SHBP Health Contribution and Copayment Changes

The New Jersey Division of Pensions and Benefits implemented changes to the State Health Benefits Program (SHBP) effective July 1, 2007, that include changes to health insurance contribution and copayment amounts. The standard insurance contribution for employees enrolled in any SHBP medical and/or prescription coverage plan is 1.5 percent of the employee’s annual base salary. This contribution amount remains at 1.5 percent of annual base pay regardless of the plan (Traditional, NJ Plus, or any HMO), level of coverage (single, member and spouse/partner, parent and child, or family), or type of coverage (medical and/or prescription coverage). The university will begin payroll deductions for many employees to cover this insurance contribution in September. For employees paid on a 10-month basis, the new insurance contribution will become effective September 1, 2007.

An employee may elect to terminate his or her SHBP medical and prescription coverage to avoid paying the 1.5 percent insurance contribution by completing both a SHBP Waiver Form and Health Application Form. These two forms are available online and must be returned to Payroll Services, Administrative Services Building, Room 317, Busch Campus no later than August 31, 2007. Upon receipt of the forms, medical and/or prescription coverage will be terminated effective August 31, 2007. Employees currently not enrolled in medical or prescription coverage are not subject to the 1.5 percent insurance contribution.

Changes to copayment amounts were instituted effective July 1, 2007. The copayment per office visit to primary care physicians and specialists increased from $10 to $15 under NJ Plus and all HMO plans. The emergency room copayment increased from $25 to $50, although this copayment is waived if the member is admitted to the hospital.

An additional tier of prescription drug copayments was added for brand name drugs with generic equivalents. The new copayment amount is $25 per 30-day supply through a pharmacy and $40 per 90-day supply for mail order prescriptions. The current copayment amounts for generic drugs and for brand name drugs that do not have generic equivalents remain the same.

For additional information about the changes to the State Health Benefits program, visit the UHR website. You may also refer to the Frequently Asked Questions, or contact a Benefits Specialist at 732-932-3020, ext. 4077 for assistance.

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