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Back to Active Fund Table of Contents
ACTIVE FUND
Eligibility
- Who is eligible for coverage?
- Who is a "member"?
- Who is a "dependent"?
- What is a "full-time student"?
- Commencement of coverage
- Termination of coverage
- When does coverage for eligible children cease?
- Changing the dependent record
Members of the PBA Health and Welfare Fund and their eligible dependents.
A member is an active Police Officer on the payroll of the City of New York Police Department and for whom the City contributes to the Health and Welfare Fund of the Patrolmen's Benevolent Association, or is an active Police Officer on suspension, or is the widow and/or dependent child of an active Police Officer declared line of duty by the Department. Additionally, those members or dependents whose benefits were discontinued, but have elected to exercise their rights under COBRA to purchase continued coverage are also considered members of the Health and Welfare Fund (benefits may vary according to the level of basic benefits purchased under COBRA).
Dependents include your legal spouse, registered domestic partner and your unmarried dependent children nineteen (19) years of age or younger. Unmarried children age nineteen (19) or older may be covered as Full-Time Students until the age of twenty-three (23). Disabled children may be covered as long as they are disabled and the member is eligible.
Eligible children include natural children, legally adopted children, children for whom you have court-appointed guardianship, and step-children who live in your home and live with you permanently.
What is a "Full-Time Student"?
In order to qualify for Full-Time Student coverage the dependent must meet the following guidelines:
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The school must be accredited in the state in which the school is located.
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The student must be enrolled in a degree or diploma program.
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The student must be enrolled as a Full-Time Student, as determined by the school (usually 12 credits).
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The member must supply at least 50% of the student's support, and the student must be an eligible dependent of the member.
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The member must submit a "Change of Dependent" form (PBA-6), with a statement from the school's registrar's office stating that the child is a full-time Student.
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Trade or Correspondence Schools do not qualify.
Your coverage begins on the date you are appointed as an active Police Officer of the Police Department of the City of New York. Coverage for your eligible dependents begins on that same date as long as they have been listed on your enrollment card.
Dependents acquired after your date of appointment as a result of marriage, birth, etc., will be covered as of the date of the event (marriage, birth, etc.). The PBA Funds Office must receive the required notification, (PBA-6), within thirty-one (31) days of that event. When notification is not received within thirty-one (31) days, the dependent will be covered as of the date the PBA Funds Office receives the proper notification.
Be advised that notifying the Health and Welfare Fund of the PBA of your change in eligibility status does not constitute notification to the City of New York. The member is required to complete the proper City forms to notify the City of any dependent(s) acquired after your date of appointment.
The City also has stringent guidelines regarding the time period whereby notification is deemed to be acceptable. Please review the City of New York Employee Benefits Program - Summary Program Description for further detail.
In order to cover a domestic partner in the Health and Welfare Fund, a member must be covered by the City health plan coverage. The actual approval of the domestic partnership will be handled by the City's Health Benefits Program (646) 610-5122. Part of this approval process will be the issuance of a letter which can be presented to the Health and Welfare Fund certifying that a domestic partner has been approved for health benefit coverage.
Coverage for you and your eligible dependents terminates on the date you are assigned as a Detective or promoted to the rank of Sergeant or above, or you are removed from the active payroll of the Police Department of the City of New York (except for those officers on suspension).
Benefits also cease upon the death of the member, unless the New York City Police Pension Board classifies the death as a "Line of Duty" death. In this case, benefits will be continued for the widow and/or dependent children.
Coverage for a spouse ceases upon divorce from the member. In addition to timely notification to the Fund, (31 days), a complete copy of the divorce decree must be provided to the PBA Funds Office.
When Does Coverage for Eligible Children Cease?
Coverage for eligible children ceases on the day they marry or, the end of the month in which they attain the age of nineteen (19), whichever occurs first. However, coverage may be continued if they are:
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Unmarried and attending school as a Full-Time Student. They may remain covered until December 31 of the year in which they attain the age of twenty-three (23), they graduate, or leave school whichever occurs first.
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Unmarried children that can not support themselves due to mental illness, developmental disability, mental retardation, or physical handicap. The disability must have occurred prior to the normal termination date of the child's coverage at age nineteen (19).
If a change occurs in a dependent's status, (e.g., marriage, divorce, birth, adoption, becoming a full-time student, death, etc.), the member must contact the PBA Funds Office and request a "Change of Dependent" form (PBA-6). The completed form must be returned to the PBA Funds Office with the proper documentation (marriage certificate, birth certificate, a statement from school's registrar's office, etc.) Financial aid statements, tuition charges, etc. are not acceptable.
