Amends GS 143-166.2 by expanding upon the definition of killed in the line of duty as it applies to the Public Safety Employees' Death Benefits Act, to provide that when the death of a firefighter occurs as a direct and proximate result of any cancer diagnosis that qualified the firefighter for benefits under the Firefighters' Cancer Insurance Program and because of which benefits under that program were received, then that firefighter is presumed to have been killed in the line of duty.

Enacts new GS 58-86A-10, deeming any firefighter having received a benefit under the Firefighters' Health Benefits Pilot Program as having received benefits under the Firefighters' Cancer Insurance Program.

Amends GS 58-86A-1 by adding that the Firefighters' Cancer Insurance Program (Program) is a permanent continuation of the Firefighters' Health Benefits Pilot Program. Prohibits the State Fire Marshal from purchasing commercial insurance for the Program and requires contracting with a third-party administrator instead. Makes additional conforming and technical changes.

Amends GS 58-86A-2 by defining the Firefighters' Health Benefits Pilot Program and Program (The Firefighters' Cancer Insurance Program).

Appropriates $2 million in recurring funds from the General Fund to the Department of State Treasurer for each year of the 2025-27 fiscal biennium to be used for benefits payable under the Public Safety Employees' Death Benefits Act related to the implementation of this act.

Effective July 1, 2025, and applies to qualifying deaths occurring on or after that date.