Form Fp-0867-0215 Alternate Benefit Program Enrollment/transfer Application (Page 2 of 3) in pdf

FP-0867-0215

STATE OF NEW JERSEY

DEPARTMENT OF THE TREASURY

DIVISION OF PENSIONS AND BENEFITS

PO BOX 295, TRENTON, NJ 08625-0295

ALTERNATE BENEFIT PROGRAM

ENROLLMENT/TRANSFER APPLICATION

(For transfers from PERS/TPAF)

GENERAL INFORMATION

ELIGIBILITY — All full-time faculty and administrative personnel required to possess a Bachelor's Degree are

eligible for enrollment in the Alternate Benefit Program (ABP). Adjunct Faculty and Part-Time Instructors are

also eligible for enrollment in the ABP under the provisions of Chapter 89, P.L. 2008. Other employees hired in

a temporary position are not eligible. Employees earning less than 50% of the normal base salary are not eligi-

ble. Employees with F or J visas are not eligible. Note: A retiree from any New Jersey State-administered retire-

ment system is ineligible to participate in the Alternate Benefit Program.

VESTING ELIGIBILITY CRITERIA — See Item 6. A member is immediately vested if he/she owns a retirement

contract that contains both employer and employee contributions that is based upon employment in the field of

higher education or transfers an active or vested New Jersey State-administered retirement system account to

the ABP. The retirement contract must be in force, that is, the employee is entitled to receive benefits at a future

date. The member is also immediately vested if he/she is an active or vested member of a State-administered

retirement system of any state in the United States.

INVESTMENT CARRIER SELECTION — ABP members must complete an Alternate Benefit Program Provider

Election and Allocation Form and the application forms of each investment carrier selected.

INSTRUCTIONS FOR COMPLETING THE APPLICATION

Parts I & II are to be completed by the employee. Part III is to be completed by the employer.

Part I — Please complete items 1 - 8.

Part II — If you were recently a member of the New Jersey Teachers’ Pensions and Annuity Fund (TPAF), the

Police and Firemen's Retirement System (PFRS) or the Public Employees’ Retirement System (PERS) and did

not withdraw your contributions from that retirement system, you may remain in, or transfer into, the PERS and

waive participation in the Alternate Benefit Program (ABP). You may obtain a proper transfer form from your per-

sonnel office. However, if you elect to participate in the ABP, this Enrollment Application must be completed and

submitted to transfer contributions to the ABP.

Note: The Designation of Beneficiary for Group Life Insurance is no longer a part of this application.

Upon enrollment a new ABP member’s estate is automatically designated as the beneficiary for any death ben-

efit. New members should update their beneficiary information by completing an ABP Designation of Beneficiary

form and submitting it to the Division of Pensions and Benefits. For individuals age 60 or older, to be covered

by the group life and disability insurance programs, you must submit to a medical examination to prove insura-

bility. A medical examination will be arranged for you. Upon advice from the insurance carrier that you have

proved insurability, you will be covered. This does not change your beneficiary designation for your annuity.

Contact your individual investment carrier(s) for changes to your annuity.

IN THE EVENT THAT YOU CANNOT COMPLETE THE ABP ENROLLMENT APPLICATION ONLINE USING

THE EMPLOYERS’ PENSIONS AND BENEFITS INFORMATION SYSTEM (EPIC), please mail a completed

copy of this Enrollment/Transfer Application to:

Division of Pensions and Benefits

Defined Benefit & Defined Contribution Plans Reporting Bureau

PO Box 295

Trenton, NJ 08625-0295

Form Fp-0867-0215 Alternate Benefit Program Enrollment/transfer Application Page 2

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