October
30, 1998
TO:
Certifying Officers
Public Employees' Retirement System
FROM: Margaret M. McMahon
Director
SUBJECT: EMPLOYEE CONTRIBUTION
RATES FOR GROUP LIFE INSURANCE
The Contributory Insurance rate for the Public Employees' Retirement System (PERS)
will change from 0.55% to 0.50% of salary effective January 1999. This rate change
is the result of an accumulation of reserves in the plan due to good group experience
and the return on investment of the existing reserves.
The contributory insurance rate of 0.40% for members
of the Teachers' Pension and Annuity Fund (TPAF) remains unchanged for 1999.
As a reminder, the pension contribution
reduction for PERS and TPAF from 5% to 4.5% of salary remains in effect through
calendar year 1999.
Please
take the necessary actions to adjust your payroll systems. If you have any questions,
please call (609) 292-7524.
August
14, 1998
TO: State
Biweekly Benefits Administrators
State University and College Benefits Administrators
Palisades Interstate Parkway Commission Benefits Administrator
State Human
Resource Directors
FROM:
Margaret M. McMahon, Director
SUBJECT:
OCTOBER OPEN ENROLLMENT FOR 1999 NEW JERSEY STATE EMPLOYEES TAX SAVINGS PROGRAM
(Tax$ave '99)
The Annual
Open Enrollment for the calendar year 1999 New Jersey State Employees Tax Savings
Program (Tax$ave '99) will be conducted from October 1 through November 2, 1998.
Employees of the State, state universities and colleges, and the Palisades Interstate
Parkway 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:
- The
Premium Option Plan (POP); and
- Two Flexible
Spending Accounts (FSA's):
- Unreimbursed
Medical Spending Account (UMSA); and
-
Dependent Care Spending Account (DCSA).
Tax$ave offers eligible employees a unique opportunity to increase their available
income by reducing their federal tax liability. Each year eligible employees must
review their personal financial circumstances and decide if they wish to participate
or not. Open enrollment offers employees the opportunity to conduct this review
and then act on their decision. Participation in Tax$ave in 1998 does not
carry over automatically into 1999. Employees must enroll again to participate
in a FSA for calendar year 1999. Employees who do not wish to participate in POP
in 1999 must file a POP Declination Form and return it to their benefits administrator
by November 2. This letter provides information on the open enrollment for
Tax$ave '99 and identifies the publications and support available to assist you
in explaining this important benefit program to your employees.
Please do your utmost to inform your employees of
the open enrollment and to educate them on the valuable benefits that Tax$ave
offers them. We believe that more employees would join if they were aware of this
beneficial tax saving program.
The enclosed Open Enrollment Milestones chart lists
the critical dates of the Tax$ave '99 Annual Open Enrollment and outlines the
efforts being made to educate employees. Please use this chart as a checklist
to guide your activities during the open enrollment.
We will conduct 90 minute Tax$ave '99 orientation workshops for employer benefits
administrators in Newark on September 10, Sewell on September 15, and Trenton
on September 16, 1998. The workshops will include the information in this letter,
an overview of the three components of Tax$ave, instructions on the use of our
Internet site to educate employees, and a question and answer period. Representatives
of the Division of Pensions and Benefits and the Family Security Insurance Agency,
Inc. (FSIA), the company contracted to administer the Tax$ave Flexible Spending
Accounts for the State, will participate in the workshops. Reservations are required
for all workshop locations. Please see the enclosed Tax$ave '99 Employer Workshops
orientation schedule and reservation instructions.
We will officially announce the open enrollment to employees paid through Centralized
Payroll with their September 18 paycheck. There will be a message on their pay
stub and three payroll inserts. The inserts are:
- A Tax$ave '99 Newsletter that will announce
the open enrollment, outline the components of the program with emphasis on its
tax saving advantages, and identify the November 2, 1998 deadline for submission
of all election materials. A copy of the newsletter is enclosed;
-
A FSA pamphlet that will describe the UMSA and DCSA plans. This pamphlet will
be similar to the one provided employees in the 1998 plan year open enrollment;
and
- A POP pamphlet that will explain
the advantages and disadvantages of participation. A copy of the POP pamphlet
is enclosed.
The other open enrollment
materials you will need are the POP declination form and FSA Election Kits. We
will send you a supply of the declination forms, a copy of which is attached.
A supply of FSA Election Kits will be sent directly to benefits administrators,
upon request, by the FSIA for distribution to those employees who request them.
The FSA Election Kits from the 1998 open enrollment may still be used for the
1999 open enrollment.
We will provide colleges, universities, and the Palisades Interstate Parkway Commission
sufficient copies of the Tax$ave '99 Newsletter and the POP pamphlet for all eligible
employees. The FSIA will provide sufficient copies of the FSA pamphlet for distribution
to all of your eligible employees. We will also provide a new POP Declination
Form you can reproduce.
The
FSIA is scheduling regional educational seminars that are open to all eligible
employees. The FSIA will also be available to provide educational seminars of
about 60 minutes duration (including Q & A) at your workplace to interested employees.
These have proven to be very successful educational tools and we strongly encourage
you to make them available to your employees. Please see the enclosed request
form for dates, times, and locations or to schedule a FSIA representative.
In addition to announcing the open
enrollment to employees paid through Centralized Payroll with their September
18 paycheck, we will provide reminder messages about the Tax$ave '99 Open Enrollment
to those employees through pay stub messages on October 2 and October 16. A copy
of the text of these messages is enclosed. We encourage colleges and universities
to provide their employees with similar reminders.
If employees want to pay federal income and Social Security taxes on the salary
used to pay their medical and dental premiums in 1999, 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
POP Declination Forms to benefits administrators by November 2, 1998, who
must then forward them to payroll. State Biweekly employee POP Declination Forms
must reach Centralized Payroll by November 6, 1998. Colleges, universities, and
the Palisades Interstate Parkway Commission need to identify their own filing
deadlines for POP based on their own payroll schedules.
We will also instruct employees to mail FSA Election
Applications directly to the FSIA. All Election Forms must be postmarked no
later than November 2, 1998 to be accepted. Those postmarked after November
2, 1998, will be returned without action. Benefits offices should not be involved
in processing or mailing FSA Election Applications.
Employees enrolled in either the UMSA or DCSA plans for the 1998 calendar year
and who wish to continue participation in 1999, may reenroll over the phone by
calling the FSIA's automated voice response unit at 1-800-224-4426. The FSIA will
inform current participating employees of this opportunity through a direct mailing
in September.
New this year
is the ability to enroll or reenroll over the Internet. Go to the Tax$ave site
at: http://www.fsia-inc.com/taxsave.html
and follow the simple directions.
You may access further information on Tax$ave through the Division of Pensions
and Benefits Internet homepage at: http://www.state.nj.us/treasury/pensions
or the FSIA homepage for the Division at: http://www.fsia-inc.com/taxsave.html.
If you have any questions about
Tax$ave or the open enrollment, call the FSIA at 1-800-224-4426. To reserve seats
at the Tax$ave '99 Employer Orientation and schedule the FSIA to conduct seminars
for your employees, please follow the instructions on the enclosures. Your involvement
in this open enrollment is the key to the presentation of this valuable benefit
program to State employees.
Enclosures:
Open Enrollment Milestones
Tax$ave '99 Employer Workshops
Tax$ave '99 Newsletter
The Premium Option Plan 1999
Declination of POP
for Plan Year 1999
Request for Tax$ave '99 Employee Seminars
Tax$ave '99
Open Enrollment Reminder Check Messages
TO:
All SHBP Benefits Administrators
FROM: Janice F. Nelson,
Assistant Director, State Health Benefits
Program
SUBJECT: SHBP COBRA
Program Change
The State
Health Benefits Program (SHBP) has changed a provision of its COBRA Program as
a result of a recent Supreme Court decision, Geissal v. Moore Medical Corporation.
This decision states that an employer cannot deny heath care continuation rights
to a qualified beneficiary because the beneficiary is covered under Medicare or
another group health plan at the time of electing COBRA coverage. The SHBP has
already implemented this change and is no longer rejecting applications for COBRA
coverage because of other coverage.
New forms and publications needed for employers to implement this program change
are enclosed. They include the following:
- A
revised initial COBRA Notice that employers
mail to newly enrolled employees and their covered family members; (NOTE: this
federally mandated initial COBRA Notice and the Notice to Employees about Federal
Health Insurance Requirements should be mailed as attachments to the employer
letter entitled Notification of Health Benefits Rights Under Federal Law. We sent
you these last two mentioned items in January 1998);
- A supply of COBRA event Notices and COBRA Applications
(State, local/educational);
- A copy of Instructions
(State, local/educational) for the benefits administrator on how to complete the
COBRA event Notice and Instructions to eligible beneficiaries on how to complete
the COBRA Application;
- A copy of Fact
Sheet #25, Employer Responsibilities Under COBRA;
- A
copy of Fact Sheet #26, Health
Benefits Options Upon Termination of Employment;
- A
copy of Fact Sheet # 30, The
Continuation of New Jersey State Health Benefits Program Insurance Under COBRA;
and
- A set of current COBRA rates in effect
since July 1, 1998.
Please recycle all obsolete initial COBRA Notices, specific COBRA Notices, Applications,
and Instructions and replace them with the ones enclosed. Use of the obsolete
publications will mislead qualified beneficiaries as to their COBRA rights under
the federal law. Other Division publications that include information about COBRA,
such as The Pensions and Benefits Administration Manual and the SHBP
Medical Plans Information Handbook, will be revised in the future.
If you have specific questions,
call Client Services at (609) 292-7524. Or call our Employer Hotline at (609)
777-1082, leave a detailed message and a counselor will return your call.
June 8, 1998
TO: State Biweekly Payroll
Benefits Administrators
FROM:
State Health Benefits Program
SUBJECT:
New Dental Expense Plan Identification Cards
Employees currently enrolled in the State Dental Expense Plan (the traditional
dental indemnity plan administered by Prudential) are receiving new dental plan
identification cards that will allow them to access the new discounted network
of dental providers called the Prudential Dental Organization (PDO). Using network
providers allows employees to take advantage of discounted services which will
reduce their out-of-pocket expenses. The coinsurance, 20% not paid by Prudential,
will be applied to discounted charges and there will be no charges in excess of
reasonable and customary allowances.
All State employees currently enrolled in the Dental Expense Plan should be receiving
these new Dental Expense Plan identification cards. Although information about
this new benefit was provided in the dental flyer distributed for open enrollment,
employees might be confused as to why they are receiving these new cards. Please
explain that they are still enrolled in the Dental Expense Plan and that this
is purely an enhancement to the dental plan. For more information, refer them
to Fact Sheet # 37, State Employee
Group Dental Program (4/98), or page 13 of the new State
Employee Group Dental Program booklet, both of which are available through
the Pensions and Benefits Home page on the Internet. Employees may also call Prudential
at 1-800-282-0555 for more information about the network.
Since the cards now being mailed are based on current
enrollments, employees who transferred out of the Dental Expense Plan during open
enrollment will also receive a card. It can be used until their new plan enrollment
takes effect on July 4, 1998.
New Prudential Claims Office: Prudential's claim service location serving
the State's Dental Expense Plan has changed. Claims will now be paid through an
office located in Albany, New York. A new dental claim form reflecting the new
address and telephone number has been developed. A copy is attached; you will
receive a supply of these new forms. Until you receive the new forms, the old
forms are still usable as claims received in the old claims center will be forwarded
appropriately.
The information
described above is available on our Internet Home Page at the following address
(URL): http://www.state.nj.us/treasury/pensions
If you have specific questions,
call Client Services at (609) 292-7254. Or call our Employer Hotline at (609)
777-1082, leave a detailed message and a counselor will return your call.
March 19, 1998
TO: Department Human Resource Directors
State Biweekly Payroll Benefits Administrators
State College and University
Human Resource Directors
State Monthly Benefits Administrators
FROM: Janice F. Nelson
Assistant Director, SHBP
SUBJECT: State Employee Group
Dental Plan Open Enrollment Information
This letter provides information concerning changes in the State Employee Group
Dental Program approved by the State Health Benefits Commission for the 1998 annual
open enrollment. The open enrollment runs from April 1 through April 30 with the
coverages/changes effective July 4 for employees paid through the State's Centralized
Payroll Unit and July 1 for all others.
CIGNA DPO Added
All current dental carriers are continuing
their participation in the State Employee Group Dental Program this year. One
Dental Provider Organization (DPO), CIGNA Dental Healthcare (DPO #5) is rejoining
the Program effective July 1. CIGNA will provide services to our members throughout
New Jersey and in the counties of New York and Pennsylvania that are adjacent
to New Jersey. The member services telephone number for information about CIGNA
DPO is 1-800-367-1037. Callers can use this number to identify participating dentists
in their zip code area through a Voice Response Unit and have a list faxed to
them. The marketing representative for CIGNA Dental, for invitations to health
fairs, is Marsha Robinson at 973-660-4031. Who also represents CIGNA HMO. One
call will get you representatives from both the DPO and HMO plans at your health
fairs.
This addition of CIGNA
to the Program occurred after the open enrollment publications were printed. Therefore,
none of those materials prepared by the Division includes this information. A
message about the availability of CIGNA DPO will be placed on the April 3rd pay
stubs of employees paid through the State's Centralized Payroll Unit. A copy of
that message is attached. Employers should use whatever opportunities are available
to them to inform employees of this newly added plan.
DPO Program Changes
Changes have
been made to the DPO program. The SHBP has required more comprehensive reporting,
grievance, and quality control requirements that should improve the service provided
our members participating in the DPO program. Additionally, the co-payment schedule
for the DPO's for basic and major services has been updated. Co-payments had not
been changed since the Program's inception with the result that dental providers
have been reluctant to service our members because they feel inadequately compensated.
Two DPO's left our Program last year and others indicated they might leave primarily
because of the outdated CO-payment schedule. The new CO-payments structure addresses
these inadequacies and increases the compensation dental providers receive directly
from the member. This should cause dental providers to be more willing to service
our members. A comparison of our program with other programs is illustrates that
our members still have the best DPO Program available.
Provider Network Added to the Dental Expense
Plan
A new feature is also being added to the Dental Expense Plan.
A provider network will be added to the Dental Expense Plan which will operate
much like the P.A.C.E. Network in the medical program's Traditional Plan. The
member is under no obligation to use the network of providers. The network, called
the Prudential Dental Organization, will consist of dentists under contract to
the plan who agree to provide dental services at a discounted rate. Since the
total cost of a service is less with a network dentist, the member's 20 percent
coinsurance will be less if the member then uses the network. We hope to have
this service it will be in place by May 1. Prior to the effective date of this
service we will provide you with information about the participating providers
in the network, and send you a written description detailing how the network will
operate.
New State
Employee Group Dental Program Handbook
As a result of the changes
to both the Dental Expense Plan and the DPO's, we are printing a new State Employee
Group Dental Program Handbook, which we hope to have in your hands in early April
for distribution to your employees. We will send you a pre-production copy later
this month for your information and reference. The new State Employee Group Dental
Program Handbook will also be available on the SHBP Home Page on the Internet
(http://www.state.nj.us/treasury/pensions/shbp.htm). We are also updating
A rate chart is attached. Stuff is missing
here!
No Prescription
Drug Coverage Through HMOs
In an unrelated matter, several HMOs have
published marketing materials for this open enrollment period that provide incorrect
information regarding prescription drug coverage available in the coverage they
provide to State employees. HMO plans available to active employees of the State
do not contain any prescription drug coverage because active employees have drug
coverage under the State Prescription Drug Plan. These HMO plans do, however,
provide prescription drug coverage for State retirees because retirees do not
have drug coverage under the State Prescription Drug Plan.
If you have any questions, please call Client Services
at (609) 292-7524 or call the Employer Hotline at (609) 777-1082 and leave a message.
A staff member will return your call on the next work day.
attachments
State Employee Group Dental Program Open Enrollment Information
March 19, 1998
February 1998
TO: Participating Local Employers
FROM: Janice F. Nelson
Assistant Director,
State Health Benefits
Program
SUBJECT:
SHBP Local Group Plan and Rate Actions
This letter summarizes the actions concerning HMO plan changes and rates taken
by the State Health Benefits Commission on January 30, 1998. My letter to you
in December 1997 described rate actions taken by the Commission
regarding the Traditional Plan, NJ PLUS, and the State Prescription Drug plan.
The Commission took the following
actions:
HMOs Rates With
and Without Drugs. The Commission voted to have each HMO offer plans with
and without prescription drug coverage. The HMO plans with prescription drug coverage
will be offered to active employees of local employers who offer no separate prescription
drug plan and to all retirees. The HMO plans without prescription drug coverage
will be offered to active employees of local employers who offer a separate prescription
drug plan. This decision ensures all employees and retirees have adequate prescription
drug coverage, reduces coverage redundancy, reduces costs for employers who offer
a separate prescription plan, and gives employees and retirees who need drug coverage
a broader selection of medical plans than they had previously. Local group rates
for HMOs without drug coverage showed a slight increase, somewhat below national
trends. Local group rates for HMOs with drug coverage showed greater increases,
primarily because of the cost of adding the prescription drug coverage. HMO rates
for retirees increased, also primarily because of the cost of adding the prescription
drug coverage.
HMO Standards.
The Commission adopted a set of minimum operating and coverage standards
for managed care plans to ensure an adequate level of care is available to members.
This also makes participating HMOs more uniform,
thereby easing member choice between plans. A summary description of the new standards
is included in the Health Capsule and the State Health Benefits Program
Plan Comparison Summary, which will be sent you later this month.
Plan Changes (effective on July
1, 1998). QualMed HMO will no longer provide coverage to SHBP participants.
Prudential Healthcare HMO will reduce its service area to New Jersey and will
no longer provide coverage in New York, Pennsylvania, or Connecticut. Physicians
Healthcare Plan will be merged with HMO Blue (through acquisition). Ten HMOs will
therefore be available to employees during the upcoming open enrollment.
NOTE: All QualMed members and Prudential
Healthcare HMO members who live outside New Jersey will have to change their coverage
during the open enrollment. Failure to do so will result in their having no coverage
beginning July 1, 1998. Prudential Healthcare HMO members who live in New Jersey
but have a Primary Care Provider located outside NJ will have to contact Prudential
to select a new Primary Care Provider or switch plans during the open enrollment.
Members of Physicians Healthcare Plan will be automatically transferred to HMO
Blue unless they change their coverage during the open enrollment.
We have enclosed for your use SHBP rate charts for
employees, with and without drugs, and a rate chart for retirees, with drugs.
We will send you informational materials concerning the HMO plan changes and minimum
standards discussed above for distribution to your employees later this month.
These materials will include sufficient copies for all your employees of the open
enrollment edition of the Health Capsule and the State Health Benefits
Program Plan Comparison Summary.
Finally, we have enclosed a copy of the New Jersey HMOs: Performance Report
produced by the Department of Health and Senior Services. This report card is
a tool available to New Jersey residents to assist them in evaluating and selecting
a health insurance carrier. Information on how to order more copies is provided
in the report. The report is also available on the Internet at the following address:
http://www.state.nj.us/health
If you have questions about the
information in this letter, contact Client Services at (609) 292-7524 or call
the Employer Hotline at (609) 777-1082 and leave a message. A staff member will
return your call on the next business day.
Attachments
January 1998
TO: Participating SHBP Employers
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: Required Notices To SHBP
Enrollees
Federal law
mandates employers to provide notice of requirements of certain pieces of federal
legislation to employees and their dependents upon their enrollment in the employers
group health insurance. State Health Benefits Program (SHBP) participating employers
have been providing initial notices for several years concerning the Consolidated
Omnibus Budget Reconciliation Act (COBRA) program. To this must now be added an
initial notice about the federal Health Insurance and Portability Accounting Act
(HIPAA).
The attached documents
provide everything you, as an employer, need to comply with the initial notice
requirements of both COBRA and HIPAA. Enclosure one is a cover
letter forwarding the required notices. You should modify this enclosure to reflect
its being mailed from your location to an employee and dependents.
NOTE: To meet federal requirements, the letter must be addressed to the employee
and Family, it must be mailed (first class mail is sufficient), and a copy must
be retained to prove compliance. The second and third enclosures can be used
"as is" as attachments to your modified enclosure one. Enclosure
two updates and replaces the previous COBRA initial notification provided
you. Enclosure three is a new HIPAA notice.
Federal law also requires that all enrollees
- employees and dependents - in employer provided health plans be notified annually
of HIPAA requirements and how the employer's plan compares with them. The notice
at enclosure three will meet this requirement. You will have to mail a copy to
all your SHBP enrolled employees to satisfy the requirement to properly notify
dependents. Please complete your mailing prior to the annual open enrollment period.
Questions about this memorandum
should be directed to the Employer Hotline at (609) 777-1082. Leave a message
and a staff member will return your call within one business day.
enc.
ENCLOSURE 1
(Employer Letterhead)
(Date)
TO (Employee Name) AND FAMILY
(Address)
FROM: (Employer)
SUBJECT: Notification of Health Benefits Rights Under Federal Law
This letter provides information about health benefits
that federal law requires your employer to send to you and your family members
enrolled under your State Health Benefits Program (SHBP) coverage. Everyone enrolled
under your SHBP coverage should read this information. You should keep it for
future reference.
The first
enclosure concerns the federal program known as Consolidated Omnibus Budget Reconciliation
Act (COBRA). COBRA allows you or your covered dependents to extend health benefits
coverage under the SHBP employer group plan in certain cases where you would otherwise
lose that coverage. See the first enclosure for details about your rights under
COBRA.
The second enclosure
provides information from several federal laws enacted in 1996. These include
the Health Insurance Portability and Accounting Act (HIPAA), the Mental Health
Parity Act, and the Newborns' and Mothers' Health Protection Act. These laws establish
certain coverage requirements applicable to most employer health insurance plans.
Plans such as the SHBP may exempt themselves from some of these requirements as
long as participants of the plan are notified of the exemption. See the second
enclosure for details about the health insurance coverage required by these federal
laws.
There is nothing that
you or your family members have to do as a result of this mailing. The sole purpose
is to inform you of your rights under these federal laws and, by doing so, to
comply with the notification requirements contained in the laws. If you have any
questions concerning this package, you should contact (employer human resource/benefits
manager contact information) or the Division of Pensions and Benefits at (609)
292-7524.
The Notice (Form HC-0247-1297) has been revised, click here
for the new revised Notice.
December 1997
TO: Participating Local Employers
FROM: Janice F. Nelson
Assistant Director,
State Health Benefits Program
SUBJECT: Local Group Rate Actions
At its December 19, 1997 public meeting, the State
Health Benefits Commission established fiscal year rates for the Local Group of
the State Health Benefits Program which become effective July 1, 1998. The Commission
established rates for the Traditional Plan, NJ PLUS, and the State Prescription
Drug Plan. HMO rates will be established in Commission meetings to be scheduled
in January 1998. Complete rate charts will be provided to you shortly after the
HMO rates are set.
Changes
shown apply to all levels of coverage within each plan.
EDUCATION EMPLOYERS
PLAN
ACTIVE
RATE CHANGE RETIREE RATE CHANGE
Traditional Plan
+3.5%
+3.5%
NJ PLUS
-13.0%
No change
State Prescription
+13.6%
NA
Drug
ALL OTHER EMPLOYERS
PLAN
ACTIVE
RATE CHANGE RETIREE RATE CHANGE
Traditional Plan
+3.5%
+3.5%
NJ PLUS
-5.0%
No change
State Prescription
+13.6%
NA
Drug
Performance
of the SHBP has been relatively good in 1997 compared to similar type plans elsewhere.
Survey data and industry trends reflect increases of from 9-11% for Traditional
type plans, 5-7% increases for NJ PLUS type plans, and 12-15% increases for prescription
plans.
If you have questions,
contact Client Services at (609) 292-7524 or call the Employer Hotline at (609)
777-1082 and leave a message. A staff member will call you on the next business
day.