• Special Open Enrollment Information

    May 2022

    New Garden State Plan

    Flexible Spending (FSA) & Dependent Care (DCA) Accounts

    • Forms must be submitted to Manal Fouad by Tuesday, May 31, 2022.
    • This enrollment will be for a short plan year from July 1 to December 31, 2022. 
    • There will be a virtual Q&A session on May 19, 2022 @ 3:15pm to address any questions (meeting link)
    • The maximum contribution for the six-month period is $1,425 for FSA and $2,500 for DCA.
    • Click here to access the form.

    2022-2023 Summer Savings Program

    • Forms must be submitted to Manal Fouad by Friday, September 2, 2022.
    • Click here to access the form.

Medical Plan Information

Prescription Plan Information

Dental Plan Information

Waiving Coverage

    • Medical Coverage Waiver Form

    • The waiver form must be completed and submitted to Manal Fouad by October 31, 2021. It must be accompanied by a copy of your insurance card, as well as copies of your marriage certificate and birth certificates, if applicable.

Summaries of Benefits & Coverage


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

    Ms. Manal Fouad

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