (App. Div. 2004)(citing N.J.S.A. 52:14-17.28). "The State Health Benefits Program is, in effect, the ... make payments on claims and to limit or exclude benefits. N.J.S.A. 52:14-17.29(B). Additionally, the SHBC has final authority to adjudicate ... deemed reasonable and necessary for the administration of" the program. N.J.S.A. 52:14-17.27. Pursuant to the enabling legislation's grant, the SHBC ...

docket:	a1311-12
court:	New Jersey Superior Court Appellate Division
decided:	2013-11-11
status:	Published
citation:	433 N.J.Super. 430 80 A.3d 1160
Document Size:	49006

28 PRINCETON NEUROLOGICAL SURGERY, P.C v. HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY -- rank: 673

... 264 N.J. Super. 141, 151 (App. Div. 1993); see N.J.S.A. 52:14-17.24 to -45. 'The [SHBP] is, in effect, the State ... exclude benefits.' Beaver, 433 N.J. Super. at 433 (citing N.J.S.A. 52:14-17.29(B)). The Act empowers the Commission to create 'rules ... as may be deemed reasonable and necessary for [its] administration . . . .' N.J.S.A. 52:14-17.27(a). Pursuant to this authority the Commission adopted N ... has the authority to adjudicate disputes related to the SHBP, N.J.S.A. 52:14-17.27, and through N.J.A.C. 17:9-1 ...

docket:	a0486-22
court:	NJ Superior Court Appellate Division
decided:	2024-01-17
status:	Unpublished
citation:
Document Size:	34551

29 BOROUGH OF EAST RUTHERFORD v. EAST RUTHERFORD PBA LOCAL 275 -- rank: 668

... State Health Benefits Plan (SHBP), effective January 1, 2007. See N.J.S.A. 52:14-17.29(C). We reverse. I. The PBA entered into a ... the Borough's argument that the matter was preempted by N.J.S.A. 52:14-17.29(C), the provision increasing member co-pays for doctor ... laws." The judge determined that that provision, when read with N.J.S.A. 52:14-17.29(C) governing co-payments for visits to the doctor ... participant, states in pertinent part — and I'm referencing N.J.S.A. 52:14-17.36 regarding participation in [the] Health and Benefits Program. And ... C. 17:9-1.4 likewise required such uniformity. Because N.J.S.A. 52:14-17.29(C) required co-payments of ten dollars, the "arbitration ... undermining the SHBC's determination, embodied in the amendment to N.J.S.A. 52:14-17.29(C), to uniformly increase co-payments for doctor ...

docket:	a5310-09
court:	NJ Superior Court Appellate Division
decided:	2011-03-22
status:	unpublished
citation:
Document Size:	30648

30 E.W. v. STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY DIVISION OF PENSIONS AND BENEFITS -- rank: 648

... 93). III. Under the School Employees' Health Benefits Program Act, N.J.S.A. 52:14-17.46.1 to -.11, the Commission is responsible for the ... health benefits program for various school employees and their dependents. N.J.S.A. 52:14- 17.46.4 to -.5. The Commission has the authority to ... deemed reasonable and necessary for the administration of this act.' N.J.S.A. 52:14- 17.46.4. The health benefits offered to SEHBP members are ... Commission with carriers that administer the terms of the plan. N.J.S.A. 52:14-17.46.5. The plan's terms and conditions are set ... the governing statutes, regulations, and the policies of the carriers. N.J.S.A. 52:14-17.46.6 to -.7; N.J.A.C. 17:9 ...

docket:	a1064-16
court:	NJ Superior Court Appellate Division
decided:	2018-04-20
status:	unpublished
citation:
Document Size:	43939