172 Frequently Asked Questions
1 - Why is coverage restricted to NJ PLUS?
- The law states that coverage will be in the State's managed care
plan, which is the NJ PLUS plan.
2 - Why is the prescription drug coverage extra?
- The State's managed care plan does not include prescription drug
coverage because it is designed to operate in conjunction with a
separate stand-alone drug plan. The State Health Benefits Commission
has a policy that all members enrolled under the SHBP be offered
a prescription drug benefit.
3 - Why do the plans available under Chapter 172 cost more than
the same plans for full-time State employees?
- The law requires the covered employee to pay the full cost of
the coverage plus an administrative fee so the State would incur
no expense for this program. The SHBP actuaries valued the plans
and the Commission approved the rates being charged.
4 - Are all part-time employees eligible for this coverage?
- No. To be eligible, the part-time employee must be a member of
a retirement system administered by the State of New Jersey and
must work for the State, a State college or university, the Palisades
Interstate Parkway Commission, the New Jersey Building Authority,
the NJ State Library, or the New Jersey Commerce and Economic Growth
5 - Are all part-time faculty members at institutions of higher
education eligible for coverage?
- No. The part-time faculty member must be a member of a retirement
system administered by the State of New Jersey and must work
at an institution of higher education that participates in the SHBP.
6 - Since Chapter 172 is effective on January 1, 2004, why is
the initial coverage not effective until March 1, 2004?
- The statutes governing the State Health Benefits Program require
a 60-day waiting period when an employee first becomes eligible
7 - Can the employer use payroll deductions to pay for the part-time
- No. The sole payment system will be direct billing from the Division
of Pensions and Benefits.
8 - Does Chapter 172 entitle part-time employees to any other
benefits, such as dental coverage or Tax$ave,
the State's Section 125 Program?
- No. Chapter 172 entitles eligible employees only to NJ PLUS plan
coverage at their own expense.
9 - If an adjunct teaching at two colleges which participate
in the SHBP terminates employment at the college through which he
or she has enrolled in the Chapter 172 coverage, can the employee
immediately enroll at the other college without a waiting period?
- Yes, but the application must be submitted within 60 days of the
termination of employment.
10 - If an eligible part-time employee or faculty member opts
not to enroll during this initial offering, when is the next opportunity
for him or her to enroll?
- During the SHBP annual open enrollment period unless a HIPAA qualifying
event occurs, that is, if the employee loses other group coverage
from a spouse or other employment.
11 - Because of the nature of adjunct employment, we sometimes
don't know if an adjunct will be teaching until after the semester
starts. When do we file the Transmittal of Deletions and what termination
date do we use - the end of the previous semester?
- You file the Transmittal of Deletions when you know that
the adjunct will not be re-employed that semester. Use the date
when you know the adjunct won't be working, not the end of the previous
12 - When am I required to send out a COBRA Notice to a Chapter
172 covered employee and family?
- You must send the initial general COBRA Notice advising on the
future eligibility for COBRA when the employee first enrolls. You
must send a specific COBRA Notice when an employee or family member
loses coverage because of a COBRA event.
13 - When am I required to send out a HIPAA Notice to a Chapter
172 covered employee and family?
- You must send the SHBP's Notice of HIPAA Compliance when the employee
first enrolls. You must send a Certificate of Coverage when an employee
or family member loses coverage, regardless of the cause.
14 - Since the Chapter 172 employees are paying for coverage
directly to the Division of Pensions and Benefits, how will I know
if they are covered and are eligible for COBRA when an COBRA event
- You will be able to check for coverage through the Chapter 172
monthly Alpha listing of your covered employees. In the near future,
you will be able to get that information from the SHIPS application
on EPIC (Employer Pensions and Benefits Information Connection)
when that feature is activated in 2004.
15 - If a part-time employee or faculty member has Chapter 172
coverage upon retirement, would he or she be eligible for post-retirement
- Yes, but enrollment will be limited to the NJ PLUS as it was while
they were actively at work. The retiree NJ PLUS plan, however, has
prescription drug coverage built into it.
16 - If the part-time employee or faculty member with Chapter
172 coverage upon retirement has over 25 years of pension service,
would he or she be eligible for employer-paid post-retirement medical
- No. Chapter 172 specifically states that Chapter 172 coverage
does not qualify for employer-paid post-retirement medical coverage.
Question 17 -Why does eligibility for Chapter 172 coverage,
whether I enroll or not, cause me to lose my New Jersey Individual
Health Coverage Program (ICHP) policy?
- The laws governing the IHCP were written to encourage the use
of employer-provided group coverage and therefore require the termination
of the IHCP policy if group coverage is available. There is a provision
in the IHCP law that allows the employee to re-enroll in the IHCP
policy, under certain conditions, during the IHCP open enrollment
period in October. You should contact the IHCP Board at the Department
of Banking and Insurance at 1-800-838-0935 for more information
about this subject.