Eligibility and Enrollment

 

Eligibility

Eligibility for coverage is determined by the State Health Benefits Program (SHBP).  To be eligible for coverage, you must work full-time (35 hours per week or more).  Enrollments, terminations, and changes to coverage, must be presented through Human Resources to the Division of Pensions and Benefits.

Chapter 172, P.L. 2003 provides certain part-time staff and part-time faculty members’ eligibility for enrollment in the State Health Benefits Plan (SHBP) if the employee is enrolled in a State-administered retirement system. The employee must pay the full cost for coverage.  Contact the Division of Pensions and Benefits, at (609) 292-7524 or visit the Divisions website at: www.state.nj.us/treasury/pensions for additional information.

 

Enrollment

Employees and their dependents are not automatically covered by the medical or dental plans until enrolled. A Health and Dental Enrollment Application must be completed and submitted through Human Resources. When completing the enrollment forms, provide all the information requested on the application along with any required supporting documentation.  If you do not enroll all eligible members of your family within 60 days of the time you or they first become eligible for coverage, you must wait until the Open Enrollment period, which generally occurs once a year usually during the month of October. 

Health Benefits Enrollment Application 

 

Transfer of Employment

If you transfer to the university from another State employer, coverage may be continued without any waiting period provided that you are still enrolled by the State Health Benefits Program and file a new Health Benefits Enrollment Application.

 

Eligible Dependents

Eligible dependents include your spouse, civil union partner, same-sex domestic partner and/or your children. An eligible individual may only enroll in the SHBP/SEHBP as an employee or retiree, or be covered as a dependent. Children may only be covered by one participating subscriber.

 

Open Enrollment

The State Health Benefits Program (SHBP) has designated the month of October as the annual Open Enrollment period for the State Health Benefits Program. This is your annual opportunity to assess your individual or family benefits needs and revise your health and/or dental plans. All changes made during Open Enrollment will be effective on the first day of January.  Special Open Enrollment Periods are occasionally conducted because of changes that occur during the plan year that impact employees’ coverage cost.  When these changes occur, the State Health Benefits Commission will authorize a special Open Enrollment.

 

Change in Family Status Enrollment

If you have a change in family status, you must complete new enrollment forms.  You have 60 days after marriage, entering into a civil union or same-sex domestic partnership or the birth/adoption of a child to add the new dependent. If you neglect to add the dependent within 60 days of the change in status event, you must wait for the annual Open Enrollment Period. 

If an employee has a change in family status through separation, divorce, or death, you must complete a new enrollment application to change coverage. 

If you have an HMO and move out of the HMOs service area, you can change immediately.

 

Multiple Enrollments

Individuals may belong to SHBP medical plans as either an employee or a dependent, but not both.

Individuals may belong to SHBP dental plans as either an employee or a dependent, but not both.

Two state employees married, same-sex domestic partner or civil union partner cannot both cover the same children.