State (Centralized Payroll)
State (montly payroll)
Rutgers and
NJIT
Local Government and
School Boards
January
21, 2000
| TO: |
State Health Benefits
Program Participating Local Employers |
| FROM: |
Janice F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
SHBP Open Enrollment
2000 |
The State Health Benefits Program (SHBP) Open Enrollment period
for local employees will begin on March 1, 2000, and end on March
31, 2000. Completed employer certified applications must arrive
at the Health Benefits Bureau no later than April 10, 2000. All
changes to coverage made during Open Enrollment will be effective
on July 1, 2000.
The State Health Benefits Commission is in the process of finalizing
rates. We have included a milestone chart (Enclosure
4) that lists key Open Enrollment 2000 events and dates, and
the projected delivery dates for all Open Enrollment publications.
The publications will include a revised 2000 NJ PLUS Physician and
Hospital Directory with a form for additional copies, sufficient
copies of the revised SHBP Plan Comparison Summary chart for all
employees and the Open Enrollment issue of the Health Capsule newsletter.
The Division of Pensions and Benefits is available to support your
Open Enrollment program. If you are having a health fair for your
employees, a representative from Horizon Blue Cross Blue Shield
of New Jersey (Horizon BCBSNJ) or the Division of Pensions and Benefits,
on behalf of the SHBP, can attend and answer questions regarding
the NJ PLUS and the Traditional Plan. In addition, you should contact
the individual HMOs directly to request plan representation.
If you wish to schedule educational presentations for your employees
about the various plans available through the SHBP, please use the
enclosed Request for Open Enrollment Support form (Enclosure
1) to schedule your health fair or educational seminar. This
form may be mailed or faxed to the address/number listed on the
form. To facilitate scheduling and maximize your chances of having
your request fulfilled, please submit your request as soon as possible.
You may also contact your assigned Horizon BCBSNJ Account Manager
to schedule your request. You must provide a suitable room and a
minimum of 10-15 employees for each session. Each session will last
approximately 50 minutes.
In addition, we will be conducting regional seminars for employer
benefits administrators during February. The seminars will provide
an update on SHBP plan changes that have recently occurred, and
some insight into the new rates effective July 2000. A SHBP Employer
Informational Seminar Registration form (Enclosure 2) listing the
seminar dates and times is attached, along with the directions to
the seminar sites.
If you have any questions about the Open Enrollment support services,
or the informational seminars, please get in touch with the contact
person shown on the attached forms. Thank you for your cooperation.
Enclosures:
- Request for
Open Enrollment Support Form Requires Acrobat Reader.
Click here to download the Reader:
- SHBP Employer Informational
Seminar Registration Form
- Directions to Regional Seminars
- 2000 SHBP Open Enrollment
Milestone Chart
- Unified
Provider Directory Flier Requires Acrobat Reader.
Click here to download the Reader:
February
18, 2000
| TO: |
State Health Benefits
Program Participating Local Government Employers
State Health Benefits Program Participating Local Education
Employers |
| FROM: |
Janice F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
SHBP Open Enrollment
2000 |
Enclosed you will find approved rates and plan information that
will assist your employees in making informed decisions concerning
their health care coverage during Open Enrollment 2000. We have
included rate charts for employees with and without prescription
drug coverage and all retiree rates. Also, we have enclosed a chart
showing the available SHBP medical plans with contact information.
The Division of Pensions and Benefits
is in the process of changing the State Health Benefits Program
plan year from a fiscal year to a calendar year. This transition
will necessitate two Open Enrollments in 2000 – the current Spring
Open Enrollment with changes effective July 1, 2000, and a second
Open Enrollment in the fall with changes effective January 1,
2001. Thereafter, the annual Open Enrollment will be each fall
for changes effective the following January. This means that there
will be no Open Enrollment in the spring of 2001. Because of the
plan year change, the enclosed rates have been approved for an
18-month period, effective July 1, 2000 through December 31, 2001.
Please see the details of this plan year change in the Health
Capsule newsletter scheduled for delivery to you during the first
week of March.
The rate increases for the plans
are generally in keeping with national and regional trends for
comparable plans. The new rates are based on last year's claims
experience, and projections of health benefits expenditures anticipated
over the 18-month rating period. Several of the managed-care plans,
including NJ PLUS, experienced higher than expected claims for
the most recent period, resulting in large rate increases. Others,
such as Aetna US Healthcare, had little or no increase in rates.
Regardless, all plans continue to provide excellent value for
employers and employees who participate in the SHBP.
The most significant factor contributing
to the rate increases is the continuing rapid growth of prescription
drug expenditures. This is demonstrated by a 27.7 percent increase
in the State Prescription Drug Program and by significantly higher
rate increases for medical plan coverage that includes prescription
drugs. We continue to work closely with our health care consultants
to explore options for slowing the rate of increase in this area,
while still providing quality coverage for our participants.
This growth in expenditures is even
more pronounced in the retiree rates. For retirees covered by
Medicare, more than 50 percent of the SHBP premium goes toward
the cost of providing prescription drug coverage. Effective January
1, 2000, the State Health Benefits Commission has implemented
a new retiree prescription drug card program for NJ PLUS and Traditional
Plan members, which should help ensure access and affordability
of prescription drugs for these members, while encouraging more
cost-effective choices.
A number of changes in SHBP program
modifications and Traditional Plan rating structures in recent
years provided a reason to review the policy regarding employee
contributions for costs in excess of the Traditional Plan. As
a result, there is no provision in the attached rates for employee
contributions for HMO premiums above the Traditional Plan rate.
The following changes have been made
to the health plans offered by the SHBP since the last Open Enrollment.
- Aetna US Healthcare has
acquired Prudential HealthCare HMO for the plan year
beginning July 2000. SHBP members enrolled in Prudential will
be automatically transferred to Aetna US Healthcare effective
July 1, 2000, unless the employee changes to another SHBP health
plan during this Open Enrollment period. Prudential members
should continue to use their Prudential identification cards
and may continue to see their Prudential Primary Care Physician
(PCP) through June 30, 2000. Aetna US Healthcare will send new
ID cards to Prudential members before July 1, 2000. Prudential
members should check with their Prudential PCP to determine
if the physician plans to participate with Aetna US Healthcare
after July 1, 2000. If the Prudential PCP will not be joining
with Aetna US Healthcare, the member must choose an Aetna US
Healthcare PCP before July 1, 2000, or change to a different
SHBP plan during this Open Enrollment period. Prudential members
who wish to change to a health plan other than Aetna US Healthcare
must submit an application for change to their benefits administrator
by March 31, 2000. The new plan will be effective on July 1,
2000.
- Physicians Health Services
(PHS) has received approval by the State Health Benefits
Commission to introduce a pilot program effective July 1, 2000
that will allow PHS members to receive services from a PHS participating
specialist without obtaining a referral from the Primary Care
Physician (PCP). Although there is no need for a referral, members
will still be required to select a PCP for routine care and
are encouraged to coordinate care from a specialist through
their PCP. While no referral from the PCP is necessary for specialty
care, a referral is still required for hospitals and lab work.
During the first week of March, you
should be receiving sufficient copies of the SHBP Comparison Summary
chart and the Health Capsule newsletter for distribution to your
employees. These publications will provide more details on Open
Enrollment issues. You should have already received your advance
copy of the NJ PLUS Physician and Hospital Directory along with
a chart providing contact names for arranging a health fair at
your location.
In addition, we are pleased to enclose
a copy of the 1999 New Jersey HMO Performance Report: Compare
Your Choices. This HMO annual report card is a publication
of the Department of Health and Senior Services designed to help
health care consumers make more informed choices. Additional copies
may be requested by contacting the Office of Managed-Care, Department
of Health and Senior Services, PO Box 360, Trenton, NJ 08625-0360,
or calling 1-888-393-1062. The report is also available over the
Internet at: www.state.nj.us/health
If you have any questions about the
Open Enrollment, please contact our Office of Client Services
at (609) 292-7524.
Enclosures: Active
and Retiree Rate Charts
1999 HMO Performance
Report
Medical Plan Contacts
(SEMREG-L) (Enclosure 2)
SHBP EMPLOYER INFORMATIONAL
SEMINAR REGISTRATION
EMPLOYER NAME ________________________________________________________
EMPLOYER POINT OF CONTACT ___________________________________________
TELEPHONE NUMBERS____________________________________________________
(Voice) (Fax)
ADDRESS _________________________________________________________________
REQUESTED SEMINAR (Please indicate the number of people attending
the seminar on the line next to
the requested seminar date):
SITE: Horizon BCBSNJ, 3 Penn Plaza East, Newark:
_______ February 14 10:00 a.m. to 12:00 noon (Go to Lobby
for directions)
SITE: Hamilton Township Public Library, One Municipal Drive, Hamilton:
_______ February 17 10:00 a.m. to 12:00 noon
_______ February 17 1:30 p.m. to 3:30 p.m.
SITE: Ocean County College, College Drive, Toms River:
_______ February 22 10:00 a.m. to 12:00 noon (College
Center Room A & B)
SITE: Gloucester County Regional Training Center, 1492 Tanyard
Road, Sewell:
_______ February 24 10:00 a.m. to 12:00 noon (Rodgers
Room)
SITE: Morris County Fire and Police Academy, 500 W. Hanover Ave,
Parsippany:
_______ February 28 10:00 a.m. to 12:00 noon (Room 118)
_______ February 28 1:30 p.m. to 3:30 p.m. (Room 118)
Send registration to: Kim Bruno
State Health Benefits Program
c/o Horizon Blue Cross Blue Shield of New Jersey
3 Penn Plaza East PP-03C
Newark, NJ 07105-2200
or fax to (973) 466-5326.
Call (973) 466-6666, the 2000 SHBP
Open Enrollment Hotline, if you have questions about this request.
(Enclosure 4)
2000 SHBP OPEN
ENROLLMENT MILESTONE CHART
for Participating Local Employers
Note: If the event is underlined, you should be accomplishing
the event.
PROJECTED
DATE |
EVENT |
| January 21 |
Initial Open Enrollment
Letter mailed to employers. |
| February 14 |
Fiscal Year 2000
rate charts sent to employers.
Disseminate rate information to employees as necessary. |
| February 14 |
Request for Open
Enrollment Support form should be submitted if you wish support
for your Health Fair or educational seminars, or need additional
copies of the 2000 NJ PLUS Physician and Hospital Directory. |
| February 14-28 |
Regional Employer
Benefit Administrator seminars conducted by the SHBP. |
| February 18 |
Advanced copy of
the 2000 NJ PLUS Physician and Hospital Directory shipped
to local employers. |
February 28
. |
SHBP Plan Comparison
Summary charts and the Health Capsule shipped to employers.
Distribute to employees |
| March 1 |
Open Enrollment
Begins |
| .March 1-31 |
Health Fairs and
Educational Seminars conducted (optional). |
| March 31 |
Open Enrollment
Ends |
| April 10 |
Employer certified
applications due at the Health Benefits Bureau. |
| July 1 |
Open Enrollment
changes effective. |
January 31, 2000
| TO: |
State Monthly Human
Resource Directors/Benefits Administrators |
| FROM: |
Janice F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
SHBP Open Enrollment
2000 (See also March 8 letter) |
The State Health Benefits Program
(SHBP) Open Enrollment period for State monthly employees will
begin on April 1, 2000, and end on April 30, 2000. Completed employer
certified health benefits and/or dental applications must arrive
at the Health Benefits Bureau no later than May 5, 2000. Open
Enrollment applications should not be sent with other applications
submitted at the same time. Also, a member's medical and dental
applications should be sent together to facilitate processing.
All changes to coverage made during Open Enrollment will be effective
on July 1, 2000.
The State Health Benefits Commission
is in the process of finalizing rates. As in the past, once rates
have been determined we will provide you with a sample generic
Open Enrollment announcement flyer to reproduce, providing a list
of medical and dental plans and costs for State employees not
paid through Centralized Payroll.
We have included a milestone chart
(Enclosure 1) that lists key Open Enrollment
2000 events and dates, and the projected delivery schedule for
all Open Enrollment publications. During the last week of February,
you will receive your advance copy of the revised 2000 NJ PLUS
Physician and Hospital Directory. You may order more directories
using the enclosed Request for Open Enrollment Support
form (Enclosure 2). Participating provider information
for all SHBP plans is available in the Unified Provider Directory
through our SHBP home page at: www.state.nj.us/treasury/pensions/
shbp.htm
Sufficient copies of the revised
SHBP Plan Comparison Summary chart and the Open Enrollment
issue of the Health Capsule newsletter will be shipped
to your location approximately March 15. Please distribute these
informative publications to all participating SHBP members at
your location. State employees paid through the State's Centralized
Payroll Unit will receive these publications with their March
31 paychecks.
The Division of Pensions and Benefits
is available to support your Open Enrollment program. If you are
having a health fair for your employees, a representative from
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)
or the Division of Pensions and Benefits, on behalf of the SHBP,
can attend and answer questions regarding the NJ PLUS and the
Traditional Plan. In addition, you should contact the individual
HMOs directly to request plan representation. Lists of all the
SHBP medical and dental plans (Enclosure
3a/3b), along with their service areas and telephone numbers,
are enclosed for your use in identifying and contacting HMOs and
DPOs to attend your health fair.
If you wish to schedule a health
fair or educational presentations for your employees about the
various plans available through the SHBP, please use the enclosed
Request for Open Enrollment Support form (Enclosure 2). This form may be mailed or
faxed to the address/number listed on the form. To facilitate
scheduling and maximize your chances of having your request fulfilled,
please submit your request as soon as possible. You must provide
a suitable room and a minimum of 10-15 employees for each session.
Each session will last approximately 50 minutes.
We will be conducting seminars for
benefits administrators in the Trenton area (Mercer County Library)
on March 20 and in Newark (Horizon BCBSNJ) on March 22. The seminars
will provide an update on SHBP plan changes that have recently
occurred, and some insight into the new rates effective July 2000.
A SHBP Employer Informational Seminar Registration form
(Enclosure 4) listing the seminar dates and times is attached,
along with the directions to the seminar sites.
If you have any questions about Open
Enrollment or the information in this letter, please contact our
Client Services staff at (609) 292-7524. Questions regarding the
informational seminars should be addressed to the contact person
shown on the attached forms. Thank you for your cooperation.
Enclosures:
- 2000 SHBP
Open Enrollment Milestone Chart
- Request for
Open Enrollment Support Form (requires Acrobat Reader.
Click here to download the Reader:
)
- Health Fair
Contacts - Medical (3a) and Dental (3b)
- SHBP Employer Informational Seminar
Registration Form
- Directions to Regional
Seminars - Trenton and Newark
March 8, 2000
| TO: |
State
Monthly Human Resource Directors/Benefits Administrators |
| FROM: |
Janice
F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
State
Health Benefits Program (SHBP) Open Enrollment 2000 |
The State Health Benefits Program
(SHBP) Open Enrollment period for State monthly employees will
begin on April 1, 2000, and end on April 30, 2000. Enclosed you
will find plan information and rate charts that will assist your
employees in making informed decisions concerning their health
care coverage during the Open Enrollment.
The Division of Pensions and Benefits
is in the process of changing the State Health Benefits Program
plan year from a fiscal year to a calendar year. This transition
will necessitate two Open Enrollments in 2000 - the current Spring
Open Enrollment with changes effective July 1, 2000, and a second
Open Enrollment in the fall with changes effective December 30,
2000. Employees will have the opportunity to change medical, prescription
drug, or dental plan coverage during both Open Enrollments. Thereafter,
the annual Open Enrollment will be each fall for changes effective
the following January 1. This means that there will be
no Open Enrollment in the spring of 2001. Because of the
change to the plan year, the enclosed rates have been approved
for an 18-month period, effective July 1, 2000 through December
31, 2001.
Unions representing most State employees
have settled new contracts that provide for revised premium sharing
arrangements with the State. The contracts are identical with
respect to their premium sharing provisions. There is no premium
cost to any employee who enrolls in NJ PLUS. Employees will
pay 5 percent of the premium cost if enrolled in an HMO,
or 25 percent of the premium cost if enrolled in the Traditional
Plan. These percentages apply regardless of salary level or
date of hire. Employees who are represented by unions which have
not settled a new contract with the State will continue to share
in the premium cost of the Traditional Plan according to the provisions
of their lapsed contracts. Details on the change to a calendar
plan year and premium sharing for both the new and old contract
models can be found in the Health Capsule newsletter.
Enclosed are a selection of Open
Enrollment announcement flyers that list the available medical
and dental plans and their costs to your employees. Flyers are
provided for three different payroll schedules (Monthly, 24
Pay Periods, and 26 Pay Periods). Choose the flyer
that corresponds to your location's payroll schedule. This is
a master copy and may be reproduced to meet your employees' needs.
If you have specific questions about the flyers, contact Kathy
Coates by telephone at (609) 633-1462 or by fax at (609) 292-9500.
Sufficient copies of the SHBP
Comparison Summary chart and the Health Capsule
newsletter will be shipped to your location on approximately March
15. Please
distribute these informative publications
to all participating SHBP members. State employees paid through
the State's Centralized Payroll Unit will receive these publications
with their March 31 paychecks.
Premium sharing provides an opportunity
for your employees to evaluate their health benefits. If they
premium share and participate in the State's Premium Option
Plan (POP), their premium amounts are paid with pre-tax dollars.
The result will provide savings on federal, Medicare, and Social
Security taxes, and return that savings to net income. The benefits
of POP are further addressed in the Health Capsule.
The following changes have been made
to the health plans offered by the SHBP and are effective this
Open Enrollment.
- Aetna US Healthcare has
acquired Prudential HealthCare HMO for the plan year
beginning July 2000. SHBP members enrolled in Prudential will
be automatically transferred to Aetna US Healthcare effective
July 1, 2000, unless the employee changes to another SHBP health
plan during this Open Enrollment period. Prudential members
should continue to use their Prudential identification cards
and may continue to see their Prudential Primary Care Physician
(PCP) through June 30, 2000. Prudential members should receive
their new ID cards from Aetna US Healthcare by July 1, 2000.
Prudential members should check
with their Prudential PCP to determine if the physician plans
to participate with Aetna US Healthcare after July 1, 2000.
If the Prudential PCP will not be joining with Aetna US Healthcare,
the member must choose an Aetna US Healthcare PCP before July
1, 2000, or change to a different SHBP plan during this Open
Enrollment period.
Prudential members who wish to
change to a health plan other than Aetna US Healthcare must
submit an application for change to their benefits administrator
by April 30, 2000. The new plan will be effective on July 1,
2000.
- Physicians Health Services
(PHS) has received approval by the State Health Benefits
Commission to introduce a pilot program, effective July 1, 2000,
that will allow PHS members to receive services from a PHS participating
specialist without
obtaining a referral from the
Primary Care Physician (PCP). Although there is no need for
a referral, members will still be required to select a PCP
for routine care and are encouraged to coordinate care from
a specialist through their PCP. While
no referral from the PCP is necessary
for specialty care, a referral is still required for hospitals
and lab work.
The following changes have been made
to the State Employee Group Dental Program effective for
the plan year beginning July 2000.
- Three DPOs - CIGNA, Community
Dental Associates, and Atlantic Southern (BeneCare)
- will have slightly higher premium levels than the other DPOs.
The State Employee Group Dental Program requires participating
DPOs to credential their dentists and report on all dental services
provided to State employees and their families. The data reported
by the DPOs allows the State to monitor the quality of dental
care provided by the DPOs. Based on a review of the reported
information, these plans have been noted as providing services
superior to the high standards required of all participating
DPOs. Although these plans cost a little more than the others,
remember that the additional cost indicates that these three
plans provide a superior quality of service.
- Statewide DPO, Inc. will
no longer be participating in the State Employee Group Dental
Program after July 1, 2000. Employees enrolled in this plan
must change to another dental plan during this Open Enrollment
if they wish to retain dental coverage after July 1, 2000.
We are pleased to enclose a copy
of the 1999 New Jersey HMO Performance Report: Compare Your
Choices. This annual HMO report card is a publication of the
New Jersey Department of Health and Senior Services designed to
help health care consumers make more informed choices. Additional
copies may be requested by contacting the Office of Managed-Care,
Department of Health and Senior Services, PO Box 360, Trenton,
NJ 08625-0360, or calling 1-888-393-1062. The report is also available
over the Internet at: www.state.nj.us/health
If you have any questions about the
Open Enrollment, please contact our Office of Client Services
at (609) 292-7524.
Enclosures: Open Enrollment 2000
Flyer(s) (medical/dental
rates)
Medical Plan Contacts
1999 HMO Performance
Report
March 8, 2000
| TO: |
Campus
Human Resource Directors |
| FROM: |
Janice
F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
State
Health Benefits Program (SHBP) Open Enrollment 2000 |
The State Health Benefits Program
(SHBP) Open Enrollment period for State monthly employees will
begin on April 1, 2000, and end on April 30, 2000. Enclosed you
will find plan information and rate charts that will assist your
employees in making informed decisions concerning their health
care coverage during the Open Enrollment.
The Division of Pensions and Benefits
is in the process of changing the State Health Benefits Program
plan year from a fiscal year to a calendar year. This transition
will necessitate two Open Enrollments in 2000 - the current Spring
Open Enrollment with changes effective July 1, 2000, and a second
Open Enrollment in the fall with changes effective December 30,
2000. Employees will have the opportunity to change medical, prescription
drug, or dental plan coverage during both Open Enrollments. Thereafter,
the annual Open Enrollment will be each fall for changes effective
the following January 1. This means that there will be
no Open Enrollment in the spring of 2001. Because of the
change to the plan year, the enclosed rates have been approved
for an 18-month period, effective July 1, 2000 through December
31, 2001.
Unions representing most State employees
have settled new contracts that provide for revised premium sharing
arrangements with the State. The contracts are identical with
respect to their premium sharing provisions. There is no premium
cost to any employee who enrolls in NJ PLUS. Employees will
pay 5 percent of the premium cost if enrolled in an HMO,
or 25 percent of the premium cost if enrolled in the Traditional
Plan. These percentages apply regardless of salary level or
date of hire. Employees who are represented by unions which have
not settled a new contract with the State will continue to share
in the premium cost of the Traditional Plan according to the provisions
of their lapsed contracts. Details on the change to a calendar
plan year and premium sharing for both the new and old contract
models can be found in the Health Capsule newsletter and
the Open Enrollment flyer (see enclosed, along with a chart of
medical plan contacts).
Enclosed is an Open Enrollment
announcement flyer that lists the available medical and dental
plans and their costs to your employees. This is a master copy
tailored to your location which may be reproduced to meet your
employees' needs. If you have specific questions about the flyer,
contact Kathy Coates by telephone at (609) 633-1462 or by fax
at (609) 292-9500.
Sufficient copies of the SHBP
Comparison Summary chart and the Health Capsule
newsletter will be shipped to your location on approximately March
15. Please
distribute these informative publications
to all participating SHBP members. State employees paid through
the State's Centralized Payroll Unit will receive these publications
with their March 31 paychecks.
Premium sharing provides an opportunity
for your employees to evaluate their health benefits. If they
premium share and participate in the State's Premium Option
Plan (POP), their premium amounts are paid with pre-tax dollars.
The result will provide savings on federal, Medicare, and Social
Security taxes, and return that savings to net income. The benefits
of POP are further addressed in the Health Capsule.
The following changes have been made
to the health plans offered by the SHBP and are effective this
Open Enrollment.
- Aetna US Healthcare has
acquired Prudential HealthCare HMO for the plan year
beginning July 2000. SHBP members enrolled in Prudential will
be automatically transferred to Aetna US Healthcare effective
July 1, 2000, unless the employee changes to another SHBP health
plan during this Open Enrollment period. Prudential members
should continue to use their Prudential identification cards
and may continue to see their Prudential Primary Care Physician
(PCP) through June 30, 2000. Prudential members should receive
their new ID cards from Aetna US Healthcare by July 1, 2000.
Prudential members should check
with their Prudential PCP to determine if the physician plans
to participate with Aetna US Healthcare after July 1, 2000.
If the Prudential PCP will not be joining with Aetna US Healthcare,
the member must choose an Aetna US Healthcare PCP before July
1, 2000, or change to a different SHBP plan during this Open
Enrollment period.
Prudential members who wish to
change to a health plan other than Aetna US Healthcare must
submit an application for change to their benefits administrator
by April 30, 2000. The new plan will be effective on July 1,
2000.
- Physicians Health Services
(PHS) has received approval by the State Health Benefits
Commission to introduce a pilot program, effective July 1, 2000,
that will allow PHS members to receive services from a PHS participating
specialist without
obtaining a referral from the
Primary Care Physician (PCP). Although there is no need for
a referral, members will still be required to select a PCP
for routine care and are encouraged to coordinate care from
a specialist through their PCP. While
no referral from the PCP is necessary
for specialty care, a referral is still required for hospitals
and lab work.
The following changes have been made
to the State Employee Group Dental Program effective for
the plan year beginning July 2000.
- Three DPOs - CIGNA, Community
Dental Associates, and Atlantic Southern (BeneCare)
- will have slightly higher premium levels than the other DPOs.
The State Employee Group Dental Program requires participating
DPOs to credential their dentists and report on all dental services
provided to State employees and their families. The data reported
by the DPOs allows the State to monitor the quality of dental
care provided by the DPOs. Based on a review of the reported
information, these plans have been noted as providing services
superior to the high standards required of all participating
DPOs. Although these plans cost a little more than the others,
remember that the additional cost indicates that these three
plans provide a superior quality of service.
- Statewide DPO, Inc. will
no longer be participating in the State Employee Group Dental
Program after July 1, 2000. Employees enrolled in this plan
must change to another dental plan during this Open Enrollment
if they wish to retain dental coverage after July 1, 2000.
We are pleased to enclose a copy
of the 1999 New Jersey HMO Performance Report: Compare Your
Choices. This annual HMO report card is a publication of the
New Jersey Department of Health and Senior Services designed to
help health care consumers make more informed choices. Additional
copies may be requested by contacting the Office of Managed-Care,
Department of Health and Senior Services, PO Box 360, Trenton,
NJ 08625-0360, or calling 1-888-393-1062. The report is also available
over the Internet at: www.state.nj.us/health
If you have any questions about the
Open Enrollment, please contact our Office of Client Services
at (609) 292-7524.
Enclosures: Open Enrollment 2000
Flyer (medical/dental
rates)
Medical Plan Contacts
1999 HMO Performance
Report
Check Message for Pay Period 7 (March
31)
The 2000 Open Enrollment for the
State Health Benefits Program will be conducted during the month
of April. Open Enrollment materials being distributed with this
paycheck are the Health Capsule, the Dental and Medical Open Enrollment
Flyer, and the July 2000 SHBP Plan Comparison Summary Chart. Be
sure to get them from your benefits administrator and READ them.
They contain important information about your benefits.
Check Message for Pay Period 8 (April
14)
The 2000 Open Enrollment for medical,
prescription drug, and dental coverage under the State Health
Benefits Program is being conducted during the month of April.
Several plan changes are being made, employee costs for coverage
are changing, Prudential HMO is merging with Aetna-US Healthcare,
and one dental plan, Statewide DPO, Inc. (DPO #315), is being
eliminated from our program. If you are enrolled in the Statewide
DPO, Inc. and you want dental coverage after July 1, 2000, you
must select another dental plan during the open enrollment. Please
take this opportunity to review your medical benefits to see what
coverage best suits your family's needs. Contact your benefits
administrator for necessary applications and information.
Check Message for Pay Period 9 (April
28)
The State Health Benefits Program
2000 Open Enrollment ends on April 30, 2000. This will be the
last day you can make changes to your medical, prescription drug,
and dental coverage. If you haven't already taken care of business,
see your benefits administrator immediately!
(STmonMILESTONE) (Enclosure 1)
SHBP
OPEN ENROLLMENT 2000 MILESTONE CHART
For Monthly State
Employers
Note: If the event is underlined,
you should be accomplishing the event.
PROJECTED
DATE |
EVENT |
| January
31 |
Initial
Open Enrollment Letter mailed to State employers. |
| February
28 |
Advance
copy of the 2000 NJ PLUS Physician and Hospital
Directory shipped to State employers. |
| March
13 |
Final
Open Enrollment Letter mailed to State employers with Fiscal
Year 2000 rate charts. Disseminate rate information to
employees as necessary. |
| March
15 |
A supply
of the Health Capsule and SHBP Plan Comparison Summary chart
mailed to monthly employers to be distributed to all SHBP
covered employees. |
| March
17 |
Request for Open Enrollment Support form should
be submitted if you wish support for your Health Fair or educational
seminars, or need additional copies of the 2000 NJ
PLUS Physician and Hospital Directory. |
| March
20 |
State Employer Benefit Administrator seminars conducted by
the SHBP in the Trenton area. |
| March
22 |
State Employer Benefit Administrator seminars conducted by
the SHBP in Newark. |
| April
1 |
Open Enrollment Begins. |
| April
1-30 |
Health Fairs and Educational Seminars conducted (optional). |
| April
30 |
Open Enrollment Ends. |
| May
5 |
Employer certified applications
due at the Health Benefits Bureau.
|
| July
1 |
Open
Enrollment changes effective. |
HFC2000 (Enclosure 3a)
NEW JERSEY STATE
HEALTH BENEFITS PROGRAM
MEDICAL PLANS -
HEALTH FAIR CONTACTS*
|
PLAN NAME
|
PLAN/
HMO #
|
PHONE
NUMBER
|
CONTACT NAME
|
NJ
PLUS
Administered by Horizon Blue Cross
Blue Shield of New Jersey |
001
|
973-466-6666
|
Kim Bruno
|
Traditional
Plan
Administered by Horizon Blue Cross
Blue Shield of New Jersey |
002
|
973-466-6666
|
Kim Bruno
|
HEALTH MAINTENANCE
ORGANIZATIONS
Horizon HMO |
010
|
973-466-6666
|
Kim Bruno
|
| Aetna/US
Healthcare |
019
|
215-775-6035
|
Ellen Thomas
|
| CIGNA
HealthCare |
020
|
973-660-4029
|
Ginny Fowler
|
| Oxford
Health Plan |
028
|
732-623-1937
|
Janet Green
|
| AmeriHealth
HMO Plan |
033
|
856-778-6505
|
Lisa Schneider/Kari
Goldberg
|
| Physicians
Health Services |
034
|
732-918-6973
|
Michael DeLuca
|
| University
Health Plans, Inc. |
036
|
973-623-8700
|
Frank Alkin,
Extension 613
|
*The phone numbers
are NOT for membership services - please do not provide them to
your employees.
(HD-416-2000) (Enclosure 3b)
NEW JERSEY STATE HEALTH
BENEFITS PROGRAM
DENTAL PLANS -
HEALTH FAIR CONTACTS*
|
PLAN NAME
|
UNIT/
DPO #
|
PHONE
NUMBER
|
CONTACT
NAME
|
| Atlantic
Southern Dental Foundation (Benecare) |
301
|
800-843-4727
|
Customer Service
- Mrs. Serota
|
| Community
Dental Associates |
302
|
856-692-4670
|
Maryanne
|
| CIGNA
Dental Health, Inc. |
305
|
973-660-4029
|
Ginny Fowler
|
| Group
Dental Health Administrators, Inc. |
306
|
908-241-9700
|
Betty Guarino
|
| International
Health Care Services |
307
|
516-542-2247
|
Linda Dempsey
|
| Oracare
DPO, Inc. |
308
|
856-983-3838
|
Wendy Worrell,
Extension #123
|
| Unity
Dental Health Services, PA |
311
|
973-276-4900
|
Michael Dubman,
Extension #4904
|
| Flagship
Health Systems, Inc. |
312
|
973-285-4045
|
Melissa Cabrera
|
| Statewide
DPO, Inc. |
315
|
908-221-9595
|
Steve Lane
|
| Horizon
Dental Choice |
317
|
973-466-6666
|
Kim Bruno
|
| Prudential
Healthcare DMO |
319
|
973-716-2550
|
Barbara DeVenuto
|
Dental
Expense Plan -
Administered by the Prudential |
399
|
973-716-2550
|
Barbara DeVenuto
|
*The phone numbers
are NOT for membership services - please do not provide them to
your employees
January
31, 2000
| TO: |
State
Departmental Human Resource Directors
State Biweekly Benefits Administrators |
| FROM: |
Janice
F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
SHBP
Open Enrollment 2000 |
The State Health Benefits Program (SHBP) Open Enrollment period
for State biweekly employees will begin on April 1, 2000, and end
on April 30, 2000. Completed employer certified health benefits
and/or dental applications must arrive at the Health Benefits Bureau
no later than May 5, 2000. Open Enrollment applications should not
be sent with other applications submitted at the same time. Also,
a member's medical and dental applications should be sent together
to facilitate processing. All changes to coverage made during Open
Enrollment will be effective on July 1, 2000, with any required
deductions taken beginning with pay period 13 (paycheck of June
23, 2000).
The State Health Benefits Commission
is in the process of finalizing rates. We have included a milestone
chart (Enclosure 1) that lists key Open Enrollment
2000 events and dates, and the projected delivery schedule for
all Open Enrollment publications. During the last week of February,
you will receive your advance copy of the revised 2000 NJ PLUS
Physician and Hospital Directory. You may order more directories
using the enclosed Request for Open Enrollment Support
form (Enclosure 2). Participating provider information for all
SHBP plans is available in the Unified Provider Directory through
our SHBP home page at: www.state.nj.us/treasury/pensions/shbp.htm
A copy of the revised SHBP Plan
Comparison Summary chart, the Open Enrollment issue of the
Health Capsule newsletter, and an Open Enrollment announcement
flyer providing a list of medical and dental plans and their costs
will be distributed with the March 31 paychecks to all employees
paid through Centralized Payroll.
The Division of Pensions and Benefits
is available to support your Open Enrollment program. If you are
having a health fair for your employees, a representative from
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)
or the Division of Pensions and Benefits, on behalf of the SHBP,
can attend and answer questions
regarding the NJ PLUS and the Traditional Plan. In addition, you
should contact the individual HMOs directly to request plan representation.
Lists of all the SHBP medical and dental plans (Enclosure
3a/3b), along with their service areas and telephone numbers,
are enclosed for your use in identifying and contacting HMOs and
DPOs to attend your health fair.
If you wish to schedule a health
fair or educational presentations for your employees about the
various plans available through the SHBP, please use the enclosed
Request for Open Enrollment Support form (Enclosure
2). This form may be mailed or faxed to the address/number
listed on the form. To facilitate scheduling and maximize your
chances of having your request fulfilled, please submit your request
as soon as possible. You must provide a suitable room and a minimum
of 10-15 employees for each session. Each session will last approximately
50 minutes.
We will be conducting seminars for
benefits administrators in the Trenton area (Mercer County Library)
on March 20 and in Newark (Horizon BCBSNJ) on March 22. The seminars
will provide an update on SHBP plan changes that have recently
occurred, and some insight into the new rates effective July 2000.
A SHBP Employer Informational Seminar Registration form
(Enclosure 4) listing the seminar dates and times is attached,
along with the directions to the seminar sites.
If you have any questions about Open
Enrollment or the information in this letter, please contact our
Client Services staff at (609) 292-7524. Questions regarding the
informational seminars should be addressed to the contact person
shown on the attached forms. Thank you for your cooperation.
Enclosures:
- 2000 SHBP Open Enrollment
Milestone Chart
- Request for
Open Enrollment Support Form (requires Acrobat Reader.
Click here to download the Reader:
)
- Health Fair
Contacts - Medical (3a) and Dental (3b)
- SHBP Employer Informational Seminar
Registration Form
- Directions to Regional
Seminars - Trenton (5a) and Newark (5b)
March 6, 2000
| TO: |
State
Department Human Resource Directors
State Biweekly Benefits Administrators |
| FROM: |
Janice
F. Nelson
Assistant Director for Health Benefits |
| SUBJECT: |
State
Health Benefits Program (SHBP) Open Enrollment 2000 |
The State Health Benefits Program
(SHBP) Open Enrollment period for State biweekly employees will
begin on April 1, 2000, and end on April 30, 2000. Enclosed you
will find plan information and rate charts that will assist your
employees in making informed decisions concerning their health
care coverage during the Open Enrollment.
The Division of Pensions and Benefits is in the process of changing
the State Health Benefits Program plan year from a fiscal year
to a calendar year. This transition will necessitate two Open
Enrollments in 2000 - the current Spring Open Enrollment with
changes effective July 1, 2000, and a second Open Enrollment in
the fall with changes effective December 30, 2000. Employees will
have the opportunity to change medical, prescription drug, or
dental plan coverage during both Open Enrollments. Thereafter,
the annual Open Enrollment will be each fall for changes effective
the first pay period of the new payroll year. This means that
there will be no Open Enrollment in the spring of 2001. Because
of the change to the plan year, the enclosed rates have been approved
for an 18-month period, effective July 1, 2000 through December
31, 2001.
Unions representing most State employees have settled new contracts
that provide for revised premium sharing arrangements with the
State. The contracts are identical with respect to their premium
sharing provisions. There is no premium cost to any employee who
enrolls in NJ PLUS. Employees will pay 5 percent of the premium
cost if enrolled in an HMO, or 25 percent of the premium cost
if enrolled in the Traditional Plan. These percentages apply regardless
of salary level or date of hire. Employees who are represented
by unions which have not settled a new contract with the State
will continue to share in the premium cost of the Traditional
Plan according to the provisions of their lapsed contracts. Details
on the change to a calendar plan year and premium sharing for
both the new and old contract models can be found in the Health
Capsule newsletter and the Open Enrollment flyer (see enclosed,
along with a chart of medical plan contacts). These publications,
along with the SHBP Comparison Summary chart, will be distributed
with the March 31 paychecks to all State employees paid through
Centralized Payroll.
Premium sharing provides an opportunity for your employees to
evaluate their health benefits. If they premium share and participate
in the State's Premium Option Plan (POP), their premium amounts
are paid with pre-tax dollars. The result will provide savings
on federal, Medicare, and Social Security taxes, and return that
savings to net income. The benefits of POP are further addressed
in the Health Capsule.
The following changes have been made to the health plans offered
by the SHBP and are effective for this Open Enrollment.
- Aetna US Healthcare has acquired
Prudential HealthCare HMO for the plan year beginning July 2000.
SHBP members enrolled in Prudential will be automatically transferred
to Aetna US Healthcare effective July 1, 2000, unless the employee
changes to another SHBP health plan during this Open Enrollment
period. Prudential members should continue to use their Prudential
identification cards and may continue to see their Prudential
Primary Care Physician (PCP) through June 30, 2000. Prudential
members should receive their new ID cards from Aetna US Healthcare
by July 1, 2000.
Prudential members should check
with their Prudential PCP to determine if the physician plans
to participate with Aetna US Healthcare after July 1, 2000.
If the Prudential PCP will not be joining with Aetna US Healthcare,
the member must choose an Aetna US Healthcare PCP before July
1, 2000, or change to a different SHBP plan during this Open
Enrollment period.
Prudential members who wish to
change to a health plan other than Aetna US Healthcare must
submit an application for change to their benefits administrator
by April 30, 2000. The new plan will be effective on July
1, 2000.
- Physicians Health Services (PHS)
has received approval by the State Health Benefits Commission
to introduce a pilot program, effective July 1, 2000, that will
allow PHS members to receive services from a PHS participating
specialist without obtaining a referral from the Primary Care
Physician (PCP). Although there is no need for a referral, members
will still be required to select a PCP for routine care and
are encouraged to coordinate care from a specialist through
their PCP. While no referral from the PCP is necessary for specialty
care, a referral is still required for hospitals and lab work.
The following changes have been made to the State Employee Group
Dental Program effective for the plan year beginning July 2000.
- Three DPOs - CIGNA, Community
Dental Associates, and Atlantic Southern (BeneCare) - will have
slightly higher premium levels than the other DPOs. The State
Employee Group Dental Program requires participating DPOs to
credential their dentists and report on all dental services
provided to State employees and their families. The data reported
by the DPOs allows the State to monitor the quality of dental
care provided by the DPOs. Based on a review of the reported
information, these plans have been noted as providing services
superior to the high standards required of all participating
DPOs. Although these plans cost a little more than the others,
remember that the additional cost indicates that these three
plans provide a superior quality of service.
- Statewide DPO, Inc. will no longer
be participating in the State Employee Group Dental Program
after July 1, 2000. Employees enrolled in this plan must change
to another dental plan during this Open Enrollment if they wish
to retain dental coverage after July 1, 2000.
We are pleased to enclose a copy of the 1999 New Jersey HMO Performance
Report: Compare Your Choices. This annual HMO report card is a
publication of the New Jersey Department of Health and Senior
Services designed to help health care consumers make more informed
choices. Additional copies may be requested by contacting the
Office of Managed-Care, Department of Health and Senior Services,
PO Box 360, Trenton, NJ 08625-0360, or calling 1-888-393-1062.
The report is also available over the Internet at: www.state.nj.us/health
If you have any questions about the Open Enrollment, please contact
our Office of Client Services at (609) 292-7524.
Enclosures: Open Enrollment 2000 Announcement Flyer (medical/dental
rates)
Medical Plan Contacts
1999 HMO Performance
Report
HB-0032-2000
NEW
JERSEY STATE HEALTH BENEFITS PROGRAM - MEDICAL PLANS
|
PLAN NAME
|
PLAN/
HMO #
|
PHONE
NUMBER
|
SERVICE AREAS
|
NJ
PLUS
Administered by Horizon Blue Cross
Blue Shield of New Jersey |
001
|
800-414-7427
|
In-Network:
All of New Jersey and Delaware
Parts of New York and Pennsylvania
Out-of-Network: Unrestricted |
Traditional
Plan
Administered by Horizon Blue Cross
Blue Shield of New Jersey |
002
|
800-414-7427
|
Unrestricted |
HEALTH MAINTENANCE
ORGANIZATIONS
| Horizon
HMO |
010
|
800-355-2583
|
All
of New Jersey and Bucks County, Pennsylvania |
| Aetna/US
Healthcare |
019
|
800-309-2386
|
All
of New Jersey, Washington DC and Connecticut
Parts of New York, Pennsylvania, Maryland, Virginia, Illinois,
Texas, Georgia, Delaware and California |
| CIGNA
HealthCare |
020
|
800-832-3211
|
All
of New Jersey, Pennsylvania, New York, Connecticut and Delaware |
| Oxford
Health Plan |
028
|
800-444-6222
|
All
of New Jersey
Parts of New York |
| AmeriHealth
HMO Plan |
033
|
800-454-7651
|
All
of New Jersey and Delaware
Parts of Pennsylvania |
| Physicians
Health Services |
034
|
800-535-3647
|
All
of New Jersey
Parts of New York and Connecticut |
| University
Health Plans, Inc. |
036
|
800-564-6847
|
All
of New Jersey |
If you have access to the Internet,
you can look up SHBP plan participating doctors in our Unified
Provider Directory on the SHBP home page:
http://www.state.nj.us/treasury/pensions/shbp.htm
(STbwMILESTONE)(Enclosure 1)
SHBP
OPEN ENROLLMENT 2000 MILESTONE CHART
for Biweekly State
Employers
Note: If the event is underlined,
you should be accomplishing the event.
PROJECTED
DATE |
EVENT |
| January
31 |
Initial
Open Enrollment Letter mailed to State employers. |
| February
28 |
Advance
copy of the 2000 NJ PLUS Physician and Hospital
Directory shipped to State employers. |
| March
13 |
Final
Open Enrollment Letter mailed to State employers with Fiscal
Year 2000 rate charts. Disseminate rate information to
employees as necessary - they will receive rate charts
with March 31 paycheck. |
| March
17 |
Request
for Open Enrollment Support form should be submitted
if you wish support for your Health Fair or educational seminars,
or need additional copies of the 2000 NJ PLUS
Physician and Hospital Directory. |
| March
20 |
State
Employer Benefit Administrator seminars conducted by the SHBP
in the Trenton area. |
| March
22 |
State
Employer Benefit Administrator seminars conducted by the SHBP
in Newark. |
| March
31 |
A copy
of the Health Capsule, SHBP Plan Comparison Summary
chart, and the Open Enrollment announcement flyer with medical
and dental charts included in paychecks through centralized
payroll. |
| April
1 |
Open
Enrollment Begins. |
| April
1-30 |
Health
Fairs and Educational Seminars conducted (optional). |
| April
30 |
Open
Enrollment Ends. |
| May
5 |
Employer
certified applications due at the Health Benefits Bureau. |
| July
1 |
Open
Enrollment changes effective. |