Health, Prescription Drug, Dental and Vision Care Plans


Choosing a medical and dental plan is an important decision and one that requires careful consideration.  While many services are the same from plan to plan, others may vary from one plan to another.  It is important that you review the services provided by your plan, or one you are considering joining, to determine if the services meet the needs of you and your dependents.

Click here to view the available medical plans and the plan calculator


​Health

Health and Dental Coverage During Sabbaticals and Other Leaves

An employee, who is on a Sabbatical Leave, FMLA, or other approved paid leaves of absence, will have continued medical and dental coverage.  Employees on an unpaid leave of absence must contact HR for information on billing for continued medical and dental coverage during the period of the leave.

 

Medicare Coverage While Employed

In general, it is not necessary for a Medicare-eligible employee, spouse, civil union partner, eligible same-sex domestic partner, or eligible child(ren) to be covered by Medicare while the employee remains actively at work.  However, if you or your dependents become eligible for Medicare due to End Stage Renal Disease (ESRD) you and/or your dependents must enroll in Medicare Part A and Part B even though you are actively at work.

 

Retiree Medical Contributions

Employees who attained 20 or more years of service credit as of June 28, 2011, and have 25 years of service at retirement, will be subject to a contribution towards post-retirement medical coverage based on the applicable percentage of premium.  A minimum contribution of 1.5% of the monthly retirement allowance is required.

 

Waiver of Coverage

If an employee wishes to waive health, prescription drug or dental coverage, the Waiver Application and the Health and/or Dental Enrollment Application must be completed along with proof of coverage under a spouse’s or partners dependent coverage.  Coverage may be resumed if the spouse’s or partner’s dependent coverage is no longer in effect.

 

Health Plan Enrollment Application


Prescription Drug Plan

Prescription drug coverage begins and ends when health benefits start and terminate.  The plan is administered by Express Scripts, and the amount you pay for prescription drugs is determined by the medical plan you select.

  • Retail Pharmacy
    Normally, retail pharmacy co-payment amounts are for a 30-day supply.  However, you may obtain up to a 90-day supply of your prescription drug.  To do so, you must pay two copayments for a 31 to 60-day supply or three co-payments for a 61 to 90 day supply.
  • Mail Order Service
    Mail order benefits are available where participants can receive up to a 90-day supply of prescription drugs for one co-payment.

Program Overview

  • Administered by Express Scripts
  • Over 60,000 pharmacies nationwide participate
  • Most pharmacies in New Jersey participate
  • Prescription co-payments determined by the health plan selected

Click here for detailed Prescription Drug Plan Information


Dental

 

Dental Plans

Please review the plan rules including exclusions and limitations before selecting a plan.  You must remain in the dental plan you select for at least 12 months before you can transfer to another dental plan

Eligibility for coverage is the same as the employee eligibility for enrollment in a health plan.

Enrollment in a dental plan is optional.  If you do not enroll when first eligible, you will have the option to enroll each year during the annual SHBP Open Enrollment Period.

In deciding whether to enroll and which plan to choose, you should consider the differences in out-of-pocket costs, the covered services between a Dental Plan Organization and the Dental Expense Plan, and the degree of flexibility that you may want in selecting a dentist.

Dental Plan Enrollment Application

Click here for detailed Dental Plan Information


Vision

 

Vision Care

The Vision Care benefit provides a reimbursement for employees and their eligible dependents of $35.00 for an eye exam, and a reimbursement of $35.00 for single vision lenses or contacts, or $40.00 for bifocal or progressive lenses.  Frames are not covered.  Faculty and staff and their eligible dependents are entitled to receive one reimbursement in a designated two year period (July 1, 2014 – June 30, 2016). 

To receive the reimbursement:

  • Obtain an original itemized receipt for the purchase of corrective lenses.
  • Complete a Vision Care Reimbursement Form
  • Forward the form along with the itemized receipt(s) to Human Resources.

COBRA

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 requires that most employers sponsoring group health plans offer employees and their eligible dependents the opportunity to temporarily extend their group health coverage in certain instances where coverage under the plan would otherwise end.

For SHBP participants, COBRA is not a separate health program; it is a continuation of SHBP coverage under the provisions of the federal law.

  • Fact Sheet #30, Continuation of Health Benefits Under COBRA (PDF, 36K)

Additional COBRA Information