Note: SHBP Plans for State Employees Covered Under New Labor Agreements Effective July 2007
PLAN
&
TELEPHONE #
#102 TRADITIONAL1
1-800-414-7427
www.horizonblue.com/shbp
#004 - NJ PLUS
www.horizonblue.com/shbp
#005
AETNA HMO
1-800-309-2386
www.aetna.com
#006
CIGNA HEALTHCARE HMO
1-800-244-6224
www.cigna.com/health
#007
OXFORD HMO
1-800-760-4566
www.oxfordhealth.com
#008
AMERIHEALTH HMO
1-800-877-9829
www.amerihealth.com
#009
HEALTH NET6 HMO
1-800-441-5741
www.healthnet.com
PLAN
&
TELEPHONE #
In-network
1-800-414-7427		 Out-of-network1
1-800-
414-7427
SERVICE AREA
 Unrestricted All of NJ and FL;
Parts of DE, NY, and PA		 Unrestricted All of NJ, CT, DE, ME, and Wash.DC; Parts of AZ, FL, GA, IL, IN, MA, MD, NC, NH, NV, NY, OH, PA, TN, TX, VA, and WA All of NJ, AZ, CT, DE, MD, ME, NH, NM, RI, VT & Wash. DC; Parts of AL, AR, CA, CO, FL, GA, ID, IL, IN, KS, KY, LA, MA, MI, MO, MS, NV, NY, NC, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WV All of NJ;
Parts of NY		 All of NJ and DE;
Parts of PA		 All of NJ and CT;
Parts of NY
SERVICE AREA
ALCOHOL ABUSE (INPATIENT) Same as any other illness Same as any other illness Same as any other illness 100% detox; rehab-28 days at 100% per occurrence 100% detox; rehab-30 days at 100% per occurrence 100% detox and rehab-30 days at 100% per occurrence 100% detox; rehab-28 days at 100% per occurrence 100% detox; rehab-28 days at 100% per occurrence ALCOHOL ABUSE (INPATIENT)
DRUG ABUSE (INPATIENT) Same as any other illness Same as any other illness Same as any other illness 100% detox; rehab-28 days at 100% per occurrence 100% detox; rehab-30 days at 100% per occurrence 100% detox; rehab-30 days at 100% per occurrence 100% detox; rehab-28 days at 100% per occurrence 100% detox; rehab-28 days at 100% per occurrence DRUG ABUSE (INPATIENT)
ALCOHOL ABUSE (OUTPATIENT) Same as any other illness 100%, no visit limit 70% after deductible 100% up to 60 visits per calendar year 100% up to 60 visits per calendar year 100% up to 60 visits per calendar year 100% up to 60 visits per calendar year 100% up to 60 visits per calendar year ALCOHOL ABUSE (OUTPATIENT)
DRUG ABUSE (OUTPATIENT) Same as any other illness 100%, no visit limit 70% after deductible 100% up to 60 days per calendar year 100% up to 60 days per calendar year 100% up to 60 visits per calendar year 100% up to 60 visits per calendar year

100% up to 60 visits per calendar year

DRUG ABUSE (OUTPATIENT)
MENTAL HEALTH3 (INPATIENT) 100% for 20 days per calendar year; balance at 80% after deductible up to annual and/or lifetime maximums 100% up to 25 days per calendar year; balance at 90% up to annual and/or lifetime maximums 50 days per calendar year at 50% after deductible up to annual lifetime maximums 100% up to 35 days per
calendar year		 100% up to 30 days per calendar year 100% up to 30 days per calendar year 100% up to 30 days per calendar year 100% up to 30 days per calendar year MENTAL HEALTH3 (INPATIENT)
MENTAL HEALTH3 (OUTPATIENT) 80% after deductible up to annual and/or lifetime maximums 90% up to annual and/or lifetime maximums 70% after deductible up to annual and/or lifetime maximums 100% after $15 copayment per visit for up to 30 visits per
calendar year		 100% after $15 copayment per visit for up to 30 visits per year

100% after $15 copayment per visit for up to 30 visits per
calendar year

 100% after $15 copayment per visit for up to 30 visits per calendar year 100% after $15 copayment per visit for up to 30 visits per calendar year MENTAL HEALTH3 (OUTPATIENT)
1Benefits, excluding hospital expenses, are based on the Horizon's discounted provider network allowance or the "reasonable and customary" fee schedule at the 90% percentile. Some State employees may not be eligible for
enrollment in the Traditional Plan.

3Biologically-based mental health conditions are treated like any other illness and not subject to annual or lifetime mental health dollar maximums or separate mental health visit limits.

6Referral is not required from a PCP to a participating specialist.