Section 22820 Of Article 4. Eligibility From California Government Code >> Division 5. >> Title 2. >> Part 5. >> Chapter 1. >> Article 4.
22820
. (a) Upon the death, on or after January 1, 2002, of a
firefighter employed by a county, city, city and county, district, or
other political subdivision of the state, a firefighter employed by
the Department of Forestry and Fire Protection, a firefighter
employed by the federal government who was a resident of this state
and whose regular duty assignment was to perform firefighting
services within this state, or a peace officer as defined in Section
830.1, 830.2, 830.3, 830.31, 830.32, 830.33, 830.34, 830.35, 830.36,
830.37, 830.38, 830.39, 830.4, 830.5, 830.55, or 830.6 of the Penal
Code, if the death occurred as a result of injury or disease arising
out of and in the course of his or her official duties, the surviving
spouse or other eligible family member of the deceased firefighter
or peace officer, if uninsured, is deemed to be an annuitant under
Section 22760 for purposes of enrollment. All eligible family members
of the deceased firefighter or peace officer who are uninsured may
enroll in a health benefit plan of the surviving spouse's choice.
However, an unmarried child of the surviving spouse is not eligible
to enroll in a health benefit plan under this section if the child
was not a family member under Section 22775 and regulations pertinent
thereto prior to the firefighter's or peace officer's date of death.
The employer of the deceased firefighter or peace officer shall
notify the board within 10 business days of the death of the employee
if a spouse or family member may be eligible for enrollment in a
health benefit plan under this section.
(b) Upon notification, the board shall promptly determine
eligibility and shall forward to the eligible spouse or family member
the materials necessary for enrollment. In the event of a dispute
regarding whether a firefighter's or peace officer's death occurred
as a result of injury or disease arising out of and in the course of
his or her official duties as required under subdivision (a), that
dispute shall be determined by the Workers' Compensation Appeals
Board, subject to the same procedures and standards applicable to
hearings relating to claims for workers' compensation benefits. The
jurisdiction of the Workers' Compensation Appeals Board under this
section is limited to the sole issue of industrial causation and this
section does not authorize the Workers' Compensation Appeals Board
to award costs against the system.
(c) (1) Notwithstanding any other provision of law, and except as
otherwise provided in subdivision (d), the state shall pay the
employer contribution required for enrollment under this part for the
uninsured surviving spouse of a deceased firefighter or peace
officer for life, and the other uninsured eligible family members of
a deceased firefighter or peace officer, provided the family member
meets the eligibility requirements of Section 22775 and regulations
pertinent thereto.
(2) The contribution payable by the state for each uninsured
surviving spouse and other uninsured eligible family members shall be
adjusted annually and be equal to the amount specified in Section
22871.
(3) The state's contribution under this section shall commence on
the effective date of enrollment of the uninsured surviving spouse or
other uninsured eligible family members. The contribution of each
surviving spouse and eligible family member shall be the total cost
per month of the benefit coverage afforded him or her under the plan
less the portion contributed by the state pursuant to this section.
(d) The cancellation of coverage by an annuitant, as defined in
this section, shall be final without option to reenroll, unless
coverage is canceled because of enrollment in an insurance plan from
another source.
(e) For purposes of this section, "surviving spouse" means a
spouse who was married to the deceased firefighter or peace officer
on the deceased's date of death and either was married for a
continuous period of at least one year prior to the date of death or
was married to the deceased prior to the date the deceased
firefighter or peace officer sustained the injury or disease
resulting in death.
(f) For purposes of this section, "uninsured" means that the
surviving spouse is not enrolled in an employer-sponsored health plan
under which the employer contribution covers 100 percent of the cost
of health care premiums.
(g) The board has no duty to identify, locate, or notify any
surviving spouse or eligible family member who may be or may become
eligible for benefits under this section.