SB 1203, as introduced, Hertzberg. Firefighters and peace officers: health benefits.
Under the Public Employees’ Medical and Hospital Care Act (PEMHCA), an uninsured surviving spouse or other eligible family member of a deceased firefighter or peace officer is eligible to enroll in a health benefit plan approved or maintained by the Board of Administration of the Public Employees’ Retirement System if the death of the firefighter or peace officer occurred as a result of injury or disease arising out of, and in the course of, the firefighter’s or peace officer’s official duties, as specified. Under PEMHCA, the employer of a deceased firefighter or peace officer is required to notify the board within 10 days of the death of the firefighter or peace officer if a spouse or a family member may be so eligible for enrollment.
This bill would require the employer to also provide the board with updated contact information of the spouse or family member. By requiring local government employers to provide this contact information, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 22820 of the Government Code is
2amended to read:
(a) Upon the death, on or after January 1, 2002, of a
4firefighter employed by a county, city, city and county, district,
5or other political subdivision of the state, a firefighter employed
6by the Department of Forestry and Fire Protection, a firefighter
7employed by the federal government who was a resident of this
8state and whose regular duty assignment was to perform
9firefighting services within this state, or a peace officer as defined
10in Section 830.1, 830.2, 830.3, 830.31, 830.32, 830.33, 830.34,
11830.35, 830.36, 830.37, 830.38, 830.39, 830.4, 830.5, 830.55, or
12830.6 of the Penal Code, if the death occurred as a result of injury
13or disease arising out of and in the course of his or her official
14duties, the surviving spouse or other eligible family member of
15the deceased firefighter or
peace officer, if uninsured, is deemed
16to be an annuitant under Section 22760 for purposes of enrollment.
17All eligible family members of the deceased firefighter or peace
18officer who are uninsured may enroll in a health benefit plan of
19the surviving spouse’s choice. However, an unmarried child of the
20surviving spouse is not eligible to enroll in a health benefit plan
21under this section if the child was not a family member under
22Section 22775 and regulations pertinent thereto prior to the
23firefighter’s or peace officer’s date of death. The employer of the
24deceased firefighter or peace officer shall notify the board within
2510 business days of the death of the employee if a spouse or family
26member may be eligible for enrollment in a health benefit plan
27under thisbegin delete section.end deletebegin insert section, and shall provide the board with
28updated contact information of the
spouse or family member.end insert
29(b) Upon notification, the board shall promptly determine
30eligibility and shall forward to the eligible spouse or family
31member the materials necessary for enrollment. In the event of a
32dispute regarding whether a firefighter’s or peace officer’s death
33occurred as a result of injury or disease arising out of and in the
P3 1course of his or her official duties as required under subdivision
2(a), that dispute shall be determined by the Workers’ Compensation
3Appeals Board, subject to the same procedures and standards
4applicable to hearings relating to claims for workers’ compensation
5benefits. The jurisdiction of the Workers’ Compensation Appeals
6Board under this section is limited to the sole issue of industrial
7causation and this section does not authorize the Workers’
8Compensation Appeals Board to award costs against the system.
9(c) (1) Notwithstanding any other provision of law, and except
10as otherwise provided in subdivision (d), the state shall pay the
11employer contribution required for enrollment under this part for
12the uninsured surviving spouse of a deceased firefighter or peace
13officer for life, and the other uninsured eligible family members
14of a deceased firefighter or peace officer, provided the family
15member meets the eligibility requirements of Section 22775 and
16regulations pertinent thereto.
17(2) The contribution payable by the state for each uninsured
18surviving spouse and other uninsured eligible family members
19shall be adjusted annually and be equal to the amount specified in
20Section 22871.
21(3) The state’s contribution under this section shall commence
22on the effective date of enrollment of the uninsured surviving
23spouse or other uninsured eligible family
members. The
24contribution of each surviving spouse and eligible family member
25shall be the total cost per month of the benefit coverage afforded
26him or her under the plan less the portion contributed by the state
27pursuant to this section.
28(d) The cancellation of coverage by an annuitant, as defined in
29this section, shall be final without option to reenroll, unless
30coverage is canceled because of enrollment in an insurance plan
31from another source.
32(e) For purposes of this section, “surviving spouse” means a
33spouse who was married to the deceased firefighter or peace officer
34on the deceased’s date of death and either was married for a
35continuous period of at least one year prior to the date of death or
36was married to the deceased prior to the date the deceased
37firefighter or peace officer sustained the injury or disease resulting
38in death.
39(f) For purposes of this section, “uninsured” means that the
40surviving spouse is not enrolled in an employer-sponsored health
P4 1plan under which the employer contribution covers 100 percent
2of the cost of health care premiums.
3(g) The board has no duty to identify, locate, or notify any
4surviving spouse or eligible family member who may be or may
5become eligible for benefits under this section.
If the Commission on State Mandates determines that
7this act contains costs mandated by the state, reimbursement to
8local agencies and school districts for those costs shall be made
9pursuant to Part 7 (commencing with Section 17500) of Division
104 of Title 2 of the Government Code.
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