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Open Enrollment for SHBP 2014

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Human Resources

Open Enrollment for SHBP 2014

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The Office of Human Resources at Kean University would like to inform you that the State Health Benefits Program (SHBP) Open Enrollment period for full-time Kean University employees began on October 1, 2013, and will end on November 1, 2013.

During the Open Enrollment period employees can make general changes (adding or deleting dependents, changing coverage levels, etc.) or enroll in a different medical or dental plan. 

All changes to coverage made during this Open Enrollment period will be effective on January 1, 2014.

MEDICAL PLANS AVAILABLE

The current plans available through the State Health Benefits Program (SHBP) will still be available in plan year 2014. Both Aetna and Horizon Blue Cross Blue Shield of New Jersey will continue to offer Preferred Provider Organization (PPO) plans, Health Maintenance Organization (HMO) plans, and High Deductible Health Plans.

NEW FOR 2014

Four new medical plan choices are being added for the 2014 plan year.

  • New 2035 Plan Design — included in the plan offerings for State employees this Open Enrollment are the new 2035 medical plan designs. The new 2035 plans feature a $20 copayment for a primary care visit, $35 copayment for a specialist visit, and a new prescription drug plan: all designed to reduce premium costs and lower employee contributions. 

Medical plans available to full-time Kean University employees in 2014 are:

PLAN

TYPE

STATUS

NJ Direct 15

PPO

Existing 2013 Plan

NJ Direct 1525

PPO

Existing 2013 Plan

NJ Direct 2030

PPO

Existing 2013 Plan

NJ Direct 2035

PPO

NEW

Horizon HMO*

HMO

Existing 2013 Plan

Horizon HMO 1525*

HMO

Existing 2013 Plan

Horizon HMO 2030*

HMO

Existing 2013 Plan

Horizon HMO 2035*

HMO

NEW

NJ Direct HD 1500

High Deductible Plan

Existing 2013 Plan

NJ Direct HD 4000

High Deductible Plan

Existing 2013 Plan

Aetna Freedom15

PPO

Existing 2013 Plan

Aetna Freedom1525

PPO

Existing 2013 Plan

Aetna Freedom2030

PPO

Existing 2013 Plan

Aetna Freedom2035

PPO

NEW

Aetna HMO

HMO

Existing 2013 Plan

Aetna HMO 1525

HMO

Existing 2013 Plan

Aetna HMO 2030

HMO

Existing 2013 Plan

Aetna HMO 2035

HMO

NEW

Aetna Value HD1500

High Deductible Plan

Existing 2013 Plan

Aetna Value HD4000

High Deductible Plan

Existing 2013 Plan

*Note: The service areas for the Horizon HMOs are limited to New Jersey, Delaware, and bordering counties in Pennsylvania and New York.

A NEW Plan Comparison Chart is available at: http://www.nj.gov/treasury/pensions/hb_open_enrollment_2013/ha-0895.pdf

NEW - SHBP WELLNESS PROGRAM

Beginning with the 2014 plan year, the SHBP will launch NJWELL — a new wellness program designed to help you live a healthy lifestyle. NJWELL is open to employees who are enrolled in the SHBP. Spouses and eligible partners can also participate, as long as they are covered by the SHBP plan.

Through NJWELL, employees receive incentives for participating in simple screenings, health assessments, and participating in other wellness and healthy lifestyle activities. And since healthier individuals typically require less-costly health care, the NJWELL program can help the SHBP contain health care costs and pass those savings to you, through lower premium rates in the future.

In 2014, NJWELL will focus on helping employees understand their current health status. It is anticipated that employees and their covered spouses/partners will each receive a $100 gift card when they earn 250 Wellness Points by participating in both a:

  • Biometric Screening — A participant earns 100 points by having a biometric screening, which identifies potential health risks. Participants can complete a screening by having their physician complete an attestation form at their annual physical. The attestation form will be available on the Division of Pensions and Benefits website starting in January. 
  • Health Assessment — A participant earns 150 points by completing a short online Health Assessment questionnaire about the participant’s general lifestyle. Health Assessment questionnaires will be available in January for members who register at their health plan’s online portal. 

All Biometric Screening and Health Assessment information will be confidentially collected and stored by the participant’s health plan. The results are provided only to the participant; by law, they cannot be shared with an employer.

In future years, active employees and their covered spouses/partners can earn points and obtain increased financial incentives for performing a wide array of wellness activities. These will include reaching goals associated with the biometric screening, such as lowering cholesterol, blood sugar, blood pressure and BMI, or quitting smoking. They can also earn points for receiving preventive screenings, working with a health coach, and completing online activities.

In a few weeks, a flyer will be mailed to you from the Division of Pensions and Benefits, if you are enrolled in the SHBP, announcing NJWELL and providing initial information about the program. Subsequently, you will receive information on NJWELL directly from either Aetna or Horizon, depending on the SHBP benefit plan option in which you are enrolled.

Additional information about NJWELL will be provided via email by the Office of Human Resources as it becomes available from the Division of Pension and Benefits in the coming months.

PAYROLL DEDUCTIONS AVAILABLE FOR HDHP PARTICIPANTS 

Employees participating in the one of the High Deductible Health Plans (HDHP) are able to have tax deferred contributions from their paychecks to fund their Health Savings Account (HSA).

SUMMARIES OF BENEFITS AND COVERAGE

Detailed information about the SHBP’s medical plans is available through new Summaries of Benefits and Coverage which are posted online at: http://www.state.nj.us/treasury/pensions/hb-sbc-state-active.shtml

EMPLOYEE CONTRIBUTIONS FOR SHBP COVERAGE

Pursuant to the Pension and Health Benefit Reform (Chapter 78, P.L. 2011), employees must pay a percentage of the medical and prescription plan premiums (or 1.5% of annual salary if greater).

Most State employees are currently subject to a four-year phase-in of contribution rates, and pay at the “Year Three” contribution level. “Year Three” contribution rates apply for the period of July 1, 2013 through June 30, 2014. “Year Four” full contribution rates will become effective July 1, 2014 and thereafter.

The increase in plan premiums also increases the required employee contribution for medical and prescription coverage. Employees who are considering a change of medical plan based on cost should review the contribution amounts for both “Year Three” and “Year Four” contributions.

Percentage of premium contribution worksheets and online calculators have been revised for 2014 rates, and are available through links at: http://www.nj.gov/treasury/pensions/hb-percentage14-monthly.shtml

WAIVING SHBP COVERAGE

State employees are permitted to waive SHBP medical and prescription coverage — and avoid the required employee contribution — provided that they have other health care coverage. To waive coverage a SHBP State Waiver form and a Health Benefit Application must be completed during Open Enrollment. To waive coverage effective January 1, 2014, employees should indicate “Open Enrollment” on the waiver form; otherwise, the waiver will be effective before January 1st.

FORMS YOU NEED TO ENROLL IN OR CHANGE HEALTH COVERAGE

Health Benefits Program Application
PPOs and HMOs
http://www.nj.gov/treasury/pensions/epbam/exhibits/pdf/ha0891.pdf
HDHPs
http://www.state.nj.us/treasury/pensions/epbam/exhibits/pdf/ha0910.pdf
HSA Contribution Form
http://www.state.nj.us/treasury/pensions/epbam/exhibits/pdf/ha0914.pdf

DENTAL PLANS 

Dental coverage is offered to all full-time Kean University employees through the Employee Dental Plans. Seven different dental plans are offered based on one of two different plan designs — Dental Plan Organizations (DPO) and a Dental Expense Plan(PPO).

Six DPOs are available: Aetna DMO; BeneCare; CIGNA DHMO; Community Dental Associates; Healthplex; and Horizon Dental Choice.

DPOs contract with a network of providers for dental services. When an employee or dependent uses a DPO dentist, diagnostic and preventive services are covered in full. Most other eligible expenses require a small copayment. Members must use a provider that participates with the DPO selected to receive coverage. Be sure to confirm that the dentist or dental facility selected is taking new patients and participates with the SHBP Employee Dental Plans, since DPOs also service other organizations.

The Dental Expense Plan is a PPO plan that allows members to obtain services from any dentist; however, as a PPO, using an in-network provider will reduce an employee’s costs. After satisfying an annual deductible (no deductible for preventive services), members are reimbursed a percentage of the reasonable and customary charges for eligible services.

Employees must remain enrolled in a dental plan for a minimum of 12 months before they will be allowed to change plans.This means that an employee who was not enrolled in a dental plan as of January 1, 2013, will not be permitted to change dental plans during this Open Enrollment.

The employee cost for coverage under a dental plan is 50 percent of the actual dental plan premium. Therefore, the employee cost varies depending on which dental plan an employee chooses; however, the rate for coverage under a DPO remains considerably less expensive than the Dental Expense Plan.

Dental Plan Rates for 2014 were approved by the State Health Benefits Commission and rate charts for dental coverage are available at: http://www.state.nj.us/treasury/pensions/hb_open_enrollment_2013/state-monthly-dental.pdf

Dental Plan Websites

http://www.state.nj.us/treasury/pensions/employee-dental-plans.shtml 

Dental Plan Fact Sheet
http://www.state.nj.us/treasury/pensions/pdf/factsheets/fact37.pdf
 

FORM YOU NEED TO ENROLL IN OR CHANGE DENTAL COVERAGE

Employee Dental Plans Application

http://www.state.nj.us/treasury/pensions/epbam/exhibits/pdf/hd0719.pdf

NEW - SOCIAL MEDIA 

The Division of Pensions and Benefits will launch official Facebook, Twitter, and YouTube pages. These social media accounts have been created for the limited purpose of generally discussing NJDPB pension plans, health benefit programs, and NJDPB administration and operations. These sites are not intended nor created to be a general public forum, or to discuss individual member or annuitant specific information. We

encourage you to stay connected to the Division through the new social media accounts listed below:

www.facebook.com/NJDPB
www.twitter.com/NJDPB1
www.youtube.com/user/DPBNJ

Additional Information
If you have additional questions regarding Open Enrollment, please feel free to contact Yrelys Tapanes, Managing Assistant Director-Benefits at Kean University, by calling 908-737-3313 or via email at ytapanes@kean.edu. You may also review the following SHBP open enrollment information from the Division of Pension and Benefits: http://www.state.nj.us/treasury/pensions/open-2013.shtml or http://www.state.nj.us/treasury/pensions/health-benefits.shtml. 

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