Date: October 27, 2011
To: Eligible Full-time Employees
From: Vivian Fernández
Vice President Faculty and Staff Resources
Subject: Important Time-Sensitive Information Regarding the SHBP Extended Open Enrollment Period until November 11, 2011 and the 12 New SHBP Health Plan Options

This is to provide a reminder that the annual Open Enrollment period for the State Health Benefits Program (SHBP) and the New Jersey Tax$ave program has been extended through November 11, 2011. In addition, this message serves as a follow-up to earlier communications regarding significant changes in New Jersey State health benefits law. We have received notification from the State of New Jersey Division of Pensions and Benefits that 12 new health care plan options have been added to the current plan options.

We ask that you take the time to review the information on all available plan options and the changes to premium contributions during this Open Enrollment period. Please note that if you do not wish to make any changes to your health or dental benefits, you need take no further action. However, you must renew your New Jersey Tax$ave Program (i.e., Section 125 Flexible Spending Accounts) annually during the Open Enrollment period. All changes made during Open Enrollment will become effective January 1, 2012.

Open Enrollment Change Options

You can make changes to these plans during the Open Enrollment period:

  • Medical
  • Dental
  • Prescription Drug
  • Tax$ave – Section 125 Flexible Spending Accounts (Medical and Dependent Care)
  • Premium Option Plan Waiver

Detailed information on how to make plan changes is available on the Open Enrollment website.

Current Health Insurance Plans

The original three plans (NJ Direct 15, Aetna HMO and CIGNA HMO) will still be available. No action is required if you wish to remain in your current health and prescription plan.

New Health Plan Designs

The new plans are structured to provide eligible employees with flexible health care cost sharing options. To this end, employees are able to select a plan that best meets their personal circumstances, health care utilization needs, and individual cost sharing preferences. Employees may select a plan with higher copayments and/or deductibles in order to reduce their biweekly premium contribution, or they may select a plan with higher biweekly premium contributions and lower copayments and/or deductibles.

Health Plan Comparisons

In addition to the three current health plan options, Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ), Aetna and CIGNA are offering four additional plan options. All of the new plans provide essentially the same level of covered services as the existing plans. The primary difference is in how you choose to distribute the total cost. An employer funded Health Savings Account (HSA) also is available with one of the High Deductible (HD) plan options, although the state is still finalizing the specifics of this option. The following chart provides an overview of all the available health plans.

SHBP Health Plans
Current Plans Current Plan Highlights

NJ Direct 15 (PPO)

Aetna HMO

Cigna HMO

  • $15.00 Copayment for Primary Care
  • $15.00 Copayment for Specialist Care
  • $50.00 Copayment for Emergency Room Visit
  • Retail Prescription Copayments - $3.00 Generic, $10.00 Brand name (no generic available), $25.00 Brand name
  • Mail order Prescription Copayments - $5.00 Generic, $15.00 Brand name (no generic available), $40.00 Brand name
1525 Plans 1525 Plan Highlights

NJ Direct 1525

Aetna 1525

CIGNA 1525

  • $15.00 Copayment for Primary Care
  • $25.00 Copayment for Specialist Care
  • $75.00 Copayment for Emergency Room Visit
  • Retail Prescription Copayments - $7.00 Generic, $16.00 Brand name (no generic available), $35.00 Brand name
  • Mail order Prescription Copayments - $18.00 Generic, $40.00 Brand name (no generic available), $88.00 Brand name
2030 Plans 2030 Plan Highlights

NJ Direct 2030

Aetna 2030

CIGNA 2030

  • $20.00 Copayment for Primary Care
  • $30.00 Copayment for Specialist Care ($20.00 for Dependent Children up to their 19th birthday)
  • $125.00 Copayment for Emergency Room Visit
  • Retail Prescription Copayments - $3.00 Generic, $18.00 Brand name, no generic available, $46.00 Brand name
  • Mail order Prescription Copayments - $5.00 Generic, $36.00 Brand name, no generic available, $92.00 Brand name
HD 1500 Plans HD 1500 Plan Highlights

NJ Direct HD 1500

Aetna HD 1500

CIGNA HD 1500

  • $1500.00 Individual In-Network Deductible, $3,000 Employee +1 or more
  • 20% coinsurance after deductible is satisfied
  • $1,000 In-Network Individual, $2,000 Family Out-of-Pocket Maximum
  • Prescription is integrated with the medical plan and is subject to deductible and coinsurance
  • $300.00 Employer Funded Health Savings Account
HD 4000 Plans HD 4000 Plan Highlights

NJ Direct HD 4000

Aetna HD 4000

CIGNA HD 4000

  • $4000.00 individual In-Network Deductible, $8,000 Employee +1 or more
  • 20% coinsurance after deductible is satisfied
  • $1,000 In-Network Individual, $2,000 Family Out-of-Pocket Maximum
  • Prescription is integrated with the medical plan and is subject to deductible and coinsurance

In order to determine the best option for your individual needs, we encourage you to take the time to review the more detailed plan information, and avail yourself of the following resources:

Changes to the Insurance Premium Structure

Currently, employees who participate in the State Health Benefits Program (SHBP) contribute 1.5% of their base salary toward health insurance and/or prescription regardless of the level of coverage. The new law introduces a sliding fee scale premium structure for the SHBP medical and prescription plans which will be phased in over a four year period for current employees. Under the new law, if an employee’s current contribution rate is higher than what they would pay with the new premium structure, the employee will continue to contribute 1.5% of base salary until such time that the new premium exceeds the 1.5% contribution rate. Please note that under no circumstances will the SHBP contribution rates be reduced as a result of this change in premium contribution structure. All changes in SHBP premium contributions will be effective January 1, 2012. The Employee Pre-Tax Medical and Prescription Insurance Premium Estimator can help you gauge your future health costs.

Dental Plans

The dental plan options have not changed. However, the Aetna Dental Expense plan has changed from a passive PPO to a true PPO plan effective January 1, 2012. The in-network benefits have not changed. The Out-of-Network benefits have been modified. The out-of-network deductible is $75.00 individual and $150 for family. The Out-of-Network coverage percentages have also been modified. You may view the Dental Expense Plan Change Information Sheet for details and the 2012 Dental Rates.

University Human Resources will be conducting informational sessions on the Camden, Newark and New Brunswick Campuses to explain the new health plan options. More information will be provided when the sessions are scheduled.

If you have any questions regarding the pension and health reform changes, please contact a Benefits Specialist at 848-932-3990 or at benefits@hr.rutgers.edu.