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| Date: | January 7, 2008 |
| To: | Employees Enrolled in the State Health Benefits Program (SHBP) |
| From: | Sandra L. Russell |
| Subject: | SHBP Medical Plan Changes |
Effective April 1, 2008, the New Jersey State Health Benefits Program (SHBP) will no longer offer the Traditional and NJ PLUS plans. Two types of medical plans will be available: a Preferred Provider Organization (PPO) and Health Maintenance Organizations (HMOs). The SHBP has awarded the PPO contract to Horizon Blue Cross Blue Shield of New Jersey and HMO contracts to Aetna and CIGNA.
Members currently contributing 1.5% of their salary for health insurance will continue to pay this insurance contribution regardless of the plan type (PPO or HMO) or level of coverage (e.g., family or single). The SHBP will announce premium rates in late January for members not currently paying the 1.5% insurance contribution.
Both plan types are managed care plans that provide for wellness and preventive care as well as coverage for injury and illness. The PPO plan for active employees is Horizon NJ DIRECT 15. This plan does not require referrals and has a $15 copayment for services received from preferred providers. The PPO allows for treatment of injury or illness by non-preferred providers with a $100 deductible and 70% coinsurance for most services. The HMOs have a $15 copayment for services received from network providers. Non-emergency out-of-network services are not covered under the HMOs. The NJ DIRECT 15 PPO and both HMO plans offer extensive national provider networks.
How does this affect me?
A special Open Enrollment period will be held January 28 through February 15, 2008. This is a “passive” Open Enrollment process, meaning that employees who are currently covered under the SHBP will automatically be transferred to the new plans as outlined below:
- If you are currently enrolled in the Traditional Plan or NJ PLUS, you will automatically be enrolled in the Horizon NJ DIRECT 15 plan.
- If you are currently enrolled in an HMO plan that is not being renewed (AmeriHealth, Health Net, or Oxford), you will be automatically enrolled in Horizon NJ DIRECT 15.
- If you are currently enrolled in either the Aetna HMO or CIGNA HMO, you will remain in that HMO plan.
Do I need to do anything?
No action is required on your part unless you wish to select a different medical plan or waive your medical coverage. To elect a different plan, you must complete a SHBP Enrollment Application (updated form is not yet available from the SHBP). If you would like to waive medical coverage, both a SHBP Enrollment Application and a SHBP Waiver/Reinstatement Form must be completed. All completed forms must be received by Payroll Services, 65 Davidson Road, ASB Room 317, Busch Campus by noon on February 15, 2008.
The special Open Enrollment period is for medical plan changes only. Members may not add dependents, change coverage levels, or make dental or prescription drug plan changes at this time.
Where can I get more information?
Representatives from the medical plan providers and University Human Resources will be available to answer questions and offer additional plan information between 10 a.m. and 3 p.m. on the following dates:
January 30 – Camden Campus Center, Multipurpose Room
January 31 – Cook Campus, Administrative Services Building II, Community Room
February 4 – Busch Campus Center, Multipurpose Room
February 5 – Rutgers Student Center, Multipurpose Room
February 6 – Newark Campus, Blumenthal Hall, Room 201
The SHBP will release a comprehensive guide to the new medical plans, provider directories, a plan comparison, and an updated online Unified Provider Directory in late January.
For the latest information about changes to the SHBP medical plans and to access enrollment/waiver forms, visit http://uhr.rutgers.edu/ben/SHBPMedChanges2008.htm or contact a UHR Benefits Specialist at 732-932-3020, ext. 4077.
