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2019 Plan Year Information

Open Enrollment ended October 31, 2018. All Plan Year 2019 health benefits information for active employees can be found here. Choose from the topic areas listed in the menu above.


What's New

New Zero Copay Plans for School Employees / $500 NJWELL Incentive

Members of the SEHBP will have two new plans to choose from for Plan Year 2019. Both Aetna and Horizon will offer plans under the new “zero copay” plan design. The new plans will be called Aetna Freedom Zero and NJ DIRECT ZERO, and they will be available to active employees and their dependents. Members will have no copayment for either primary or specialist care office visits. For a detailed list of member copays, deductibles, and other costs for these new plans, as well as a comparison to all available plans, please see the Local Education Active Group Medical Plan Design – Plan Year 2019 plan design chart and the NJ DIRECT ZERO flyer / Aetna Freedom Zero flyer.

Members who enroll in one of the zero copay plans will also be offered an increased NJWELL incentive for Plan Year 2019. NJ DIRECT ZERO and Aetna Freedom Zero participants will be eligible to receive up to $500 in gift cards! Members enrolled in the other plans offered by the SEHBP will continue to be eligible to receive a possible $250 in rewards. For more information, visit www.nj.gov/njwell

Note: These plans and incentive are for members of the School Employees’ Health Benefits Program only.

Continuation of Incentive for Joining Tiered-Network Plans

For Plan Year 2019, the SHBP will continue to offer an Incentive Program to join the Tiered-Network plans: the Aetna Liberty Plan and the Horizon OMNIA Health Plan.

  • State employees may participate
  • Local government employees may participate if their employer has adopted a resolution to take part in the Incentive Program
  • Available to first-time enrollees in a tiered-network medical plan and continuing for two complete plan years
  • Choice of either the Aetna Liberty Plan or the Horizon OMNIA Health Plan
  • Employee financial incentive:
    • $1,000 for single
    • $1,250 for member/spouse/partner
    • $1,250 for parent/child(ren)
    • $2,000 for family
  • Incentive amount shall be paid by a gift card within the first quarter of Plan Year 2019 and is reportable as taxable income
  • Incentive will be forfeited and returned to the SHBP if subscriber fails to remain enrolled for at least two plan years (1/1/19 through 12/31/20)

To enroll in one of the tiered-network plans, submit your certified application during our Open Enrollment period. For more information about the tiered-network plans and the financial incentive program, see the Tiered-Network Incentive Program page of our website.

Direct Primary Care Members Offered a Simple Way to Earn an NJWELL Gift Card

The SHBP and SEHBP offer employees and their covered dependents the opportunity to join a Direct Primary Care doctor’s office at no additional cost. This is available as an added benefit of the Horizon and Aetna* plans and does not require any changes to your health insurance.

For SHBP and SEHBP members, one of the advantages of joining a Direct Primary Care doctor from Paladina or R-Health is a simpler way to earn your NJWELL reward this year. All you have to do is complete a health assessment, have a comprehensive physical exam, and a follow-up visit to get your gift card. Please visit the Direct Primary Care Doctor’s Office page on our website to view the many benefits of joining this program!

*R-Health only

Note:  Effective October 22, 2018, this incentive is for members of the State Health Benefits Program and School Employees' Health Benefits Program.