Who is eligible for Open Enrollment?
If your employer gets health benefits through the School Employees Health Benefits Plan (SEHBP) and you were employed with your current employer before July 1, 2021, you may change your health benefits plan during Open Enrollment, which is available from October 1-31, 2021. After October 31, the only way to make any changes to plans if there is a major change-of-life situation, defined as marriage, birth, death and certain other events.
Do I have to participate in open enrollment?
No. If you do not participate in the open enrollment, you and your dependents will stay in your current plan. NJEA encourages members to use the open enrollment period to review their current health benefits, to see if other benefit options are available and to choose the benefit option that provide the best combination of coverage and value based on the member’s individual circumstances.
What plans are available to me during the Open Enrollment?
If your contract currently offers the Direct 10 and/or Direct 15, you will continue to have access to those plans along with the New Jersey Educators Health Plan. (NJEHP)
Can I choose the Garden State Plan?
The SEHBP anticipates that the Garden State Health Plan (GSHP) will be an available option for all members beginning in January 2022, but there will be a special enrollment prior to January for members wishing to make that change. Members who want to enroll in the GSHP should keep their current plan until the special enrollment period for GSHP opens.
How does the NJEHP compare to the Direct 10 and Direct 15 plans?
The NJEHP uses the same network of doctors, in and out of New Jersey, as the Direct 10 and Direct 15 plans. For full details about co-payments and deductibles, please review the charts here.
How would the amount I pay for health benefits change if I move to the NJEHP?
Premium sharing for the NJEHP will be based on a percentage of salary set out in the law. For full details, please review the charts here. Most members will save money by moving into the NJEHP. The savings can be significant in many cases.
Premium sharing for the Direct 10 and Direct 15 plans will continue to be calculated at Ch. 78, Tier 4 levels or at whatever other contribution arrangement has been negotiated in your contract. That premium sharing remains negotiable.
How do I change plans during open enrollment?
The New Jersey Division of Pension and Benefits has changed the process for members to make changes to their health benefits through the SEHBP. Members can visit the Virtual Benefits Fair or log in via their MyNewJersey account to review plan options and decide if they need to make any changes. Members will need to register for Benefitsolver in order to have access to their health benefits account. Review “Guideline to getting access to Benefitsolver via MyNewJersey” for directions to register for Benefitsolver.
Where can I find more details about plan benefits, coverages, and costs?
Horizon has details and information about all SEHBP plans — including premium contribution calculators and an open enrollment webinar — at horizonblue.com/shbp/.