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Open Enrollment

 

STATE HEALTH BENEFITS PROGRAM (SHBP) OPEN ENROLLMENT  

Annually there is an open enrollment period for The State Health Benefits Program (SHBP). This generally occurs in October.


Open Enrollment allows employees to make general changes (adding or deleting dependents, changing coverage levels, etc.) or enroll in a different medical or dental plan. All changes to coverage made during the Open Enrollment period become effective on January 1 of the upcoming year.


ONLINE ENROLLMENT THROUGH MYNJBENEFITSHUB

All health benefit elections must be submitted online through mynjbenefitshub. Employees should review their Benefits Summary for accuracy even if they are not making any changes during the Open Enrollment period. It is essential that employees maintain accurate mailing and email addresses to receive important information.

Employee Contributions for SHBP coverage 

For 2023, employee contributions rates increased. 

To view your estimated new rates, please go to Calculator for 2023 and follow these instructions:

  • Select Employee type:
    • State Union Negotiated (for IFPTE, AFT, Managers, NJLESA, NJSOLEA)
    • State CWA (for CWA)
    • State All Other (for PBA)
  • Select coverage type:  family, single, etc.
  • Select prescription plan:  shbp employee prescription drug plan
  • Enter Annual Base Pay (You may find this on Workday under Compensation)
  • Select “Date of Hire” as a FT employee (either Prior to 7/1/2019 or 7/1/2019 or after)

This will generate annual costs for plans available to you.  10 month faculty member may divide the sum by 22 to obtain an estimate of the biweekly employee deduction.  12 month employees may divide this by 26.

You can view your current payroll deductions for benefits by viewing your payslip in Workday.

Percentage of salary and percentage of premium contribution worksheets for 2023 are available here on the NJDPB website.


Copay Increases 

As of January 1, 2023, the specialist office visit copayment for State active members enrolled in the CWA Unity DIRECT, CWA Unity DIRECT 2019, NJDIRECT, and NJ DIRECT 2019 PPO plans, the HMO plans, and the Tiered Network plan shall be $15 more than the co-payment for a primary care office visit. Urgent Care visits shall be $30 more than the co-payment for a primary care visit.

 

For your information for 2023; Medical Plan Side-by-Side Comparisons

https://www.state.nj.us/treasury/pensions/documents/hb/oe2023/2023-shbp-state-overview.pdf

 

Prescription Drug – Comparison Charts

https://www.state.nj.us/treasury/pensions/documents/hb/oe2023/ha1059.pdf

https://www.state.nj.us/treasury/pensions/documents/hb/oe2023/ha1035.pdf

https://www.state.nj.us/treasury/pensions/documents/hb/oe2023/ha0895.pdf


INCENTIVE PROGRAM FOR THE TIERED NETWORK PLAN

For 2023, first-time enrollees in the Incentive Program for Horizon OMNIA receive a financial incentive of $1,000 provided they remain enrolled for the plan year. The incentive is paid by gift card no later than the end of the current tax year and is deemed reportable income for tax purposes.

 

MEMBERSHIP TO DIRECT PRIMARY CARE MEDICAL HOME DOCTOR’S OFFICE INCLUDED IN SHBP AT NO ADDITIONAL COST

The SHBP offers employees and their covered dependents the opportunity to join a Direct Primary Care doctor's office at no additional cost. This is available as part of the Horizon plans and does not require any changes to members’ health plan elections. 

More information regarding Direct Primary Care Medical Homes can be found here. 

 

NJWELL PROGRAM

NJWELL provides inclusive and holistic experiences to meet members’ needs through activities and education programming to support healthy lifestyles. NJWELL is open to employees who are enrolled in the SHBP. Spouses and eligible partners also can participate, as long as they are covered by the SHBP plan. Participants have access to specialized programming and benefits, including live wellness events, fitness challenges, and online wellness platforms tailored to their unique needs.  Participants can also earn up to a possible $350 in rewards based on points earned from participation in NJWELL. The current NJWELL 2023 Plan Year ends on October 31, 2023. For information about the program, visit the NJWELL.



2023 PLAN OVERVIEWS

The SHBP 2023 Plan Overviews provided by Horizon contain a side-by-side view of the basic benefits, copayments, and other out-of-pocket costs for the SHBP medical and prescription drug plans.  The 2023 Plan Overviews can be found on the NJDPB website. 

 

SUMMARIES OF BENEFITS AND COVERAGE

Detailed information about the SHBP’s medical plans is available through the Summaries of Benefits and Coverage. A link to the 2023 summaries can be found on the NJDPB website.


DENTAL PLANS

For Plan Year 2023, there were no dental plan changes. Dental coverage is offered to eligible employees through the Employee Dental Plans. Six different dental plans are offered based on one of two different plan designs — Dental Plan Organizations (DPO) and a Dental Expense Plan (DEP). 

• Five DPOs are available: Aetna DMO; CIGNA DHMO; Healthplex; Horizon Dental Choice; and MetLife. 

DPOs contract with a network of providers for dental services. When an employee or dependent uses a DPO dentist, diagnostic and preventive services are covered in full. Most other eligible expenses require a small copayment. Members must use a provider that participates with the selected DPO to receive coverage. Be sure to confirm that the dentist or dental facility is taking new patients and participates with the SHBP Employee Dental Plans, since DPOs also service other organizations. 

• The Dental Expense Plan is a Preferred Provider Organization (PPO) plan that allows members to obtain services from any dentist; however, using an in-network provider will reduce an employee’s costs. After satisfying an annual deductible (no deductible for preventive services), members are reimbursed a percentage of the reasonable and customary charges for eligible services. 

 

Resources

Benefitsolver - login here

The Company Key is SHBP/SEHBP (all capital letters)

Employee Guide to Logging into Benefitsolver 

 

ADDITIONAL INFORMATION

If you have questions regarding the SHBP Open Enrollment, please contact benefits@kean.edu.