Employers' Pensions and Benefits Administration Manual (EPBAM)

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1999 Certifying Officer Letters

Subject

Date

Rule Change for NJAC 17:2-4.7, Reporting Actual Salary for Part-Time Employees December 1999
SHBP COBRA Program Change December 1999
SHBP COBRA Program Change (Local Goverment and School Boards) December 1999
Ineligible positions; Interim appointment to board of education [TPAF] December 22, 1999

HIPAA Update

November, 1999

Pension Compensation and SACT Contribution Limits for Calendar Year 2000

November, 1999

Membership Survey (State Centralized Payroll locations only)

November 15, 1999

Ch. 247, P.L. 1999 Remittance of 403(b) contributions (Institutions of Higher Learning)

October, 1999

Ch. 247, P.L. 1999 Remittance of 403(b) contributions (School Boards)

October, 1999

New rule in re: Ch 330, P.L. 1997

October 4, 1999

New TPAF Handbook

September, 1999

Tax$ave 2000

August 30, 1999

Enhancement to TEPS

August, 1999

Chapter 132, P.L. 1999, Carrying loans into retirement

July 14, 1999

Exclusion from Social Security Coverage of Students

June 17, 1999

State Health Benefits Program Premium Holiday

June 15, 1999

Office Closing -- May 21, 1999

May 17, 1999

Workers' Compensation: Employers' Responsibilities for Pension Contributions

April, 1999

Legislation Change: SHBP Participating Employer Payment of Post-Retirement Medical Costs

April 15, 1999

Reporting Salary for Part-time Hourly Employees in PERS

March 15, 1999

SHBP 1999 Open Enrollment (State Monthly)

SHBP Open Enrollment (State Bi-weekly)

March 3, 1999

Enrollment Eligibility of Professors and Instructors Employed on a Temporary, Provisional or Adjunct Basis by Public Institutions of Higher Education

February 23, 1999

SHBP 1999 Open-enrollment

February 19, 1999

State bi-weekly employees enrolled in HIP

February 8, 1999

Employees enrolled in HIP

February 8, 1999

1999 SHBP Open Enrollment

January 20, 1999

1999 HIPAA Update

December 31, 1998

2007 Certifying Officer Letters
2006 Certifying Officer Letters

2005 Certifying Officer Letters

2004 Certifying Officer Letters

2003 Certifying Officer Letters

2002 Certifying Officer Letters
2001 Certifying Officer Letters
2000 Certifying Officer Letters
1998 Certifying Officer Letters
1997 Certifying Officer Letters


December 1998

 

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 during 1997 and 1998 to comply with the requirements of HIPAA. These actions included:

At the request of the State Health Benefits Commission (Commission), Buck Consultants has conducted an analysis of current mental health coverage under the Traditional Plan and NJ PLUS. They have outlined several mental health plan design alternatives that would be compliant with HIPAA requirements. The Commission will evaluate these alternatives for possible implementation in a future plan year. Since the mental health limitations currently in effect are detailed in the law governing the SHBP, a change in plan design may require legislative action.

A mental health parity exemption must be filed each plan year if a group plan is not HIPAA compliant. The Commission has voted to file an exemption for 1999. Therefore, mental health benefits will remain unchanged through 1999. 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 Hotline at (609) 777-1082 and leave a message. A staff member will return your call on the next business day.

encl.

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:

FEDERAL REQUIREMENT
SHBP STATUS
Issue Certificates of Coverage to all employees and or dependents who lose coverage. Participating employers provided sample certificate to use coverage.
Limit restrictions of coverage for pre-existing conditions. All SHBP plans exceed this requirement since they have no pre-existing condition restrictions.
Offer a special enrollment period to individuals who meet certain conditions, i.e., an employee or employee's dependent, who declined coverage because of other medical coverage, must have an opportunity for special enrollment should the other coverage end. All SHBP plans will comply with this HIPAA requirement for employees and family members.
Eliminate discrimination against participants and beneficiaries based on health status. All SHBP plans comply with this requirement. (Note: the SHBP "actively at work" requirement is waived only for employees not at work due to illness).
Provide a minimum level of hospital coverage for newborns and mothers All SHBP plans meet this requirement.
Provide parity in mental health benefits All SHBP HMO plans meet this requirement. The SHBP has exempted the Traditional Plan and NJ PLUS for 1998 and 1999 from mental health parity - different limits continue to exist for these plans.
Provide annual notice to covered members of any plan provisions not in compliance with HIPAA requirements. Participating employers provided (December 1998 and December 1999) sample certificate to use to meet this requirement.


Notice to State Health Benefits Program Participants about Compliance with Federal Health Insurance Requirements

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:

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 an exemption from HIPAA compliance on mental health parity (requirement #5) for 1998 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 1999. 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 1999.

The SHBP has conducted a study to review the design of mental health benefits in the Traditional Plan and NJ PLUS. Several alternatives have been proposed, which the Commission will evaluate for possible implementation in future plan years.


January 20, 1999

 

To:

State Health Benefits Program Participating Local Employers

From:

Janice F. Nelson
Assistant Director, State Health Benefits Program

Subject:

SHBP 1999 Open Enrollment

The State Health Benefits Program (SHBP) Open Enrollment period for local employees will begin on March 1, 1999, and end on March 31, 1999. Completed employer certified applications must arrive at the Health Benefits Bureau no later than April 9, 1999. All changes to coverage made during Open Enrollment will be effective on July 1, 1999.

The State Health Benefits Commission will finalize rates for July 1, 1999 later this month. We will send you a chart of the approved rates and plan information in mid February.

Three revised SHBP publications will be available to your employees during this Open Enrollment. A description of the publications and projected delivery dates follow:

A revised 1999 NJ PLUS Physician and Hospital Directory will be shipped in mid to late February. Initially, you will receive ten copies of this directory. You may order additional copies of the NJ PLUS Physician and Hospital Directory using the Request for Open Enrollment Support Form at enclosure 1.

Revised SHBP Plan Comparison Summary charts will be mailed to you by the end of February. You will be supplied sufficient copies for all of your SHBP participating employees.

A special Open Enrollment issue of the Health Capsule will be provided to you in the same shipment with the plan comparison chart mentioned above for distribution to your employees. This newsletter will provide information of practical use to your employees about the SHBP and Open Enrollment. It will include updates on any health plan name, service area, and benefit changes. It will also include important information about the federal HIPAA regulations.

The Division of Pensions and Benefits is available to support your Open Enrollment program. If you are having a health fair for your employees, a representative from Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) or the Division of Pensions and Benefits, on behalf of the SHBP, can attend and answer questions regarding the Traditional Plan, NJ PLUS and the HMOs.

If you wish to schedule educational presentations for your employees about the various plans available through the SHBP, that request can also be accommodated. You would have to provide a suitable room and a minimum of 10-15 employees for each session. Each session will last about 50 minutes. Use the Request for Open Enrollment Support Form attached as enclosure 1 to schedule your health fair or educational seminars. This form may be mailed or faxed to the address/number listed on the form. You may also contact your assigned Horizon BCBSNJ Account Manager to schedule your request. To facilitate scheduling and maximize your chances of our fulfilling your request, please submit your request as soon as possible.

We will be conducting regional seminars for employer benefits administrators during February. The seminars will provide an update on SHBP plan changes that have recently occurred, and an explanation of the new rates effective July 1999. A registration form listing seminar dates is attached as enclosure 2. Directions to the seminar sites are provided as enclosures 3a through 3e.

A 1999 SHBP Open Enrollment Milestone Chart that lists key events and dates is attached as enclosure 4. Separate this enclosure and use it to monitor the tasks you must accomplish and the receipt of materials we have promised in this letter.

If you have any questions about the Open Enrollment or the information in this letter, please call the Division of Pensions and Benefits' Employer Hotline at (609) 777-1082 and leave a message. A staff member will return your call on the next work day.

Enclosures

1 Request for Open Enrollment Support Form
2 SHBP Employer Informational Seminar Registration Form
3 Directions to Regional Seminars (3a through 3e)
4 1999 SHBP Open Enrollment Milestone Chart
5 Unified Provider Directory Flier


(Enclosure 1)

REQUEST FOR OPEN ENROLLMENT SUPPORT

EMPLOYER NAME __________________________________

EMPLOYER POINT OF CONTACT ______________________
(Name)

TELEPHONE NUMBERS ____________________ __________
(Voice), (Fax)

ADDRESS (PHYSICAL LOCATION)______________________

____________________________________________

                `                                                                                                                                                                                                                                                                                                       
HEALTH BENEFITS FAIR ____________        ________________
                                                          (Date)                  (Time: From - To)                                                                                               

HEALTH BENEFITS EDUCATIONAL SEMINARS

 ____________       _______________    ________
   (Date)                                (Times)               (Estimated # of Participants)
                                                                                                                                       
NJ PLUS PHYSICIAN AND HOSPITAL DIRECTORY   ___________ COPIES

DIRECTIONS TO YOUR LOCATION (FROM NEWARK)

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

DIRECTIONS TO YOUR LOCATION (FROM TRENTON)____________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

Send request to:
						  Kim Bruno
                        State Health Benefits Program
                        c/o Horizon Blue Cross Blue Shield of New Jersey
                        3 Penn Plaza East  PP-03C
                        Newark, NJ 07105-2200 
                        or fax to (973) 466-5326.

Call 1-973-466-6666, the 1999 SHBP Open Enrollment Hotline, if
you have questions about this request.
  


(Enclosure 2)

SHBP EMPLOYER INFORMATIONAL SEMINAR REGISTRATION

EMPLOYER NAME _______________________________________

EMPLOYER POINT OF CONTACT ___________________________
                `                       (Name)
                                                           
TELEPHONE NUMBERS _____________     _________________
                        									(Voice)                 (Fax)
                                                             
ADDRESS ____________________________________________

_____________________________________________________


REQUESTED SEMINAR (Please indicate the number of people attending
the seminar on the line next to the requested seminar date):

SITE: Horizon BCBSNJ, 3 Penn Plaza East, Newark

DATE:  February 9  10:00 a.m. to 12:00 p.m. (Go to Lobby for
directions)

SITE: Division of Pensions and Benefits, 50 W. State Street, Trenton

DATE: February 16  10:00 a.m. to 12:00 p.m. (Go to 3rd Floor
Reception Area)

DATE: February 16  1:00 p.m. to 3:00 p.m. (Go to 3rd Floor
Reception Area)

SITE: Horizon BCBSNJ, 3501 Route 66, Neptune

DATE: February 18  10:00 a.m. to 12:00 p.m. (Go to Security
Building)

SITE: Gloucester County Regional Training Center, 1492 Tanyard
Road, Sewell

DATE: February 22  10:00 a.m. to 12:00 p.m. (Rodgers Room)

SITE: Morris County Fire and Police Academy, 500 W. Hanover Ave,
Parsippany

DATE: February 25  10:00 a.m. to 12:00 p.m. (Room 135)

DATE: February 25  1:00 p.m. to 3:00 p.m. (Room 135)


Send request to:
				         Kim Bruno
                        State Health Benefits Program
                        c/o Horizon Blue Cross Blue Shield of New Jersey
                        3 Penn Plaza East  PP-03C
                        Newark, NJ 07105-2200 
                        or fax to (973) 466-5326.

Call 1-973-466-6666, the 1999 SHBP Open Enrollment Hotline, if
you have questions about this request.
  

(Enclosure 3)


(Enclosure 4)

1999 SHBP Open Enrollment Milestone Chart for Participating Local Employers

Note: If the event is underlined, you should be accomplishing the event.

DATE EVENT
JAN 20 Initial Open Enrollment Letter mailed to employers.
FEB 8 FY 99 Rate charts sent to employers. Disseminate rate information to employees as necessary.
FEB 12 Request for Open Enrollment Support form should be submitted if you wish additional copies of the 1999 NJ PLUS Physician and Hospital Directory, or SHBP support for your Health Fair/educational seminars.
FEB 16 Ten copies of the 1999 NJ PLUS Provider Physician and Hospital Directory shipped to employers.
FEB 9-25 Regional Employer Benefit Administrator seminars conducted by the SHBP.
FEB 26 SHBP Plan Comparison Summary chart and the Health Capsule shipped to employers. Distribute to employees.
MARCH 1 Open Enrollment Begins.
MARCH 1-26 Health Fairs and Educational Seminars conducted (optional).
MARCH 31 Open Enrollment Ends.
APRIL 9 Employer certified applications due at Health Benefits Bureau.
JULY 1 Open Enrollment changes effective


(Enclosure 5)


February 8, 1999

 

TO: State Biweekly Payroll Benefits Administrators
FROM: Florence J. Sheppard
Chief, Health Benefits Bureau
SUBJECT: Special Open Enrollment for Employees Enrolled in HIP Health Plan of NJ

HIP Health Plan of New Jersey is being dissolved effective the close of business of March 31, 1999. Therefore, a Special Open Enrollment for employees enrolled in HIP will begin immediately. Properly completed New Jersey State Health Benefits Program applications, certified by the employer, must be at the Health Benefits Bureau no later than March 5, 1999 to ensure enrollment in the new health plan by the date HIP coverage ends. The effective date of plan changes made during the Special Open Enrollment will be based on the date of receipt of the applications at the Division. Applications received by February 19 will be effective on March 13. Applications received by March 5 will effective on March 27, 1999. Applications received after March 5, 1999 will still be processed, however, since HIP will be dissolved on March 31, 1999, a late plan change may result in a delay in new coverage.

If our records reflect coverage in HIP by any employees in your payroll location, a list of those employees is attached. Special Open Enrollment Applications should not be held until the end of the Open Enrollment, but should be submitted as received with the attached cover sheet. They should not be mixed with applications for the 1999 Open Enrollment, new employees, or regular coverage changes.

The Special Open Enrollment will follow normal Open Enrollment rules. That is, eligible employees may add dependents in addition to changing plans. The Special Open Enrollment is restricted, however, to medical plans only. Information provided for the 1998 Annual Open Enrollment is still valid for this Special Open Enrollment. Employees who wish to see if their current physician participates in other SHBP managed care plans should check the Unified Provider Directory at the following address on the Internet:

http://www.state.nj.us/treasury/pensions/shbp.htm

An employee who changes plans during this Special HIP Open Enrollment may also participate in the regular 1999 Open Enrollment.

Please do not allow new employees to enroll in HIP Health Plan of NJ. If a new employee has recently elected HIP and the coverage has not yet started, contact us to arrange replacement coverage.

If you have any questions, please contact Client Services at (609) 292-7524.

attachments


February 8, 1999

FROM: Florence J. Sheppard
Chief, Health Benefits Bureau
SUBJECT: Special Open Enrollment for Employees Enrolled in HIP Health Plan of NJ

HIP Health Plan of New Jersey is being dissolved effective the close of business on March 31, 1999. Therefore, a Special Open Enrollment for employees enrolled in HIP will begin immediately. Properly completed New Jersey State Health Benefits Program applications, certified by the employer, must be at the Health Benefits Bureau no later than March 15, 1999 to ensure enrollment in the new health plan by April 1, 1999 when HIP coverage ends. Applications received after March 15, 1999 will still be processed, however, since HIP will be dissolved on March 31, 1999, a late plan change may result in a delay in new coverage.

If our records reflect coverage in HIP by any of your employees, a list of those employees is attached. Special Open Enrollment Applications should not be held until the end of the Open Enrollment, but should be submitted as received with the attached cover sheet. They should not be mixed with applications for the 1999 Open Enrollment, new employees, or regular coverage changes.

The Special Open Enrollment will follow normal Open Enrollment rules. That is, eligible employees may add dependents in addition to changing plans. The Special Open Enrollment is restricted, however, to medical plans only. Information provided for the 1998 Annual Open Enrollment is still valid for this Special Open Enrollment. Employees who wish to see if their current physician participates in other SHBP managed care plans should check the Unified Provider Directory at the following address on the Internet:

http://www.state.nj.us/treasury/pensions/shbp.htm

An employee who changes plans during this Special Open Enrollment may also participate in the regular 1999 Open Enrollment.

Please do not allow new employees to enroll in HIP Health Plan of NJ. If a new employee has recently elected HIP and the coverage has not yet started, contact us to arrange replacement coverage.

If you have any questions, please contact Client Services at (609) 292-7524.

attachments


SPECIAL HIP OPEN ENROLLMENT TRANSMITTAL
TO: Division of Pensions and Benefits
Health Benefits Bureau
Attn: Active Enrollment Section
P.O. Box 299
Trenton, NJ 08625-0299

Attached are ______ State Health Benefits Program Enrollment Applications for employees currently enrolled in HIP Health Plan of New Jersey who are changing coverage to another medical plan.

_________________________   __________________________
  (Name of Employer)                      (SHBP Location or Payroll Number)


_________________________    __________________________
  (Name of Benefits Administrator)                           


URL: http://www.state.nj.us/treasury/pensions/coletter.htm

NJ Division of Pensions and Benefits
PO Box 295, Trenton NJ 08625-0295
Telephone: (609) 292-7524

Questions or comments, e-mail Division of Pensions and Benefits


February 19, 1999

 

To:

State Health Benefits Program Participating Local Employers

From:

Janice F. Nelson
Assistant Director for Health Benefits

Subject:

SHBP 1999 Open Enrollment

Enclosed you will find approved rates and plan information that will assist your employees in making informed decisions concerning their health care coverage during the 1999 Open Enrollment.

In addition to benefit changes to the health plans offered by the SHBP since the last Open Enrollment, there have been changes to some of the plan names, service coverage areas, and general contact information. The following list provides important changes since the last plan year.

In addition, there have been the following changes to the State Prescription Drug Program for the July 1999 plan year:


February 23, 1999

TO:

Certifying Officers
Public Employees Retirement System

FROM:

Margaret M. McMahon
Director

SUBJECT:

Enrollment Eligibility of Professors and Instructors Employed on a Temporary, Provisional or Adjunct Basis by Public Institutions of Higher Education

The Public Employees Retirement System (PERS) Board of Trustees recently adopted N.J.A.C. 17:2-2.6. This rule clarifies the eligibility requirements for enrollment into the PERS of professors and instructors employed on a temporary, provisional or adjunct basis at public institutions of higher education. In accordance with the rule, a professor or instructor not employed in a regularly appointed teaching or administrative staff position, civil service position, or regularly budgeted positions will be eligible for enrollment in PERS if (s)he

A professor or instructor who teaches courses which provide no academic credit and vary in length from the normal school term will not be eligible for enrollment, or service and salary credit on the basis of those courses.

Employees meeting the criteria for enrollment should be enrolled in the PERS. Employees not meeting the criteria for enrollment should not be enrolled in the PERS. Contributions that may have been made from employees not eligible for membership based upon this rule should discontinue as of April 1, 1999. Any contributions made and service earned will not be taken away for those already credited for such service. If PERS membership becomes inactive because of the application of this rule, the membership of those with less than ten years of service credit will expire in two years in accordance with system rules, unless the member obtains employment that meets eligibility requirements.

If you have any questions, please call Client Services at (609) 292-7524.


March 3, 1999

TO: State Monthly Human Resource Directors/Benefits Administrators
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: SHBP 1999 OPEN ENROLLMENT

 

The State Health Benefits Program (SHBP) Open Enrollment period for State monthly employees will begin on April 1, 1999, and end on April 30, 1999. Completed employer-certified health benefits and/or dental applications must arrive at the Health Benefits Bureau no later than May 5, 1999. Open enrollment applications should not be sent with other applications submitted at the same time. Also, a member's medical and dental applications should be sent together to facilitate processing. All changes to coverage made during this Open Enrollment period will be effective on July 1, 1999.

Enclosed you will find rates and plan information that will help you assist your employees in making informed decisions concerning their health care coverage during the 1999 Open Enrollment.

In addition to benefit changes to the health plans offered by the SHBP since the last Open Enrollment, there have been changes to some of the plan names, service coverage areas, and general contact information. The following list provides important changes since the last plan year.

The following changes have been made to the State Prescription Drug Program for the plan year beginning July 1999.

The new SHBP rates for State employer groups, effective July 1, 1999, are enclosed. The rate changes, reflected in the summary chart below, compare favorably nationwide. Increases of similar type plans industry wide range from 1% to 4% higher than our SHBP increases.

During the first week of March, you will receive your initial ten copies of the NJ PLUS Physician and Hospital Directory. You may order more directories using the enclosed Request for Open Enrollment Support form. Participating provider information for all SHBP plans is available in the Unified Provider Directory through our SHBP homepage at: http://www.state.nj.us/treasury/pensions/shbp.htm

Sufficient copies of the SHBP Plan Comparison Summary chart and the Open Enrollment issue of the Health Capsule newsletter, will be shipped to your location approximately March 15. Please distribute these informative publications to all participating SHBP members. State employees paid through the State's Centralized Payroll Unit will receive these publications with their March 19 pay checks. An Open Enrollment announcement flyer providing a list of medical and dental plans and their costs has been prepared and enclosed. This generic flyer for State employees not paid through Centralized Payroll is a master copy and may be reproduced to meet your needs. In addition, if we provided you with a tailored flyer for your location last year, we have included a copy for your reference - Do not use this flyer. At your request, we will again tailor this flyer for 1999 Open Enrollment. Contact Kathy Coates, no later than March 19, by telephone at (609) 633-1462, or Fax (609) 633-9590, with the information you require on your flyer, e.g. date of first deduction, number of pay periods over which the deductions are taken, when and to whom applications must be submitted. We will provide you with a customized master copy for you to reproduce.

The Division of Pensions and Benefits is available to support your Open Enrollment program. If you are having a health fair for your employees, a representative from Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), on behalf of the SHBP, or from the Division of Pensions and Benefits, can attend and answer questions regarding the Traditional Plan, NJ PLUS, and the HMOs. Lists of all the SHBP medical and dental plans with their service areas and telephone numbers are enclosed for your use in identifying and contacting HMOs and DPOs to attend your health fair. If you wish to schedule educational presentations for your employees about the various plans available through the SHBP, that request can also be accommodated. You must provide a suitable room and a minimum of 10-15 employees for each session. Each session will last about 50 minutes. Use the enclosed Request for Open Enrollment Support form to schedule your health fair or educational seminars. This form may be mailed or faxed to the address/number listed on the form. You may also contact your assigned Horizon BCBSNJ Account Manager to schedule your request. To facilitate scheduling and maximize your chances of having your request fulfilled, please submit your request as soon as possible.

We will be conducting seminars for benefits administrators on March 16 in Trenton (State Police Museum - West Trenton) and on March 18 in Newark (Horizon BCBSNJ Auditorium). The seminars will provide an update on the new rates for premium sharing effective July 1, 1999, and SHBP medical and dental plan changes that have occurred since the last open enrollment. A registration form listing seminar dates is attached. Directions to the seminar sites are enclosed.

A 1999 SHBP Open Enrollment Milestone Chart that lists key events and dates is attached. Use this chart to monitor the tasks you must accomplish and the receipt of the materials we have promised in this letter.

If you have any questions about the Open Enrollment or the information in this letter, please contact our Client Services staff at (609) 292-7524, or call our Employer Hotline at (609) 777-1082 and leave a message. A staff member will return your call on the next business day.

Enclosures:

1999 SHBP OPEN ENROLLMENT MILESTONE CHART

Note: If the event is underlined, you should be accomplishing the event.
DATE EVENT
MARCH 3 Initial Open Enrollment Letter mailed to State employers. Rate charts effective July 1999 included.
MARCH 5 Ten sample copies of NJ PLUS Physician and Hospital Directory shipped to employers.
MARCH 15 Request for Open Enrollment Support should be submitted if you wish additional copies of the NJ PLUS Physician and Hospital Directory or SHBP support for your Health Benefits Fair/educational seminars.
MARCH 15 A supply of the Health Capsule and SHBP Plan Comparison Summary chart mailed to monthly employers to be distributed to all SHBP employees.
MARCH 16 Benefits administrator seminars conducted by the SHBP in West Trenton.
MARCH 18 Benefits administrator seminars conducted by the SHBP in Newark.
APRIL 1 Open Enrollment begins.
APRIL 1-30 Health Fairs and Educational Seminars conducted (optional).
APRIL 30 Open Enrollment ends.
MAY 5 Employer-certified applications due at Health Benefits Bureau.
JULY 1 Open Enrollment changes effective.


NEW JERSEY STATE HEALTH BENEFITS PROGRAM MEDICAL PLANS

For Dental Program Plans

NAME                                                                                 PLAN/HMO#       		                        PHONE 	                         SERVICE AREA*
                                                            
NJ PLUS                                                                             001                                    800-414-7427    In-Network: All of New Jersey & Delaware, 
     Administered by Horizon Blue Cross                                                                                             Parts of New York & Pennsylvania
     Blue Shield of New Jersey                                                                                                                Out of Network: Unrestricted
Traditional Plan                                                                          002                                              800-414-7427     Unrestricted
        Administered by Horizon Blue Cross 
        Blue Shield of New Jersey

HEALTH MAINTENANCE ORGANIZATIONS
Horizon HMO                                                                             010                                              800-355-2583    All of New Jersey & Bucks County,Pennsylvania 
Prudential HealthCare HMO                                                    017                                              800-422-7399    All of New Jersey
Aetna/US Healthcare                                                                019                                              800-309-2386    All of New Jersey, Washington DC & Connecticut; Parts of New York, Pennsylvania,Maryland,Virginia,Illinois & Delaware
CIGNA HealthCare                                                                    020                                              800-832-3211    All of New Jersey, Pennsylvania, New York, Connecticut &    Delaware
Oxford Health Plan                                                                     028                                              800-444-6222    All of New Jersey, Parts of New York
AmeriHealth HMO Plan                                                            033                                              800-454-7651    All of New Jersey & Delaware, Parts of Pennsylvania
Physicians Health Services                                                      034                                              800-535-3647    All of New Jersey & Connecticut, Parts of New York
University Health Plans, Inc.                                                   036                                              800-564-6847    All of New Jersey

*For specific HMO service areas, see the HMO Zip Code Listing available from your benefits administrator, or contact the HMO directly.

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

NEW JERSEY STATE DENTAL PROGRAM PLANS

DPO #      NAME                                                           PHONE #              SERVING*
301     Atlantic Southern Dental Foundation         800-843-4727        All of New Jersey, Eastern Pennsylvania
302     Community Dental Associates                 609-451-8844        Cumberland County
305     CIGNA Dental Health Inc.                    800-367-1037        All of New Jersey, Eastern Pennsylvania, Parts of New York
306     Group Dental Health Administrators, Inc.    908-241-9700        Mercer, Union, Middlesex and Essex Counties
307     International Health Care Services          800-468-0600        All of New Jersey, Bucks County and Philadelphia
308     Oracare DPO, Inc.                           800-672-2273        All of New Jersey, Eastern Pennsylvania
311     Unity Dental Health Services, PA            800-648-0146        All of New Jersey
312     Flagship Health Systems, Inc.               800-722-3524        All of New Jersey
315     Statewide DPO, Inc.                         800-839-8910        All of New Jersey
317     Horizon Dental Choice                       800-433-6825        All of New Jersey
319     Prudential Healthcare DMO                   800-843-3661        All of New Jersey, Eastern Pennsylvania
399     Dental Expense Plan                         800-282-0555        Unrestricted
          Administered by Prudential                 
*For specific areas of service, contact the DPO.

NEW JERSEY STATE HEALTH BENEFITS PROGRAM MEDICAL PLANS
HEALTH FAIR CONTACTS

                          PLAN        PHONE
              NAME             HMO#      NUMBER        CONTACT
NJ PLUS                         001       973-466-6666     Kim Bruno
  Administered by Horizon Blue Cross
   Blue Shield of New Jersey
Traditional Plan                002       973-466-6666     Kim Bruno
  Administered by Horizon Blue Cross
   Blue Shield of New Jersey
HEALTH MAINTENANCE ORGANIZATIONS
Horizon HMO                     010      973-466-6666      Kim Bruno
Prudential HealthCare HMO       017       215-442-2933     Crystal Mahmde
Aetna/US Healthcare             019       215-775-6035     Ellen Thomas
CIGNA HealthCare                020       973-660-4029     Ginny Fowler
Oxford Health Plan              028       732-767-4937     Janet Green
AmeriHealth HMO Plan            033       609-778-6505     Lisa Schneider
Physcians Health Services       034       732-918-6436     Mary Ellen Stoddard
University Health               036       973-623-8700     Frank Alkin
   Plans, Inc.

NEW JERSEY DENTAL PROGRAM

MONTHLY GROUP RATES EFFECTIVE 7/1/99

DPO STATE MONTHLY GROUP (SAME RATES FOR ALL PARTICIPATING DPOs)

  DPO UNIT #    DPO CARRIER 
        301     ATLANTIC SOUTHERN DENTAL FOUNDATION     
        302     COMMUNITY DENTAL ASSOCIATES
        305     CIGNA DENTAL HEALTH, INC.
        306     GROUP DENTAL HEALTH ADMINISTRATORS, INC.
        307     INTERNATIONAL HEALTH CARE SERVICES      
        308     ORACARE DPO, INC.       
        311     UNITY DENTAL HEALTH SERVICES    
        312     FLAGSHIP HEALTH SYSTEMS, INC.   
        315     STATEWIDE DPO, INC.     
        317     HORIZON DENTAL CHOICE   
        319     PRUDENTIAL HEALTHCARE DMO
        

DESCRIPTION     EMPLOYER      EMPLOYEE
OF COVERAGE     SHARE         SHARE           TOTAL 
SINGLE          $ 8.47        $ 8.46          $16.93
MEMBER & SPOUSE     $14.72        $14.71          $29.43
FAMILY          $24.08        $24.07          $48.15
PARENT & CHILD  $17.84            $17.84          $35.68


DENTAL EXPENSE PLAN (PRUDENTIAL #399) STATE MONTHLY GROUP

DESCRIPTION     EMPLOYER      EMPLOYEE 
OF COVERAGE     SHARE          SHARE           TOTAL        
SINGLE          $16.03         $16.03          $32.06
MEMBER & SPOUSE     $24.71         $24.71          $49.42
FAMILY          $40.99         $40.99          $81.98
PARENT & CHILD      $32.29         $32.29          $64.58           


March 3, 1999

TO: State Department Human Resource Directors
State Biweekly Benefits Administrators
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: SHBP 1999 OPEN ENROLLMENT

 

The State Health Benefits Program (SHBP) Open Enrollment period for State biweekly employees will begin on April 1, 1999, and end on April 30, 1999. Completed employer-certified health benefits and/or dental applications must arrive at the Health Benefits Bureau no later than May 5, 1999. Open enrollment applications should not be sent with other applications submitted at the same time. Also, a member's medical and dental applications should be sent together to facilitate processing. All changes to coverage made during this Open Enrollment period will be effective on July 3, 1999 with any required deductions taken beginning with pay period 14 (pay check of June 25, 1999).

Enclosed you will find rates and plan information that will help you assist your employees in making informed decisions concerning their health care coverage during the 1999 Open Enrollment.

In addition to benefit changes to the health plans offered by the SHBP since the last Open Enrollment, there have been changes to some of the plan names, service coverage areas, and general contact information. The following list provides important changes since the last plan year.

The following changes have been made to the State Prescription Drug Program for the plan year beginning July 1999.

In addition, the following change to the State Dental Program is effective for the plan year beginning July 1999.

The new SHBP rates for State employer groups, effective July 3, 1999, are enclosed. The rate changes, reflected in the summary chart below, compare favorably nationwide. Increases of similar type plans industry wide range from 1% to 4% higher than our SHBP increases.

During the first week of March, you will receive your initial ten copies of the NJ PLUS Physician and Hospital Directory. You may order more directories using the enclosed Request for Open Enrollment Support form. Participating provider information for all SHBP plans is available in the Unified Provider Directory through out SHBP homepage at: http://www.state.nj.us/treasury/pensions/shbp.htm

A copy of the SHBP Plan Comparison Summary chart, the special Open Enrollment issue of the Health Capsule newsletter, and an Open Enrollment announcement flyer providing a list of medical and dental plans and their costs will be distributed with the March 19 pay checks to all State employees paid through Centralized Payroll.

The Division of Pensions and Benefits is available to support your Open Enrollment program. If you are having a health fair for your employees, a representative from Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), on behalf of the SHBP, or from the Division of Pensions and Benefits can attend and answer questions regarding the Traditional Plan, NJ PLUS, and the HMOs. Lists of all the SHBP medical and dental plans with their service areas and telephone numbers are enclosed for your use in identifying and contacting HMOs and DPOs to attend your health fair.

If you wish to schedule educational presentations for your employees about the various plans available through the SHBP, that request can also be accommodated. You must provide a suitable room and a minimum of 10-15 employees for each session. Each session will last about 50 minutes. Use the enclosed Request for Open Enrollment Support form to schedule your health fair or educational seminars. This form may be mailed or faxed to the address/number listed on the form. You may also contact your assigned Horizon BCBSNJ Account Manager to schedule your request. To facilitate scheduling and maximize your chances of having your request fulfilled, please submit your request as soon as possible.

We will be conducting seminars for benefits administrators on March 16 in Trenton (State Police Museum - West Trenton) and on March 18 in Newark (Horizon BCBSNJ Auditorium). The seminars will provide an update on the new rates for premium sharing effective July 3, 1999, and SHBP medical and dental plan changes that have occurred since the last open enrollment. A registration form listing seminar dates is attached. Directions to the seminar sites are enclosed. A 1999 SHBP Open Enrollment Milestone Chart that lists key events and dates is attached. Use this chart to monitor the tasks you must accomplish and the receipt of the materials we have promised in this letter.

If you have any questions about the Open Enrollment or the information in this letter, please contact our Client Services staff at (609) 292-7524, or call our Employer Hotline at (609) 777-1082 and leave a message. A staff member will return your call on the next business day.

Enclosures:


1999 SHBP OPEN ENROLLMENT MILESTONE CHART

Note: If the event is underlined, you should be accomplishing the event.

DATE                            EVENT

MARCH 3          Initial Open Enrollment Letter mailed to State employers.
                Rate charts effective July 1999 included.

MARCH 5         Ten sample copies of NJ PLUS Physician and Hospital Directory shipped to employers.

MARCH 15        Request for Open Enrollment Support should be submitted if you wish additional copies of the NJ PLUS Physician and Hospital Directory or SHBP support for your Health Benefits Fair/educational seminars.

MARCH 16        Benefits administrator seminars conducted by the SHBP in West Trenton.

MARCH 18        Benefits administrator seminars conducted by the SHBP in Newark.

MARCH 19        A copy of the Health Capsule, SHBP Plan Comparison Summary, and the Open Enrollment flyer with medical and dental charts included in pay checks through centralized payroll.

APRIL 1          Open Enrollment begins.

APRIL 1-30       Health Fairs and Educational Seminars conducted (optional).

APRIL 30         Open Enrollment ends.

MAY 5            Employer-certified applications due at Health Benefits Bureau.

JULY 3           Open Enrollment changes effective.


DEPARTMENT OF THE TREASURY - DIVISION OF PENSIONS AND BENEFITS
NEW JERSEY STATE DENTAL PROGRAM
BIWEEKLY GROUP RATES EFFECTIVE 7/3/99
        
DPO STATE BIWEEKLY GROUP (SAME RATES FOR ALL PARTICIPATING DPOs)

  DPO UNIT #    DPO CARRIER     
        301     ATLANTIC SOUTHERN DENTAL FOUNDATION     
        302     COMMUNITY DENTAL ASSOCIATES
        305     CIGNA DENTAL HEALTH, INC.
        306     GROUP DENTAL HEALTH ADMINISTRATORS, INC.        
        307     INTERNATIONAL HEALTH CARE SERVICES      
        308     ORACARE DPO, INC.       
        311     UNITY DENTAL HEALTH SERVICES    
        312     FLAGSHIP HEALTH SYSTEMS, INC.   
        315     STATEWIDE DPO, INC.     
        317     HORIZON DENTAL CHOICE   
        319     PRUDENTIAL HEALTHCARE DMO
        

DESCRIPTION                        EMPLOYER        EMPLOYEE
OF COVERAGE     SHARE                SHARE          TOTAL       
SINGLE           $3.90             $3.89            $7.79
MEMBER & SPOUSE      $6.78             $6.77            $13.55
FAMILY           $11.08            $11.08           $22.16
PARENT & CHILD       $8.21             $8.21            $16.42


DENTAL EXPENSE PLAN (PRUDENTIAL #399) STATE BIWEEKLY GROUP

DESCRIPTION                        EMPLOYER        EMPLOYEE 
OF COVERAGE       SHARE              SHARE           TOTAL      
SINGLE           $ 7.38            $ 7.38           $14.76
MEMBER & SPOUSE      $11.38            $11.37           $22.75
FAMILY           $18.87            $18.87           $37.74
PARENT & CHILD       $14.87            $14.86           $29.73      

March 15, 1999

TO: Certifying Officers
FROM: John D. Megariotis
Assistant Director, Finance
SUBJECT: Reporting Salary for Part-time Hourly Employees in PERS

 

The Division of Pensions and Benefits is considering changing a rule concerning the reporting of salary for part-time hourly employees enrolled in the Public Employees' Retirement System (PERS) and would like to get your input on whether you would like to see this rule changed. The Division has received comments from many employers and employees on this subject. Employers are concerned about problems with estimating the annual salary and employees have complained about not having their benefit calculated on actual salary. Please complete the enclosed survey on this issue and return it to our office by March 31, 1999. You may return the survey by mail or fax it to us at (609) 396-9784.

Currently, employers are asked to estimate the annual salary that a part-time hourly employee will receive, divide that into even monthly amounts, and report that salary on each quarterly report. The advantage to this method is that the salary and pension deductions remain constant from month to month, thereby requiring no changes to the quarterly report of salary and contributions when the employee's hours vary.

The proposed change to this rule would require employers to report the actual base salary paid to the employee. This would eliminate the guesswork of estimating the hours of work and annual salary while simplifying payroll procedures since deductions would be based on actual salary. It would also eliminate any requirement to manage the hours worked in any given quarter to approximate the estimate. At the same time, however, it would require the employer to adjust the quarterly report each time to reflect the change in salary, pension contribution and contributory life insurance contribution since the last quarter. Benefits would be calculated on actual salary paid, as many employees have requested, rather than estimated salary.

Please note that this change would affect part-time hourly employees only. All other employees would continue to be reported as they have in the past. If you have any questions regarding the survey, please contact the Division's Audit/Billing Section at (609) 984-4808.

enclosure


TO: Benefits Managers, SHBP Participating Local Employers Benefits Managers, SHBP Participating Educational Employers

FROM: Janice Nelson, Assistant Director, State Health Benefits Program

DATE: April 15, 1999

SUBJECT: Legislation Change: SHBP Participating Employer Payment of Post-Retirement Medical Costs

Governor Whitman recently signed into law, Chapter 48, P.L. 1999. This law changes the rules of the State Health Benefits Program (SHBP) regarding a participating employer's payment of medical coverage for its retirees. Chapter 48 provides considerable flexibility to employers to manage their post-retirement medical costs and brings SHBP eligibility standards for employer paid coverage into alignment with local government laws. The new law essentially does the following:

The attached set of Questions and Answers (Qs & As) describe the new law and its impact on SHBP rules regarding employer payment of post-retirement medical coverage. The Chapter 48 Resolution form, required by the law and described in the Qs & As, is available upon request.

If you have any questions after reading the Qs & As, you may write us at the address above, Email us at "pensions.nj@treas.state.nj.us", or call the SHBP Employer Hotline at (609) 777-1082. Leave your name, location, telephone number, and question and a staff member will get back to you.

attachment

Chapter 48, P.L. 1999 Questions and Answers

General

 

 

The New Rules

Eligibility

 

Contributions - Payment for Coverage

 

Employees Not Covered By Bargaining Agreements

 

Chapter 48's Relationship to Chapter 88

 

15. Q - Can a Chapter 88 employer change its payment arrangement for retirees under the provisions of this law?

A - Yes, by filing a Chapter 48 Resolution with the SHBP. The changes will apply only to future retirees not already qualified under Chapter 88 when the new resolution takes effect.

16. Q - If a Chapter 88 employer changes its payment arrangement for future retirees, who is "grandfathered" under the law?

A - Retirees currently covered by the Chapter 88 employer and any active employee with 25 years of service as of the effective date of the Chapter 48 Resolution are "grandfathered" under the law. That is, regardless of when these employees retire, the employer must pay the full costs of their retired coverage, including the Part B Medicare premium, as was required under Chapter 88.

17. Q - Will an employer that withdrew from the SHBP, after its adoption of Chapter 88, be bound by the provisions of Chapter 88 if it elects to reenter the SHBP?

A - The employer will have to notify the SHBP of its post retirement medical payment obligations when it enrolls by filing a Chapter 48 resolution.

Administration

Adopting Chapter 48, P.L. 1999

Other


April 1999

The section of the New Jersey Administrative Code (NJAC 17:1-4.39) addressing the obligation of employers to remit pension contributions on behalf of employees with a workers' compensation award was recently amended. The revised rule clarifies the employer's responsibilities in this area. This memorandum explains those responsibilities.

There is a distinction drawn between temporary and permanent disability benefits paid by workers' compensation. The employer is always responsible for payment of the employee's pension contributions when the employee is receiving temporary disability benefits under workers' compensation without pay. The contribution is based on the salary the employee was receiving immediately before the receipt of workers' compensation benefits.

When an employee's award of permanent disability benefits under workers' compensation begins, the employer is responsible to continue to pay the employee's pension contributions if the following two conditions exist:

Important Note: the employee will have to file for a disability retirement and meet the total and permanent disability criteria of the retirement system before he/she can receive a retirement allowance based on a disability retirement. Being in receipt of a workers' compensation award does not guarantee qualification for a disability retirement.


The employer would not be responsible for remitting employee pension contributions for an employee with a permanent disability workers' compensation award if any of the following conditions exist:

If the employer ceases remitting contributions because the employee has voluntarily resigned from employment or the employee was terminated for reasons unrelated to the workers' compensation award, the employer must notify the Division of Pensions and Benefits by correcting the quarterly Report of Contributions. In accordance with normal policy, if the correction covers prior period adjustments, a detailed letter should be sent to the Audit/Billing Section. In either event, you should attach appropriate supporting documentation, such as the workers' compensation award, letter of resignation, and/or termination agreement.

On a separate, but related subject, employee contributions are required to keep PERS Contributory Group Life Insurance (GLI) in effect while the employer is responsible for paying the employee's pension contribution for the member receiving periodic workers' compensation benefits. The employer is responsible for notifying the employee that these GLI contributions must be remitted, in advance, directly to the pension fund. The employer may, at its discretion, make arrangements to collect contributory GLI premiums from the employee and remit and report them in the normal manner. Failure to make these payments will result in the termination of the contributory GLI.

If you have questions regarding the employer's responsibility for a member's pension contributions while on workers' compensation, please contact the Audit/Billing Section at (609) 777-0888.

 


May 14, 1999

The Telecommunications Unit of the Division of Pensions and Benefits will be closed on Friday, May 21st. Over the past few months we have been working with Lucent Technology to develop a telephone system that better meets the needs of our membership. The implementation of this system will occur after business on Thursday, May 20th. We will be testing the system to ensure that it is up and running for normal business on Monday, May 24th.

The Automated Information System at (609) 292-7524 will still be operational on Friday. You will be able to obtain member account and loan information for your employees as normal. We are providing a telephone number to be used in the event of an emergency (such as reporting a death of a member). The telephone number is (609) 292-9816. Non-emergencies should be deferred until Monday, May 24th or you may e-mail us at: Pensions.nj@treas.state.nj.us

The conversion to the new telephone system will be phased in over several weeks. A description of the new system is attached for your information. Information brochures you can provide to your employees on how to use the system to the best advantage will be provided in the near future.

attachment

New Telephone System at the Division of Pensions and Benefits

The Division of Pensions and Benefits receives thousands of telephone calls every day. The only feasible way to handle these calls is through the use of automated telephone systems so the Division established a Client Services call center several years ago. This call center includes an Automatic Call Distribution (ACD) system, a Voice Response Unit (VRU) (our Automatic Information System), and the Benefits Information Library (BIL). These systems have allowed the Division to receive and process an extraordinarily large number of calls every year. However, they are old and have reached the limit of their capacity. The old BIL and the five applications on the old VRU have been very successful, but they have only a one way link with the ACD (out). The ACD has worked well but it operates on a first in first out approach with the call going to the next available agent, regardless of the needs of the customer or the skills of the agent. Additionally, the number of calls has been increasing significantly while the staff level has remained essentially steady or even been slightly reduced. As a result, busy signals are frequent and hold times are long.

A promising solution to our problem of not being able to handle client calls involves using improved technology to make the staff we have more efficient. We have been working for several months with Lucent Technologies to develop a new telephone system to meet our business needs. We will begin to implement this new system on May 20th and phase it in over several weeks. The new system will have the same three basic components, an ACD, VRU, and BIL. However, they will all be new, much improved, and fully integrated.

The new telephone system will provide the following enhanced capabilities:

These system capabilities will be phased into operation over several weeks beginning May 20th. The new ACD and BIL will be installed at this time and will operate separately from the old VRU. The new VRU will become operational around mid-June with the improved loan application and the old account information, withdrawal, purchase, and retirement estimate applications. Also in mid-June, the CTI application will be installed. Finally, towards the end of the summer, the new VRU applications (deferred compensation and SACT valuations and retired payroll information) will become available.

Pamphlets are being prepared that will assist members and employers to navigate through the new telephone system to use its capabilities in the most efficient manner.

 


We are pleased to announce that the State Health Benefits Commission has approved October 1999 as a premium holiday month for the local and educational employers of the State Health Benefits Program (SHBP). The premium holiday only applies to local and educational group employers that were actively participating in the State Health Benefits Program (SHBP) in December 1998.

The holiday applies to active employees, retirees, and COBRA participants enrolled in the Traditional Plan and NJ PLUS. The holiday applies to Traditional Plan and NJ PLUS coverage charges due on October 10th.

Local group retirees and COBRA participants who pay for their own Traditional Plan and NJ PLUS coverage will not be billed for the month of October 1999. Retirees who have the cost deducted from their pension checks will have a message on their checks explaining the premium holiday. Those retirees and COBRA participants who are sent a bill for their Traditional Plan and NJ PLUS coverage will receive a bill with no premium due for October with an explanation of the premium holiday.

If you have any questions, you may write us at the address above, Email us at "pensions.nj@treas.state.nj.us", or call the SHBP Employer Hotline at (609) 777-1082. Leave your name, employer name, telephone number, and question and a staff member will get back to you.


June 17, 1999

TO:

Certifying Officers

FROM:

William H. Kale
Assistant Director, Client Services

SUBJECT:

Exclusion from Social Security Coverage of Students

Federal and State legislation has recently been enacted to exclude from Social Security coverage services performed by certain students employed by public schools, colleges or universities. This exclusion applies to student services performed and paid after June 30, 2000. Revenue Procedure 98-16, 1998-5 I.R.B, IRC Sec(s). 3121 (attached) sets forth some generally applicable standards for determining whether or not services performed by student employees are eligible for this exclusion.

Internal Revenue Code Section 3121(b)(10) provides the exemption from FICA and Medicare taxes for students employed at the school, college or university in which they are enrolled and regularly attending classes. An individual who is at least a half-time undergraduate, graduate or professional student and who is not a career employee will qualify for the exclusion with respect to services performed at or for the institutions of higher education in which (s)he is enrolled. Services performed by a student for any other employer do not qualify for this exception. The exemption also does not apply to an otherwise eligible student not enrolled in classes during summer or breaks of more than five weeks.

This exclusion does not apply to employees who are postdoctoral students, postdoctoral fellows, medical residents or medical interns because the services performed by these employees cannot be assumed to be incidental to and for the purpose of pursuing a course of study.

Membership in the Public Employees' Retirement System (PERS) is contingent upon participation in Social Security. Therefore, students who are members of the PERS will no longer be eligible for PERS enrollment from those positions when the exclusion for student services from Social Security coverage becomes effective. Employers will be required to stop taking pension deductions as of the effective date of the exclusion and to note the reason why they stopped deductions in the remarks column of the Report of Contributions. Affected students would then have the option of either withdrawing their pension contributions if they are not actively contributing from another PERS location, or leaving their contributions in the System for up to two years before their accounts expire.

If you have any questions regarding the application of this exclusion for students at institutions of higher education, please contact John Harabedian, Tax Director at Rutgers, The State University at (732) 445-2054 (Email: jharabed@rci.rutgers.edu). Questions regarding specific issues of eligibility for this exclusion from Social Security coverage should be directed to the IRS at (202) 622-4606.

attachment


July 14, 1999

TO: Certifying Officers

FROM:

Margaret M. McMahon
Director

SUBJECT:

CHAPTER 132, P.L. 1999: Carrying Loans into Retirement

Chapter 132, P.L. 1999 provides that any member of the Public Employees' Retirement System (PERS), Teachers' Pension and Annuity Fund (TPAF), Police and Firemen's Retirement System (PFRS), State Police Retirement System (SPRS), and Judicial Retirement System (JRS) who retires with an outstanding loan may carry that loan payment into retirement. The law, effective June 25th, states that the loan deductions from the retirement benefit payments will be in the same monthly amount that was deducted from the member's compensation immediately preceding retirement until the loan, with interest, is repaid. Previously, only members retiring on a disability pension or retiring as a result of medical illness or disability could repay loans in this manner.

If the retiree dies before the loan is paid, the remaining loan balance will be paid from proceeds of any other benefits payable on the account of the retiree. These repayments will be either in the form of monthly payments due to the beneficiaries or as a lump sum payable from the pension or group life insurance.

All retirees with loan balances who have submitted their retirement application with a July 1, 1999 or later retirement date will automatically be processed to continue monthly loan payments into retirement. The Division sent these retirees a letter explaining that monthly loan deductions will be taken in lieu of total withholding of retirement checks. If they do not want the monthly loan deduction taken, they will have the option of paying the loan balance in full prior to their retirement date. All Applications for Retirement Allowance will be modified to reflect the provisions of Chapter 132 in the near future. (Until the new applications are printed, those members who wish to continue their loan payments in retirement may either check the box "Continue Payments into Retirement" on the current applications or leave that question blank).

All current retirees who are having their entire pension check withheld until their loan balance is paid will be converted, upon written request to the Division, to a monthly payment plan. Monthly deductions will begin with the first retirement check cycle following the Division's receipt of the request. Loan deductions already taken from retirement checks will be used toward reducing the balance of the loan and will not be refunded to the member.

Chapter 132 also eliminates the requirement that State Police Retirement System (SPRS) members' loan repayment schedules be calculated to result in the loan being paid by age 55. This may significantly reduce the minimum repayment amount for active SPRS members over age 50 who take a loan in the future.

If you have any questions about this subject, call Client Services at (609) 292-7524 or call the Employer Hotline at (609) 777-1082 and leave a message.


August, 1999

To:

Certifying Officer
Public Employees' Retirement System
Teachers' Pension and Annuity Fund
Police and Firemen's Retirement System

From:

John D. Megariotis
Assistant Director - Financial
Division of Pensions and Benefits

Subject: Enhancement to the Transmittal Electronic Payment System (TEPS)

The Division of Pensions and Benefits has expanded the Transmittal Electronic Payment System (TEPS) to allow employers to pay transmittal shortage statements through TEPS beginning September 1, 1999. The Division sends reporting districts statements of shortages when the due figure on the quarterly Report of Contributions does not equal the sum of the transmittal remittances applicable to that quarter.

We have modified the audio response unit (ARU) script to include the additional payment type. We have also taken this opportunity to update the system instructions and the question and answer section. The basic procedure for making your transmittal payment remains the same. The new script is on pages 7 and 8 of the enclosed telephone procedure guide. Please review this information and make special note of the following:

Transmittal shortage statement payments can only be paid through TEPS effective September 1, 1999. Please do not submit checks for transmittal shortages after that date as they will be returned.

If you have questions related to the TEPS system, please contact the TEPS Helpline at (888) 835-3345 or FAX your inquiries to the Audit/Billing Section of the Division of Pensions and Benefits at (609) 633-1708.

Thank you.


August 30, 1999

TO: State Biweekly Benefits Administrators
State University and College Benefits Administrators
Palisades Interstate Parkway Benefits Administrator
NJ Commerce and Economic Growth Commission Benefits Administrator
State Human Resource Directors
FROM: Margaret M. McMahon
Director
SUBJECT: OCTOBER OPEN ENROLLMENT FOR THE NEW JERSEY STATE EMPLOYEES TAX SAVINGS PROGRAM (Tax$ave 2000)

 

The Annual Open Enrollment for the calendar year 2000 New Jersey State Employees Tax Savings Program (Tax$ave 2000) will be conducted from October 1 through November 5, 1999. Employees of the State, state universities and colleges, Palisades Interstate Parkway Commission, and the NJ Commerce and Economic Growth Commission, who are eligible for participation in the New Jersey State Health Benefits Program, may participate in Tax$ave. Tax$ave consists of three components:

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 1999 does not carry over automatically into 2000. Employees must enroll again to participate in an FSA for calendar year 2000. Employees who do not wish to take advantage of POP in 2000 must file a Declination of Premium Option Plan (POP) for Plan Year 2000 and return it to their benefits administrator by November 5. This letter provides information on the Open Enrollment for Tax$ave 2000 and identifies the publications and support available to assist you in explaining this important benefit program to your employees.

Please do your best 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 made aware and understood the value of this beneficial tax saving program.

The enclosed Open Enrollment Milestones chart lists the critical dates of the Tax$ave 2000 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 a 90-minute Tax$ave 2000 orientation workshop in Trenton on September 22, 1999 for benefits administrators. The workshop will include the information in this letter, an overview of the three components of Tax$ave, instructions on the use of our Internet site to educate employees, and a question and answer period. 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 2000 Employer Workshop orientation flyer with reservation instructions.

We will officially announce the open enrollment to employees paid through Centralized Payroll with a September 17th paycheck message. Along with their October 1 paycheck, there will be a message on their pay stub and three payroll inserts. The inserts are:


October 4, 1999

To:

Certifying Officers
Police and Firemen's Retirement System
Public Employees' Retirement System
From: Janice F. Nelson
Assistant Director, State Health Benefits Program
Subject: Adoption of New Rule Concerning Chapter 330, P.L. 1997
(Post-retirement Health Benefits for Policemen and Firemen)

The State Health Benefits Commission adopted a new rule concerning Chapter 330, P.L. 1997 at its meeting on September 29, 1999. Chapter 330 provides health benefits under the State Health Benefits Program (SHBP) to local policemen and firemen who retire after 25 years of service (or on disability) and who do not receive any payment towards retiree health coverage from their employers. The State will pay 80% of the cost of the least expensive statewide plan offered in the SHBP and the retiree will pay the remainder.

The purpose of the rule is to clarify the eligibility requirements for participation in the program. The Division of Pensions and Benefits will be reviewing retired policemen and firemen not currently enrolled to determine their eligibility for benefits under the new Chapter 330 rule. The Division may request from you information necessary for this determination. Eligibility of retired policemen and firemen for benefits under Chapter 330 will depend on the health benefits provided by the employer for retired policemen and firemen as of the effective date of the law, July 1, 1998, as indicated in labor and other employment contracts, and ordinances and resolutions of the employers.

The purpose of Chapter 330 is to provide a "safety net" of health benefits coverage for eligible policemen and firemen who are not receiving payment for such coverage from their employers. It is not intended to alter any existing retiree health care benefits provided by employers on the effective date of the law. Since the eligibility of retirees will be based upon what their employers provided for retiree health care on the effective date of the law, a reduction in the benefits provided by employers after that date would not qualify their retirees for benefits under this law. Conversely, employers increasing health benefits coverage for retirees after the effective date will affect their eligibility for benefits.

Attached is a list of questions and answers for frequently asked and anticipated questions on Chapter 330 and this new rule. You can view the new rule on the Division's Internet Web site (http:///www.state.nj.us/treasury/pensions). If you have questions about this new rule, call Client Services at (609) 292-7524.

attachment

DIVISION OF PENSIONS AND BENEFITS

CHAPTER 330, PUBLIC LAWS OF 1997

QUESTIONS AND ANSWERS

 

September 1999

 

Chapter 330 provides health benefits to local police officers and firefighters who retire after 25 years of service (or on a disability) and who do not receive any payment towards retiree health coverage from their employers. The State will pay 80% of the cost of the least expensive statewide plan offered in the State Health Benefits Program and the retiree will pay the remainder. The Division's application of the law has changed based on the adoption of a new rule by the State Health Benefits Commission.

 

  1. Q - Why was this new rule adopted? A - Some aspects of the law were not clear and required interpretation. The new rule provides necessary clarification of who is eligible under the law.

  2.  Q - What is the basic thrust of the new rule?
    A - The new rule focuses on whether the retiree is receiving employer payment towards post-retirement medical benefits as the determining factor in eligibility for 330 coverage. Previously, the emphasis was on whether the employer was providing payment for medical benefits to any of its retirees under the provisions of contracts and ordinances in effect on July 1, 1998.


  3. Q - If an employer who offered payment for post-retirement medical coverage to retirees at the time Chapter 330 became effective (July 1, 1998), stops providing that coverage, will its retirees be eligible for Chapter 330 coverage?
    A - No. Eligibility of retirees of an employer is based on what an employer was doing for its retirees when the law became effective. The law was not intended to be an incentive for an employer to do less for its retirees. The Division will refer to contracts and Ordinances in effect on July 1, 1998 to determine retiree eligibility.


  4.  Q - What's the bottom line of the rule?
    A - Retirees, who otherwise meet the eligibility requirements under Chapter 330 and do not receive any form of payment for retiree medical coverage from their employers, will be eligible for benefits under Chapter 330.


  5.  Q - What retirees are now eligible for Chapter 330 coverage?
    A - Coverage under Chapter 330 is available to qualified current and future retirees of the Police and Firemen's Retirement System (PFRS) and the Consolidated Police and Firemen's Pension Fund (CPFPF) and to certain retirees of the Public Employees' Retirement System (PERS) who were law enforcement officers. A qualified retiree is one who


  6.  Q - What retirees are not eligible for Chapter 330 coverage?
    A - A retiree who


  7.  Q - Under the previous interpretation of the law, retirees who had health benefits coverage from other employment were not eligible for Chapter 330 coverage. Has that changed?
    A - The otherwise eligible retiree is still not eligible for Chapter 330 coverage while he has coverage from other employment. However, when that coverage from other employment ends, the retiree is eligible to enroll in Chapter 330 coverage as long as he notifies of the Division of the loss of other coverage within sixty days.


  8.  Q - Does coverage as a dependent under a spouse's health insurance policy disqualify a retiree who would otherwise qualify for Chapter 330 coverage?
    A - No. Only coverage as an employee would disqualify the retiree for Chapter 330 coverage.
  9. Q - Will retirees who receive a post-retirement medical benefit for only a specific period of time be eligible for Chapter 330 coverage when that employer-provided benefit ends?
    A - Yes. retirees must notify the Division within sixty days of the end of the benefit they receive from their employers to obtain coverage under Chapter 330.


  10. Q - How will retirees who were ineligible for Chapter 330 coverage under the previous interpretation know they are now eligible for coverage?
    A - The Division will attempt to contact all retirees who were previously denied coverage because their employers provided post-retirement medical benefits to some of its retirees. We will include an article on the new interpretation of Chapter 330 in the January issue of Pension News and we will ask the police and fire unions to publicize this in their various publications.

  11.  Q - How will the Division of Pensions and Benefits ascertain whether a retiree is receiving any post-retirement medical benefit from his employer?
    A - The retiree will certify to that fact when they apply for Chapter 330 coverage. If there is a question, the Division will ask the employer for verification.

  12.  Q - If an enrolled retiree dies, is the surviving spouse eligible for Chapter 330 benefits?
    A - Surviving spouses of retirees enrolled in the SHBP under Chapter 330 may elect to remain in the State Health Benefits Program by paying the full cost of coverage if the retiree had included the spouse under his/her coverage. If the retiree covered dependent children, the surviving spouse could also include them in the coverage.

  13. Q - If a retiree has minor children as his/her surviving dependents, can those dependents continue coverage after the death of the retiree?
    A - Normal SHBP rules would apply for surviving children. If the children were enrolled for coverage and they received a survivor's pension benefit, they could remain in the SHBP by paying the full cost of coverage as long as the pension benefit continues, normally age 18. When the pension benefit ended, they would be able to continue the health benefits under the provisions of the federal COBRA law at their own expense for a period up to three years.

  14. Q - The State Health Benefits Program requires everyone eligible for Medicare who is covered under the Retiree Group to enroll in the full Medicare program, that is Parts A (Hospitalization) and B (Medical). What about retirees who do not have enough quarters of Social Security coverage to qualify for Part A of Medicare? Would these retirees be able to enroll in the SHBP without Medicare coverage?
    A - Enrollment in Medicare Parts A and B for retirees and their dependents who are eligible for Medicare coverage, either because of age or disability, is a requirement for SHBP coverage. If the retiree and/or spouse lack sufficient quarters of Social Security coverage to qualify for Part A of Medicare at no expense, then it may be purchased from the federal Health Care Finance Administration. Part B benefits also would have to be purchased.

  15.  Q - How is the cost for Chapter 330 coverage shared between the State and the retiree?
    A - The State will pay 80% of the cost of the least expensive plan in the SHBP for the level of coverage (Single, Member and Spouse, etc.) chosen by the retiree. The retiree will pay the remainder of the cost. This could be more than 20% if the plan the retiree chooses is a more expensive one.

  16.  Q - What is the least expensive plan?
    A - There is no single least expensive plan. The least expensive plan varies by coverage level (Single, Member and Spouse, etc.) and is subject to change every year as plan rates are renewed. The Division will provide retirees with a rate chart showing the dollar amount that the State will provide towards coverage at each coverage level and the cost to the employee for the plan they select.

  17.  Q - Can my public employer reimburse me for the part of my coverage that the State does not pay?
    A - No, the employer from which you retired cannot reimburse you for your Chapter 330 costs. To do so would disqualify you for coverage under this law.


October 1999
To: Certifying Officer
Institutions of Higher Education
From: John D. Megariotis
Assistant Director, Finance
Subject: Chapter 247, PL 1999 - Remittance of 403(b) Contributions

The Governor has signed Chapter 247, PL 1999 (formerly Assembly Bill #2023) into law with an effective date of November 15, 1999. This bill requires 403(b) salary reductions from an employee to be transmitted and credited to the employees' account within five business days from the pay date.

In order to comply with this legislation, the Division of Pensions and Benefits has made the following changes to the reporting guidelines:

    1. All 403(b) amounts payable on behalf of an employee for a pay period, shall be transmitted and credited not later than the fifth business day after the date on which the employee is paid for that pay period.
    2. The employing institution has the discretion to remit the employer and employee contributions along with the 403(b) contributions, or you can continue to report all deductions other than the 403(b) reductions in accordance with your current reporting policies.

The Alternate Benefit Program's Employer Contribution Report will remain a monthly reporting and reimbursement schedule.

Members of the Public Employees' Retirement System, Teachers' Pension and Annuity Fund and/or the Police and Firemen's Retirement System participating in the Supplemental Annuity Collective Annuity (SACT) Tax Sheltered Annuity Program are required to have 403(b) salary reductions remitted to the Division of Pensions and Benefits within the timeframes prescribed by this law. Contributions for these members will be made through the Transmittal Electronic Payment System (TEPS).

If have any questions regarding this matter, please contact James Jefferson at (609) 292-2914.


October 1999
To: Certifying Officer
Public Employees' Retirement System - Boards of Education
Teachers' Pension and Annuity Fund
From: John D. Megariotis
Assistant Director, Finance
Subject: Chapter 247, PL 1999 - Remittance of 403(b) Contributions

The Governor has signed Chapter 247, PL 1999 (formerly Assembly Bill #2023) into law with an effective date of November 15, 1999. This bill requires 403(b) salary reductions on behalf of an employee to be transmitted and credited within five business days from the pay date.

Employees of local boards of education may participate in the SACT 403(b) program or a 403(b) plan administered by their employer. This new law impacts both arrangements.

Members of the Public Employees' Retirement System and Teachers' Pension and Annuity Fund in the Supplemental Annuity (SACT) Tax Sheltered Annuity Program are required to have 403(b) salary reductions remitted to the Division of Pensions and Benefits within the timeframes prescribed by law. Contribution for these members will be made through the Transmittal Electronic Payment System (TEPS).

If you have any questions regarding this matter, please contact Fred Polio at (609) 292-2623.


November 15, 1999

TO:

Certifying Officers, State Of New Jersey
FROM: Enrollment And Purchase Bureau

SUBJECT:

Membership Survey

In order to assist you in the pension enrollment process, the enclosed report has been prepared for your location that lists those employees who have not had pension deductions for the past 18 months. Please review the status of these employees and determine if they should be enrolled in pension. Some individuals on the list may be retired from other pension systems and would be ineligible to participate in another State-administered retirement system.

If you determine that an employee is eligible for pension participation, please submit an enrollment application. If an enrollment application has been submitted for an eligible employee, please disregard this notice. There is no need to return this list to the Division of Pensions and Benefits. This survey was prepared strictly for informational purposes and to provide you with an opportunity to review pension eligibility for your employees.

If you should have specific questions regarding eligibility, please contact Client Services at (609) 292-7524.

Enclosure


MEMORANDUM

TO:

Certifying Officers: Public Employees' Retirement System
Teachers' Pension and Annuity Fund
Police and Firemen's Retirement System
Alternate Benefit Program

FROM: John D. Megariotis
Assistant Director, Finance
DATE: November 1999
SUBJECT: Pension Compensation and SACT Contribution Limits for Calendar Year 2000

Chapter 113, P.L. 1997 provides that the annual compensation on which employer and employee contributions and benefits may be based cannot exceed the annual compensation limit set by the Internal Revenue's Code section 401(a)(17). The Commissioner of the IRS indexes the limit for inflation each calendar year once the accumulated increases exceed $10,000. The federal limit for calendar year 1999 was $160,000.

For calendar year 2000, the limit has been increased to $170,000.

This limit does not apply when a member of the retirement system meets the following two conditions:

If you have employees who were enrolled prior to July 1996 and will reach or exceed the pensionable compensation limit, you should complete the employer intent package if you have not already done so. This will tell us if you wish to grandfather employees hired before July 1996 who exceed the annual compensation limit. Please contact Henry Matwiejewicz at (609) 984-0574 to receive the package.

In addition, each year the Internal Revenue Service (IRS) adjusts dollar amount thresholds under the federal tax code based on changes in the consumer price index (CPI). One area the IRS considers annually is retirement plan maximum deferral amounts. The IRS has announced that the maximum elective deferral limit for section 403(b) tax sheltered annuity plans (including the Supplemental Annuity Collective Trust of New Jersey Tax Shelter Program) will increase from $10,000 to $10,500 per year because of increases in the CPI.

New Jersey State Law still limits a participant's annual contributions to the Supplemental Annuity Collective Trust of New Jersey (SACT) to 10% of base salary. Therefore, the maximum a SACT / Tax Shelter participant may contribute during 2000 will be 10% of base salary or $10,500, whichever is less. Your employees wishing to defer the maximum allowable amount in 2000, but whose current authorized salary reduction percentage will not allow them to reach that maximum, should complete a SACT Change of Contribution Rate Request form and a Salary Reduction Agreement. These forms must be submitted, through your Human Resource representative, to the NJ Division of Pensions and Benefits. Your Human Resource office may obtain a supply of these forms by calling the SACT office at (609) 292-3440.

For more details on the changes in pension plan limits, look on the IRS Web site (www.irs.gov) under "IRS Newsstand" and then click on "News Releases and Fact Sheets." Look for IR-1999-80, headlined: "Pension Plan Limitations For Tax Year 2000."

If you have any questions concerning this matter, please contact Marge Budzinski at (609) 292-3440.


November 1999


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 during 1997 and 1998 to comply with the requirements of HIPAA. These actions included:
· establishing procedures to provide departing employees with certificates of coverage for use with their next health carrier;
· amending SHBP rules to comply with HIPAA coverage requirements;
· filing exemptions for 1998 and 1999 to the provisions of mental health parity in accordance with HIPAA procedures for the Traditional Plan and NJ PLUS; and
· providing employers with a required notice of compliance with HIPAA to be distributed to all employees and their family members upon enrollment.
At the request of the State Health Benefits Commission (Commission), Buck Consultants conducted an analysis of current mental health coverage under the Traditional Plan and NJ PLUS. They have outlined several mental health plan design alternatives that would be compliant with HIPAA requirements. The Commission has evaluated these alternatives for possible implementation in a future plan year. 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.

A mental health parity exemption must be filed each plan year if a group plan is not HIPAA compliant. The Commission has voted to file an exemption for 2000. Therefore, mental health benefits will remain unchanged through 2000 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:

FEDERAL REQUIREMENT

SHBP STATUS

Issue Certificates of Coverage to all employees and or dependents who lose coverage. Participating employers were provided (August 1997) a sample certificate to use to meet this requirement.
Limit restrictions of coverage for pre-existing conditions. All SHBP plans exceed this requirement since they have no pre-existing condition restrictions.
Offer a special enrollment period to individuals who meet certain conditions, i.e., an employee or employee's dependent, who declined coverage because of other medical coverage, must have an opportunity for special enrollment should the other coverage end. All SHBP plans comply with this HIPAA requirement for employees and family members.
Eliminate discrimination against participants and beneficiaries based on health status. All SHBP plans comply with this requirement. (Note: the SHBP "actively at work" requirement is waived only for employees not at work due to illness).
Provide a minimum level of hospital coverage for newborns and mothers All SHBP plans meet this requirement.
Provide parity in mental health benefits All SHBP HMO plans meet this requirement. The SHBP has exempted the Traditional Plan and NJ PLUS for 2000 from mental health parity - different limits continue to exist for these plans.
Provide annual notice to covered members of any plan provisions not in compliance with HIPAA requirements. A sample certificate to use to meet this requirement is enclosed.

 


HB-0364-1199

Notice to State Health Benefits Program Participants about Compliance with Federal Health Insurance Requirements


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 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, Since aall 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 and 1999 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 2000. 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.

The SHBP has conducted a study to review the design of mental health benefits in the Traditional Plan and NJ PLUS. Several alternatives have been proposed, which the Commission will evaluate for possible implementation in future plan years.





December 22, 1999

To: Certifying Office
Boards of Education
Teachers' Pension and Annuity Fund
From: William H. Kale
Assistant Director, Client Services
Subject: Application of New Rule: N.J.A.C. 17:3-2.6
Ineligible Positions; Interim Appointment to Boards of Education

The Teachers' Pension and Annuity Fund Board of Trustees adopted the new rule N.J.A.C. 17:3-2.6; Ineligible Positions; Interim Appointment to Boards of Education, effective December 20, 1999, which provides that:

Any person retired from the Teachers' Pension and Annuity Fund who is temporarily appointed to any position listed in N.J.A.C. 17:3-2.1 or the functional equivalent thereof shall be ineligible for enrollment in the retirement system if the total time for all interim appointments with one board of education does not exceed six months. If the total time for all the interim appointments with one board of education exceeds six months, the individual shall be declared an employee for pension purposes and shall be enrolled in the Fund effective the first day of the seventh month of service.

Boards of Education with interim appointees will have six months from the effective date of the rule to either hire permanent employees for those positions or reenroll the interim appointees into the Teachers' Pension and Annuity Fund. The enrollment date would be July 1, 2000.

For interim appointments made after the effective date of the rule, the retiree must either end employment within the six month period defined by the rule or must reenroll with an effective date of the first day of the seventh month of employment.

Multiple interim appointments with the same employer would be combined when calculating the six months. Retirees may change employers and work for periods of no more than six months with each different employer.

If you have any questions regarding the application of this new rule, please contact the Client Services Bureau at (609) 292-7524.



December 1999

TO: All County, Municipal, and Board or Education SHBP Benefits Administrators
FROM: Janice F. Nelson,
Assistant Director, State Health Benefits Program
SUBJECT: SHBP COBRA Program Change

 

 

 

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 requires that an employer must offer employees, and/or their covered dependents, the opportunity to temporarily extend their group health insurance coverage in certain instances where coverage under the plan would otherwise end. Earlier this year, the Internal Revenue Service (IRS) issued two sets of long-awaited regulations that incorporate statutory changes and many of the judicial interpretations of COBRA over the years.
The new IRS regulations have resulted in two changes, effective January 1, 2000, to the State Health Benefits Program's (SHBP) administration of COBRA coverage.
The first change sets new rules for the relationship between COBRA and the federal and State Family Leave Acts. Currently, leave taken under the federal and/or State Family Leave Act is subtracted from a member's COBRA eligibility period. After January 1, 2000, the time a member spends on federal or State family leave will not count as part of the COBRA eligibility period.
The second change now offers qualified COBRA beneficiaries the same rights to coverage at Open Enrollment as are available to active employees. This means that any former employee or dependent who elected to enroll under COBRA is able to enroll in any SHBP medical coverage and, if offered by the employer, State prescription drug coverage during the SHBP Open Enrollment period regardless of whether they elected to enroll for the coverage when he or she went into COBRA. This affords a COBRA enrollee the same opportunity to enroll for benefits during the SHBP Open Enrollment period as an active employee. However, any time of non-participation in the benefit is counted toward the maximum COBRA coverage period.
All COBRA enrollees will receive Open Enrollment information, mailed directly to the address on file with the SHBP, prior to the SHBP Open Enrollment period in March. Members may also request information by writing to the COBRA Administrator, Division of Pensions and Benefits, Health Benefits Bureau, PO Box 299, Trenton, NJ 08625-0299.


December 1999

TO: All State SHBP Benefits Administrators
FROM: Janice F. Nelson,
Assistant Director, State Health Benefits Program
SUBJECT: SHBP COBRA Program Change

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 requires that an employer must offer employees, and/or their covered dependents, the opportunity to temporarily extend their group health insurance coverage in certain instances where coverage under the plan would otherwise end. Earlier this year, the Internal Revenue Service (IRS) issued two sets of long-awaited regulations that incorporate statutory changes and many of the judicial interpretations of COBRA over the years.
The new IRS regulations have resulted in two changes, effective January 1, 2000, to the State Health Benefits Program's (SHBP) administration of COBRA coverage.
The first change sets new rules for the relationship between COBRA and the federal and State Family Leave Acts. Currently, leave taken under the federal and/or State Family Leave Act is subtracted from a member's COBRA eligibility period. After January 1, 2000, the time a member spends on federal or State family leave will not count as part of the COBRA eligibility period.
The second change now offers qualified COBRA beneficiaries the same rights to coverage at Open Enrollment as are available to active employees. This means that any former employee or dependent who elected to enroll under COBRA is able to enroll in any SHBP medical coverage, State prescription drug, dental, or vision coverage during the SHBP Open Enrollment period regardless of whether they elected to enroll for the coverage when he or she went into COBRA. This affords a COBRA enrollee the same opportunity to enroll for benefits during the SHBP Open Enrollment period as an active employee. However, any time of non-participation in the benefit is counted toward the maximum COBRA coverage period.
All COBRA enrollees will receive Open Enrollment information, mailed directly to the address on file with the SHBP, prior to the SHBP Open Enrollment period in April. Members may also request information by writing to the COBRA Administrator, Division of Pensions and Benefits, Health Benefits Bureau, PO Box 299, Trenton, NJ 08625-0299.


MEMORANDUM


To: Certifying Officers
Public Employees' Retirement System
From: John D. Megariotis
Assistant Director, Financial
Subject: Rule Change for NJAC 17:2-4.7, Reporting Actual Salary for Part-Time Employees
Date: December 1999

The Public Employees' Retirement System's Board of Trustees at its November 17th meeting adopted a rule change for NJAC 17:2-4.7, that will become effective on January 1, 2000. The amendment requires reporting districts to use the actual creditable salary earned by employees, and not estimated salary, for part-time hourly, on-call and per diem employees.

The new rule eliminates much of the guesswork that has been, but should not be, involved in the reporting of salaries. The rule ensures that pension contributions are based on actual earnings and service, not an estimate of earnings. Perhaps more importantly, it is fairer to members in that they get what they earned, i.e., both in the sense of a pension benefit as well as their regular paychecks. Your employees do not lose any portion of their check paying pension contributions for hours not worked and salary not earned when they worked fewer hours than estimated.

The enrollment criteria for part-time hourly, per diem, and on-call employees remains unchanged. Hourly and per diem employees should be enrolled after 12 months of continuous employment, as long as the employees meet all other eligibility criteria. On-call, as needed employees who work an average of 10 days per month for 10-month employees or 12 days per month for 12-month employees are eligible for enrollment, as long as all other eligibility criteria are met. However, once membership is established, an employee must only meet the $1,500 minimum salary regulation to continue membership; the number of hours worked in a month or a year is no longer applicable. This provides greater equity in granting service credit. A member is entitled to a month of service as long as the actual creditable salary being reported exceeds the monthly minimum for enrollment. In other words, when a 10-month member has a monthly reportable salary exceeding $150 (one tenth of $1,500), the member should be reported for that month. Similarly, $125 (one twelfth of $1,500) is the minimum monthly reportable salary for a 12-month member. However, if the member does not make the minimum monthly salary no contributions or salary should be reported.

This rule change has some impact on completing the quarterly Report of Contributions. Since the Report is prepared prior to the close of a calendar quarter, it is impossible to project the salaries for these employees onto your quarterly Report. Whenever the quarterly actual creditable salary differs from the prior quarter, you must correct the base salary and corresponding deductions for pension and contributory life insurance premiums, if applicable. The Division realizes that this will increase the work involved in completing the quarterly Report. However, keep in mind that you no longer need to spend time calculating the estimated salaries. This is in addition to the merits of the rule providing deductions from actual earnings instead of educated guesses, and providing the member's with retirement benefits computed on what the employee earned.

It may facilitate the completion of your quarterly Report for the Division of Pensions and Benefits to list your part time, on call and per diem members on a separate bureau. To have the members on your Report listed separately, please send your written request to:

Robert Morley
Audit/Billing Section
Division of Pensions and Benefits
PO Box 295
Trenton, NJ 08625-0295


With your request, include a listing of the members to be put on the separate bureau. This listing must provide the member's membership number, last name and first name. In lieu of a manually prepared list, you can identify the members by sending a copy of your most recently filed quarterly Report and highlight the members for the separate bureau.

As a related matter, you may recall that the Division of Pensions and Benefits sent out a survey last March seeking your opinion as to whether part-time, on call and per diem employees should be reported on actual or estimated base salary. The survey results favored reporting on actual creditable salary. Over one-half of the reporting districts responded to the survey. I would like to take this opportunity to thank you for your participation. Your input was very meaningful in assisting us with this rule change.

If you have any questions regarding this matter, please contact the Audit/Billing Section at (609) 292-3630.