Certifying Officer Letters 2000
2007
Certifying Officer Letters December 2000 To: State Health Benefits Program Participating Employers From: Janice F. Nelson, Assistant Director, State Health Benefits Program Subject: Health Insurance Portability and Accountability Act (HIPAA) Update The federal Health Insurance Portability and Accountability Act (HIPAA) of 1996 contained a number of provisions that affected the State Health Benefits Program (SHBP) and its participating employers. The SHBP implemented several actions to comply with the requirements of HIPAA. These actions included:
Since the mental health limitations currently in effect are detailed in the law governing the SHBP, a change in plan design would require legislative action. Therefore, the SHBP must file a mental health parity exemption each plan year as long as a group plan is not HIPAA compliant. The Commission has voted to file an exemption for 2001. Therefore, mental health benefits will remain unchanged through 2001 unless the statute governing the SHBP is amended. Since HIPAA has a continuing notification requirement, a revised compliance notice reflecting this exemption from federal mental health parity requirements is attached for your use with newly enrolling employees and family members. You should send it at the same time you send the initial notice of COBRA rights. A brief refresher on HIPAA is also attached for your information. If you have questions, contact Client Services at (609) 292-7524 or call the Employer's SHBP Hotline at (609) 777-1082 and leave a message. A staff member will return your call on the next business day. FEDERAL HEALTH INSURANCE ACTS OF 1996 Three pieces of federal legislation were enacted in 1996 that established several requirements to group health plans and insured health products. These were the Health Insurance Portability and Accountability Act (HIPAA), the Mental Health Parity Act, and the Newborns' and Mothers' Health Protection Act. HIPAA included the reporting requirements covering all three pieces of legislation and is therefore used to refer to all three acts. The requirements of the legislation and SHBP status on each requirement are show below:
Notice
to State Health Benefits Program Participants about This notice is being provided to inform you about State Health Benefits Program (SHBP) conformance with federal health insurance regulations. The Health Insurance Portability and Accountability Act (HIPAA), the Mental Health Parity Act, and the Newborns' and Mothers' Health Protection Act, federal laws enacted in 1996, contain a number of provisions that have affected the SHBP since January, 1998. HIPAA required all group health plans to implement the following provisions that are contained in the three federal laws: #1 - Limit the use of pre-existing condition restrictions to a maximum of twelve months; #2 - Offer a special enrollment period to employees and dependents who do not enroll in the plan when initially eligible because they have other coverage, and who subsequently lose that coverage; #3 - Eliminate discrimination against participants and beneficiaries based on health status; #4 - Provide a minimum level of hospital coverage for newborns and mothers, generally 48 hours for a vaginal delivery and 96 hours for a cesarean delivery; and #5 - Provide parity in mental health benefits, that is, any dollar limitations applied to mental health treatment cannot be lower than those on medical and surgical benefits. Since January 1, 1998, all SHBP plans have met or exceeded HIPAA requirements #1 through #4 above. SHBP HMOs also have complied with requirement #5 above. The State Health Benefits Commission filed exemptions from HIPAA compliance on mental health parity (requirement #5) for 1998, 1999, and 2000 for the Traditional Plan and NJ PLUS, as self-insured, non-federal governmental plans are permitted to do. The Commission has voted to continue that exemption through 2001. As a result, the mental health limits for the Traditional Plan and NJ PLUS that are described in the New Jersey State Health Benefits Program Medical Plans Information Handbook will remain in effect throughout 2000. MEMORANDUM October 2000 TO: SHBP
Participating Local Government Employers FROM: NJ State Health Benefits Program SUBJECT: Health Maintenance Organization (HMO) Expansion of Service Area The NJ State Health Benefits Program (SHBP) will be expanding service areas for two of our HMOs: Aetna US Healthcare and CIGNA Healthcare effective January 1, 2001. The SHBP will begin offering these two HMOs in several states outside of the New Jersey region. Aetna US Healthcare is expanded to parts of Arizona, California, Florida, Georgia, Illinois, Indiana, Maryland, North Carolina, Texas and Virginia. CIGNA Healthcare is expanded to parts of California, Florida, Georgia, North Carolina, Pennsylvania, Virginia, and West Virginia. CIGNA will also include the entire state of South Carolina, Arizona, Maryland except the City of Ocean City and all zip codes in Washington D.C. The areas of expansion are shown on the attached charts. This expansion is only open to the retirees enrolled in the SHBP. Aetna US Healthcare and CIGNA will be sending out information packets to those retirees living within the expansion areas during the months of October and November. The cost of coverage for these HMOs will not change as a result of the service area expansion. Rates will remain as currently approved. The next rate change will become effective January 1, 2002. Members/dependents enrolled in the federal Medicare program must continue their enrollment in both Parts A and B. Medicare will pay for all medical services as primary, with the HMO coverage as a supplement. This expansion will give retirees a managed care option to the Traditional Plan. Any questions regarding this matter should be directed to our Client Services Unit at (609) 292-7524. November 3, 2000 To: All Pension Funds Certifying Officers From: William
H. Kale Subject: Military Service After Enrollment Amended Rule: N.J.A.C. 17:1-4.36 The Division of Pensions and Benefits adopted an amendment to the New Jersey Administrative Code regarding military service credit (copy of rule attached). This was done to comply with federal requirements under the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) 38 USC 4301 et seq. The rule applies to all the defined benefit and defined contribution retirement systems administered by the Division of Pensions and Benefits. This memorandum explains the new requirements of this rule and what employers must do to implement its provisions and comply with the federal law. Military service used for benefits qualification USERRA provides benefit protection to an employee who leaves public employment after October 13, 1994, to serve in the uniformed services and then returns to public employment within time frames specified in the law, normally within ninety days of the end of the uniformed service. That employee is entitled to the restoration of certain pension and similar benefits that would have accrued but for the employee's absence due to the qualified USERRA service. USERRA requires an employer to treat an employee's period of service in the uniformed services as if the employee had never left public employment for the purposes of vesting and/or determining eligibility for retirement and health benefits. For example, an employee with 24 years of pension credit and one year of USERRA-eligible service in the uniformed services would have 25 years of service for the purpose of determining eligibility for retirement. That employee, if a PERS or TPAF member, would be eligible to collect a retirement benefit before age 60 under the Early Retirement provisions. The employee would also be eligible for employer-paid health benefits coverage based on 25 years of service (if the employer normally provided this benefit). An example for vesting purposes would be that an employee with eight years of pension credit and two years of USERRA-eligible service would be vested. Special Note: The employee need not return to employment with the same public employer (s) he left to enter the military service. The employee can return to employment with a different public employer, as long as that employer participates in the same retirement system the member was in prior to the USERRA-eligible service. For example, a PERS member from "Township A" terminated employment to serve in the uniformed services for two years. Upon completion of the military service, the employee returns to public employment at "Township B" within the timeframe specified by law. The employee is eligible for USERRA service credit. Military service used for benefit calculation While the USERRA-eligible service will be used to determine eligibility for benefits, the actual calculation of retirement benefits will not use the USERRA-eligible service unless the employee pays required pension contributions for the period of military service. The employee may, however, receive this pension credit for the period of uniformed service by making the pension contributions that would have been required had the employee not left employment to serve in the uniformed services. Once notified of the USERRA-eligible service, the Division will contact affected employees and ask if they wish to make the necessary contributions for the period of military service so that it will be used in the calculation of their retirement allowances. The contributions will be based upon the pensionable salary the employee would have received had the employee not gone for military service. If the determination of that pensionable salary is not reasonably certain by the employer, contributions will be made on the basis of the employee's average pensionable compensation during the ten- or twelve-month period immediately preceding the military service. Any payment to the plan described in this paragraph must be made during the period that begins on the date of reemployment and continues for the lesser of either five years or three times the period of the uniformed service. For example, if an employee returns to employment after three months of USERRA-eligible service, back deductions for that service must be paid during the first nine months after the return to work. Note: an exception to this timeframe because of the delay in implementation of the federal law is described later in this letter. Additional supplemental plan elective contributions USERRA also provides that employees are permitted to make additional elective deferrals for any programs, e.g., deferred compensation, SACT, or ACTS programs, in which they were enrolled immediately prior to their military service. These deferrals may not exceed the maximum amount employees would have been permitted to contribute during the period of military service had the employees been continuously employed by the public employer during those periods. The USERRA Process The following actions should occur when an employee returns to covered employment within the time frames specified under USERRA.
Notifying employees and catching up Employers should notify employees of the benefit protection provided by USERRA and this special opportunity to obtain service credit for any periods of uniformed service since October 13, 1994. This can be done by posting the attached notice to employee bulletin boards, distributing a synopsis of the benefit in a human resource newsletter, and/or directly contacting employees the employer can identify as having USERRA-eligible service. Employees eligible for USERRA credit who returned to public employment between October 13, 1994 and the present date may apply for this service until December 31, 2000. The employer should submit a Request for Userra-Eligible Service to the Division for employees who may have qualified for service credit under USERRA since its enactment in October 1994. We need that information to give the employees service credit for benefit eligibility purposes. After December 31, 2000, any request for credit for USERRA-eligible service should be made within 30 days of return to employment. If the member wants the USERRA-eligible service to be used to calculate benefits, the request will have to be made so contributions can be collected within the lesser of either five years or three times the period of the uniformed service from the date of reemployment. Special situations USERRA provides that those contributions or lump sum payments made by employees for USERRA-eligible service periods shall be deferred from federal taxation. Therefore, they must be taken through payroll deductions. Employers should be prepared to process lump sum requests made by employees. Employee requests to make additional elective contributions to supplemental programs for the USERRA-eligible service periods should be made directly to each employer. You should contact your supplemental plan administrator for instructions on how to process and report these voluntary contributions. Instructions for the State administered supplemental plans, i.e., Deferred Compensation, SACT, and ACTS, will be issued in separate communications. Alternate Benefit Program Employers If an employee who participates in the Alternate Benefit Program (ABP) is re-employed under the provisions of USERRA by an employer who participates in the ABP, the employer is liable to the employee's pension plan for funding any obligation of the plan to provide benefits. That is, the employer must allocate the amount of any employer contribution for that employee in the same manner and extent that the allocation occurred for other employees during the same period of service. However, the employee is entitled to these employer contributions only if (s) he makes the employee contributions to the plan for the period of uniformed service. The procedures shown in the USERRA Process on page two will also be used for the ABP. The vehicle for reporting the employee contributions and securing reimbursement from the State of New Jersey for the employer's contribution will be the Alternate Benefit Program Employer Contribution Report. Under the Mandatory Back Deduction section of the report, the employer should report the employee's name, Alternate Benefit Program number, and the salary amount on which the employee contributions to the plan for the period of uniformed service are made. A notation indicating that this salary is relative to military service after employment should also be provided. The employer is not required nor expected to make up the earnings that contributions made for USERRA-eligible service would have made had the employee been employed continuously. Summary A public employer who hires a member of a New Jersey public retirement system administered by the Division of Pensions and Benefits under the provisions of USERRA should submit a Request for Userra-Eligible Service to the Division within 30 days of that employee's return from service in the uniformed services. There is a catch-up period until December 31, 2000 to submit a Request for Userra-Eligible Service for eligible service since October 1994, when the federal law was effective. Any requests for this USERRA-eligible service received after December 31, 2000, must be received within the time frames specified under USERRA. If you have any questions, contact Client Services at (609) 292-7524 or E-mail us at pensions.nj@treas.state.nj.us Enclosures: N.JA.C. 17:1-4.36, Peacetime Military
Service; Service Credit ATTENTION: EMPLOYEES WITH MILITARY SERVICE If you meet the criteria shown below, you may qualify for additional pension benefits under the federal Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA). If you
USERRA provides benefit protection to an employee who leaves public employment after October 13, 1994, to serve in the uniformed services and then returns to public employment within time frames specified in the law. (Note: The law says that an employee must normally return to public employment within 90 days of the end of the uniformed service to qualify for USERRA benefits). That employee is entitled to the restoration of certain pension and similar benefits that would have accrued but for the employee's absence due to the qualified USERRA service. USERRA requires an employer to treat an employee's period of service in the uniformed services as if the employee had never left public employment for the purposes of vesting and/or determining eligibility for retirement and health benefits. The service time will not be included in the service time used to calculate your retirement allowance, only to qualify for the retirement benefit. You will, however, be able to have your USERRA time included for benefit calculation by making the pension contributions that would have been made had you not left employment for military service. If you think you may meet the criteria shown above, ask your Personnel/Human Resources Office for a Request for USERRA-Eligible Service form so the Division of Pensions and Benefits can determine your eligibility for pension service credit under the provisions of USERRA. October 19, 2000 TO: Certifying Officers, Police and Firemen's Retirement System FROM: Thomas P. Bryan, Director SUBJECT: PFRS Retirement Options for Members with 20 to 25 Years of Service The enactment of Chapter 428, PL 1999, in January of this year has raised some questions concerning the retirement benefits available to members of the Police and Firemen's Retirement System (PFRS) with more than 20 but less than 25 years of credited service. The purpose of this memorandum is to provide information on the benefits available to these members and hopefully answer the questions. There are several retirement possibilities for PFRS members with more than 20 but less than 25 years of credited service. Service Retirement Members enrolled in the PFRS when Chapter 428 was enacted are eligible to receive a service retirement allowance equal to 50% of final compensation. If they are forced to retire because of the mandatory retirement age (65) with less than 25 years of service, they will receive an additional 3% of final compensation per year of service for their 21st through 25th years. Accidental Disability Retirement Members who are totally and permanently disabled as a direct result of a traumatic event arising out of the performance of their regular or assigned duties may file for an accidental disability retirement allowance. This provides a benefit equal to 2/3rds of the member's salary at the time of the accident or at the time of retirement, whichever is higher. Ordinary Disability Retirement Members with at least four years of service who are totally and permanently disabled, not as a direct result of a traumatic event arising out of the performance of their regular or assigned duties, may file for an ordinary disability retirement allowance. This provides a benefit equal to 40% of the member's final salary. Ordinary Disability Retirement Filed by the Employer Employers may request retirement for members who are totally and permanently disabled by filing an ordinary disability retirement application for them. Members with more than 20 years of service, if approved by the PFRS Board of Trustees for ordinary disability retirement filed by the employer, will receive a retirement allowance equal to 50% of final compensation plus 3% for each year of creditable service over 20 years up to 25 years of credited service. Ordinary disability retirement filed by the employer is not a new benefit, but the increase in the amount of the benefit for members with more than 20 but less than 25 years is new as provided in Chapter 428. The clear intent of Chapter 428 is that if a member with 20 or more years of service is permanently and totally incapacitated for the performance of regular or assigned duties, the member should be retired on an ordinary disability retirement benefit and should receive the higher retirement allowance. The employer's responsibility in situations like this has not changed as a result of Chapter 428. If the employer believes that the member is permanently and totally incapacitated for the performance of regular or assigned duties [and has at least four years of service credit*], the employer should initiate the retirement application to qualify the member for the higher benefit under the law. If a member with over 20 years of service has already filed for an ordinary disability, the Division will process the retirement for the higher benefit upon receipt of a letter, signed by the certifying officer, indicating that the employer believes the member is permanently and totally incapacitated for the performance of regular or assigned duties. A sample letter is attached. If you have questions about this letter, please write to the address above, E-mail the Division at pensions.nj@treas.state.nj.us or call Client Services at (609) 292-7524. The Employer Education Unit of the Division of Pensions and Benefits is available to all public employers for assistance and training on pension enrollment issues, completing the Quarterly Report of Contributions, and general pensions processing. To contact the Employer Education Unit, write, E-mail, or call (609) 777-2112 or (609) 777-2111. * annotation in brackets [] not in original letter. (SAMPLE LETTER) Employer Letterhead (Date)
State
Health Benefits Program Local Government and School Boards August 18, 2000 TO: State Health Benefits Program Participating Local Employers FROM: Janice F. Nelson, Assistant Director for Health Benefits SUBJECT: Fall 2000 SHBP Open Enrollment The State Health Benefits Program (SHBP) Open Enrollment period for local employees will begin on September 18, and end on October 31, 2000. Completed employer certified applications must arrive at the Health Benefits Bureau no later than November 6, 2000. All changes to coverage made during the fall open enrollment will be effective on January 1, 2001. This is the second open enrollment in 2000, and marks the SHBP's change from a plan year based on the fiscal year (July 1 - June 30) to one based on the calendar year (January 1- December 31). Because of the plan year change, future SHBP Open Enrollment periods will be held each fall for changes effective the following January. This means that there will be no open enrollment in the spring of 2001 and this open enrollment is your employees' only chance to change their benefit status until the fall of 2001. While the SHBP's plan year is changing, there have been no other changes to the health plans or to the benefits they offer. Enclosed you will find approved rates and other plan information. We have included rate charts for employees with and without prescription drug coverage. All rates for SHBP health and prescription drug plans were set as of July 1, 2000, for an 18-month period (through December 31, 2001), so premiums will not change with this open enrollment period. Also enclosed are:
Because of the recent spring Open Enrollment, the SHBP will not be coordinating health fairs for the fall. Publications scheduled for distribution include an Open Enrollment issue of the Health Capsule newsletter. You will receive sufficient copies of the Health Capsule for distribution to all of your employees. Also scheduled for distribution is a publication of particular note - the SHBP Summary Program Description (SPD). This is a new publication for your employees that provides an overview of the SHBP, a description of each plan offered, and comparisons of selected benefits. You will receive sufficient copies of the SPD for distribution to all of your employees. If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524. Thank you for your cooperation. Enclosures: 2000 SHBP Open Enrollment Milestone Chart SHBP Medical Plans and Contact Information Health
Benefit Rate Charts (LOC - MILESTONE) FALL
2000 SHBP OPEN ENROLLMENT MILESTONE CHART Note: If the event is underlined, you should be accomplishing the event.
August 18, 2000 TO: State Monthly Human Resource Directors/Benefits Administrators FROM: Janice F. Nelson, Assistant Director for Health Benefits SUBJECT: Fall 2000 State Health Benefits Program (SHBP) Open Enrollment The State Health Benefits Program (SHBP) Open Enrollment period for State monthly employees will begin on September 18, and end on October 31, 2000. Completed employer certified health benefit and/or dental applications must arrive at the Health Benefits Bureau no later than November 6, 2000. All changes to coverage made during the fall open enrollment will be effective on January 1, 2001. This is the second open enrollment in 2000, and marks the SHBP's change from a plan year based on the fiscal year (July 1 - June 30) to one based on the calendar year (January 1- December 31). Because of the plan year change, future SHBP Open Enrollment periods will be held each fall for changes effective the following January. This means that there will be no open enrollment in the spring of 2001 and this open enrollment is your employees' only chance to change their benefit status until the fall of 2001. While the SHBP's plan year is changing, there have been no other changes to the health plans or to the benefits they offer. All rates for SHBP health, dental, prescription drug, and vision plans were set as of July 1, 2000, for an 18-month period (through December 31, 2001), so premiums will not change with this open enrollment period. Unions representing most State employees have new contracts in effect that provide for premium sharing arrangements with the State. The contracts are identical with respect to their premium sharing provisions. There is no premium cost to any employee who enrolls in NJ PLUS. Employees will pay 5 percent of the premium cost if enrolled in an HMO, or 25 percent of the premium cost if enrolled in the Traditional Plan. These percentages apply regardless of salary level or date of hire. Enclosed you will find sample Open Enrollment announcement fliers that provide a list of medical and dental plans and the premium sharing costs for State employees not paid through Centralized Payroll. The fliers are provided for three different payroll schedules (Monthly, 24 Pay Periods, and 26 Pay Periods). Choose the flier that corresponds to your location's payroll schedule. These fliers are designed to assist your employees in making informed decisions concerning their health care coverage during this open enrollment. These are master copies and may be reproduced for distribution to your employees (State employees paid through the State's Centralized Payroll Unit will receive these publications with their September 15 paychecks). If you have specific questions about the fliers, contact Steven R. Stokley by telephone at (609) 633-1462 or by fax at (609) 292-9500. Also included with this letter are:
With the change to a fall open enrollment, the SHBP Open Enrollment now runs concurrently with the State Employees Tax Savings Program (Tax$ave) Open Enrollment. Tax$ave is a benefit program, available to State employees who are eligible for the SHBP. Tax$ave can save you money by paying health benefit premiums and eligible unreimbursed medical and/or dependent care expenses from before-tax dollars. See the Health Capsule newsletter and the Tax$ave 2001 Open Enrollment materials for more information, or call to reserve a place at the workshops. Because of the recent spring Open Enrollment, the SHBP will not be coordinating health fairs for the fall. Another publication scheduled for distribution is the Open Enrollment issue of the Health Capsule newsletter. Sufficient copies will be provided for distribution to all of your employees. Also scheduled for distribution is a publication of particular note - the SHBP Summary Program Description (SPD). This is a new publication for your employees that provides an overview of the SHBP, a description of each plan offered, and comparisons of selected benefits. You will receive sufficient copies of the SPD for distribution to all of your employees. If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524. Thank you for your cooperation. Enclosures: Health and Dental Plan Rate Charts/Fliers 2000 SHBP Open Enrollment Milestone Chart Unified Provider Directory Flier Tax$ave/SHBP Employer Workshop Flier August 18, 2000 TO: Campus Human Resource Directors FROM: Janice F. Nelson, Assistant Director for Health Benefits SUBJECT: Fall 2000 State Health Benefits Program (SHBP) Open Enrollment The State Health Benefits Program (SHBP) Open Enrollment period for State monthly employees will begin on September 18, and end on October 31, 2000. Completed employer certified health benefit and/or dental applications must arrive at the Health Benefits Bureau no later than November 6, 2000. All changes to coverage made during the fall open enrollment will be effective on January 1, 2001. This is the second open enrollment in 2000, and marks the SHBP's change from a plan year based on the fiscal year (July 1 - June 30) to one based on the calendar year (January 1- December 31). Because of the plan year change, future SHBP Open Enrollment periods will be held each fall for changes effective the following January. This means that there will be no open enrollment in the spring of 2001 and this open enrollment is your employees' only chance to change their benefit status until the fall of 2001. While the SHBP's plan year is changing, there have been no other changes to the health plans or to the benefits they offer. All rates for SHBP health, dental, prescription drug, and vision plans were set as of July 1, 2000, for an 18-month period (through December 31, 2001), so premiums will not change with this open enrollment period. Unions representing most State employees have new contracts in effect that provide for premium sharing arrangements with the State. The contracts are identical with respect to their premium sharing provisions. There is no premium cost to any employee who enrolls in NJ PLUS. Employees will pay 5 percent of the premium cost if enrolled in an HMO, or 25 percent of the premium cost if enrolled in the Traditional Plan. These percentages apply regardless of salary level or date of hire. Employees who are represented by unions which have not settled a new contract with the State will continue to share in the premium cost of the Traditional Plan according to the provisions of their old contracts. Enclosed you will find a sample Open Enrollment announcement flier that provides a list of medical and dental plans and the premium sharing costs for your employees. This flier is designed to assist your employees in making informed decisions concerning their health care coverage during this open enrollment. This is a master copy tailored to your location which may be reproduced for distribution to your employees (State employees paid through the State's Centralized Payroll Unit will receive these publications with their September 15 paychecks). If you have specific questions about the flyer, contact Steven R. Stokley by telephone at (609) 633-1462 or by fax at (609) 292-9500. Also included with this letter are:
With the change to a fall open enrollment, the SHBP Open Enrollment now runs concurrently with the State Employees Tax Savings Program (Tax$ave) Open Enrollment. Tax$ave is a benefit program, available to State employees who are eligible for the SHBP. Tax$ave can save you money by paying health benefit premiums and eligible unreimbursed medical and/or dependent care expenses from before-tax dollars. See the Health Capsule newsletter and the Tax$ave 2001 Open Enrollment materials for more information, or call to reserve a place at the workshops. Because of the recent spring Open Enrollment, the SHBP will not be coordinating health fairs for the fall. Another publication scheduled for distribution is the Open Enrollment issue of the Health Capsule newsletter. You will receive sufficient copies for distribution to all of your employees. Also scheduled for distribution is a publication of particular note - the SHBP Summary Program Description (SPD). This is a new publication for your employees that provides an overview of the SHBP, a description of each plan offered, and comparisons of selected benefits. You will receive sufficient copies of the SPD for distribution to all of your employees. If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524. Thank you for your cooperation. Enclosures: Health and Dental Plan Rate Charts/Flier Unified Provider Directory Flier 2000 SHBP Open Enrollment Milestone Chart Tax$ave/SHBP Employer Workshop Flier (STMON - MILESTONE) FALL
2000 SHBP OPEN ENROLLMENT MILESTONE CHART Note: If the event is underlined, you should be accomplishing the event.
August 18, 2000 TO: State Departmental Human Resource Directors & State Biweekly Benefits Administrators FROM: Janice F. Nelson, Assistant Director for Health Benefits SUBJECT: Fall 2000 SHBP Open Enrollment The State Health Benefits Program (SHBP) Open Enrollment period for State biweekly employees will begin on September 18, and end on October 31, 2000. Completed employer certified health benefit and/or dental applications must arrive at the Health Benefits Bureau no later than November 6, 2000. All changes to coverage made during the fall open enrollment will be effective on December 30, 2000, for employees paid through the State's Centralized Payroll Unit, and January 1, 2001, for all other employees. This is the second open enrollment in 2000, and marks the SHBP's change from a plan year based on the fiscal year (July 1 - June 30) to one based on the calendar year (January 1- December 31). Because of the plan year change, future SHBP Open Enrollment periods will be held each fall for changes effective the following January. This means that there will be no open enrollment in the spring of 2001 and this open enrollment is your employees' only chance to change their benefit status until the fall of 2001. While the SHBP's plan year is changing, there have been no other changes to the health plans or to the benefits they offer. All rates for SHBP health, dental, prescription drug, and vision plans were set as of July 1, 2000, for an 18-month period (through December 31, 2001), so premiums will not change with this open enrollment period. Unions representing most State employees have new contracts in effect that provide for premium sharing arrangements with the State. The contracts are identical with respect to their premium sharing provisions. There is no premium cost to any employee who enrolls in NJ PLUS. Employees will pay 5 percent of the premium cost if enrolled in an HMO, or 25 percent of the premium cost if enrolled in the Traditional Plan. These percentages apply regardless of salary level or date of hire. Employees who are represented by unions which have not settled a new contract with the State will continue to share in the premium cost of the Traditional Plan according to the provisions of their old contracts. Enclosed you will find sample Open Enrollment announcement fliers that provide a list of medical and dental plans and the premium sharing costs for State employees paid through Centralized Payroll. These fliers are designed to assist your employees in making informed decisions concerning their health care coverage during this open enrollment and will be distributed to your employees with their September 15 paychecks. Also included with this letter are:
With the change to a fall open enrollment, the SHBP Open Enrollment now runs concurrently with the State Employees Tax Savings Program (Tax$ave) Open Enrollment. Tax$ave is a benefit program, available to State employees who are eligible for the SHBP. Tax$ave can save employees money by paying health benefit premiums and eligible unreimbursed medical and/or dependent care expenses from before-tax dollars. Workshops will be presented for benefits administrators on September 7 at the Division of Pensions and Benefits' Trenton offices. Topics of discussion will be the benefits of Tax$ave and the recent changes to the SHBP plan year. See the Health Capsule newsletter and the Tax$ave 2001 Open Enrollment materials for more information, and call to reserve a place at the workshops. Because of the recent spring Open Enrollment, the SHBP will not be coordinating health fairs for the fall. Another publication scheduled for distribution is the Open Enrollment issue of the Health Capsule newsletter. This will also be distributed to all of your employees with their September 15 paychecks. Also scheduled for distribution is a publication of particular note - the SHBP Summary Program Description (SPD). This is a new publication for your employees that provides an overview of the SHBP, a description of each plan offered, and comparisons of selected benefits. You will receive sufficient copies of the SPD for distribution to all of your employees. If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524. Thank you for your cooperation. Enclosures: Health and Dental Plan Rate Charts/Flier 2000 SHBP Open Enrollment Milestone Chart Unified Provider Directory Flier Tax$ave/SHBP Employer Workshop Flier (STBW - MILESTONE) FALL
2000 SHBP OPEN ENROLLMENT MILESTONE CHART Note: If the event is underlined, you should be accomplishing the event.
NEW JERSEY STATE HEALTH BENEFITS PROGRAM - MEDICAL PLANS
HEALTH MAINTENANCE ORGANIZATIONS
If you have access to the Internet, you can look up SHBP plan participating doctors in our Unified Provider Directory on the SHBP home page: http://www.state.nj.us/treasury/pensions/shbp.htm August 10, 2000 TO: Benefits Administrators
FROM: John
D. Megariotis SUBJECT: OCTOBER OPEN ENROLLMENT FOR THE NEW JERSEY STATE EMPLOYEES TAX SAVINGS PROGRAM (Tax$ave 2001) The Annual Open Enrollment for the calendar year 2001 New Jersey State Employees Tax Savings Program (Tax$ave 2001) will be conducted from September 18 through October 31, 2000. Employees of the State, state universities and colleges, Palisades Interstate Parkway Commission, and the NJ Commerce and Economic Growth Commission, who are eligible for participation in the New Jersey State Health Benefits Program, may participate in Tax$ave. Tax$ave consists of three components:
UMSA and DCSA are also referred to as Flexible Spending Accounts (FSA's). Tax$ave offers eligible employees a unique opportunity to increase their available income by reducing their federal tax liability. Each year eligible employees must should review their personal financial circumstances and decide if they wish to participate or not. Open Enrollment offers employees the opportunity to conduct this review and then act on their decision. Participation in Tax$ave in 2000 does not carry over automatically into 2001. Employees must enroll again to participate in an FSA for calendar year 2001. Employees who do not wish to take advantage of POP in 2001 must file a Declination of Premium Option Plan (POP) form. Of particular note this year is that the Tax$ave 2001 Open Enrollment period has been expanded to will coincide with the new fall State Health Benefits Program (SHBP) Open Enrollment for medical, dental, and prescription drug benefits. While the Tax$ave remain program is a separate program from the SHBP, the two programs complement each other. Tax$ave allows employees to save taxes on any SHBP premiums they pay and lets them set aside pre-tax income to pay many of the expenses not covered by the SHBP plans. This letter provides information on the open enrollment for Tax$ave 2001 and identifies the publications and support available to assist you in explaining this important benefit program to your employees. A separate letter will be provided specifically addressing the SHBP Open Enrollment. Please do your best make a concerted effort to inform your employees of the open enrollment and to educate them on the valuable benefits that Tax$ave offers them. We believe that more employees would participate in Tax$ave if they were made aware and understood the value of the tax savings offered by the program. The enclosed Tax$ave Open Enrollment Milestones chart lists the critical dates of the Tax$ave 2001 Annual Open Enrollment and outlines the efforts being made to educate employees. Please use this chart as a checklist to guide your activities during the open enrollment. We will conduct 90-minute open enrollment workshops for benefits administrators at our offices in Trenton on September 7, 2000. The workshops will cover both the Tax$ave 2001 and the SHBP Open Enrollments. It will include a review of the information in this letter and the SHBP Open Enrollment announcement letter, an overview of the two programs, including any recent changes, and a question and answer period. Reservations are required for the Trenton workshop to be held at the Division of Pensions and Benefits. Please see the enclosed 2001 Open Enrollment Employer Workshop flyer with reservation instructions. We will conduct a 90-minute Tax$ave 2001 orientation open enrollment workshops for benefits administrators at our offices in Trenton on September 7, 2000., for benefits administrators. The workshop will cover both the Tax$ave 2001 and the SHBP open enrollments. They will include review the information in this letter and the SHBP open enrollment announcement letter, an overview of the three components of Tax$ave two programs, including any recent changes, instructions on the use of our Internet site to educate employees, and a question and answer period. A representative of the Division of Pensions and Benefits and Horizon Healthcare Insurance Agency, Inc. (Horizon), the company contracted to administer the Tax$ave Flexible Spending Accounts for the State, will participate in the workshop. Reservations are required for the Trenton workshop to be held at the Division of Pensions and Benefits. Please see the enclosed Tax$ave 2001 Open Enrollment Employer Workshop orientation flyer with reservation instructions. We will officially announce the open enrollment to employees paid through Centralized Payroll about the open enrollment period with an August 18 paycheck message. Along with their September 1 paycheck there will be another a Tax$ave 2001 Open Enrollment announcement message on their paycheck and three payroll inserts. These inserts are:
The other open enrollment materials you will need are the Declination of Premium Option Plan (POP) for Plan Year 2001 form and the FSA Election Kits. The Division will send you a minimal supply of the declination forms, a sample of which is are attached and can be copied. A new FSA Election Kit for 2001 will be sent directly to benefits administrators by Horizon, along with a request form for additional kits, directly to benefits administrators by Horizon, for distribution to those employees who request them. The FSA Election Kits from the 2000 open enrollment may still be used for the 2001 open enrollment. The Division will provide colleges, universities, the Palisades Interstate Parkway Commission, and the NJ Commerce and Economic Growth Commission with sufficient copies of the Tax$ave 2001 Open Enrollment News and the Premium Option Plan 2001 pamphlet for all eligible employees. Horizon will provide sufficient copies of the FSA pamphlet for distribution to all of your eligible employees. Upon request, Horizon will provide Tax$ave educational seminars of about 60 minutes in duration (including Q & A) at your workplace for interested employees. These have proven to be very successful educational tools and we strongly encourage you to make them available to your employees. Please see the enclosed request form to schedule a Horizon representative. In addition to announcing the open enrollment to employees paid through Centralized Payroll with their August 18 and September 1 paychecks, we will provide reminder messages about the Tax$ave 2001 Open Enrollment to those employees through pay stub messages on September 29, October 13, and October 27. A copy of the text of these messages is enclosed. We encourage colleges and universities to provide their employees with similar reminders to ensure they don't allow this opportunity to slip by without action. If employees want to pay federal income and Social Security taxes on the salary used to pay their medical and dental premiums in 2001, they must complete a POP form declining the federal tax break they could receive. We will tell employees to obtain the forms from you. We will be instructing employees to return the Declination of Premium Option Plan (POP) forms to benefits administrators by October 31, 2000. Benefits administrators must then forward declination forms to payroll. State Biweekly employee POP declination forms must reach Centralized Payroll by November 17, 2000. Colleges, universities, Palisades Interstate Parkway Commission, and the NJ Commerce and Economic Growth Commission need to identify their own filing deadlines for POP based on their own payroll schedules. Employees have three ways of enrolling in the Tax Savings accounts again this year: mail, telephone, and Internet. The Tax$ave publications will provide the following instructions to employees:
To enable telephone and Internet enrollment, Horizon requests that by September 11, 2000, colleges, universities, the Palisades Interstate Parkway Commission, and the NJ Commerce and Economic Growth Commission provide them with a file of eligible employees for Tax$ave (eligible as of 9/1/00) by September 11, 2000 to enable electronic enrollment availability. Employers having questions regarding this file should contact Horizon directly. There is one significant change to Tax$ave rules this year. It pertains only to the DCSA. If an employee participating in the DCSA changes dependent care providers or if there is a change in the fees charged by the provider (as long as the provider is not a relative), this is considered a "change in family status." This allows the employee to request to cancel or change the amount being deducted from their pay for dependent care expenses. If you have any questions about Tax$ave 2001 or the open enrollment, call the Horizon Healthcare Insurance Agency, Inc. at 1-800-224-4426. To reserve seats at the Tax$ave 2001 Open eEnrollment Employer Workshop Orientation or to schedule Horizon to conduct Tax$ave seminars for your employees, please follow the instructions on the enclosures. Remember, you may access information on Tax$ave through the Division of Pensions and Benefits' Internet homepagsite at: www.state.nj.us/treasury/pensions/taxsave.htm Your involvement in this open enrollment is the key to the presentation of this valuable benefit program to your employees. We appreciate your cooperation. Enclosures: Tax$ave
2001 Open Enrollment Milestones TAX$AVE 2001 OPEN ENROLLMENT MILESTONES
During this year's Open Enrollment for Tax$ave 2001, Horizon Healthcare Insurance Agency, Inc. (Horizon) will be happy to respond to your request for an informational session at your location. A representative from Horizon will explain the Tax$ave program to your employees and be available to answer any questions or concerns about this beneficial tax savings opportunity. Please complete the request below and fax it to the Horizon representative listed at the bottom of this form. Individual Location Meetings - Minimum 25 Employees Per Session If you have less than 25 interested employees, call Horizon and ask about a conference call! Employer Name ______________________________________________________________ Requester's Name _____________________________________________________________ Contact Numbers _(voice)__________________________________(fax)__________________ Address _____________________________________________________________________ Proposed Dates/Times of Employee Seminars (Allow 60 minutes per session) You must provide an overhead projector. Fax
requests to: Please include directions to the seminar site with your request. If you have any questions about this request form, call Horizon Healthcare at 1-800-224-4426. Fall 2000 Open Enrollment Employer Workshop The Division of Pensions and Benefits and the Horizon Healthcare Insurance Agency, Inc. (Horizon) will conduct workshops for State human resources/benefits administrators responsible for administering the New Jersey State Employee Tax Savings Program (Tax$ave) and the State Health Benefits Program (SHBP). You may choose to attend any one of the four identical sessions offered in Trenton. The workshops will be scheduled for September 7, 2000 and will last about 90 minutes. We will address the Tax$ave and SHBP Open Enrollment (time frames, deadlines, available support), a brief overview of the components of Tax$ave and the SHBP, including any recent changes, and any questions raised by attendees. Reservations for the workshop are required.
TO: Certifying Officers FROM: Thomas P. Bryan, Acting Director DATE: May 19, 2000 SUBJECT: Introduction of Field Audit Unit The Division of Pensions and Benefits has recently reestablished its field audit unit. The purpose of this unit is to verify participating employers' understanding of the requirements of the numerous statutes, regulations, and procedures governing pension and other benefits programs. Several operational studies conducted during the past couple of years have indicated that employers participating in Division administered benefits programs, and the Division itself, would benefit from the reinstitution of the field visits by Division audit staff. The unit will begin to operate in June of this year. We will conduct the initial visits with employers close to the Division offices in Trenton as operating and reporting procedures are developed and refined. Thereafter, we will randomly select employers throughout the State for visits. Occasionally, we will schedule visits in response to a perceived issue or problem and employers may request a visit by the field audit unit. The ultimate, ambitious aim is to visit every employer who participates in one or more of the Division administered pension systems, the State Health Benefits Program, or both. The Division will notify employers scheduled for visits by letter and then coordinate the dates and requirements by telephone. We do not intend the visits to be unnecessarily burdensome or to interfere significantly with your normal work operations. We expect that the results will be beneficial in that the Division will become more attuned to the difficulties employers encounter in administering our programs and to your specific needs. Likewise, employers should benefit through the validation of correct procedures they are using and the identification of any shortfalls that could become major problems if not addressed. Thank you in advance for your anticipated cooperation as we launch this new endeavor. To:SHBP
Participating Local Government Employers From: New Jersey State Health Benefits Program Subject: Special Open Enrollment Extension Date: May 5, 2000 Horizon BCBSNJ recently signed a new hospital contract with West Jersey Health System (Virtua Health System including Marlton, Vorhees, Berlin, Camden and Burlington Memorial hospitals). The contract settlement, which is retroactive to January 1, 2000, affects the provider networks of NJ PLUS and Horizon HMO. During the recent open enrollment, State Health Benefits Program (SHBP) members may have made plan changes out of NJ PLUS or Horizon HMO or made decisions not to enroll in NJ PLUS or Horizon HMO based on the fact that these hospitals were not part of the provider network. Therefore, the SHBP is permitting these employees the opportunity to submit an application for enrollment into NJ PLUS or Horizon HMO for an effective date of July 1, 2000. Please advise your employees of this opportunity. This special extension of the open enrollment period is only to permit enrollment in NJ PLUS or Horizon HMO. All employer certified enrollment applications must be received in this office no later than May 31, 2000. Please mark these applications as "Special Extended OE" to assist us in identifying this application as the employee's final request for enrollment during this annual open enrollment period. We appreciate your cooperation in this matter. If you have any further questions regarding this matter, please contact our Office of Client Services at (609) 292-7524. To: Certifying Officers, Police and Firemen's Retirement System From: William Kale SUBJECT: PFRS Enrollment Eligibility and Age Limits Date: May 2, 2000 The maximum age restriction is sometimes a deciding factor of candidate eligibility for enrollment into the Police and Firemen's Retirement System (PFRS). In recent years, federal and state legislation, judicial rulings, and procedural changes have led to, sometimes confusing, changes in the PFRS eligibility requirements concerning age. The attached Fact Sheet #8, Enrollment Eligibility and Age Limits: PFRS, provides information that should clarify the rules of PFRS enrollment that concern age limits. The fact sheet includes: a brief history of the maximum age limit, the requirements for meeting the age limit, and enrollment "exceptions" for some candidates who exceed the age limit. Two highlights of the fact sheet are the delineation of the different rules governing Civil Service (Title 11) versus non-Civil Service employers and the rules differences between municipal, county, and state employers. One important enrollment change described in this Fact Sheet concerns employees, provisionally hired into PFRS eligible titles, who are awaiting permanent appointment. Previously, municipal employees in this situation have not been able to join any pension system. Now they must be enrolled in the Public Employees' Retirement System after twelve months in their temporary position. This fact sheet will prove useful for the majority of age limit questions related to PFRS enrollment you are likely to face. If you need further clarification concerning a specific candidate, contact the Enrollment Bureau, Division of Pensions and Benefits, PO Box 295, Trenton, NJ 08625-0295. Also, the Employer Education Unit of the Division of Pensions and Benefits is available for assistance and training on enrollment issues for all state-administered pension funds, as well as the completing of the Quarterly Report of Contributions, forms completion, and general pensions processing. To contact the Employer Education Unit, call (609) 777-2112 or (609) 777-2111. To:SHBP
Participating Local Government Employers FROM: Janice F. Nelson, Assistant Director for Health Benefits SUBJECT: Increase in Prescription Drug Supply Limit at Retail Pharmacies and Change to ID Card Ordering Procedures Date: April 24, 2000 The State Health Benefits Commission revised its existing retail pharmacy 30-day supply limit at its meeting on April 12, 2000. Effective May 1, 2000, State Health Benefits Program (SHBP) members (active members enrolled under the State Prescription Drug Plan and retirees enrolled under the Traditional Plan or NJ PLUS) can have prescriptions filled at a retail pharmacy for up to and including a 90-day supply. The disbursement of a 90-day supply is contingent upon the receipt of co-payments from eligible participants as shown in the charts below and a physician's prescription for the 90-day supply. State and Local Active Employees Enrolled in the State Prescription Drug Plan
All Retirees Enrolled in the Traditional Plan and NJ PLUS Retiree Prescription Drug Plan
Previously, a SHBP member could only receive a prescription for greater than 30 day through the mail order program. This change gives SHBP participants who want the convenience of a 90-day supply the option to select either a retail or mail order pharmacy. In essence, this change permits employees and retirees who want the 90-day supply to pay the same co-payment in one visit for a 90-day supply that he or she would have paid in three visits for three 30-day supplies. There is no cost advantage to the member, other than the convenience of only one trip to the pharmacy. Employees and retirees will continue to receive additional savings if they use the mail-order program. There will be no issuance of new identification (ID) cards to support this change. The members' current ID card will access these benefits. ID Card Ordering Procedure Change: All State and Local Participating Employers: Any requests for replacement ID cards must be made directly to the employee's insurance plan and not to the State Health Benefits Bureau. Requests for Traditional Plan or State Prescription Drug Plan ID cards should be made directly to Horizon Blue Cross Blue Shield at 1-800-414-7427 just as is currently done for NJ PLUS cards. Please discard any forms (HB-80-197-493) addressed to the State Health Benefits Bureau that you may have been using to request ID cards. State Biweekly and State Monthly Employers Only: Effective immediately, all identification cards issued for active State employees enrolled in the State Prescription Drug Plan and/or the Traditional Plan will be mailed directly to the employee's home address. The employer will no longer be involved in the distribution of these identification cards. Therefore, it is important that an employee advise the SHBP of any address changes. Address changes can be submitted to the Division of Pensions and Benefits by letter to the address on the letterhead, by E-mail to pensions.nj@treas.state.nj.us, or by contacting our Office of Client Services by calling (609) 292-7524 during regular business hours. For those members who wish to call after regular business hours, they may call (609) 777-4355, select PROMPT 2, to leave their address change information. Enclosed is a letter to be distributed to employees enrolled in the State Prescription Drug Plan. Retirees will be notified in their annual rate change mailer and in their retiree newsletter, the New Jersey State Health Benefits Program Health Reporter. If you have any questions regarding this information, please contact our Office of Client Services at (609) 292-7524.
My January 21,
2000 memorandum on Chapter 415, P. L. 1999 provided information
on the implementation of this law that reduced the employee pension
contribution rate for members of the Public Employees' Retirement
System from 4.5 percent to 3 percent for calendar years 2000 and
2001. That memorandum instructed you to continue to take back deductions
as certified. The purpose of this memorandum is to advise you that
the Division will be recalculating and recertifying, at 3 percent,
back deduction schedules previously certified for February 1 and
March 1, 2000. January 1, 2000 back deduction schedules will not
be recertified. January 31, 2000
The State Health
Benefits Program is authorizing a Special Open Enrollment during
the month of February for those NJ PLUS and Horizon HMO members
who are affected by the Horizon Blue Cross Blue Shield of NJ (Horizon
BCBSNJ) network hospital terminations of West Jersey Health System
(Virtua Health System) that occurred on December 31, 1999 and Memorial
Hospital of Burlington County that occurred on January 28, 2000.
Please note that these hospital network changes have no impact on
members enrolled in the Traditional Plan. TO: NJ
PLUS AND HORIZON HMO MEMBERS
If you do not
elect to make a plan change during this Special Open Enrollment
you will have another opportunity to do so during the regular annual
open enrollment. The next annual open enrollment period is the month
of March for Local employees and Local COBRA enrollees and April
for all State biweekly, State Monthly, Colleges and University employees
and State COBRA enrollees for a coverage effective date of July
1, 2000. Retirees may make a plan change once every twelve months.
Governor Whitman
signed Chapter 415, P.L. 1999 into law on January 18, 2000. This
law further reduces the Public Employees' Retirement System (PERS)
employee pension contribution rate for calendar years 2000 and 2001
from 4.5 percent to 3 percent. It does not affect contribution rates
for any other retirement system. The rate reduction is due to the
continued existence of a significant level of surplus assets in
the fund.
Contact Client Services at (609) 292-7524 if you have questions. |
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