Long Term Care Introduction
Long term care comprises
a broad range of services needed by persons of all ages with physical
or mental impairments who have lost their ability to function
independently. People who need assistance in performing at least
two (2) activities of daily living, such as bathing, dressing,
toileting, transferring (moving in and out of bed or chair), eating,
and continence, are considered to be in need of long term care.
Individuals with a cognitive impairment are also generally considered
to need long term care.
Long term care services include personal
care, home health care, rehabilitation, adult day care, care management,
social services, assisted living, and nursing home services. Long
term care services may be needed on a regular basis over a period
of several months, several years, or a lifetime.
The State of New Jersey Public Employees Long Term
Care Group Insurance Plan
of New Jersey Public Employees Long Term Care Group Insurance
Plan (Plan) will pay a daily
benefit amount toward the cost of care in the home and community,
such as home health care, adult day care, informal care, and care
that is provided in licensed facilities, such as assisted living
and nursing homes. Eligible active and retired employees and their eligible family members have several choices of daily benefit
levels, as well as a number of benefit options to choose from. The Plan provides care management services, resource
and referral services, and respite care, offering relief for the
friend or family member who is caring for the covered employee
or family member.
Employees Who Are Eligible
Enrollment in the State
of New Jersey Public Employees Long Term Care Group Insurance Plan is open to
almost all individuals who are employed by the State or a State college or
university, and their eligible family members; individuals
who were employed by the State, or a State college or university
at the time of their retirement, and their eligible family members; and active and retired employees of most local governmental and educational entities operating in the State of New Jersey, provided that the local employer has adopted the request resolution offering the Plan to its active and retired employees, and their eligible family members.
Eligible family members will include:
The spouse of each active and retired
employee; adult children and stepchildren; parents, stepparents
and parents-in-law; grandparents, step-grandparents and grandparents-in-law
of the employee.
In the case of most
active State employees and employees of the State's colleges and universities, the employer will deduct the premiums
from the employee's paycheck. Employees will only be permitted
to authorize payroll deductions for themselves and their spouses.
All other enrolled individuals will be offered direct home billing
Adding or Changing Coverage
Employees who qualify will always
have the opportunity to enroll or to change their coverage. For more information, visit:
Division of Pensions and Benefits Long Term Care Information Page
of New Jersey Long Term Care Insurance Plan Page