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SHBP Open Enrollment 2000

State (Centralized Payroll)

State (montly payroll)

Rutgers and NJIT

Local Government and School Boards

January 21, 2000

TO: State Health Benefits Program Participating Local Employers
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: SHBP Open Enrollment 2000 (See also February 18 letter)

The State Health Benefits Program (SHBP) Open Enrollment period for local employees will begin on March 1, 2000, and end on March 31, 2000. Completed employer certified applications must arrive at the Health Benefits Bureau no later than April 10, 2000. All changes to coverage made during Open Enrollment will be effective on July 1, 2000.

The State Health Benefits Commission is in the process of finalizing rates. We have included a milestone chart (Enclosure 4) that lists key Open Enrollment 2000 events and dates, and the projected delivery dates for all Open Enrollment publications. The publications will include a revised 2000 NJ PLUS Physician and Hospital Directory with a form for additional copies, sufficient copies of the revised SHBP Plan Comparison Summary chart for all employees and the Open Enrollment issue of the Health Capsule newsletter.

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 NJ PLUS and the Traditional Plan. In addition, you should contact the individual HMOs directly to request plan representation.

If you wish to schedule educational presentations for your employees about the various plans available through the SHBP, please use the enclosed Request for Open Enrollment Support form (Enclosure 1) to schedule your health fair or educational seminar. This form may be mailed or faxed to the address/number listed on the form. To facilitate scheduling and maximize your chances of having your request fulfilled, please submit your request as soon as possible. You may also contact your assigned Horizon BCBSNJ Account Manager to schedule your request. You must provide a suitable room and a minimum of 10-15 employees for each session. Each session will last approximately 50 minutes.

In addition, 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 some insight into the new rates effective July 2000. A SHBP Employer Informational Seminar Registration form (Enclosure 2) listing the seminar dates and times is attached, along with the directions to the seminar sites.

If you have any questions about the Open Enrollment support services, or the informational seminars, please get in touch with the contact person shown on the attached forms. Thank you for your cooperation.



Enclosures:

  1. Request for OpenEnrollment Support Form
  2. SHBP Employer Informational Seminar Registration Form
  3. Directions to Regional Seminars
  4. 2000 SHBP Open Enrollment Milestone Chart
  5. Unified Provider Directory Flier



February 18, 2000

TO: State Health Benefits Program Participating Local Government Employers
State Health Benefits Program Participating Local Education Employers
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: SHBP Open Enrollment 2000

Enclosed you will find approved rates and plan information that will assist your employees in making informed decisions concerning their health care coverage during Open Enrollment 2000. We have included rate charts for employees with and without prescription drug coverage and all retiree rates. Also, we have enclosed a chart showing the available SHBP medical plans with contact information.

The Division of Pensions and Benefits is in the process of changing the State Health Benefits Program plan year from a fiscal year to a calendar year. This transition will necessitate two Open Enrollments in 2000 the current Spring Open Enrollment with changes effective July 1, 2000, and a second Open Enrollment in the fall with changes effective January 1, 2001. Thereafter, the annual Open Enrollment will be each fall for changes effective the following January. This means that there will be no Open Enrollment in the spring of 2001. Because of the plan year change, the enclosed rates have been approved for an 18-month period, effective July 1, 2000 through December 31, 2001. Please see the details of this plan year change in the Health Capsule newsletter scheduled for delivery to you during the first week of March.

The rate increases for the plans are generally in keeping with national and regional trends for comparable plans. The new rates are based on last year's claims experience, and projections of health benefits expenditures anticipated over the 18-month rating period. Several of the managed-care plans, including NJ PLUS, experienced higher than expected claims for the most recent period, resulting in large rate increases. Others, such as Aetna US Healthcare, had little or no increase in rates. Regardless, all plans continue to provide excellent value for employers and employees who participate in the SHBP.

The most significant factor contributing to the rate increases is the continuing rapid growth of prescription drug expenditures. This is demonstrated by a 27.7 percent increase in the State Prescription Drug Program and by significantly higher rate increases for medical plan coverage that includes prescription drugs. We continue to work closely with our health care consultants to explore options for slowing the rate of increase in this area, while still providing quality coverage for our participants.

This growth in expenditures is even more pronounced in the retiree rates. For retirees covered by Medicare, more than 50 percent of the SHBP premium goes toward the cost of providing prescription drug coverage. Effective January 1, 2000, the State Health Benefits Commission has implemented a new retiree prescription drug card program for NJ PLUS and Traditional Plan members, which should help ensure access and affordability of prescription drugs for these members, while encouraging more cost-effective choices.

A number of changes in SHBP program modifications and Traditional Plan rating structures in recent years provided a reason to review the policy regarding employee contributions for costs in excess of the Traditional Plan. As a result, there is no provision in the attached rates for employee contributions for HMO premiums above the Traditional Plan rate.

The following changes have been made to the health plans offered by the SHBP since the last Open Enrollment.

  • Aetna US Healthcare has acquired Prudential HealthCare HMO for the plan year beginning July 2000. SHBP members enrolled in Prudential will be automatically transferred to Aetna US Healthcare effective July 1, 2000, unless the employee changes to another SHBP health plan during this Open Enrollment period. Prudential members should continue to use their Prudential identification cards and may continue to see their Prudential Primary Care Physician (PCP) through June 30, 2000. Aetna US Healthcare will send new ID cards to Prudential members before July 1, 2000. Prudential members should check with their Prudential PCP to determine if the physician plans to participate with Aetna US Healthcare after July 1, 2000. If the Prudential PCP will not be joining with Aetna US Healthcare, the member must choose an Aetna US Healthcare PCP before July 1, 2000, or change to a different SHBP plan during this Open Enrollment period. Prudential members who wish to change to a health plan other than Aetna US Healthcare must submit an application for change to their benefits administrator by March 31, 2000. The new plan will be effective on July 1, 2000.

  • Physicians Health Services (PHS) has received approval by the State Health Benefits Commission to introduce a pilot program effective July 1, 2000 that will allow PHS members to receive services from a PHS participating specialist without obtaining a referral from the Primary Care Physician (PCP). Although there is no need for a referral, members will still be required to select a PCP for routine care and are encouraged to coordinate care from a specialist through their PCP. While no referral from the PCP is necessary for specialty care, a referral is still required for hospitals and lab work.

During the first week of March, you should be receiving sufficient copies of the SHBP Comparison Summary chart and the Health Capsule newsletter for distribution to your employees. These publications will provide more details on Open Enrollment issues. You should have already received your advance copy of the NJ PLUS Physician and Hospital Directory along with a chart providing contact names for arranging a health fair at your location.

In addition, we are pleased to enclose a copy of the 1999 New Jersey HMO Performance Report: Compare Your Choices. This HMO annual report card is a publication of the Department of Health and Senior Services designed to help health care consumers make more informed choices. Additional copies may be requested by contacting the Office of Managed-Care, Department of Health and Senior Services, PO Box 360, Trenton, NJ 08625-0360, or calling 1-888-393-1062. The report is also available over the Internet at: www.state.nj.us/health

If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524.

Enclosures: Active and Retiree Rate Charts
1999 HMO Performance Report
Medical Plan Contacts



(Enclosure 4)

2000 SHBP OPEN ENROLLMENT MILESTONE CHART
for Participating Local Employers


Note: If the event is underlined, you should be accomplishing the event.
PROJECTED
DATE
EVENT
January 21 Initial Open Enrollment Letter mailed to employers.
February 14 Fiscal Year 2000 rate charts sent to employers.
Disseminate rate information to employees as necessary.
February 14 Request for Open Enrollment Support form should be submitted if you wish support for your Health Fair or educational seminars, or need additional copies of the 2000 NJ PLUS Physician and Hospital Directory.
February 14-28 Regional Employer Benefit Administrator seminars conducted by the SHBP.
February 18 Advanced copy of the 2000 NJ PLUS Physician and Hospital Directory shipped to local employers.
February 28
.
SHBP Plan Comparison Summary charts and the Health Capsule shipped to employers. Distribute to employees
March 1 Open Enrollment Begins
.March 1-31 Health Fairs and Educational Seminars conducted (optional).
March 31 Open Enrollment Ends
April 10 Employer certified applications due at the Health Benefits Bureau.
July 1 Open Enrollment changes effective.


January 31, 2000

 

 
TO: State Monthly Human Resource Directors/Benefits Administrators
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: SHBP Open Enrollment 2000 (See also March 8 letter)

The State Health Benefits Program (SHBP) Open Enrollment period for State monthly employees will begin on April 1, 2000, and end on April 30, 2000. Completed employer certified health benefits and/or dental applications must arrive at the Health Benefits Bureau no later than May 5, 2000. 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 Open Enrollment will be effective on July 1, 2000.

The State Health Benefits Commission is in the process of finalizing rates. As in the past, once rates have been determined we will provide you with a sample generic Open Enrollment announcement flyer to reproduce, providing a list of medical and dental plans and costs for State employees not paid through Centralized Payroll.

We have included a milestone chart (Enclosure 1) that lists key Open Enrollment 2000 events and dates, and the projected delivery schedule for all Open Enrollment publications. During the last week of February, you will receive your advance copy of the revised 2000 NJ PLUS Physician and Hospital Directory. You may order more directories using the enclosed Request for Open Enrollment Support form (Enclosure 2). Participating provider information for all SHBP plans is available in the Unified Provider Directory through our SHBP home page at: www.state.nj.us/treasury/pensions/ shbp.htm

Sufficient copies of the revised 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 at your location. State employees paid through the State's Centralized Payroll Unit will receive these publications with their March 31 paychecks.

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 NJ PLUS and the Traditional Plan. In addition, you should contact the individual HMOs directly to request plan representation. Lists of all the SHBP medical and dental plans (Enclosure 3a/3b), along 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 a health fair or educational presentations for your employees about the various plans available through the SHBP, please use the enclosed Request for Open Enrollment Support form (Enclosure 2). This form may be mailed or faxed to the address/number listed on the form. To facilitate scheduling and maximize your chances of having your request fulfilled, please submit your request as soon as possible. You must provide a suitable room and a minimum of 10-15 employees for each session. Each session will last approximately 50 minutes.

We will be conducting seminars for benefits administrators in the Trenton area (Mercer County Library) on March 20 and in Newark (Horizon BCBSNJ) on March 22. The seminars will provide an update on SHBP plan changes that have recently occurred, and some insight into the new rates effective July 2000. A SHBP Employer Informational Seminar Registration form (Enclosure 4) listing the seminar dates and times is attached, along with the directions to the seminar sites.

If you have any questions about Open Enrollment or the information in this letter, please contact our Client Services staff at (609) 292-7524. Questions regarding the informational seminars should be addressed to the contact person shown on the attached forms. Thank you for your cooperation.

 Enclosures:

  1. 2000 SHBP Open Enrollment Milestone Chart
  2. Request for Open Enrollment Support Form (requires Acrobat Reader.
  3. Health Fair Contacts - Medical (3a) and Dental (3b)
  4. SHBP Employer Informational Seminar Registration Form
  5. Directions to Regional Seminars - Trenton and Newark


March 8, 2000

 
TO: State Monthly Human Resource Directors/Benefits Administrators
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: State Health Benefits Program (SHBP) Open Enrollment 2000

The State Health Benefits Program (SHBP) Open Enrollment period for State monthly employees will begin on April 1, 2000, and end on April 30, 2000. Enclosed you will find plan information and rate charts that will assist your employees in making informed decisions concerning their health care coverage during the Open Enrollment.

The Division of Pensions and Benefits is in the process of changing the State Health Benefits Program plan year from a fiscal year to a calendar year. This transition will necessitate two Open Enrollments in 2000 - the current Spring Open Enrollment with changes effective July 1, 2000, and a second Open Enrollment in the fall with changes effective December 30, 2000. Employees will have the opportunity to change medical, prescription drug, or dental plan coverage during both Open Enrollments. Thereafter, the annual Open Enrollment will be each fall for changes effective the following January 1. This means that there will be no Open Enrollment in the spring of 2001. Because of the change to the plan year, the enclosed rates have been approved for an 18-month period, effective July 1, 2000 through December 31, 2001.

Unions representing most State employees have settled new contracts that provide for revised premium sharing arrangements with the State. The contracts are identical with respect to their premium sharing provisions. There is no premium cost to any employee who enrolls in NJ PLUS. Employees will pay 5 percent of the premium cost if enrolled in an HMO, or 25 percent of the premium cost if enrolled in the Traditional Plan. These percentages apply regardless of salary level or date of hire. Employees who are represented by unions which have not settled a new contract with the State will continue to share in the premium cost of the Traditional Plan according to the provisions of their lapsed contracts. Details on the change to a calendar plan year and premium sharing for both the new and old contract models can be found in the Health Capsule newsletter.

Enclosed are a selection of Open Enrollment announcement flyers that list the available medical and dental plans and their costs to your employees. Flyers are provided for three different payroll schedules (Monthly, 24 Pay Periods, and 26 Pay Periods). Choose the flyer that corresponds to your location's payroll schedule. This is a master copy and may be reproduced to meet your employees' needs. If you have specific questions about the flyers, contact Kathy Coates by telephone at (609) 633-1462 or by fax at (609) 292-9500.

Sufficient copies of the SHBP Comparison Summary chart and the Health Capsule newsletter will be shipped to your location on 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 31 paychecks.

Premium sharing provides an opportunity for your employees to evaluate their health benefits. If they premium share and participate in the State's Premium Option Plan (POP), their premium amounts are paid with pre-tax dollars. The result will provide savings on federal, Medicare, and Social Security taxes, and return that savings to net income. The benefits of POP are further addressed in the Health Capsule.

The following changes have been made to the health plans offered by the SHBP and are effective this Open Enrollment.

  • Aetna US Healthcare has acquired Prudential HealthCare HMO for the plan year beginning July 2000. SHBP members enrolled in Prudential will be automatically transferred to Aetna US Healthcare effective July 1, 2000, unless the employee changes to another SHBP health plan during this Open Enrollment period. Prudential members should continue to use their Prudential identification cards and may continue to see their Prudential Primary Care Physician (PCP) through June 30, 2000. Prudential members should receive their new ID cards from Aetna US Healthcare by July 1, 2000.

    Prudential members should check with their Prudential PCP to determine if the physician plans to participate with Aetna US Healthcare after July 1, 2000. If the Prudential PCP will not be joining with Aetna US Healthcare, the member must choose an Aetna US Healthcare PCP before July 1, 2000, or change to a different SHBP plan during this Open Enrollment period.

    Prudential members who wish to change to a health plan other than Aetna US Healthcare must submit an application for change to their benefits administrator by April 30, 2000. The new plan will be effective on July 1, 2000.

  • Physicians Health Services (PHS) has received approval by the State Health Benefits Commission to introduce a pilot program, effective July 1, 2000, that will allow PHS members to receive services from a PHS participating specialist without

    obtaining a referral from the Primary Care Physician (PCP). Although there is no need for a referral, members will still be required to select a PCP for routine care and are encouraged to coordinate care from a specialist through their PCP. While

    no referral from the PCP is necessary for specialty care, a referral is still required for hospitals and lab work.

The following changes have been made to the State Employee Group Dental Program effective for the plan year beginning July 2000.

  • Three DPOs - CIGNA, Community Dental Associates, and Atlantic Southern (BeneCare) - will have slightly higher premium levels than the other DPOs. The State Employee Group Dental Program requires participating DPOs to credential their dentists and report on all dental services provided to State employees and their families. The data reported by the DPOs allows the State to monitor the quality of dental care provided by the DPOs. Based on a review of the reported information, these plans have been noted as providing services superior to the high standards required of all participating DPOs. Although these plans cost a little more than the others, remember that the additional cost indicates that these three plans provide a superior quality of service.
  • Statewide DPO, Inc. will no longer be participating in the State Employee Group Dental Program after July 1, 2000. Employees enrolled in this plan must change to another dental plan during this Open Enrollment if they wish to retain dental coverage after July 1, 2000.

We are pleased to enclose a copy of the 1999 New Jersey HMO Performance Report: Compare Your Choices. This annual HMO report card is a publication of the New Jersey Department of Health and Senior Services designed to help health care consumers make more informed choices. Additional copies may be requested by contacting the Office of Managed-Care, Department of Health and Senior Services, PO Box 360, Trenton, NJ 08625-0360, or calling 1-888-393-1062. The report is also available over the Internet at: www.state.nj.us/health

If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524.

 

Enclosures: Open Enrollment 2000 Flyer(s) (medical/dental rates)
Medical Plan Contacts
1999 HMO Performance Report



March 8, 2000

 
TO: Campus Human Resource Directors
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: State Health Benefits Program (SHBP) Open Enrollment 2000

The State Health Benefits Program (SHBP) Open Enrollment period for State monthly employees will begin on April 1, 2000, and end on April 30, 2000. Enclosed you will find plan information and rate charts that will assist your employees in making informed decisions concerning their health care coverage during the Open Enrollment.

The Division of Pensions and Benefits is in the process of changing the State Health Benefits Program plan year from a fiscal year to a calendar year. This transition will necessitate two Open Enrollments in 2000 - the current Spring Open Enrollment with changes effective July 1, 2000, and a second Open Enrollment in the fall with changes effective December 30, 2000. Employees will have the opportunity to change medical, prescription drug, or dental plan coverage during both Open Enrollments. Thereafter, the annual Open Enrollment will be each fall for changes effective the following January 1. This means that there will be no Open Enrollment in the spring of 2001. Because of the change to the plan year, the enclosed rates have been approved for an 18-month period, effective July 1, 2000 through December 31, 2001.

Unions representing most State employees have settled new contracts that provide for revised premium sharing arrangements with the State. The contracts are identical with respect to their premium sharing provisions. There is no premium cost to any employee who enrolls in NJ PLUS. Employees will pay 5 percent of the premium cost if enrolled in an HMO, or 25 percent of the premium cost if enrolled in the Traditional Plan. These percentages apply regardless of salary level or date of hire. Employees who are represented by unions which have not settled a new contract with the State will continue to share in the premium cost of the Traditional Plan according to the provisions of their lapsed contracts. Details on the change to a calendar plan year and premium sharing for both the new and old contract models can be found in the Health Capsule newsletter and the Open Enrollment flyer (see enclosed, along with a chart of medical plan contacts).

 Enclosed is an Open Enrollment announcement flyer that lists the available medical and dental plans and their costs to your employees. This is a master copy tailored to your location which may be reproduced to meet your employees' needs. If you have specific questions about the flyer, contact Kathy Coates by telephone at (609) 633-1462 or by fax at (609) 292-9500.

Sufficient copies of the SHBP Comparison Summary chart and the Health Capsule newsletter will be shipped to your location on 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 31 paychecks.

Premium sharing provides an opportunity for your employees to evaluate their health benefits. If they premium share and participate in the State's Premium Option Plan (POP), their premium amounts are paid with pre-tax dollars. The result will provide savings on federal, Medicare, and Social Security taxes, and return that savings to net income. The benefits of POP are further addressed in the Health Capsule.

The following changes have been made to the health plans offered by the SHBP and are effective this Open Enrollment.

  • Aetna US Healthcare has acquired Prudential HealthCare HMO for the plan year beginning July 2000. SHBP members enrolled in Prudential will be automatically transferred to Aetna US Healthcare effective July 1, 2000, unless the employee changes to another SHBP health plan during this Open Enrollment period. Prudential members should continue to use their Prudential identification cards and may continue to see their Prudential Primary Care Physician (PCP) through June 30, 2000. Prudential members should receive their new ID cards from Aetna US Healthcare by July 1, 2000.

    Prudential members should check with their Prudential PCP to determine if the physician plans to participate with Aetna US Healthcare after July 1, 2000. If the Prudential PCP will not be joining with Aetna US Healthcare, the member must choose an Aetna US Healthcare PCP before July 1, 2000, or change to a different SHBP plan during this Open Enrollment period.

    Prudential members who wish to change to a health plan other than Aetna US Healthcare must submit an application for change to their benefits administrator by April 30, 2000. The new plan will be effective on July 1, 2000.

  • Physicians Health Services (PHS) has received approval by the State Health Benefits Commission to introduce a pilot program, effective July 1, 2000, that will allow PHS members to receive services from a PHS participating specialist without

    obtaining a referral from the Primary Care Physician (PCP). Although there is no need for a referral, members will still be required to select a PCP for routine care and are encouraged to coordinate care from a specialist through their PCP. While

    no referral from the PCP is necessary for specialty care, a referral is still required for hospitals and lab work.

The following changes have been made to the State Employee Group Dental Program effective for the plan year beginning July 2000.

  • Three DPOs - CIGNA, Community Dental Associates, and Atlantic Southern (BeneCare) - will have slightly higher premium levels than the other DPOs. The State Employee Group Dental Program requires participating DPOs to credential their dentists and report on all dental services provided to State employees and their families. The data reported by the DPOs allows the State to monitor the quality of dental care provided by the DPOs. Based on a review of the reported information, these plans have been noted as providing services superior to the high standards required of all participating DPOs. Although these plans cost a little more than the others, remember that the additional cost indicates that these three plans provide a superior quality of service.
  • Statewide DPO, Inc. will no longer be participating in the State Employee Group Dental Program after July 1, 2000. Employees enrolled in this plan must change to another dental plan during this Open Enrollment if they wish to retain dental coverage after July 1, 2000.

We are pleased to enclose a copy of the 1999 New Jersey HMO Performance Report: Compare Your Choices. This annual HMO report card is a publication of the New Jersey Department of Health and Senior Services designed to help health care consumers make more informed choices. Additional copies may be requested by contacting the Office of Managed-Care, Department of Health and Senior Services, PO Box 360, Trenton, NJ 08625-0360, or calling 1-888-393-1062. The report is also available over the Internet at: www.state.nj.us/health

If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524.

 

Enclosures: Open Enrollment 2000 Flyer (medical/dental rates)
Medical Plan Contacts
1999 HMO Performance Report



 

Check Message for Pay Period 7 (March 31)

The 2000 Open Enrollment for the State Health Benefits Program will be conducted during the month of April. Open Enrollment materials being distributed with this paycheck are the Health Capsule, the Dental and Medical Open Enrollment Flyer, and the July 2000 SHBP Plan Comparison Summary Chart. Be sure to get them from your benefits administrator and READ them. They contain important information about your benefits.

Check Message for Pay Period 8 (April 14)

The 2000 Open Enrollment for medical, prescription drug, and dental coverage under the State Health Benefits Program is being conducted during the month of April. Several plan changes are being made, employee costs for coverage are changing, Prudential HMO is merging with Aetna-US Healthcare, and one dental plan, Statewide DPO, Inc. (DPO #315), is being eliminated from our program. If you are enrolled in the Statewide DPO, Inc. and you want dental coverage after July 1, 2000, you must select another dental plan during the open enrollment. Please take this opportunity to review your medical benefits to see what coverage best suits your family's needs. Contact your benefits administrator for necessary applications and information.

Check Message for Pay Period 9 (April 28)

The State Health Benefits Program 2000 Open Enrollment ends on April 30, 2000. This will be the last day you can make changes to your medical, prescription drug, and dental coverage. If you haven't already taken care of business, see your benefits administrator immediately!


SHBP OPEN ENROLLMENT 2000 MILESTONE CHART

For Monthly State Employers

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

PROJECTED DATE EVENT
January 31 Initial Open Enrollment Letter mailed to State employers.
February 28 Advance copy of the 2000 NJ PLUS Physician and Hospital Directory shipped to State employers.
March 13 Final Open Enrollment Letter mailed to State employers with Fiscal Year 2000 rate charts. Disseminate rate information to employees as necessary.
March 15 A supply of the Health Capsule and SHBP Plan Comparison Summary chart mailed to monthly employers to be distributed to all SHBP covered employees.
March 17 Request for Open Enrollment Support form should be submitted if you wish support for your Health Fair or educational seminars, or need additional copies of the 2000 NJ PLUS Physician and Hospital Directory.
March 20 State Employer Benefit Administrator seminars conducted by the SHBP in the Trenton area.
March 22 State Employer Benefit 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 the Health Benefits Bureau.

July 1 Open Enrollment changes effective.


NEW JERSEY STATE HEALTH BENEFITS PROGRAM

MEDICAL PLANS - HEALTH FAIR CONTACTS* 

 PLAN NAME

PLAN/HMO #

PHONE NUMBER

CONTACT NAME

NJ PLUS
Administered by Horizon Blue Cross
Blue Shield of New Jersey

001

973-466-6666

Kim Bruno

Traditional Plan
Administered by Horizon Blue Cross
Blue Shield of New Jersey

002

973-466-6666

Kim Bruno

HEALTH MAINTENANCE ORGANIZATIONS

 Horizon HMO

010

973-466-6666

Kim Bruno

Aetna/US Healthcare

019

215-775-6035

Ellen Thomas

CIGNA HealthCare

020

973-660-4029

Ginny Fowler

Oxford Health Plan

028

732-623-1937

Janet Green

AmeriHealth HMO Plan

033

856-778-6505

Lisa Schneider/Kari Goldberg

Physicians Health Services

034

732-918-6973

Michael DeLuca

University Health Plans, Inc.

036

973-623-8700

Frank Alkin, Extension 613

*The phone numbers are NOT for membership services - please do not provide them to your employees.

(HD-416-2000) (Enclosure 3b)

NEW JERSEY STATE HEALTH BENEFITS PROGRAM

DENTAL PLANS - HEALTH FAIR CONTACTS*

 PLAN NAME

UNIT/DPO #

PHONENUMBER

CONTACT NAME

Atlantic Southern Dental Foundation (Benecare)

301

800-843-4727

Customer Service - Mrs. Serota

Community Dental Associates

302

856-692-4670

Maryanne

CIGNA Dental Health, Inc.

305

973-660-4029

Ginny Fowler

Group Dental Health Administrators, Inc.

306

908-241-9700

Betty Guarino

International Health Care Services

307

516-542-2247

Linda Dempsey

Oracare DPO, Inc.

308

856-983-3838

Wendy Worrell, Extension #123

Unity Dental Health Services, PA

311

973-276-4900

Michael Dubman, Extension #4904

Flagship Health Systems, Inc.

312

973-285-4045

Melissa Cabrera

Statewide DPO, Inc.

315

908-221-9595

Steve Lane

Horizon Dental Choice

317

973-466-6666

Kim Bruno

Prudential Healthcare DMO

319

973-716-2550

Barbara DeVenuto

Dental Expense Plan -
Administered by the Prudential

399

973-716-2550

Barbara DeVenuto

*The phone numbers are NOT for membership services - please do not provide them to your employees


January 31, 2000

TO: State Departmental Human Resource Directors
State Biweekly Benefits Administrators
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT:  SHBP Open Enrollment 2000 (See also March 6 letter)

 The State Health Benefits Program (SHBP) Open Enrollment period for State biweekly employees will begin on April 1, 2000, and end on April 30, 2000. Completed employer certified health benefits and/or dental applications must arrive at the Health Benefits Bureau no later than May 5, 2000. 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 Open Enrollment will be effective on July 1, 2000, with any required deductions taken beginning with pay period 13 (paycheck of June 23, 2000).

The State Health Benefits Commission is in the process of finalizing rates. We have included a milestone chart (Enclosure 1) that lists key Open Enrollment 2000 events and dates, and the projected delivery schedule for all Open Enrollment publications. During the last week of February, you will receive your advance copy of the revised 2000 NJ PLUS Physician and Hospital Directory. You may order more directories using the enclosed Request for Open Enrollment Support form (Enclosure 2). Participating provider information for all SHBP plans is available in the Unified Provider Directory through our SHBP home page at: www.state.nj.us/treasury/pensions/shbp.htm

A copy of the revised SHBP Plan Comparison Summary chart, the 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 31 paychecks to all 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) or the Division of Pensions and Benefits, on behalf of the SHBP, can attend and answer questions


regarding the NJ PLUS and the Traditional Plan. In addition, you should contact the individual HMOs directly to request plan representation. Lists of all the SHBP medical and dental plans (Enclosure 3a/3b), along 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 a health fair or educational presentations for your employees about the various plans available through the SHBP, please use the enclosed Request for Open Enrollment Support form (Enclosure 2). This form may be mailed or faxed to the address/number listed on the form. To facilitate scheduling and maximize your chances of having your request fulfilled, please submit your request as soon as possible. You must provide a suitable room and a minimum of 10-15 employees for each session. Each session will last approximately 50 minutes.

We will be conducting seminars for benefits administrators in the Trenton area (Mercer County Library) on March 20 and in Newark (Horizon BCBSNJ) on March 22. The seminars will provide an update on SHBP plan changes that have recently occurred, and some insight into the new rates effective July 2000. A SHBP Employer Informational Seminar Registration form (Enclosure 4) listing the seminar dates and times is attached, along with the directions to the seminar sites.

If you have any questions about Open Enrollment or the information in this letter, please contact our Client Services staff at (609) 292-7524. Questions regarding the informational seminars should be addressed to the contact person shown on the attached forms. Thank you for your cooperation.

 Enclosures:

  1. 2000 SHBP Open Enrollment Milestone Chart
  2. Request for Open Enrollment Support Form
  3. Health Fair Contacts - Medical (3a) and Dental (3b)
  4. SHBP Employer Informational Seminar Registration Form
  5. Directions to Regional Seminars - Trenton (5a) and Newark (5b)

March 6, 2000

TO: State Department Human Resource Directors
State Biweekly Benefits Administrators
FROM: Janice F. Nelson
Assistant Director for Health Benefits
SUBJECT: SHBP Open Enrollment 2000

The State Health Benefits Program
(SHBP) Open Enrollment period for State biweekly employees will begin on April 1, 2000, and end on April 30, 2000. Enclosed you will find plan information and rate charts that will assist your employees in making informed decisions concerning their health care coverage during the Open Enrollment.

The Division of Pensions and Benefits is in the process of changing the State Health Benefits Program plan year from a fiscal year to a calendar year. This transition will necessitate two Open Enrollments in 2000 - the current Spring Open Enrollment with changes effective July 1, 2000, and a second Open Enrollment in the fall with changes effective December 30, 2000. Employees will have the opportunity to change medical, prescription drug, or dental plan coverage during both Open Enrollments. Thereafter, the annual Open Enrollment will be each fall for changes effective the first pay period of the new payroll year. This means that there will be no Open Enrollment in the spring of 2001. Because of the change to the plan year, the enclosed rates have been approved for an 18-month period, effective July 1, 2000 through December 31, 2001.

Unions representing most State employees have settled new contracts that provide for revised premium sharing arrangements with the State. The contracts are identical with respect to their premium sharing provisions. There is no premium cost to any employee who enrolls in NJ PLUS. Employees will pay 5 percent of the premium cost if enrolled in an HMO, or 25 percent of the premium cost if enrolled in the Traditional Plan. These percentages apply regardless of salary level or date of hire. Employees who are represented by unions which have not settled a new contract with the State will continue to share in the premium cost of the Traditional Plan according to the provisions of their lapsed contracts. Details on the change to a calendar plan year and premium sharing for both the new and old contract models can be found in the Health Capsule newsletter and the Open Enrollment flyer (see enclosed, along with a chart of medical plan contacts). These publications, along with the SHBP Comparison Summary chart, will be distributed with the March 31 paychecks to all State employees paid through Centralized Payroll.

Premium sharing provides an opportunity for your employees to evaluate their health benefits. If they premium share and participate in the State's Premium Option Plan (POP), their premium amounts are paid with pre-tax dollars. The result will provide savings on federal, Medicare, and Social Security taxes, and return that savings to net income. The benefits of POP are further addressed in the Health Capsule.

The following changes have been made to the health plans offered by the SHBP and are effective for this Open Enrollment.

  • Aetna US Healthcare has acquired Prudential HealthCare HMO for the plan year beginning July 2000. SHBP members enrolled in Prudential will be automatically transferred to Aetna US Healthcare effective July 1, 2000, unless the employee changes to another SHBP health plan during this Open Enrollment period. Prudential members should continue to use their Prudential identification cards and may continue to see their Prudential Primary Care Physician (PCP) through June 30, 2000. Prudential members should receive their new ID cards from Aetna US Healthcare by July 1, 2000.

    Prudential members should check with their Prudential PCP to determine if the physician plans to participate with Aetna US Healthcare after July 1, 2000. If the Prudential PCP will not be joining with Aetna US Healthcare, the member must choose an Aetna US Healthcare PCP before July 1, 2000, or change to a different SHBP plan during this Open Enrollment period.

    Prudential members who wish to change to a health plan other than Aetna US Healthcare must submit an application for change to their benefits administrator by April 30, 2000. The new plan will be effective on July 1, 2000.

  • Physicians Health Services (PHS) has received approval by the State Health Benefits Commission to introduce a pilot program, effective July 1, 2000, that will allow PHS members to receive services from a PHS participating specialist without obtaining a referral from the Primary Care Physician (PCP). Although there is no need for a referral, members will still be required to select a PCP for routine care and are encouraged to coordinate care from a specialist through their PCP. While no referral from the PCP is necessary for specialty care, a referral is still required for hospitals and lab work.

The following changes have been made to the State Employee Group Dental Program effective for the plan year beginning July 2000.

  • Three DPOs - CIGNA, Community Dental Associates, and Atlantic Southern (BeneCare) - will have slightly higher premium levels than the other DPOs. The State Employee Group Dental Program requires participating DPOs to credential their dentists and report on all dental services provided to State employees and their families. The data reported by the DPOs allows the State to monitor the quality of dental care provided by the DPOs. Based on a review of the reported information, these plans have been noted as providing services superior to the high standards required of all participating DPOs. Although these plans cost a little more than the others, remember that the additional cost indicates that these three plans provide a superior quality of service.

  • Statewide DPO, Inc. will no longer be participating in the State Employee Group Dental Program after July 1, 2000. Employees enrolled in this plan must change to another dental plan during this Open Enrollment if they wish to retain dental coverage after July 1, 2000.

We are pleased to enclose a copy of the 1999 New Jersey HMO Performance Report: Compare Your Choices. This annual HMO report card is a publication of the New Jersey Department of Health and Senior Services designed to help health care consumers make more informed choices. Additional copies may be requested by contacting the Office of Managed-Care, Department of Health and Senior Services, PO Box 360, Trenton, NJ 08625-0360, or calling 1-888-393-1062. The report is also available over the Internet at: www.state.nj.us/health

If you have any questions about the Open Enrollment, please contact our Office of Client Services at (609) 292-7524.



Enclosures: Open Enrollment 2000 Announcement Flyer (medical/dental rates)
Medical Plan Contacts
1999 HMO Performance Report


HB-0032-2000

NEW JERSEY STATE HEALTH BENEFITS PROGRAM - MEDICAL PLANS

 PLAN NAME

PLAN/HMO #

PHONENUMBER

SERVICE AREAS

NJ PLUS
Administered by Horizon Blue Cross
Blue Shield of New Jersey

001

800-414-7427

In-Network: All of New Jersey and Delaware
Parts of New York and Pennsylvania
Out-of-Network: Unrestricted
Traditional Plan
Administered by Horizon Blue Cross
Blue Shield of New Jersey

002

800-414-7427

Unrestricted

HEALTH MAINTENANCE ORGANIZATIONS

Horizon HMO

010

800-355-2583

All of New Jersey and Bucks County, Pennsylvania
Aetna/US Healthcare

019

800-309-2386

All of New Jersey, Washington DC and Connecticut
Parts of New York, Pennsylvania, Maryland, Virginia, Illinois, Texas, Georgia, Delaware and California
CIGNA HealthCare

020

800-832-3211

All of New Jersey, Pennsylvania, New York, Connecticut and 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 and Delaware
Parts of Pennsylvania
Physicians Health Services

034

800-535-3647

All of New Jersey
Parts of New York and Connecticut
University Health Plans, Inc.

036

800-564-6847

All of New Jersey

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

SHBP OPEN ENROLLMENT 2000 MILESTONE CHART

for Biweekly State Employers

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

PROJECTED DATE EVENT
January 31 Initial Open Enrollment Letter mailed to State employers.
February 28 Advance copy of the 2000 NJ PLUS Physician and Hospital Directory shipped to State employers.
March 13 Final Open Enrollment Letter mailed to State employers with Fiscal Year 2000 rate charts. Disseminate rate information to employees as necessary - they will receive rate charts with March 31 paycheck.
March 17 Request for Open Enrollment Support form should be submitted if you wish support for your Health Fair or educational seminars, or need additional copies of the 2000 NJ PLUS Physician and Hospital Directory.
March 20 State Employer Benefit Administrator seminars conducted by the SHBP in the Trenton area.
March 22 State Employer Benefit Administrator seminars conducted by the SHBP in Newark.
March 31 A copy of the Health Capsule, SHBP Plan Comparison Summary chart, and the Open Enrollment announcement flyer with medical and dental charts included in paychecks 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 the Health Benefits Bureau.
July 1 Open Enrollment changes effective.

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Last Updated: March 27, 2003