Human Resources

Open Enrollment 2017

*Please note Open Enrollment has been extended to November 11th, 2016

Medical Links
Medical Plan Design Comparison Chart
2017 Medical Rates
2017 Percentage of Premium Calculator
2017 Medical Application
2017 Waiver Form
Tiered Health Plans
Aetna Tier 1 Hospital List

Dental Links
Dental Fact Sheet
2017 Dental Rates
2017 Dental Application
2017 State Health Capsule








News for 2017

The dates for the Tax$ave Open Enrollment are October 3 to October 31, 2016 with plan benefits effective January 1, 2017. WageWorks administers the Tax$ave Flexible Savings Account Plans for the State of New Jersey. Find out more about the FSA plans and other Tax$ave benefits available to you Tax$ave New

The Premium Option Plan (POP) is a benefit of Tax$ave available to State employees participating in the State Health Benefits Program (SHBP). POP allows you to save money by paying any medical contributions and dental premiums you may have for your SHBP coverage with before-tax dollars. You will not have to pay federal income taxes, Medicare, or Social Security taxes on money earned which is used to pay contributions or premiums. Through the POP, you pay less in taxes and in turn increase your take-home pay. If you wish to participate in the POP, do nothing and you will automatically be enrolled and pay less in taxes. If you do not wish to take advantage of this money saving plan in 2017, you must decline enrollment by completing a Declination of Premium Option Plan form.

Changes to Medical Plans

  • Prescription Drug Changes- Effective December 1, 2016 Generic Substitution- Cost sharing for brand name drugs with a generic equivalent available will be increased. Member will pay the generic copayment plus the difference in cost between the generic drug and brand name drug.
  • Certain drugs will be excluded from coverage. If you are currently taking a medication that will no longer be eligible for coverage, ask your doctor if a preferred alternative is appropriate for you. If your doctor believes that the excluded medication is medically necessary, the doctor’s office may initiate an appeal by calling Express Scripts at (866) 220-6512.
  • Preferred Drug Step Therapy- This program will be expanded to all State Active employees and their dependents. A member is required to try and fail a lower cost prescription drug before approval of a high cost prescription drug.
  • Payment for out of network physical therapy visits maximum amount to be paid by health carrier will be limited as follows: Aetna $55.00 and Horizon Blue Cross Blue Shield $52.00. if your therapist charges more than those amounts you will be responsible to pay the difference.
  • Emergency Room Co-pays will increase by $25.00 where the co-pay is currently less than $100.00

For plan year 2017, the Division of Pensions and Benefits is implementing a “Pilot Incentive Program” for the tiered-network plans: the Aetna Liberty Plan and the Horizon OMNIA Health Plan. This program encourages employees to subscribe to one of the tiered-network plans by offering financial incentives. State employees are automatically eligible to participate in the program.

The Pilot Incentive Program is available to first-time enrollees who must remain enrolled for two years, from January 1, 2017 through December 31, 2018. This program does not extend to over-age children or COBRA members. The incentives vary depending on level of coverage:

  • Single-coverage employees receive $1,000
  • Member/Spouse or Parent/Child-covered employees receive $1,250
  • Family-covered employees receive $2,000.

This incentive is paid by gift card within the first quarter of Plan Year 2017, and is deemed reportable income for tax purposes.

IMPORTANT – The incentive shall be forfeited and returned to the SHBP if you fail to remain enrolled in a tiered-network plan for at least two plan years, except if you become ineligible for healthcare due to: layoff, involuntary separation, reduction to part-time status, or classification into an ineligible position. If you voluntarily retire or change health plans due to catastrophic or emergency health needs as determined by the Division after a full year, then the incentive shall be forfeited on a pro-rated basis.

NJ WELL

The mission of NJWELL is to cultivate healthy lifestyle choices among members to lower health risk factors, improve well-being, and ensure that New Jersey's public employees are healthy, inspired, and productive for years to come. And since healthy members typically require less costly health care, NJWELL will help the SHBP contain future costs. For the past year, the focus of NJWELL was to encourage participants to "keep going" with their fitness goals and healthy lifestyle choices. Employees and their covered spouses or partners can each receive up to $250. You must submit your assessment and proof of screening and complete your activities by October 31, 2016, in order to earn the 2016 reward. For more information about NJWELL, visit our Web site at: www.nj.gov/njwell Plan Year 2017
You and your covered spouse or partner will still have additional opportunities to earn rewards during 2017. Look out for more information about NJWELLfor Plan Year 2017.