Open Enrollment Plan Year 2021

Once again, it is that time of year for you to analyze your current benefits and decide what’s best for you and your family. You must either enroll in the health plan of your choice or waive health benefits. If you are currently enrolled in a health plan and do not enroll or waive, you will be automatically enrolled in the New Jersey Educators Health Plan (NJEHP)

By Friday, October 23, 2020, you must either elect coverage by completing a Health Benefits Enrollment Form or waive health coverage by completing a Health Benefit Waiver Form. All plan changes become effective January 1, 2021.

To get the latest plan information, view the Horizon SEHBP open enrollment on-demand webinar. Please click on the following link to view the HorizonBlue Webinar.

Health Benefit Form Submission 
The preferred method for submitting the Health Benefits Enrollment and Health Benefits Waiver is to upload the completed and signed forms with supporting documentation to Laserfiche.  You should check your Bergen email for the instructions to upload.

You can also drop off your forms in a sealed envelope addressed to Janet Doyle in the Public Safety office located at the Paramus Campus.

FAQs

Who is eligible to enroll in the health benefits?

Eligibility for Active Group coverage is determined by the School Employees’ Health Benefits Program (SEHBP). All enrollments, changes to coverage, terminations, etc. must go through your employer.

Full-time Employees
To be eligible, you must be a full-time employee or an appointed official from a local board of education employer that participates in the SEHBP. Each employer decides the minimum hours to be considered full-time by a resolution filed with the NJDPB, but it cannot be less than 25 hours per week. Employment must also be for 12 months per year, except for employees whose usual work schedule is 10 months per year (the standard school year).

What plans are being offered?

P.L. 2020, c. 44 (Chapter 44) created the New Jersey Educators Health Plan (NJEHP).  The NJEHP is a Preferred Provider Organization (PPO) plan currently administered by Horizon Blue Cross and Blue Shield of New Jersey (Horizon). NJ DIRECT10, and NJ DIRECT 15 will remain available for employees hired before July 1, 2020. Employees hired after July 1, 2020, are required to enroll in the NJEHP.

Please click here to see the 2021 Medical Plan Design Comparison Chart which provides a side-by-side view of the basic benefits, copayments, and other out-of-pocket costs for the SEHBP medical/prescription drug plans.

The 2021 SEHBP Horizon Local Education 2021 Overview provides an overview of the plans being offered.

How is prescription coverage administered?

Prescription coverage will continue to be administered by OptumRX and will continue to be bundled with the medical. 

The OptumRx website is: www.optumrx.com/stateofnewjersey

How do I calculate the cost of coverage?

Horizon BCBSNJ’s premium contribution calculator can help you calculate your health care premium costs. This tool can help you estimate your annual contribution toward the cost of your health plan. The contribution calculator uses a contribution calculation based on Chapter 44 Contribution Schedule for the NJEHP and Chapter 78 Percentage of Premium Chart for the NJ DIRECT 10 and the NJ DIRECT 15 plans. After you see your estimated cost you can select up to three plans to view a side by side comparison of each plan’s benefits.

It is important that you complete the following categories with the indicated selection:

Employee Type: Local Education
Prescription Plan: Prescription Drug coverage included with your SEHBP Plan

What if I want to waive coverage?

Employees are permitted to waive medical and prescription coverage if they have other employer-provided or retiree coverage, or other coverage as a dependent. Employers are permitted to offer an incentive to employees who waive SEHBP coverage. Under P.L. 2010, c. 2 (Chapter 2), the incentive amount for waivers is limited to 25% of the amount saved by the employer or $5,000, whichever is less. 

In addition, because multiple coverage under the SHBP/SEHBP is prohibited, waiver incentives are only payable if the other coverage is through a non-SHBP/SEHBP plan. 

Important Note: It will be necessary for employees who have previously waived coverage to complete an Health Benefit Waiver Form this year.

Do I need to complete a Health Benefit Enrollment Form or a Health Benefit Waiver Form?

Employees who do not complete a Health Benefits Enrollment Form or Health Benefit Waiver Form will be automatically enrolled in the NJEHP effective January 1, 2021.

What is your health coverage status at Bergen Community College? Do I have to complete a Health Benefits Enrollment Form?
You were hired before July 1, 2020, and you are already enrolled in NJ DIRECT 10 or NJ DIRECT 15 and will not be changing your level of coverage and DO NOT wish to be  enrolled in NJEHP YES
You were hired before July 1, 2020, and you are currently enrolled in a plan that is no longer available and DO NOT want coverage under NJEHP YES
You want to enroll in the NJEHP YES
You were hired on or after July 1, 2020, you must enroll in NJEHP YES
You are not currently enrolled in health benefits and want to enroll in health benefits for plan year 2021 Complete BOTH a Health Benefits Enrollment Form AND a Waiver Form (completing the Reinstatement portion of the form
You are not currently enrolled in health benefits and want to continue to waive your benefits at Bergen Community College Complete a Health Benefits Waiver Form 

How do I return my completed forms and supporting documentation?

The preferred method for submitting the Health Benefits Enrollment and Health Benefits Waiver is to upload the completed and signed forms with supporting documentation to Laserfiche.  You should check your Bergen email for the instructions to upload.  

You can also drop off your forms in a sealed envelope addressed to Janet Doyle in the Public Safety office located at the Paramus Campus.

You are encouraged to take the time to review the included links and information provided to make an informed decision regarding your health benefits coverage for plan year 2021. 

If you have questions please contact Janet Doyle, Benefits Administrator, at humanresourcesgroup@bergen.edu or at 201-493-5043.

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