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HomeMy Public PortalAboutr 08:165 #08-165 JULY 10, 2008 FH-0170-0501 STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY DIVISION OF PENSIONS AND BENEFITS NEW JERSEY STATE HEALTH BENEFITS PROGRAM PO Box 299 Trenton, New Jersey 08625-0299 RESOLUTION A RESOLUTION to elect a premium delay option as selected below. o One month delay (initial election) [g! Two month delay (initial election) o Add additional one month delay for a maximum premium delay of two months (for locations that have previously adopted a one month premium delay) BE IT RESOLVED: The Bd{,OI..\.~ '" o ~ CQlft~V<'- ~ Name of Employer - County - SHBP # hereby resolves to exercise its premium delay option under the SHBP as selected above, commencing Oc~obQ"r-I.). (JOB , with the premium. We understand that, should our group eiect to terminate SHBP participation sometime in the future or the Program ceases to exist, any delayed premiums will become due and payable immediately. We understand that this premium delay shall take effect 60 days foilowing receipt of this resolution by the State Health Benefits Commission. We understand, in accordance with N.J.S.A, 17:9-5.3(b), fhat full payment of health benefit charges must be received on or before the due date printed on the bill and that interest shall be applied to the total transmittal of health benefit charges from the day following the due date until the day payment is received. I hereby certify that the foregoing is a true and correct copy of a resolution duly adopted by the !SoroLl. Z}\ 0 ~ CAAevQ:t- Name of Employer onthel()~ dayof c9- AA~ ,20 of. ~~ 0. ~ Signature Assistant Municipal Clerk Official Title BELLINO - Yes COT~ON~. Y"t' DIAZ - Yes KRUM - Yes NAPLES - Absent SITARZ - Yes ~LJ:9li~V-