During the 2019/2020 Legislative Session the joint Legislative Committee of the NCSFA and NCAFC discussed the priority of Cancer Legislation for the fire service and what needed to be done to secure passage. Both self-funded workers compensation systems used in NC for the fire service feared the passage of presumptive cancer legislation, since it took cancer treatment out of the medical insurance arena and put the total cost on workers compensation insurance. This raised concerns about escalating rates. in addition, some states like Georgia had found that presumptive did not mean automatic coverage since the WC’s carriers could still challenge and deny coverage, and firefighters were still not getting benefits. It was felt that an Insurance alternative, similar to what other States like Florida, South Carolina, and even eventually Georgia had passed, may be a better alternative.
In 2020 representatives from the NC State Firefighters Association (NCSFA) met with representatives from the League of Municipalities (NCLM) and discussed an insurance option as opposed to presumptive cancer. NCLM agreed that this would be a more acceptable option than presumptive legislation. In late 2020, NCSFA again met with the League and an insurance consultant they had brought in from Georgia to discuss an insurance bill. The consultant had been involved in both Florida’s and Georgia’s legislation. A draft cancer insurance bill was developed by the consultant with input from NCSFA from the discussions.
In early 2021, the new Fire Service Joint Legislative Committee (NCSFA, NCAFC, PFFPNC) also agreed an insurance cancer bill may be a better option for passage going into the 2021 session and the specifics of the draft bill were reviewed. During the same time frame, with new Gross Premium Assessment (GPA or GPT) numbers provided by Insurance Commissioner Mike Causey, NCSFA developed a chart with options for increasing the GPA to fund cancer. The specifics of the calculations provided funding for the cancer bill (approximately $130 per firefighter), increased funding for the grant program, increased funding going to the General Fund to be used for the Fire and Rescue Pension program, and kept Relief Fund and VSWCF funding stable with normal growth going into the future.
The draft bill as well as the GPA funding option has been provided to senior legislators in the House and Senate. Last week NCSFA and members of the Joint Fire Service Legislative Committee met with key legislators from the House and Senate to discuss the bill. It is our hope that a bill with be introduced soon in the House and/or Senate. Funding options may change but we have provided them with an option. Here is a synopsis of the bill presented.
Proposed North Carolina Firefighter Cancer Insurance Language
Program Structure Specifics for Drafting
Specific Language Referencing Program as an Alternative to Workers’ Compensation
1. The legislation will include specific language describing the benefit program as an alternative to Workers’ Compensation.
2. The language states that a firefighter who files for a cancer diagnosis in the workers’ compensation is not eligible for the benefits under the alternative program.
1. Continuous Years of Service – To be eligible under the program, the firefighter must have completed five years of service.
2. No Prior Diagnosis of Cancer – To be eligible for the cancer program, a firefighter is required to confirm they had no diagnosis of a covered cancer prior to the effective date of the program.
3. Tobacco Use – A firefighter must confirm they have not used tobacco products within 1 year of their effective date of coverage to be eligible under the program.
4. Definition of Active Firefighter Status – The legislation will reference the statutory definition of an active firefighter in (B)(2) Chapter 58-84-5(3a): “Performs work or training connected with fire protection, fire prevention, fire control, fire education, fire inspection, fire investigation, rescue, Emergency Medical Services, special operations, or performs the statutory duties and responsibilities of the fire chief as set forth in G.S. 160A-292.”
Date of Diagnosis and Compensability
1. A cancer diagnosis must occur on or after the effective date of the program to qualify for the lump-sum benefit.
Cancers Covered under the Program
2. Testicular cancer.
3. Intestinal cancer.
4. Esophageal cancer.
5. Multiple myeloma
7. Non-Hodgkin’s lymphoma
8. Malignant melanoma
9. Brain cancer
10. Prostate cancer
11. Colon cancer
12. Stomach cancer
13. Kidney cancer
14. Bladder cancer
15. Ovarian Cancer
16. Breast Cancer
1. The benefit amounts for the lump-sum benefit paid upon initial diagnosis are:
a. $25,000 for a diagnosis of a severe form of cancer (Stage 3,4).
b. $6,250 for the less severe cancer (Stage 1,2).
c. The definitions of severe/less severe will appear in the legislation.
2. Recurrence Provision – The legislation will provide for a 2X recurrence benefit allowing benefits for more than one diagnosis of cancer.
a. A 2X recurrence benefit funds up to $50,000 of indemnity benefit paid for severe and/or less severe cancer diagnosis.
b. The second diagnosis must occur at least 180 days after the first diagnosis.
3. Offset/Coordination – The lump-sum benefit will not offset or coordinate with any existing health insurance program. (meaning coverage benefits from other policies will not affect the payout of this policy.)
4. Taxability of Lump-sum Benefit – As the cost of the lump-sum benefit is not paid by the firefighter, it is deemed income by the IRS and is therefore taxable at the federal level. The legislation will state the benefit is not taxable at the state level. (we can’t do anything about federal)
1. Benefit Trigger – A firefighter must be unable to perform their duty as a firefighter due to cancer.
2. Date of Disability Due to Cancer – The disability elimination period commences on the date the firefighter is no longer able to work due to cancer.
3. 180 Day Elimination Period – The legislation will require that a firefighter remain disabled for 180 days before receiving monthly benefits.
4. Three Year Benefit Duration – The program will provide a monthly benefit for up to three years providing the firefighter remains disabled.
5. Monthly Benefit
a. Salaried firefighters would receive a monthly benefit that is 60% of their monthly earnings to a maximum of $5,000.
b. Volunteer firefighters would receive a flat monthly benefit of $1,500.
c. The disability benefit will coordinate with other sources of disability income.
d. The disability benefit will not coordinate with any insurance product the firefighter purchased for themselves or their families.
e. As the cost of the lump-sum benefit is not paid by the firefighter, it is deemed income by the IRS and is therefore taxable at the federal level.
f. The legislation will state the benefit is not taxable at the state level.
1. Continuation of the Benefit Program – The program will allow a firefighter to continue the indemnity benefit when they retire or leave the fire service provided the firefighter pays the insurance premium.
2. Rates and Plan Design – The firefighter would have access to the same indemnity benefit at the same program rates.
Premium Rates and Plan Design
1. Premium Rates – The program will offer the same rate for all eligible firefighters regardless of age, fire service occupation, employer (state, municipality, county or private fire departments) or location.
2. Plan Design – The program will offer the same base plan design satisfying the mandate of the legislation.
1. Start Date of the Program – January 1, 2022. (depending upon passage date to allow for budgeting)
Revision of G.S. 143-166.2 6 (e)
In addition our current Line of Duty Death Benefit under GS 143 will be amended to include the additional cancers covered by this bill.
1. Adding Additional Compensable Cancers to Firefighter Line of Duty Benefit – Currently G.S. 143-166.2 6 (e) lists four cancers – Mesothelioma, Testicular, Intestinal and Esophageal cancers.
2. The legislation will revise the line of duty death benefit to include the cancers consistent with the cancer insurance.