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ACTIVE FUND
Eligibility
Who is Eligible for Coverage?
Members of the PBA Health and Welfare Fund and their eligible dependents.
Who is a "Member"?
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).
Who is a "Dependent"?
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.
Commencement of
Coverage
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.
Termination of 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).
Changing the Dependent Record
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.
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