State
Health Benefits Program (SHBP)
AND
School Employee's Health Benefits Program (SEHBP)
SHBP/SEHBP
NEWS | GENERAL
INFORMATION | ACTIVE
GROUP | RETIRED
GROUP
EMPLOYEE PRESCRIPTION
DRUG PLAN | DENTAL
PLANS | COBRA | ABOUT THE PROGRAMS
SHBP and SEHBP
NEWS
Open Enrollment for Plan Year 2009
October 1 — 31, 2008
Rate Renewal Reports
 Rate Renewal Summaries — Plan Year 2009 Medical and Dental Plan Rates — NEW!
Rate Renewal Reports (Full Text) — Plan Year 2009 Medical and Dental Plan Rates — NEW!
Medical Plan Handbooks
NJ DIRECT Member Handbook (PDF 356K)
— NJ DIRECT Claim Form for Out-of-Network claims (PDF
204K)
Aetna HMO Member Handbook (PDF 310K)
CIGNA HealthCare HMO Member Handbook (Updated for July 2008 — PDF 328K)
Information for State Employees remaining in the Traditional Plan and NJ PLUS
Plan Comparison Summaries
Select applicable group: State Employees, Local Government, Local Education, All Retirees
Other Information
Locate a Convenient Provider — Unified Provider Directory
Retiree Wellness Program Information —
for State retirees who attained 25 years of service after June 30, 2007.
Medicare
Part D Creditable Coverage Letter for 2008 and Medicare Part D Questions
& Answers
GENERAL
INFORMATION
Program Descriptions and Eligibility
State Health Benefits
Program Summary
Program Description through 2008 - (PDF
file - size 472k - Requires Acrobat
Reader)
Plan Comparison
Summaries for 2008 — Medical plan information, benefit comparison charts, phone numbers, and Web site addresses.
Employee Prescription Drug Plan — (retiree prescription coverage included with medical plan)
Dental Plans for State Employees, participating Local Government/Education Employees, and Retirees
Health Benefits Resources for Active employees, Retired members, and COBRA enrollees
Medical
Plans
Medical Plan Web Addresses and Phone Numbers
NJ DIRECT15 and NJ DIRECT10 Member Handbook (PDF 356K)
— NJ DIRECT Claim Form for Out-of-Network claims (PDF
204K)
Aetna HMO Member Handbook revised for plan year 2008 (PDF 310K)
CIGNA HealthCare HMO Member Handbook updated July 2008 (PDF 328K)
Information for State Employees remaining in the Traditional Plan and NJ PLUS
Unified Provider Directory — Find a participating doctor or hospital
Privacy Practices
HIPAA Notice of Privacy Practices — and HIPAA Forms
New Jersey Civil Unions and Domestic
Partnerships
CIVIL UNIONS
New Jersey Civil Union Information
Fact Sheet #75, Civil Unions
Determining
Imputed Income for Civil Union Partners
Civil Union Partner
Imputed Taxable Income Charts
DOMESTIC PARTNERS
Fact
Sheet #71, Benefits Under the Domestic Partnership Act
Domestic Partner Adopting Employers
Determining
Imputed Income for Domestic Partners
Domestic Partner
Imputed Taxable Income Charts
Over Age Children to Age 30 (Chapter 375, P.L. 2005)
Fact
Sheet #74, Helath Benefits Coverage of Children to Age 30 Under Chapter 375
Application for Chapter 375 Coverage - (PDF 27K
- Requires Acrobat
Reader)
Chapter 375 Rate Charts effective April 1, 2008
State Employees and Retirees - (PDF 8K
- Requires Acrobat
Reader)
Local Government Employees and Retirees - (PDF 8K
- Requires Acrobat
Reader)
Local Education Employees and Retirees - (PDF 8K
- Requires Acrobat
Reader)
Cost Comparison — Chapter 375 vs. COBRA
Health Benefit Bills
Other Resources
NEW! Rate Renewal Reports — Plan Year 2009 Medical and Dental Plan Rates
NJ Department of Health — NJ Hospital Performance Report
SHBP
and Consultant Review - (PDF
2.1 MB - Requires Acrobat
Reader)
ACTIVE GROUP — Information Specific to Active Group Members
(State, Local Participating Employers)
Plan Comparison
Summaries for 2008 — Medical plan information, benefit comparison charts, phone numbers, and Web site addresses.
Health Benefits Enrollment Applications for Active Employees
For Revised Medical Plans Effective April 1, 2008
Health
Benefits Application for State Employees and Local Government/Education
Employees —
(PDF
file, size 31K - Requires Acrobat
Reader)
Applications must be certified by your employer before sending it to the Division
of Pensions and Benefits.
Other Groups
Health
Benefits Application for Part-time
Employees (PDF
file, size 31K - Requires Acrobat
Reader)
Health
Benefits Application for Intermittent State Employees
(PDF
file, size 31K - Requires Acrobat
Reader)
Applications for State Employees remaining in the Traditional Plan and NJ PLUS
Prescription Drug Benefits
Employee Prescription Drug Plan for 2008
Newsletters
Guide to Choosing
a
Plan — An overview of the new
medical plans
for employees and retirees (PDF 43K)
State
Active Group Rates — State Monthly and Biweekly Active Employee Group Rates
For State CWA, AFSCME, IFPTE, and State Employees NOT covered by a labor agreement,
Members pay 1.5% of salary regardless of Medical Plan or Coverage Level selected. Charts also include shared Dental Plan costs for 2008.
View Medical/Dental Plan Charts for Biweekly Employees; Monthly Employees - (PDF 37K
- Requires Acrobat
Reader).
State Health Benefits Waiver form (PDF file, size 20K)
State Employer Group Rate Charts — effective April 1, 2008
State
Biweekly Employees - (PDF 13K
- Requires Acrobat
Reader)
State
Monthly Employees - (PDF 13K
- Requires Acrobat
Reader)
State
Part-Time Chapter 172 Employees - (PDF 15K
- Requires Acrobat
Reader)
Rates for State Employees remaining in the Traditional Plan and NJ PLUS.
Local Active Group Rates — Employer Rates for
Local Government and Local Education
Local Employer Group Rates — effective April 1, 2008
County
and Municipal Government - (PDF 38K
- Requires Acrobat
Reader)
Local
Boards of Education - (PDF 38K
- Requires Acrobat
Reader)
Local
Part-Time Chapter 172 Employees - (PDF 38K
- Requires Acrobat
Reader)
RETIRED
GROUP — Information for Retired Group Members (State,
local participating employers,
and TPAF members)
Medical Plans
Follow up to Announcement Letter to Retirees — New Medical Plans (February 1, 2008)
Announcement Letter to Retirees — New Medical Plans (January 18, 2008)
How
to Enroll — Fact Sheet #11
SHBP Retiree Wellness Program Information - For State retirees who attained 25 years of service
after June 30, 2007
Plan Comparison
Summaries for 2008 — Medical plan information, benefit comparison charts, phone numbers, and Web site addresses.
Health Benefits Enrollment Applications for Retirees
For Revised Medical Plans Effective April 1, 2008
Retired Coverage Enrollment Application - (PDF 39K
- Requires Acrobat
Reader) - New enrollees ONLY
Retiree Change of Status Application - (PDF 39K
- Requires Acrobat
Reader) - For retirees making a plan change
Newsletter
Guide to Choosing
a
SHBP Plan — An overview of the new medical plans
for employees and retirees (PDF 43K)
Retired
Group Plan Rates
Medical Plan Rates for Plan Year 2008 — Effective April 1, 2008
Rates for retirees who pay the full cost of their coverage
- If you worked
for the State, click
here
- If
you worked for a local government, non-educational employer, click
here
- If
you worked for an education employer, click
here
Rates for
retirees who share the cost of their coverage with the State
- If you worked
for the State, attained 25 years on or after July 1, 2007, or retired on a disability retirement on or after August 1, 2007 and are enrolled in NJ DIRECT15, Aetna HMO, or CIGNA HealthCare, click here
- If you worked
for the State, attained 25 years — or retired on a disability retirement — prior to July 1, 2007, and share the cost of NJ DIRECT10 coverage with the State, click
here
- If you are
a former law enforcement officer covered under Chapter 330, click
here
Premium Sharing Labor Bargaining Groups — for retired State employees enrolled in NJ DIRECT10 who attained 25 years of service between 7/1/2003 - 6/30/2007 or who
retired on a disability retirement 8/1/2003 - 7/1/2007
Retiree Prescription Drug Coverage — Included with retired group medical plan
NJ
DIRECT15 or NJ DIRECT10
State and Local Government Retiree Prescription
Drug Benefits for plan year 2008.
Local Education Retiree Prescription
Drug Benefits for plan year 2008.
Health
Maintenance Organization (HMO)
Retiree Prescription
Drug Benefits for plan year 2008.
Medicare
Part D Information for Retired Group Members
Medicare
Part D Creditable Coverage Letter for plan year 2008
(Archived Letter for plan year 2007)
Medicare
Part D Questions and Answers
Plan Year 2008 Rates for retirees enrolling in Medicare Part
D who pay the full cost of their coverage and worked
for
a State Department or Agency, a Local Government, or a Local Education employer will be mailed.
Retiree Dental
Retiree
Dental Expense Plan General Information
Retiree Dental Expense Plan Member Handbook
Retiree
Dental Expense Plan Rates for Plan Year 2008
EMPLOYEE PRESCRIPTION
DRUG PLAN — Available to employees of the State and participating local employers (click for Retiree Prescription Drug Coverage information)
Employee Prescription Drug Plan Member Handbook
Prescription Drug Plan Copayments
Effective July 2007 for State CWA, AFSCME, IFPTE, and State employees not covered by a labor agreement
Three Tier Copayment Design
Third Tier Copayment Exception
Employee Prescription Drug Plan Administrator — CVS/Caremark
CVS/Caremark
Mail Service Order Form - (PDF 81K - Requires Acrobat Reader)
CVS/Caremark Prescription Reimbursement
Standard Claim Form - (PDF 141K - Requires Acrobat Reader)
DENTAL
PLANS — Available
to employees of the State including State colleges and universities,
Retirees, and employees of participating local employers.
Active Employee Dental Plans
Employee Dental Plans for Active Employees — Dental plan names, coverage areas, phone numbers, and Web site addresses
Summary description of dental plans for Active Employees
Employee Dental Plans Member Handbook — effective through plan year 2008
State and Local Employee
Dental Application - (PDF 41K - Requires Acrobat
Reader)
Employee Dental Expense Plan Claim
Form - (PDF 149K - Requires Acrobat
Reader)
Employee Dental Plan Rates for Plan Year 2008
State
Biweekly; State
Monthly;and Local
Participating Employers - (PDF 8K - Requires Acrobat
Reader)
Retiree Dental Expense Plan
Retiree
Dental Expense Plan
Retiree Dental Expense
Plan Member Handbook
Retiree Dental Expense Plan Claim
Form - (PDF 149K - Requires Acrobat
Reader)
Retiree
Dental Expense Plan Rates for Plan Year 2008
COBRA
COBRA Information for members and dependents
COBRA Program and Medicare
Employer responsibilities under COBRA
COBRA Rates
COBRA
Rates effective April 1, 2008
COBRA Active Group Rates
State Group; Local Government; and Local Education Groups - (PDF 18K - Requires Acrobat
Reader)
COBRA Dental Rates
State Group; Local Government/Education Group - (PDF 12K - Requires Acrobat
Reader)
COBRA
Part-Time Chapter 172 Rates
State Part-Time; Local Part-Time COBRA Rates - (PDF 7K - Requires Acrobat
Reader)
COBRA
Retiree Rates
State Group; Local Government; and Local Education Groups - (PDF 16K - Requires Acrobat
Reader)
COBRA Applications
COBRA Application For State and Local Employees — (PDF
file, size 31K - Requires Acrobat
Reader)
COBRA Applications must be certified by your employer before sending it to the Division
of Pensions and Benefits.
COBRA Application, for Part-time employees — (PDF
file, size 31K - Requires Acrobat
Reader)
COBRA Application, for Intermittent State Employees — (PDF
file, size 31K - Requires Acrobat
Reader)
ABOUT THE SHBP and SEHBP
The
State Health Benefits Program (SHBP) was established in 1961 under
N.J.S.A. 52:14-17.25 et seq. to provide health benefits to State employees, retirees,
and their dependents. The SHBP was extended to employees, retirees, and
dependents of participating local public employers in 1964. Local employers must adopt a resolution
to participate in the SHBP. Rules governing
the operation and administration of the program are found in Title 17, Chapter 9 of the New Jersey Administrative Code.
The State Health Benefits Commission is
the executive body established by statute to be responsible for
operation of the SHBP. The Commission meetings are open to the public and are conducted at the Division of Pensions
and Benefits in Trenton. Plan members are entitled to appeal to
the Commission for resolution of any complaints
after they have completed the formal grievance procedure of their
plan administrator.
The
School Employees' Health Benefits Program (SEHBP) was established by
Chapter 103, P.L. 2007. It offers medical and prescription drug coverage to qualified school
employees and retirees, and their eligible dependents. Local employers must adopt a resolution
to participate in the SEHBP. The School Employees’ Health Benefits Program Act is found in
the N.J.S.A. 52:14-17.46 et seq. Rules governing the operation and administration of the
program are found in Title 17, Chapter 9 of the New Jersey Administrative Code.
The School Employees' Health Benefits Commission is
the executive body established by statute to be responsible for
operation of the SEHBP. The Commission meetings are open to the public and are conducted at the Division of Pensions
and Benefits in Trenton. Plan members are entitled to appeal to
the Commission for resolution of any complaints
after they have completed the formal grievance procedure of their
plan administrator.
The
Division of Pensions and Benefits, specifically the Health Benefits
Bureau and the Bureau of Policy and Planning, are responsible
for the daily administrative activities of the SHBP and the SEHBP. The Division provides news and updates to participating employees and retirees
through its newsletters and publications. |
