Effective 2/1/2024, the district will be participating in the School Employees' Health Benefits Program. ALL benefit-eligible employees are required to log in to the system and select the plan they would like to choose or waive coverage. 

• For instructions on how to log in and choose a plan, please review this document. 
• Employees who have not previously logged into the system will need to upload proof of dependent eligibility
  • For a spouse: marriage certificate and IRS Form 1040 for 2021 or 2022
  • For dependent children: birth certificate
• To review information about plan choices, employee contribution costs, and prescriptions, please visit the School Employees' Health Benefits Program website.

Other Quick Links and Helpful Resources:

• School Employees' Health Benefits Program ("SEHBP") introduction webinar recording
• Horizon Contribution Calculator: https://www.horizonblue.com/shbp/2024-open-enrollment/2024-premium-contribution-calculator
• Link to find an in-network provider outside of NJ (enter as guest and use prefix NJX): https://doctorfinder.horizonblue.com/dhf_search 
• Preferred Labs with Horizon: Labcorp or Quest
• Wellness Programs: Horizon Bfit and NJWell
• Horizon SHBP Member Services: 1-800-414-7427 (M-F 8 am-6 pm) 
• Horizon Behavioral Health: 1-800-991-5579
• Aetna Contact Info: 877-782-8365 (please reference SEHBP Garden State Health Plan) or AetnaStateNJ.com

• Aetna Medical Benefit Plans & Rates - This document outlines the plans available to employees for the month of January 2024 along with their costs. 
  

• Aetna DocFind - This document outlines how to determine if your providers are in-network. If you are not currently enrolled in the district's health care plan, you will need to search as a guest and use the following information to perform an accurate search: 

Aetna Enrollment Form  - For new employees enrolling in the Medical Benefit Program and employees who need to make a change as a result of a qualifying life-changing event. In section D1 you will need to write the plan you are selecting from the following choices:

• Aetna Open Access Managed Choice 10 (OAMC 10)  (State Plan Equivalent = NJ DIRECT 10)
• Aetna Open Access Managed Choice 15 (OAMC 15) (State Plan Equivalent = NJ DIRECT 15)
• Aetna NJ EHP  (State Plan Equivalent = NJ EHP)
• Aetna NJ GSP (State Plan Equivalent = NJ GSP)

Aetna’s pharmacy network is a broad national network that includes 66,000  pharmacies nationwide and includes most chains and many independent pharmacies. 

Mail Order Form

Search for a Pharmacy (use the "Find a Pharmacy" option)

• Chapter 78 Contribution Schedule (applies to employees participating in Direct10 and Direct15 medical plans)

• Educator Health Plan & Garden State Health Plan Member Contribution Rates Chart

The flex spending limit for 2024 has increased to $3,200 (with a rollover amount up to $640). The dependent care limit remains at $5,000.

• Flex Spending & Dependent Care Form

• Medical Coverage Waiver Form(updated 11/14/2023)

Due to the anticipated transition to the School Employees' Health Benefits Program on 2/1/24, you may choose to waive coverage for the full calendar year, the month of January 2024 only, or for the time period February through December 2024. Please note that if your alternate coverage is with a plan offered by the state of New Jersey, you will no longer be eligible for a cash incentive payment beginning in February 2024. Proof of valid medical coverage & dependent eligibility is required.   

• If you experience a qualifying event at any point in the year and choose to waive benefits, the waiver form must be completed and submitted to Manal Fouad (mfouad@jefftwp.org) within 60 days of the qualifying event. It must be accompanied by a copy of your insurance card, or other proof of coverage, and proof of dependent eligibility.

• Delta Dental Form

• Delta Dental of New Jersey Website (to register for online access to coverage, account information, print a replacement card, etc.)

Questions about your medical, dental or vision benefits? Please contact:

Ms. Manal Fouad

973-663-5780, ext. 5024 ~ mfouad@jefftwp.org