Active Fund: Eligibility

The benefits provided by the Health and Welfare Fund of the Patrolmen’s Benevolent Association of the City of New York are available to active New York City Police Officers (Members) and their eligible dependents.  Coverage is also available to the surviving spouse and children of a Member declared deceased in the line of duty (LOD).  Temporary continuation of coverage is available, at a cost, to former Members and dependents through COBRA.

Member

A “Member” is an active-duty New York City Police Officer for whom the City of New York is required to make a contribution to the PBA Health and Welfare Fund.  Participation under the Fund begins as of the Member’s first day of employment with the NYPD.  Coverage under the Fund ceases when one of the following events occurs:

• Employment with the NYPD ends
• The Member is promoted to the rank of Sergeant
• The Member is assigned as a Detective
• Death of the Member
• The City of New York is not required to make contributions to the Fund for the Member

Dependents

A Member’s eligible dependents include the Member’s:

• Spouse
• Domestic Partner
• Dependent Children

A “spouse” is a Member’s legally married spouse.  If a Member and spouse are already legally married on the Member’s first day of employment, eligibility for coverage for the Member’s spouse begins as of the Member’s first day of employment with the NYPD.  If the marriage occurs after the Member’s first day of employment with the NYPD, eligibility for coverage for the Member’s spouse begins on the date of the marriage.

A “domestic partner” is a Member’s domestic partner who has been approved for coverage as such by the City of New York Health Benefits Program.  Written approval of domestic partner coverage by the City of New York Health Benefits Program must be provided to the Fund in order to enroll a domestic partner.  There may be tax consequences associated with enrolling a domestic partner.  For more information, please contact the Office of Labor Relations Domestic Partnership Liaison Unit at 212-306-7605.

A Member’s “dependent children” include the Member’s natural or legally adopted children, children for whom the Member has court-appointed guardianship or custody, children required to be covered under a qualified medical child support order, and stepchildren living in the Member’s home.  Dependent children are eligible for coverage through the end of the month during which they attain the age of twenty-six (26).

Unmarried dependent children over the age of twenty-six (26) who are disabled may be covered as long as they remain disabled and the Member remains covered.   In order to remain covered beyond the age of twenty-six (26), a disabled child must:

• Be unmarried; and
• Be unable to support himself/herself due to a physical or intellectual disability or mental illness that occurred prior to age twenty-six (26); and
• Be enrolled as a disabled child in the City of New York Health Benefits Program.

A copy of the approval of coverage as a disabled child under the City of New York Health Benefits Program must be provided to the PBA Funds Office in order for the disabled child to continue to be covered.

Separate Enrollment Processes for PBA and City of New York Benefits

It is important to note that the Fund and the City of New York Health Benefits Program do not share enrollment information.  Please be sure to submit enrollment and dependent status change information separately to both the PBA Health and Welfare Fund and to the City of New York Health Benefits Program.  Updating information with one plan does not automatically update information with the other.  This applies to:

• Address changes
• Adding dependents
• Removing dependents
• Providing information regarding other coverage for COB

 
To update your information with the PBA Health & Welfare Fund, use the PBA Enrollment Form.

To update your information with the City, visit the City of New York Health Benefits Program website.