• Aetna Medical Benefit Plans - This document outlines the plans available to employees effective 1/1/23 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: 

Aenta 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)

Transition of Care Form

Aetna Health App & New Member Website Flyer

Aetna 2023 Pricing Teladoc Member Flyer

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

1. Your medication may require Prior Authorization with Aetna.  Not all medications require this, but many do (especially brand-name meds). We strongly encourage you to search the online Rx Formulary with Aetna using the following link  to confirm whether your doctor needs to request the authorization or not:  https://www.aetna.com/individuals-families/find-a-medication.html
   1. If you are enrolled in the NJ EHP or NJ GSP:  Select 2023 under “Choose A Plan Year” and  the NJ Educators Health Plan Formulary under “Choose A Plan”.
   2. If you are enrolled in the OAMC 10 or OAMC 15 (NJ Direct 10 and NJ Direct 15 Equivalents):  Select 2023 under “Choose A Plan Year” and Standard Opt Out Plan with ACSF under “Choose A Plan”.
   3. Click "View Pharmacy Plan" to find your medication or to download the guide.
2. The first time you visit your pharmacy on or after 1/1/23 be sure to confirm with the pharmacy they are using your Aetna member ID. 

Mail Order Form

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

• Brown & Brown Cost Calculator

• NJEHP Contribution Schedule

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

• Garden State Health Plan Member Contribution Rates Chart

• Flex Spending & Dependent Care Form

• Medical Coverage Waiver Form (updated 10/18/22)

• If you experience a qualifying event and choose to waive benefits, the waiver form must be completed and submitted to Manal Fouad (mfouad@jefftwp.org). It must be accompanied by a copy of your insurance card.

• Delta Dental Form

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

Annual Wellness Incentive Plan

Employees and their spouses/partners that are enrolled in the district's medical insurance plan are eligible to participate in the Wellness Incentive Plan and receive an incentive payment of $250 after completing the following requirements between 11/1/2022 and 10/31/2023:

• Create a member profile on Aetna.com
• Complete the Aetna Health Risk Assessment 
• Annual Wellness Visit with Primary Care Physician
• Complete one of the following:
  • One dental cleaning
  • One eye care check-up

Click here for complete program information and reimbursement form.

Monthly Fitness Reimbursement

Employees, their spouses/partners, and dependents over age 18, that are enrolled in the district's medical insurance plan are eligible to receive a $20 monthly Fitness Program Award from Aetna. To qualify, the participant must log 12 gym visits and/or walk 10,000 steps per day for 12 days of the month.

Reimbursement timeline: The Aetna Fitness reimbursement can be submitted with whatever frequency the member prefers (e.g. monthly, quarterly, etc). However, the request for reimbursement needs to be submitted within 12 months of the date of service. For example, if the member achieves twelve days of walking 10k or more steps during the month of March 2023, he or she would need to submit the March 2023 fitness reimbursement request by the end of February 2024.

Click here for complete program information and reimbursement form.  

Archives

Click here to view the May 2022 Newsletter 

Click here to view the February 2022 Newsletter

Click here to view the November 2021 Newsletter

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

Ms. Manal Fouad

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