|
Certifying
Officer Letters 2000
|
Subject
|
Date
|
Health
Insurance Portability and Accountability Act (HIPAA) Update |
December
2000
|
Military
Service After Enrollment
|
November
3, 2000
|
|
HMO
Expansion of Service Area
|
October
2000
|
|
PFRS
Involuntary Disability and sample Involuntary
Retirement Letter
|
October
19, 2000
|
|
SHBP
Fall Open Enrollment for 2001
|
August
18, 2000
|
|
TaxSave
2001
|
August
10, 2000
|
|
Introduction
of Field Audit Unit
|
May
19, 2000
|
| Special
Open Enrollment Extension (SHBP) |
May
5, 2000
|
| PFRS
Enrollment Eligibility and Age Limits |
May
2, 2000
|
| Increase
in Prescription Drug Supply Limit at Retail Pharmacies and
Change of ID Card Ordering Procedures (SHBP - State Prescription
Drug Plan) |
April
24, 2000
|
| Back
Payroll Deductions--Chapter 415, P. L. 1999 (PERS) |
February
14, 2000
|
| SHBP
Open Enrollment 2000 (State bi-weekly and monthly employees) |
January
31, 2000
|
| Special
Open Enrollment for NJ PLUS and Horizon HMO |
January
31, 2000
|
| SHBP
Open Enrollment 2000 (local government and school board
employees) |
January
21, 2000
|
| Changes
to PERS Employee Pension Contribution Rate |
January
21, 2000
|
2007
Certifying Officer Letters
2006
Certifying Officer Letters
2005
Certifying Officer Letters
2004
Certifying Officer Letters
2003
Certifying Officer Letters
2002 Certifying Officer Letters
2001 Certifying Officer Letters
1999 Certifying Officer Letters
1998 Certifying Officer Letters
1997 Certifying Officer Letters
December
2000
To:         State
Health Benefits Program Participating Employers
From:    Janice
F. Nelson, Assistant Director, State Health Benefits Program
Subject:
Health Insurance Portability and Accountability Act (HIPAA)
Update
The
federal Health Insurance Portability and Accountability Act (HIPAA)
of 1996 contained a number of provisions that affected the State
Health Benefits Program (SHBP) and its participating employers.
The SHBP implemented several actions to comply with the requirements
of HIPAA. These actions included:
-
establishing
procedures to provide departing employees with certificates
of coverage for use with their next health carrier;
-
amending
SHBP rules to comply with HIPAA coverage requirements;
-
filing
exemptions for 1998, 1999, and 2000 to the provisions of mental
health parity in accordance with HIPAA procedures for the
Traditional Plan and NJ PLUS; and
-
providing
employers with a required notice of compliance with HIPAA
to be distributed to all employees and their family members
upon enrollment.
Since
the mental health limitations currently in effect are detailed in
the law governing the SHBP, a change in plan design would require
legislative action. Therefore, the SHBP must file a mental health
parity exemption each plan year as long as a group plan is not HIPAA
compliant. The Commission has voted to file an exemption for 2001.
Therefore, mental health benefits will remain unchanged through
2001 unless the statute governing the SHBP is amended. Since HIPAA
has a continuing notification requirement, a revised compliance
notice reflecting this exemption from federal mental health parity
requirements is attached for your use with newly enrolling employees
and family members. You should send it at the same time you send
the initial notice of COBRA rights.
A
brief refresher on HIPAA is also attached
for your information. If you have questions, contact Client Services
at (609) 292-7524 or call the Employer's SHBP Hotline at (609) 777-1082
and leave a message. A staff member will return your call on the
next business day.
FEDERAL
HEALTH INSURANCE ACTS OF 1996
Three
pieces of federal legislation were enacted in 1996 that established
several requirements to group health plans and insured health products.
These were the Health Insurance Portability and Accountability Act
(HIPAA), the Mental Health Parity Act, and the Newborns' and Mothers'
Health Protection Act. HIPAA included the reporting requirements
covering all three pieces of legislation and is therefore used to
refer to all three acts. The requirements of the legislation and
SHBP status on each requirement are show below:
|
FEDERAL
REQUIREMENT
|
SHBP
STATUS
|
|
Issue
Certificates of Coverage to all employees and or dependents
who lose coverage.
|
Participating
employers were provided (August 1997) a sample certificate
to use to meet this requirement.
|
|
Limit
restrictions of coverage for pre-existing conditions.
|
All SHBP
plans exceed this requirement since they have no preexisting
condition restrictions.
|
|
Offer
a special enrollment period to individuals who meet certain
conditions, i.e., an employee or employee's dependent, who
declined coverage because of other medical coverage, must
have an opportunity for special enrollment should the other
coverage end.
|
All SHBP
plans comply with this HIPAA requirement for employees and
family members.
|
|
Eliminate
discrimination against participants and beneficiaries based
on health status.
|
All SHBP
plans comply with this requirement. (Note: the SHBP "actively
at work" requirement is waived only for employees
not at work due to illness).
|
|
Provide
a minimum level of hospital coverage for newborns and mothers
|
All SHBP
plans meet this requirement.
|
|
Provide
parity in mental health benefits
|
All SHBP
HMO plans meet this requirement. The SHBP has exempted the
Traditional Plan and NJ PLUS for 2001 from mental health parity
- different limits continue to exist for these plans.
|
|
Provide
annual notice to covered members of any plan provisions not
in compliance with HIPAA requirements.
|
A sample
certificate to use to meet this requirement is enclosed.
|
Notice
to State Health Benefits Program Participants about
Compliance with Federal Health Insurance Requirements
This
notice is being provided to inform you about State Health Benefits
Program (SHBP) conformance with federal health insurance regulations.
The
Health Insurance Portability and Accountability Act (HIPAA),
the Mental Health Parity Act, and the Newborns' and Mothers'
Health Protection Act, federal laws enacted in 1996, contain
a number of provisions that have affected the SHBP since January,
1998. HIPAA required all group health plans to implement the
following provisions that are contained in the three federal
laws:
#1
- Limit the use of pre-existing condition restrictions to a
maximum of twelve months;
#2
- Offer a special enrollment period to employees and dependents
who do not enroll in the plan when initially eligible because
they have other coverage, and who subsequently lose that coverage;
#3
- Eliminate discrimination against participants and beneficiaries
based on health status;
#4
- Provide a minimum level of hospital coverage for newborns
and mothers, generally 48 hours for a vaginal delivery and 96
hours for a cesarean delivery; and
#5
- Provide parity in mental health benefits, that is, any dollar
limitations applied to mental health treatment cannot be lower
than those on medical and surgical benefits.
Since
January 1, 1998, all SHBP plans have met or exceeded
HIPAA requirements #1 through #4 above. SHBP HMOs also have
complied with requirement #5 above. The State Health Benefits
Commission filed exemptions from HIPAA compliance on mental
health parity (requirement #5) for 1998, 1999, and 2000 for
the Traditional Plan and NJ PLUS, as self-insured, non-federal
governmental plans are permitted to do. The Commission has voted
to continue that exemption through 2001. As a result, the mental
health limits for the Traditional Plan and NJ PLUS that are
described in the New Jersey State Health Benefits Program
Medical Plans Information Handbook will remain in effect
throughout 2000.
MEMORANDUM
October
2000
TO: SHBP
Participating Local Government Employers
SHBP Participating Local Education Employers
State Biweekly Benefits Administrators
State Monthly Human Resource Directors/Benefits Administrators
FROM: NJ
State Health Benefits Program
SUBJECT: Health
Maintenance Organization (HMO) Expansion of Service Area
The
NJ State Health Benefits Program (SHBP) will be expanding service
areas for two of our HMOs: Aetna US Healthcare and CIGNA Healthcare
effective January 1, 2001. The SHBP will begin offering these two
HMOs in several states outside of the New Jersey region. Aetna US
Healthcare is expanded to parts of Arizona, California, Florida,
Georgia, Illinois, Indiana, Maryland, North Carolina, Texas and
Virginia. CIGNA Healthcare is expanded to parts of California, Florida,
Georgia, North Carolina, Pennsylvania, Virginia, and West Virginia.
CIGNA will also include the entire state of South Carolina, Arizona,
Maryland except the City of Ocean City and all zip codes in Washington
D.C. The areas of expansion are shown on the attached charts. This
expansion is only open to the retirees enrolled in the SHBP.
Aetna
US Healthcare and CIGNA will be sending out information packets
to those retirees living within the expansion areas during the months
of October and November. The cost of coverage for these HMOs will
not change as a result of the service area expansion. Rates will
remain as currently approved. The next rate change will become effective
January 1, 2002.
Members/dependents
enrolled in the federal Medicare program must continue their enrollment
in both Parts A and B. Medicare will pay for all medical services
as primary, with the HMO coverage as a supplement.
This
expansion will give retirees a managed care option to the Traditional
Plan. Any questions regarding this matter should be directed to
our Client Services Unit at (609) 292-7524.
November
3, 2000
To: All
Pension Funds Certifying Officers
From: William
H. Kale
Assistant Director, Client Services
Subject: Military
Service After Enrollment Amended Rule: N.J.A.C. 17:1-4.36
The
Division of Pensions and Benefits adopted an amendment to the New
Jersey Administrative Code regarding military service credit (copy
of rule attached). This was done to comply with federal requirements
under the Uniformed Services Employment and Reemployment Rights
Act of 1994 (USERRA) 38 USC 4301 et seq. The rule applies to all
the defined benefit and defined contribution retirement systems
administered by the Division of Pensions and Benefits. This memorandum
explains the new requirements of this rule and what employers must
do to implement its provisions and comply with the federal law.
Military
service used for benefits qualification
USERRA
provides benefit protection to an employee who leaves public employment
after October 13, 1994, to serve in the uniformed services and then
returns to public employment within time frames specified in the
law, normally within ninety days of the end of the uniformed service.
That employee is entitled to the restoration of certain pension
and similar benefits that would have accrued but for the employee's
absence due to the qualified USERRA service. USERRA requires
an employer to treat an employee's period of service in the uniformed
services as if the employee had never left public employment for
the purposes of vesting and/or determining eligibility for retirement
and health benefits.
For
example, an employee with 24 years of pension credit and one year
of USERRA-eligible service in the uniformed services would have
25 years of service for the purpose of determining eligibility for
retirement. That employee, if a PERS or TPAF member, would be eligible
to collect a retirement benefit before age 60 under the Early Retirement
provisions. The employee would also be eligible for employer-paid
health benefits coverage based on 25 years of service (if the employer
normally provided this benefit). An example for vesting purposes
would be that an employee with eight years of pension credit and
two years of USERRA-eligible service would be vested.
Special
Note: The employee need not return to employment with the same public
employer (s) he left to enter the military service. The employee
can return to employment with a different public employer, as long
as that employer participates in the same retirement system the
member was in prior to the USERRA-eligible service. For example,
a PERS member from "Township A" terminated employment
to serve in the uniformed services for two years. Upon completion
of the military service, the employee returns to public employment
at "Township B" within the timeframe specified by law.
The employee is eligible for USERRA service credit.
Military
service used for benefit calculation
While
the USERRA-eligible service will be used to determine eligibility
for benefits, the actual calculation of retirement benefits will
not use the USERRA-eligible service unless the employee
pays required pension contributions for the period of military service.
The employee may, however, receive this pension credit for the period
of uniformed service by making the pension contributions that would
have been required had the employee not left employment to serve
in the uniformed services. Once notified of the USERRA-eligible
service, the Division will contact affected employees and ask if
they wish to make the necessary contributions for the period of
military service so that it will be used in the calculation
of their retirement allowances. The contributions will be based
upon the pensionable salary the employee would have received had
the employee not gone for military service. If the determination
of that pensionable salary is not reasonably certain by the employer,
contributions will be made on the basis of the employee's average
pensionable compensation during the ten- or twelve-month period
immediately preceding the military service. Any payment to the plan
described in this paragraph must be made during the period that
begins on the date of reemployment and continues for the lesser
of either five years or three times the period of the uniformed
service. For example, if an employee returns to employment after
three months of USERRA-eligible service, back deductions for that
service must be paid during the first nine months after the return
to work. Note: an exception to this timeframe because of the delay
in implementation of the federal law is described later in this
letter.
Additional
supplemental plan elective contributions
USERRA also provides that employees are permitted to make additional
elective deferrals for any programs, e.g., deferred compensation,
SACT, or ACTS programs, in which they were enrolled immediately
prior to their military service. These deferrals may not exceed
the maximum amount employees would have been permitted to contribute
during the period of military service had the employees been continuously
employed by the public employer during those periods.
The
USERRA Process
The
following actions should occur when an employee returns to covered
employment within the time frames specified under USERRA.
-
The employer
should notify the Division not later than 30 days after the
employee's return from service in the uniformed services by
submitting a Request for Userra-Eligible Service. A
copy of the Request for Userra-Eligible Service is
attached. This notification is also required for employees
on a leave of absence for military service, without pay, for
which no deductions were made and no service credited to their
pension accounts. If the employee received pay from the
employer, had pension deductions taken, and, therefore, received
pension credit for the period of military service, no action
is required of the employer with respect to USERRA for pension
purposes.
-
Once notified,
the Division will annotate the employee's pension account
to reflect the USERRA credit for benefits eligibility
only. We will notify the employee of the crediting of this
USERRA-eligible service at the home address and send a quotation
for the cost to have the pension service credit count for
benefits calculation. Along with the quotation will
be an authorization form the employee must sign and return
to the Division if (s) he wishes the pension service credit
to count for benefits calculation.
-
If the
employee authorizes deductions to obtain retirement credit
for the USERRA-eligible service, the employer should take
and remit those deductions in accordance with the instructions
on the certification of payroll deductions, which the Division
of Pensions and Benefits will send to the employer.
Notifying
employees and catching up
Employers
should notify employees of the benefit protection provided by USERRA
and this special opportunity to obtain service credit for any periods
of uniformed service since October 13, 1994. This can be done by
posting the attached notice to employee bulletin boards, distributing
a synopsis of the benefit in a human resource newsletter, and/or
directly contacting employees the employer can identify as having
USERRA-eligible service.
Employees
eligible for USERRA credit who returned to public employment between
October 13, 1994 and the present date may apply for this service
until December 31, 2000. The employer should submit a Request
for Userra-Eligible Service to the Division for employees who
may have qualified for service credit under USERRA since its enactment
in October 1994. We need that information to give the employees
service credit for benefit eligibility purposes.
After
December 31, 2000, any request for credit for USERRA-eligible service
should be made within 30 days of return to employment. If
the member wants the USERRA-eligible service to be used to calculate
benefits, the request will have to be made so contributions can
be collected within the lesser of either five years or three times
the period of the uniformed service from the date of reemployment.
Special
situations
USERRA
provides that those contributions or lump sum payments made by employees
for USERRA-eligible service periods shall be deferred from federal
taxation. Therefore, they must be taken through payroll deductions.
Employers should be prepared to process lump sum requests made by
employees.
Employee
requests to make additional elective contributions to supplemental
programs for the USERRA-eligible service periods should be made
directly to each employer. You should contact your supplemental
plan administrator for instructions on how to process and report
these voluntary contributions. Instructions for the State administered
supplemental plans, i.e., Deferred Compensation, SACT, and ACTS,
will be issued in separate communications.
Alternate
Benefit Program Employers
If
an employee who participates in the Alternate Benefit Program (ABP)
is re-employed under the provisions of USERRA by an employer who
participates in the ABP, the employer is liable to the employee's
pension plan for funding any obligation of the plan to provide benefits.
That is, the employer must allocate the amount of any employer contribution
for that employee in the same manner and extent that the allocation
occurred for other employees during the same period of service.
However, the employee is entitled to these employer contributions
only if (s) he makes the employee contributions to the plan for
the period of uniformed service.
The
procedures shown in the USERRA Process on page two will also be
used for the ABP. The vehicle for reporting the employee contributions
and securing reimbursement from the State of New Jersey for the
employer's contribution will be the Alternate Benefit Program Employer
Contribution Report. Under the Mandatory Back Deduction section
of the report, the employer should report the employee's name, Alternate
Benefit Program number, and the salary amount on which the employee
contributions to the plan for the period of uniformed service are
made. A notation indicating that this salary is relative to military
service after employment should also be provided.
The
employer is not required nor expected to make up the earnings
that contributions made for USERRA-eligible service would have made
had the employee been employed continuously.
Summary
A
public employer who hires a member of a New Jersey public retirement
system administered by the Division of Pensions and Benefits under
the provisions of USERRA should submit a Request for Userra-Eligible
Service to the Division within 30 days of that employee's return
from service in the uniformed services.
There
is a catch-up period until December 31, 2000 to submit a Request
for Userra-Eligible Service for eligible service since October
1994, when the federal law was effective.
Any
requests for this USERRA-eligible service received after December
31, 2000, must be received within the time frames specified under
USERRA.
If
you have any questions, contact Client Services at (609) 292-7524
or E-mail us at pensions.nj@treas.state.nj.us
Enclosures:
N.JA.C. 17:1-4.36, Peacetime Military
Service; Service Credit
Request for Userra-Eligible Service Form
USERRA Notice for Employees
ATTENTION:
EMPLOYEES WITH MILITARY SERVICE
If
you meet the criteria shown below, you may qualify for additional
pension benefits under the federal Uniformed Services Employment
and Reemployment Rights Act of 1994 (USERRA). If you
-
Left public
service in New Jersey after October 13, 1994, to serve
on active duty in the uniformed services of the United States;
and
-
Returned
to public service in New Jersey, within time frames specified
in the USERRA law, to a position covered in the same pension
system from which you left to enter the uniformed service.
USERRA
provides benefit protection to an employee who leaves public employment
after October 13, 1994, to serve in the uniformed services and then
returns to public employment within time frames specified in the
law. (Note: The law says that an employee must normally return to
public employment within 90 days of the end of the uniformed service
to qualify for USERRA benefits). That employee is entitled to the
restoration of certain pension and similar benefits that would have
accrued but for the employee's absence due to the qualified USERRA
service. USERRA requires an employer to treat an employee's period
of service in the uniformed services as if the employee had never
left public employment for the purposes of vesting and/or determining
eligibility for retirement and health benefits. The service
time will not be included in the service time used to calculate
your retirement allowance, only to qualify for the retirement benefit.
You will, however, be able to have your USERRA time included for
benefit calculation by making the pension contributions that would
have been made had you not left employment for military service.
If
you think you may meet the criteria shown above, ask your Personnel/Human
Resources Office for a Request for USERRA-Eligible Service form
so the Division of Pensions and Benefits can determine your eligibility
for pension service credit under the provisions of USERRA.
October
19, 2000
TO: Certifying
Officers, Police and Firemen's Retirement System
FROM: Thomas
P. Bryan, Director
SUBJECT: PFRS
Retirement Options for Members with 20 to 25 Years of Service
The
enactment of Chapter 428, PL 1999, in January of this year has
raised some questions concerning the retirement benefits available
to members of the Police and Firemen's Retirement System (PFRS)
with more than 20 but less than 25 years of credited service.
The purpose of this memorandum is to provide information on the
benefits available to these members and hopefully answer the questions.
There
are several retirement possibilities for PFRS members with more
than 20 but less than 25 years of credited service.
Service
Retirement
Members
enrolled in the PFRS when Chapter 428 was enacted are eligible
to receive a service retirement allowance equal to 50% of final
compensation. If they are forced to retire because of the mandatory
retirement age (65) with less than 25 years of service, they will
receive an additional 3% of final compensation per year of service
for their 21st through 25th years.
Accidental
Disability Retirement
Members
who are totally and permanently disabled as a direct result of
a traumatic event arising out of the performance of their regular
or assigned duties may file for an accidental disability retirement
allowance. This provides a benefit equal to 2/3rds of the member's
salary at the time of the accident or at the time of retirement,
whichever is higher.
Ordinary
Disability Retirement
Members
with at least four years of service who are totally and permanently
disabled, not as a direct result of a traumatic event arising
out of the performance of their regular or assigned duties, may
file for an ordinary disability retirement allowance. This provides
a benefit equal to 40% of the member's final salary.
Ordinary
Disability Retirement Filed by the Employer
Employers
may request retirement for members who are totally and permanently
disabled by filing an ordinary disability retirement application
for them. Members with more than 20 years of service, if approved
by the PFRS Board of Trustees for ordinary disability retirement
filed by the employer, will receive a retirement allowance equal
to 50% of final compensation plus 3% for each year of creditable
service over 20 years up to 25 years of credited service.
Ordinary
disability retirement filed by the employer is not a new benefit,
but the increase in the amount of the benefit for members with
more than 20 but less than 25 years is new as provided in Chapter
428. The clear intent of Chapter 428 is that if a member
with 20 or more years of service is permanently and totally incapacitated
for the performance of regular or assigned duties, the member
should be retired on an ordinary disability retirement benefit
and should receive the higher retirement allowance. The
employer's responsibility in situations like this has not changed
as a result of Chapter 428. If the employer believes that the
member is permanently and totally incapacitated for the performance
of regular or assigned duties [and has at least four years of
service credit*], the employer should initiate the retirement
application to qualify the member for the higher benefit under
the law. If a member with over 20 years of service has already
filed for an ordinary disability, the Division will process the
retirement for the higher benefit upon receipt of a letter, signed
by the certifying officer, indicating that the employer believes
the member is permanently and totally incapacitated for the performance
of regular or assigned duties. A sample letter is attached.
If
you have questions about this letter, please write to the address
above, E-mail the Division at pensions.nj@treas.state.nj.us
or call Client Services at (609) 292-7524.
The
Employer Education Unit of the Division of Pensions and Benefits
is available to all public employers for assistance and training
on pension enrollment issues, completing the Quarterly Report
of Contributions, and general pensions processing. To contact
the Employer Education Unit, write, E-mail, or call (609) 777-2112
or (609) 777-2111.
Attachment
*
annotation in brackets [] not in original letter.
(SAMPLE
LETTER)
Employer
Letterhead
(Date)
Division
Director
Division of Pensions and Benefits
PO Box 295
Trenton, NJ 08625-0295
Dear
(Name of Division Director):
(Name
of employee) is employed by (name of location) in the position
of (title) and is an active member of the Police and Firemens
Retirement System (PFRS) with at least four years of credited
service.
We believe
that (name of the employee) is totally and permanently disabled
and can no longer perform his/her assigned duties. Since we are
unable to provide an alternative PFRS covered position with duties
capable of being performed by the employee, (name of the employee)
should be approved for a disability retirement benefit from the
PFRS.
Sincerely,
(Signature)
(Name of PFRS Certifying Officer)
(Title)
State
Health Benefits Program
Fall 2000 Open Enrollment Announcement Letters for Employers
State
(Centralized Payroll)
State
(monthly payroll)
Rutgers
and NJIT
Local
Government and School Boards
August
18, 2000
TO:              State
Health Benefits Program Participating Local Employers
FROM:        Janice
F. Nelson, Assistant Director for Health Benefits
SUBJECT: Fall
2000 SHBP Open Enrollment
The
State Health Benefits Program (SHBP) Open Enrollment period for
local employees will begin on September 18, and end on October
31, 2000. Completed employer certified applications must arrive
at the Health Benefits Bureau no later than November 6, 2000.
All changes to coverage made during the fall open enrollment will
be effective on January 1, 2001.
This
is the second open enrollment in 2000, and marks the SHBP's change
from a plan year based on the fiscal year (July 1 - June 30) to
one based on the calendar year (January 1- December 31). Because
of the plan year change, future SHBP Open Enrollment periods will
be held each fall for changes effective the following January.
This means that there will be no open enrollment in the spring
of 2001 and this open enrollment is your employees' only
chance to change their benefit status until the fall of 2001.
While
the SHBP's plan year is changing, there have been no other
changes to the health plans or to the benefits they offer.
Enclosed
you will find approved rates and other plan information. We have
included rate charts for employees with and without prescription
drug coverage. All rates for SHBP health and prescription drug
plans were set as of July 1, 2000, for an 18-month period (through
December 31, 2001), so premiums will not change with this
open enrollment period.
Also
enclosed are:
-
A milestone
chart that lists key Open Enrollment events, their dates,
and the projected delivery dates for all Open Enrollment
publications.
-
A chart
for employees showing the available SHBP medical plans
with contact information.
-
A flier
to publicize the SHBP's Unified
Provider Directory. The Unified Provider Directory is
an online service that provides a comprehensive listing
of health care providers and facilities who deliver their
services through one or more of the SHBP's health care plans.
Updated monthly, you can access the Unified Provider Directory
through the SHBP homepage at: www.state.nj.us/treasury/pensions/shbp.htm
Because
of the recent spring Open Enrollment, the SHBP will not
be coordinating health fairs for the fall.
Publications
scheduled for distribution include an Open Enrollment issue of
the Health Capsule newsletter.
You will receive sufficient copies of the Health Capsule
for distribution to all of your employees.
Also
scheduled for distribution is a publication of particular note
- the SHBP Summary Program
Description (SPD). This is a new publication
for your employees that provides an overview of the SHBP, a description
of each plan offered, and comparisons of selected benefits. You
will receive sufficient copies of the SPD for distribution to
all of your employees.
If
you have any questions about the Open Enrollment, please contact
our Office of Client Services at (609) 292-7524. Thank you for
your cooperation.
Enclosures:
2000
SHBP Open Enrollment Milestone Chart
SHBP
Medical Plans and Contact Information
Health
Benefit Rate Charts
(LOC
- MILESTONE)
FALL
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
|
|
August
18
|
Initial
Open Enrollment Letter mailed to employers.
Fiscal
Year 2000 rate charts sent to employers.
|
|
September
1-15
|
Disseminate
rate information to employees as necessary.
|
|
September
10-15
|
SHBP
Summary Program Description and the Health
Capsule newsletter shipped
to employers. Distribute to employees.
|
|
September
18
|
Open
Enrollment Begins.
|
|
October
31
|
Open
Enrollment Ends.
|
|
November
6
|
Employer
certified applications due at the Health Benefits Bureau.
|
|
January
1, 2001
|
Open
Enrollment changes effective.
|
August
18, 2000
TO:                State
Monthly Human Resource Directors/Benefits Administrators
FROM:         Janice
F. Nelson, Assistant Director for Health Benefits
SUBJECT: Fall
2000 State Health Benefits Program (SHBP) Open Enrollment
The
State Health Benefits Program (SHBP) Open Enrollment period for
State monthly employees will begin on September 18, and end on October
31, 2000. Completed employer certified health benefit and/or dental
applications must arrive at the Health Benefits Bureau no later
than November 6, 2000. All changes to coverage made during the fall
open enrollment will be effective on January 1, 2001.
This
is the second open enrollment in 2000, and marks the SHBP's change
from a plan year based on the fiscal year (July 1 - June 30) to
one based on the calendar year (January 1- December 31). Because
of the plan year change, future SHBP Open Enrollment periods will
be held each fall for changes effective the following January. This
means that there will be no open enrollment in the spring of
2001 and this open enrollment is your employees' only chance
to change their benefit status until the fall of 2001.
While
the SHBP's plan year is changing, there have been no other changes
to the health plans or to the benefits they offer.
All
rates for SHBP health, dental, prescription drug, and vision plans
were set as of July 1, 2000, for an 18-month period (through December
31, 2001), so premiums will not change with this open enrollment
period.
Unions
representing most State employees have new contracts in effect that
provide for 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.
Enclosed
you will find sample Open Enrollment announcement fliers that provide
a list of medical and dental plans and the premium sharing costs
for State employees not paid through Centralized Payroll. The fliers
are provided for three different payroll schedules (Monthly, 24
Pay Periods, and 26 Pay Periods). Choose the flier that corresponds
to your location's payroll schedule. These fliers are designed to
assist your employees in making informed decisions concerning their
health care coverage during this open enrollment. These are master
copies and may be reproduced for distribution to your employees
(State employees paid through the State's Centralized Payroll Unit
will receive these publications with their September 15 paychecks).
If you have specific questions about the fliers, contact Steven
R. Stokley by telephone at (609) 633-1462 or by fax at (609) 292-9500.
Also
included with this letter are:
-
A milestone
chart that lists key Open Enrollment events, their dates,
and the projected delivery dates for all Open Enrollment publications.
-
A flier
to publicize the SHBP's Unified
Provider Directory. The Unified Provider Directory is
an online service that provides a comprehensive listing of
health care providers and facilities who deliver their services
through one or more of the SHBP's health care plans. Updated
monthly, you can access the Unified Provider Directory through
the SHBP homepage at: www.state.nj.us/treasury/pensions/shbp.htm
With
the change to a fall open enrollment, the SHBP Open Enrollment now
runs concurrently with the State Employees Tax Savings Program (Tax$ave)
Open Enrollment. Tax$ave is a benefit program, available to State
employees who are eligible for the SHBP. Tax$ave can save you money
by paying health benefit premiums and eligible unreimbursed medical
and/or dependent care expenses from before-tax dollars. See the
Health Capsule newsletter and
the Tax$ave 2001 Open Enrollment materials for more information,
or call to reserve a place at the workshops.
Because
of the recent spring Open Enrollment, the SHBP will not be
coordinating health fairs for the fall.
Another
publication scheduled for distribution is the Open Enrollment issue
of the Health Capsule newsletter.
Sufficient copies will be provided for distribution to all of your
employees.
Also
scheduled for distribution is a publication of particular note -
the SHBP Summary Program Description
(SPD). This is a new publication for your employees
that provides an overview of the SHBP, a description of each plan
offered, and comparisons of selected benefits. You will receive
sufficient copies of the SPD for distribution to all of your employees.
If
you have any questions about the Open Enrollment, please contact
our Office of Client Services at (609) 292-7524. Thank you for your
cooperation.
Enclosures:
Health and Dental Plan Rate Charts/Fliers
2000 SHBP Open Enrollment Milestone Chart
Unified Provider Directory Flier
Tax$ave/SHBP Employer Workshop Flier
August
18, 2000
TO:              Campus
Human Resource Directors
FROM:        Janice
F. Nelson, Assistant
Director for Health Benefits
SUBJECT: Fall
2000 State Health Benefits Program (SHBP) Open Enrollment
The
State Health Benefits Program (SHBP) Open Enrollment period for
State monthly employees will begin on September 18, and end on October
31, 2000. Completed employer certified health benefit and/or dental
applications must arrive at the Health Benefits Bureau no later
than November 6, 2000. All changes to coverage made during the fall
open enrollment will be effective on January 1, 2001.
This
is the second open enrollment in 2000, and marks the SHBP's change
from a plan year based on the fiscal year (July 1 - June 30) to
one based on the calendar year (January 1- December 31). Because
of the plan year change, future SHBP Open Enrollment periods will
be held each fall for changes effective the following January. This
means that there will be no open enrollment in the spring of
2001 and this open enrollment is your employees' only chance
to change their benefit status until the fall of 2001.
While
the SHBP's plan year is changing, there have been no other changes
to the health plans or to the benefits they offer.
All
rates for SHBP health, dental, prescription drug, and vision plans
were set as of July 1, 2000, for an 18-month period (through December
31, 2001), so premiums will not change with this open enrollment
period.
Unions
representing most State employees have new contracts in effect that
provide for 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 old contracts.
Enclosed
you will find a sample Open Enrollment announcement flier that provides
a list of medical and dental plans and the premium sharing costs
for your employees. This flier is designed to assist your employees
in making informed decisions concerning their health care coverage
during this open enrollment. This is a master copy tailored to your
location which may be reproduced for distribution to your employees
(State employees paid through the State's Centralized Payroll Unit
will receive these publications with their September 15 paychecks).
If you have specific questions about the flyer, contact Steven R.
Stokley by telephone at (609) 633-1462 or by fax at (609) 292-9500.
Also
included with this letter are:
-
A flier
to publicize the SHBP's Unified
Provider Directory. The Unified Provider Directory is
an online service that provides a comprehensive listing of
health care providers and facilities who deliver their services
through one or more of the SHBP's health care plans. Updated
monthly, you can access the Unified Provider Directory through
the SHBP homepage at: www.state.nj.us/treasury/pensions/
shbp.htm
-
A registration
flier for one of four, free 90-minute Tax$ave/SHBP
Employer Workshops. These will be presented for benefits
administrators on September 7 at the Division of Pensions
and Benefits' Trenton offices. Topics of discussion will be
the benefits of Tax$ave and the recent changes to the SHBP
plan year.
With
the change to a fall open enrollment, the SHBP Open Enrollment now
runs concurrently with the State Employees Tax Savings Program (Tax$ave)
Open Enrollment. Tax$ave is a benefit program, available to State
employees who are eligible for the SHBP. Tax$ave can save you money
by paying health benefit premiums and eligible unreimbursed medical
and/or dependent care expenses from before-tax dollars. See the
Health Capsule newsletter and
the Tax$ave 2001 Open Enrollment materials for more information,
or call to reserve a place at the workshops.
Because
of the recent spring Open Enrollment, the SHBP will not be
coordinating health fairs for the fall.
Another
publication scheduled for distribution is the Open Enrollment issue
of the Health Capsule newsletter.
You will receive sufficient copies for distribution to all of your
employees.
Also
scheduled for distribution is a publication of particular note -
the SHBP Summary Program Description
(SPD). This is a new publication for your employees
that provides an overview of the SHBP, a description of each plan
offered, and comparisons of selected benefits. You will receive
sufficient copies of the SPD for distribution to all of your employees.
If
you have any questions about the Open Enrollment, please contact
our Office of Client Services at (609) 292-7524. Thank you for your
cooperation.
Enclosures:
Health and Dental Plan Rate Charts/Flier
Unified Provider Directory Flier
2000 SHBP Open Enrollment Milestone Chart
Tax$ave/SHBP Employer Workshop Flier
(STMON
- MILESTONE)
FALL
2000 SHBP OPEN ENROLLMENT MILESTONE CHART
For Monthly State Employers
Note:
If the event is underlined, you should be accomplishing the
event.
|
PROJECTED
DATE
|
EVENT
|
|
August
18
|
Initial
Open Enrollment Letter mailed to employers.
Fiscal
Year 2000 rate charts sent to employers.
|
|
September
1-15
|
Disseminate
rate information to employees as necessary.
|
|
September
7
|
State
Employer Benefit Administrator's Tax$ave/SHBP
Workshops
conducted by Division of Pensions and Benefits in Trenton.
|
|
September
10-15
|
SHBP
Summary Program Description and the Health
Capsule newsletter shipped
to employers. Distribute to employees.
|
|
September
18
|
Open
Enrollment Begins.
|
|
October
31
|
Open
Enrollment Ends.
|
|
November
6
|
Employer
certified applications due at the Health Benefits Bureau.
|
|
January
1, 2001
|
Open Enrollment
changes effective.
|
August
18, 2000
TO:
            State Departmental
Human Resource Directors
               
   State Biweekly Benefits Administrators
FROM:       Janice
F. Nelson, Assistant
Director for Health Benefits
SUBJECT: Fall
2000 SHBP Open Enrollment
The
State Health Benefits Program (SHBP) Open Enrollment period for
State biweekly employees will begin on September 18, and end on
October 31, 2000. Completed employer certified health benefit and/or
dental applications must arrive at the Health Benefits Bureau no
later than November 6, 2000. All changes to coverage made during
the fall open enrollment will be effective on December 30, 2000,
for employees paid through the State's Centralized Payroll Unit,
and January 1, 2001, for all other employees.
This
is the second open enrollment in 2000, and marks the SHBP's change
from a plan year based on the fiscal year (July 1 - June 30) to
one based on the calendar year (January 1- December 31). Because
of the plan year change, future SHBP Open Enrollment periods will
be held each fall for changes effective the following January. This
means that there will be no open enrollment in the spring of
2001 and this open enrollment is your employees' only chance
to change their benefit status until the fall of 2001.
While
the SHBP's plan year is changing, there have been no other changes
to the health plans or to the benefits they offer.
All
rates for SHBP health, dental, prescription drug, and vision plans
were set as of July 1, 2000, for an 18-month period (through December
31, 2001), so premiums will not change with this open enrollment
period.
Unions
representing most State employees have new contracts in effect that
provide for 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 old contracts.
Enclosed
you will find sample Open Enrollment announcement fliers that provide
a list of medical and dental plans and the premium sharing costs
for State employees paid through Centralized Payroll. These fliers
are designed to assist your employees in making informed decisions
concerning their health care coverage during this open enrollment
and will be distributed to your employees with their September 15
paychecks.
Also
included with this letter are:
-
A flier
to publicize the SHBP's Unified
Provider Directory. The Unified Provider Directory is
an online service that provides a comprehensive listing of
health care providers and facilities who deliver their services
through one or more of the SHBP's health care plans. Updated
monthly, you can access the Unified Provider Directory through
the SHBP homepage at: www.state.nj.us/treasury/pensions/shbp.htm
With
the change to a fall open enrollment, the SHBP Open Enrollment now
runs concurrently with the State Employees Tax Savings Program (Tax$ave)
Open Enrollment. Tax$ave is a benefit program, available to State
employees who are eligible for the SHBP. Tax$ave can save employees
money by paying health benefit premiums and eligible unreimbursed
medical and/or dependent care expenses from before-tax dollars.
Workshops will be presented for benefits administrators on September
7 at the Division of Pensions and Benefits' Trenton offices. Topics
of discussion will be the benefits of Tax$ave and the recent changes
to the SHBP plan year. See the Health
Capsule newsletter and the Tax$ave 2001 Open Enrollment
materials for more information, and call to reserve a place at the
workshops.
Because
of the recent spring Open Enrollment, the SHBP will not be
coordinating health fairs for the fall.
Another
publication scheduled for distribution is the Open Enrollment issue
of the Health Capsule newsletter.
This will also be distributed to all of your employees with their
September 15 paychecks.
Also
scheduled for distribution is a publication of particular note -
the SHBP Summary Program Description
(SPD). This is a new publication for your employees
that provides an overview of the SHBP, a description of each plan
offered, and comparisons of selected benefits. You will receive
sufficient copies of the SPD for distribution to all of your employees.
If
you have any questions about the Open Enrollment, please contact
our Office of Client Services at (609) 292-7524. Thank you for your
cooperation.
Enclosures:
Health and Dental Plan Rate Charts/Flier
2000 SHBP Open Enrollment Milestone Chart
Unified
Provider Directory Flier
Tax$ave/SHBP
Employer Workshop Flier
(STBW
- MILESTONE)
FALL
2000 SHBP OPEN ENROLLMENT MILESTONE CHART
for
Biweekly State Employers
Note:
If the event is underlined, you should be accomplishing the
event.
|
PROJECTED
DATE
|
EVENT
|
|
August
18
|
Initial
Open Enrollment Letter with sample rate charts mailed to employers.
Initial
Open Enrollment paycheck message to employees.
|
|
September
7
|
State
Employer Benefit Administrator's Tax$ave/SHBP
Workshops
conducted by Division of Pensions and Benefits in Trenton.
|
|
September
10-15
|
SHBP
Summary Program Description shipped to employers.
Distribute to employees.
|
|
September
15
|
Open Enrollment
paycheck message to employees. Health and Dental Rate Charts
and Health Capsule
newsletter distributed with payroll.
|
|
September
18
|
Open
Enrollment Begins.
|
|
September
29
|
Open Enrollment
"reminder" paycheck message to employees.
|
|
October
13
|
Open Enrollment
"reminder" paycheck message to employees.
|
|
October
27
|
Open Enrollment
"last chance" paycheck message to employees.
|
|
October
31
|
Open
Enrollment Ends.
|
|
November
6
|
Employer
certified applications due at the Health Benefits Bureau.
|
|
December
30
|
Open Enrollment
changes effective.
|
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
August
10, 2000
TO:
Benefits Administrators
State Biweekly Payroll Locations
State Universitiesy and Colleges Benefits Administrators
Palisades Interstate Parkway Commission Benefits Administrator
NJ Commerce and Economic Growth Commission Benefits Administrator
State Department Human Resource Directors
FROM: John
D. Megariotis |