Dear State Health Benefits Program Participant,
The New Jersey Division of Pensions and Benefits (NJDPB) has announced changes to all medical plans, effective July 1, 2026. As a result, a Special Open Enrollment Period will be held from April 1 through April 30, 2026.
Please be aware that your current medical plan will no longer be offered as of July 1, 2026. If you take no action during the Special Open Enrollment period, you will be automatically enrolled in an updated version of your current plan. While similar, this default plan is not identical to your existing coverage.
For this reason, all State Health Benefits Program (SHBP) participants are strongly encouraged to review:
- Their current medical plan, and
- The medical plan options available effective July 1, 2026
Doing so will help ensure you select the plan that best meets your needs and those of your family.
What’s changing?
Effective July 1, 2026, the New Jersey Division of Pensions and Benefits (NJDPB) is implementing several changes to State Health Benefits Program (SHBP) medical and prescription plans:
- Medical plan cost changes
- In‑network deductibles, copayments, and out‑of‑pocket maximums will change across all plans.
- Prescription drug coverage
- Mail‑order will be required for maintenance medications.
- Copayments and out‑of‑pocket maximums for prescription drugs will also change.
- Ambulatory Surgical Centers (ASC) requirement
- Certain procedures must be performed at an in‑network Ambulatory Surgical Center (ASC).
- If those procedures are performed at a location other than an in‑network ASC, a 50% coinsurance will apply.
What do these changes mean to you?
- Your costs may be different. Because deductibles, copayments, and out‑of‑pocket maximums are changing, your out‑of‑pocket costs for medical and prescription services may increase or decrease depending on the plan you select and how often you use care.
- You may need to change how you get prescriptions. If you take long‑term or maintenance medications, you will be required to use mail‑order pharmacy services, which may affect how and when you receive your medications.
- Where you receive care matters more. For certain procedures, using an in‑network Ambulatory Surgical Center (ASC) will be required. Choosing a non‑ASC location for these procedures could result in a significantly higher cost to you (50% coinsurance).
- Taking no action may lead to surprises. Your current medical plan will not continue as‑is. If you do not actively enroll during the Special Open Enrollment period, you will be defaulted into a similar, but not identical plan, which may have different costs and rules.
- Reviewing your options is strongly recommended. Comparing the available plans during Special Open Enrollment can help ensure you choose coverage that best fits your medical needs, prescription usage, and financial situation.
Additional information, including SHBP Benefits Fairs, detailed plan changes, and finalized premium rates, will be posted on the New Jersey Division of Pensions and Benefits (NJDPB) website as it becomes available.
Can other benefit changes be made during this Special Enrollment?
No. You may not make changes to covered dependents, dental coverage, or Flexible Spending Accounts (FSAs)
These changes can only be made during the regular annual enrollment period in October.
If I am not currently enrolled in a health plan, can I enroll during this Special Open Enrollment?
No. Employees not currently enrolled in SHBP coverage cannot enroll at this time. They will have the opportunity to enroll during the regular annual enrollment in October, with benefits effective January 1, 2027.
Where can I find information regarding the new plan offerings?
Information related to the new plans can be found on the NJDPB-State Health Benefit Webpage.
- Click on ‘Review Your Plan Choices” to view the medical plan overviews and side by side plan comparison charts.
- Plan rate information and calculators can be found by clicking on “Calculating Your Costs”
Where can I view my current health plan elections and make changes?
To review or make changes, please use BenefitSolver, the State’s online Open Enrollment tool. You can log into BenefitSolver or create an account through MyNewJersey. Should you have issues creating an account or logging in, please use the ‘Need Help” function on the Log In page. For assistance with the BenefitSolver tool, use the support feature within the application. Additional details are available on the NJ Division of Pensions and Benefits (NJDPB) website.
We are here to help.
To assist you further, your University Human Resources benefits team will be hosting two (2) virtual webinars and six (6) in-person open houses. Representatives from Horizon and Aetna will also attend all Open Houses.
The schedule of UHR Open Houses and registration information for the webinars may be found on the UHR Special Enrollment Webpage.
Our Special Enrollment webpage includes comprehensive information related to the changes and the resources available. There are Frequently Asked Questions and links to register for the UHR live webinars as well as the Horizon and Aetna webinars.
We encourage you to take advantage of this opportunity to review your plan options during this special enrollment period to ensure the “new” version of your plan continues to meet your needs.
If you have any questions, please contact the OneSource Rutgers Faculty and Staff Service Center at 732-745-7378.
Sincerely,
Vivian Fernández
Senior Vice President for Human Resources