Date: October 6, 2015
To: All Rutgers Faculty, Staff and Administrators
From: Vivian Fernández
Vice President for Faculty & Staff Resources
Re: Important Benefits Information -- Open Enrollment, Plan Year 2016 

The State Health Benefits Program (SHBP) has designated October 1, 2015 to November 2, 2015 as the annual Open Enrollment period for the State Health Benefits Program and New Jersey Tax$ave program. This is your annual opportunity to assess your benefits needs and revise your medical, prescription drug, dental, and pre-tax flexible spending accounts selections. The deadline for submission of all plan changes is October 30, 2015. All changes made during Open Enrollment will be effective on January 1, 2016. 

For more information, visit http://uhr.rutgers.edu/open-enrollment.

If you do not anticipate making any changes to your medical, dental, or prescription plan coverage options during the open enrollment period, then no action is required on your part to maintain your coverage during Open Enrollment.  However, be advised that if you are enrolled in any Flexible Spending Accounts and wish to maintain that benefit for 2016, then re-enrollment must be completed during Open Enrollment.  See the section “Tax$ave Plans” for more information.

Open Enrollment Highlights

Medical Plans

Rutgers employees will continue to be able to participate in both Aetna and Horizon Blue Cross Blue Shield of New Jersey health care plans through participation in the SHBP. However, there will be several changes to the plan options offered for Plan Year 2016.  Please see the chart below for a summary of continuing, new and discontinued plans.  Additionally, the SHBP Medical Plan and Prescription Drug Plan Comparison guide provides an informative side-by-side comparison of all major plan features, such as copays and deductibles.

Two new medical plans will be offered for the first time: Aetna Liberty and Horizon OMNIA.  These new plans will give members the flexibility to utilize providers in the carrier’s managed care network at a significant premium share reduction, with no referrals required.  Key features of these new plans, when using “Tier 1” preferred providers, are lower employee contributions, $5 primary care copays, and no in-network coinsurance. There is no out-of-network coverage with the tiered plans. 

Additionally, for both Aetna and Horizon, several HMO plans will no longer be offered.  Employees in these plans must choose a new medical plan by October 30, 2015; otherwise, they will be automatically switched to the new tiered network plan for their respective insurer on January 1, 2016. See the table below to see which plans are being discontinued for Plan Year 2016.

Other changes taking effect for the 2016 Plan Year are:

  • Payment for Out-Of-Network Chiropractic and Acupuncture visits will be limited to $35 for chiropractic and $60 for acupuncture, or 75% of the in-network cost per visit, whichever is less.  In-network provider payments remain unchanged.
  • Emergency room copays will increase by $25 where the current copay is less than $100.

Summary of Medical Plans Available -- January 1, 2016

Medical Plan Providers

Continuing Plans

New Plans

Discontinued Plans

Horizon Blue Cross Blue Shield of New Jersey

NJ DIRECT15
NJ DIRECT1525
NJ DIRECT2030
NJ DIRECT2035

Horizon HMO

NJ DIRECT HD1500
NJ DIRECT HD4000

Horizon Omnia
Horizon HMO1525
Horizon HMO2030
Horizon HMO2035
Aetna

Aetna Freedom15
Aetna Freedom1525
Aetna Freedom2030
Aetna Freedom2035

Aetna HMO

Aetna Value HD1500
Aetna Value HD4000

Aetna Liberty
Aetna HMO1525
Aetna HMO2030
Aetna HMO2035
 

You may visit http://uhr.rutgers.edu/open-enrollment for medical plan and prescription drug plan information.

Dental Plans

There will be no plan changes to the dental plan options offered under the SHBP.  You may continue to use your current dental identification card and use the same claim forms.

You may visit http://uhr.rutgers.edu/open-enrollment for dental plan information including the SHBP Dental Plan Comparison guide. Please take the time to review the 2016 Monthly Group Dental Rates linked through the UHR Open Enrolment website.

Important Exception:  Employees who began enrollment in a SHBP dental plan after January 1, 2015 will not be permitted to change dental plans during this Open Enrollment period.  Employees must remain enrolled in a dental plan for a minimum of 12 months before they are allowed to change plans. 

Express Scripts/Medco Prescription Plan

There will be no benefit changes to the SHBP employee prescription drug plan. You may continue to use your current prescription identification card and continue to refill your prescription drugs using the same claim forms. For additional information visit the SHBP Express Scripts website https://www.express-scripts.com/. The customer service telephone number on your identification card, 1-866-220-6512 will also remain the same.

Tax$ave Plans – Section 125 Flexible Spending Accounts

You can enroll in a flexible spending account program (Tax$ave) to save money on your taxes by paying for eligible healthcare and dependent care expenses with pre-tax dollars. The program, provided for under Section 125 of the Internal Revenue Code, consists of a Premium Option Plan (plan that allows your health insurance premiums to be deducted on a pre-tax basis), Unreimbursed Medical Flexible Spending Account (annual limit – $2,500), and a Dependent Care Flexible Spending Account (annual limit – $5,000). 

The Tax$ave plans do not renew automatically, therefore, you must enroll or reenroll during the Open Enrollment period to participate in the Section125 Flexible Spending Accounts in 2016. You may enroll online at http://www.wageworks.com. You may also complete the FSA Election Form http://www.state.nj.us/treasury/pensions/pdf/taxsave/fsa-enrollment-form-2016.pdf and fax to 1-866-672-4780, or mail to Wageworks Enrollment Processing, P.O. Box 1840, Tallahassee, FL 32302-1840 (must be postmarked no later than November 2, 2015). All changes made during Open Enrollment will become effective January 1, 2016. 

Changes in Coverage and Estimating Premium Costs

Changing or Waiving Coverage

In order to make changes to your health and/or dental coverage, you must complete the State Health Benefits Program Medical and/or Dental Application, and forward to University Human Resources, 57 US Highway 1, New Brunswick, NJ 08901-8554. These forms are available on the UHR website at, http://uhr.rutgers.edu/policies-resources/forms/open-enrollment.  If you are enrolling eligible dependents, the State requires submission of documentation to verify the dependent status of the enrollee with the submission of the SHBP application. A listing of acceptable documentation is available at http://uhr.rutgers.edu/sites/default/files/userfiles/DepenEligibDoc.pdf.

Waiving Health Benefits Coverage

In order to waive your health benefits you must complete a State Health Benefits Program Medical and/or Dental Application, and a SHBP State Waiver form, and forward to University Human Resources, 57 US Highway 1, New Brunswick, NJ 08901-8554. These forms are available on the UHR website at http://uhr.rutgers.edu/open-enrollment-procedure.

Please note that in order to waive coverage effective January 1, 2016, you must indicate “Open Enrollment” on the SHBP Waiver form. If “Open Enrollment” is not indicated on the form, the waiver request will be effective immediately.

Estimating Health Insurance Premium Costs

In order to assist in assessing the financial impact of each health insurance plan option, UHR has developed an online Employee Medical and Prescription Insurance Premium Estimator to help you determine the monthly premium costs for your medical and/or prescription drug coverage. The premium estimator may be accessed at http://hrservices.rutgers.edu/estimator/.

“Working For U” Benefits Fairs

University Human Resources hosts yearly benefits fairs where employees can receive free flu shots, and meet with UHR staff and vendor representatives who will provide information and answer questions. Plan literature and enrollment forms will also be available at the fairs. This year, the “Working for U” benefits fairs will be held at the following locations:

  • October 7, 10 a.m. – 4 p.m. – Rutgers University-Newark, Paul Robeson Campus Center, Multipurpose Room, 350 Martin Luther King Jr Blvd, Newark, NJ 07102
  • October 13, 10 a.m. – 3 p.m.  Rutgers University-Camden, Camden Campus Center, 326 Penn St. Camden, NJ 08102 (For Rutgers-Camden and Legacy UMDNJ Stratford Employees)
  • October 15, 10 a.m. – 4 p.m. – Rutgers University-New Brunswick, College Avenue Campus, Student Center Multipurpose Room, 126 College Ave New Brunswick, NJ 08901
  • October 16, 10 a.m. – 4 p.m. – RBHS Piscataway / New Brunswick, Medical Education Building (MEB) Courtyard, Robert Wood Johnson, 125 Patterson Street, New Brunswick, New Jersey 08901
  • October 22, 10 a.m. – 4 p.m. – RBHS Newark, Oral Health Pavilion, 50 Twelth Ave, Newark, NJ 07101
  • October 27, 10 a.m. – 4 p.m. – Rutgers University-Piscataway, Busch Campus Student Center, Multipurpose Room, 604 Bartholomew Road Piscataway, NJ 08854

Visit the UHR website at http://uhr.rutgers.edu/open-enrollment for Open Enrollment information, applications, forms, plan premiums, and additional plan resources. If you have any benefits questions, please contact a Benefits Specialist at 848-932-3990 or at benefits@hr.rutgers.edu.