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Pensions and Benefits

STATE HEALTH BENEFITS PROGRAM (SHBP) and
SCHOOL EMPLOYEES' HEALTH BENEFITS PROGRAM (SEHBP)

HEALTH BENEFITS FOR ACTIVE EMPLOYEES

ACTIVE GROUP ELIGIBILITY | PLAN INFORMATION | ENROLLMENT | APPLICATIONS AND FORMS
PRESCRIPTION DRUG PLANS | DENTAL PLANS | PLAN RATE CHARTS

HEALTH BENEFITS HOME | DEPENDENTS | RETIREES | COBRA | EMPLOYERS

 

New! Plan Year 2015 Rates and Information

New! NJWELL


ACTIVE GROUP ELIGIBILITY

Eligibility for Active Group SHBP/SEHBP coverage is determined by the State Health Benefits Program (SHBP) or School Employees’ Health Benefits Program (SEHBP). All enrollments, changes to coverage, terminations, etc. must be presented through your employer to the Division of Pensions and Benefits.

FULL-TIME EMPLOYEES

OTHER EMPLOYEES

If you have any questions concerning eligibility in the SHBP/SEHBP, contact the Division of Pensions and Benefits.


PLAN INFORMATION AND PROGRAM DESCRIPTIONS

HANDBOOKS AND PUBLICATIONS

PROVIDER INFORMATION — Find a participating doctor or hospital

PRIVACY PRACTICES

OTHER RESOURCES


ENROLLMENT

Employees and their dependents are not covered by the SHBP or SEHBP until enrolled. A Health Benefits Program Application must be completed and submitted through the employer. Provide all the information requested on the application along with any required supporting documentation.

APPLICATIONS AND FORMS

If an employee or eligible dependents are not enrolled within 60 days of the time they first become eligible for coverage, the employee must wait until the next annual Open Enrollment period to do so.


PRESCRIPTION DRUG PLANS FOR EMPLOYEES

The State Health Benefits Commission and School Employees’ Health Benefits Commission require that all covered employees have access to prescription drug coverage. The type of coverage provided and costs are determined by the prescription drug plan option provided by the employer and the medical plan the employee selects.

PRESCRIPTION DRUG BENEFITS ADMINISTRATOR

Express Scripts (formerly Medco Health Solutions) is the pharmacy benefits administrator for the SHBP and SEHBP

Express Scripts Order and Claim Forms


EMPLOYEE DENTAL PLANS

The Employee Dental Plans are available to State employees and to employees of local government and local education employers who elect to participate in the dental plans.


ACTIVE EMPLOYEE MEDICAL and DENTAL PLAN RATES

The Medical Plan Rates Listed Below Show Employer Costs — Most State Employees and Local Government/Education Employees pay a percentage of the premium or 1.5% of salary, whichever is greater.

STATE BIWEEKLY AND STATE MONTHLY EMPLOYEES Plan Year 2014

STATE BIWEEKLY AND STATE MONTHLY EMPLOYEES Plan Year 2015

LOCAL GOVERNMENT EMPLOYER GROUP RATES Plan Year 2014

LOCAL GOVERNMENT EMPLOYER GROUP RATES Plan Year 2015


LOCAL EDUCATION EMPLOYER GROUP RATES Plan Year 2014

LOCAL EDUCATION EMPLOYER GROUP RATES Plan Year 2015


DENTAL PLAN RATES Plan Year 2014

DENTAL PLAN RATES Plan Year 2015


OVER AGE CHILDREN

RETIRED GROUP RATES

COBRA RATES


HEALTH BENEFITS HOME | DEPENDENTS | RETIREES | COBRA | EMPLOYERS

 
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