Special Open Enrollment April 2026

State Health Benefits Program (SHBP) Special Open Enrollment 2026

The NJ Division of Pensions and Benefits is implementing significant plan updates to plan offerings for 2026. Due to these changes, the State Health Benefits Program (SHBP) will be offering a Special Open Enrollment period from April 1, 2026, to April 30, 2026. Plan changes made during the Special Open Enrollment will be effective July 1, 2026. 

The current medical plans will no longer be offered. 

The NJ Division of Pensions and Benefits will automatically move you to a new “26” medical plan with the same carrier that corresponds to your current medical plan effective as of July 1, 2026. 

For example, “NJ DIRECT” will become “26 NJ DIRECT.” 

This Special Open Enrollment will allow active State employees currently enrolled in a SHBP medical plan the opportunity to change their medical plan election to a different new “26” plan, other than the one to which you will be automatically enrolled. You will not be permitted to elect coverage if you previously waived medical coverage, add dependents to your existing plan, or make changes to your dental plan.  

You are not required to take any action, unless you would like to change your plan from the one that will be automatically assigned to you effective July 1, 2026.  

What is Changing?  

Below is a summary of updates to the plans.  

Please note that certain plan changes are plan specific and are dependent on your particular plan. (i.e., out of network changes do not apply to plans that do not have out of network benefits.)  To better understand changes to your own plan, please feel free to review these resources, attend a webinar from Horizon and/or Aetna or reach out to the HR Benefits team.

• In-network and out-of-network deductibles  
  • For example, the 26 NJ DIRECT plan will have a $110.00 Individual/$220.00 Family in-network deductible per calendar year (for in-network services that do not require a copayment) and a $750.00 Individual/ $1,500.00 Family deductible per calendar year for out-of-network providers.
• Out-of-network out-of-pocket maximums  
• In-network diagnostic imaging and radiology services copays
• Limits on the number of covered out-of-network physical therapy visits
• The prescription drug plans will require mail order for maintenance drugs and will see changes to copayments and out-of-pocket maximums.  
• Certain procedures will cost you less when performed at an Ambulatory Surgical Center (ASC). These centers perform planned procedures that don't require a hospital stay. • The listed procedures performed at in-network ASCs are covered at standard in-network benefit levels. • A 50% coinsurance will apply to the same procedures when performed at an outpatient hospital unless medical criteria are met and an authorization is obtained. • A 50% coinsurance will apply if these same procedures are performed at an out-of-network hospital or out-of-network ASCs. 

The links below will provide you with a quick side-by-side comparison of the new plans that will be effective as of July 1, 2026. Links to the current plan designs are provided for reference.  

For a more in-depth look at what is changing in your plan, please feel free to review the Summary of Benefits and Coverage. They are provided below for ease of reference for both current plans and new plans.  

Horizon 

Aetna 

Your Next Steps: 

• Employees are encouraged to login to your Benefitsolver Account and review the name of their current medical plan election and review the new “26” plans available.  

• We recommend you register for a webinar from Horizon and/or Aetna to explore plan changes; and join the Kean Benefits Special Open Enrollment Q&A Session on April 20, 2026 from 1 pm - 1:30 pm. Meeting Link here.

• If you are not making any plan changes, you will not have to take any action. All employees automatically will be moved to a new “26” medical plan with the same carrier that corresponds to your current medical plan (Horizon or Aetna).
• If you wish to make changes to your medical plan, please proceed to your Benefitsolver account under Special Open Enrollment.  

• Any change to enrolled dependents should be submitted using a qualifying life event with verification required. 

Please note that you will receive new cards at the end of this Special Open Enrollment for active State Health Benefits Program (SHBP) coverage effective July 1, 2026.  

Kean Benefits Q&A Virtual Session  

Join the benefits team on Monday, April 20, 2026 from 1 PM - 1:30 PM for an open Question and Answer session on the 2026 plan changes for the April Special Open Enrollment.

Meeting Link here 

Resources 

NJ State Health Benefits Plan Webinar Lineup

NJ State Heath Benefits Plan Comparison

Horizon Plans 

Webinar Lineup 

Horizon Plans - Overview  

Medical Plans

July 2026 Premium Contribution Calculator

New 2026 Plans: What You Need To Know 

Aetna 

Aetna Webinar Lineup 

Aetna Plans - Overview 

Optum RX 

Managing Your Prescriptions Online 

Questions

The HR benefits team is here to support you. If you have questions regarding this Special Open Enrollment, or your benefits, please free to contact us: 

• Via email benefits@kean.edu  

• Via phone - Paige O’Brien (908-737-3302) or benefits team contacts   

• In Person: Walk Ins welcome for general questions, appointments recommended for in depth topic reviews