Important Announcements

We are at that time of the year again when covered Employees/Retirees and their eligible Dependents will be able to make a decision based on which medical plans offered by the Fund are right for them.

The Open Enrollment period will commence on November 1, 2016 and end on November 30, 2017. Elections made during the Open Enrollment period will become effective on January 1, 2017 and remain in effect until the end of Calendar Year 2017, provided you remain eligible to participate.

If you do not make any change during the Open Enrollment period, you will automatically retain your present coverage until the next Open Enrollment period.

During the Calendar Year 2017, changes to your healthcare coverage can only be made under the following circumstances:
  • There is a change in the family status during the year (birth, death, marriage, divorce, adoption). Please make changes within 30 days of life event change.
  • The Employee or Spouse has taken a leave of absence or had a change in employment status.
  • Termination of coverage due to loss of a spouse's employment.
  • There has been a significant change in the spouse's health insurance coverage.
  • Retired employees may change plans once in a twelve (12) month period or during open enrollment.
Important Announcements for 2017

  • New Jersey Pension and Health Benefits Reform under Chapter 78, P.L. 2011 Sections 39 to 44: Required Active and Retired Employee Contributions towards Health Benefit Coverage
  • This law requires all public employees and certain public retirees to contribute toward the cost of health care benefits coverage based upon a percentage of the cost of coverage. All active public employees will pay a percentage of the cost of health care benefits coverage for themselves and any dependents. Lower compensated employees will pay a smaller percentage and more highly compensated employees will pay a higher percentage. In addition, the applicable percentage will vary based upon whether the employee has family, individual, or member with child or spouse coverage. These rates will be phased in over several years for employees employed on the contribution’s effective date who will pay 1/4, 1/2, and 2/4 of the amount of the contribution rate during the first, second and third years, respectively. The law establishes a “floor” for employee contributions so that no employee will pay an amount that is less than 1.5% of the employee's compensation. The contribution commenced on January 1, 2012 for certain public employees and upon the expiration of a collective negotiation agreement for others.

    Similar provisions in this law apply to retirees of units of local government. Retirees may be required to contribute a percentage of the cost of health care benefits coverage in retirement benefit. These provisions will not apply to public employees who, on the effective date of the law, have 20 or more years of service in one or more State or locally-administered retirement systems. A 1.5% "floor", for those retirees to whom the 1.5% contribution in current law applies, will also be applicable to these retirees.

  • New Jersey Chapter 375 over-age Dependent Children up to 30” law and DU31 Coverage until Age 31
  • This regulation only applies to fully insured programs throughout New Jersey. Currently the Fund only maintains one program that is fully-insured falling within the Chapter 375 parameters; the Oxford Freedom program. Under these provisions certain qualified over age children may elect coverage under the fully insured plan offered by the Fund (Oxford Freedom) from the time their dependent coverage eligibility would normally end until their 31st birthday. The covered parent is responsible for the full cost of this extended coverage and will be billed directly on a monthly basis.

    It is important to note that any/all dependent children ages 23 through 26 who are currently enrolled for extended coverage under the provisions of Chapter 375, P.L. 2005, will need to complete a new application to enroll as a dependent child under age 26 under the PPACA provisions effective July 1, 2012.

  • Federal Health Coverage Law - Patient Protection and Affordable Care Act


  • Provisions of the federal Patient Protection and Affordable Care Act (PPACA) include the coverage of children until age 26.

    Eligibility
  • A "child" is defined as an enrollee's child until age 26, regardless of the child's marital, student, or financial dependency status - even if the young adult no longer lives with his or her parents.
  • Coverage will be extended to eligible children through December 31 of the year they turn age 26.
  • The extension of coverage is available even if the dependent child is eligible to enroll in other employer-based coverage (aside from coverage through the parent).
    Verification

    A photocopy of the dependent child's birth certificate that includes the covered parent's name must be submitted along with the application.

    A photocopy of the dependent child's birth certificate showing the spouse/ partner's name as a parent and a photocopy of marriage/partnership certificate showing the names of the employee and spouse/partner.

    For a legal guardianship, grandchild, or foster child provide a photocopy of Affidavits of Dependency and a Final Court Order with the presiding judge's signature and seal attesting to the legal guardianship of the covered employee.



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