Employers' Pensions and Benefits Administration Manual (EPBAM)
   

 

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State of New Jersey Public Employees
Long Term Care
Group Insurance Plan


Long Term Care Introduction

Long term care comprises a broad range of services needed by persons of all ages with physical or mental impairments who have lost their ability to function independently. People who need assistance in performing at least two (2) activities of daily living, such as bathing, dressing, toileting, transferring (moving in and out of bed or chair), eating, and continence, are considered to be in need of long term care. Individuals with a cognitive impairment are also generally considered to need long term care.

Long term care services include personal care, home health care, rehabilitation, adult day care, care management, social services, assisted living, and nursing home services. Long term care services may be needed on a regular basis over a period of several months, several years, or a lifetime.

The State of New Jersey Public Employees Long Term Care Group Insurance Plan

The State of New Jersey Public Employees Long Term Care Group Insurance Plan (Plan) will pay a daily benefit amount toward the cost of care in the home and community, such as home health care, adult day care, informal care, and care that is provided in licensed facilities, such as assisted living and nursing homes. Eligible active and retired employees and their eligible family members have several choices of daily benefit levels, as well as a number of benefit options to choose from. The Plan provides care management services, resource and referral services, and respite care, offering relief for the friend or family member who is caring for the covered employee or family member.

Enrollment Eligibility

Employees Who Are Eligible

Enrollment in the State of New Jersey Public Employees Long Term Care Group Insurance Plan is open to almost all individuals who are employed by the State or a State college or university, and their eligible family members; individuals who were employed by the State, or a State college or university at the time of their retirement, and their eligible family members; and active and retired employees of most local governmental and educational entities operating in the State of New Jersey, provided that the local employer has adopted the request resolution offering the Plan to its active and retired employees, and their eligible family members. Eligible family members will include:

The spouse of each active and retired employee; adult children and stepchildren; parents, stepparents and parents-in-law; grandparents, step-grandparents and grandparents-in-law of the employee.

Payment of Premiums

In the case of most active State employees and employees of the State's colleges and universities, the employer will deduct the premiums from the employee's paycheck. Employees will only be permitted to authorize payroll deductions for themselves and their spouses. All other enrolled individuals will be offered direct home billing arrangements.

Adding or Changing Coverage

Employees who qualify will always have the opportunity to enroll or to change their coverage. For more information, visit:

The Division of Pensions and Benefits Long Term Care Information Page
Prudential's State of New Jersey Long Term Care Insurance Plan Page

 

 


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Last Updated: October 19, 2006