Medical Plan Information
-
-
Aetna Medical Benefit Comparison October 2022 - This document outlines the plans available to employees effective 1/1/23 along with their costs. These mirror the plans that are currently available under the state's School Employee Health Benefit Program.
-
Aetna DocFind - This document outlines how to determine if your providers are in-network. You will need to search as a guest and use the following information to perform an accurate search:
New Plan Name
Search using this Plan Name on Aetna’s website
Aetna Open Access Managed Choice 10
Managed Choice POS (Open Access)
Aetna Open Access Managed Choice 15
Managed Choice POS (Open Access)
Aetna NJ Educators Health Plan (NJ EHP)
Managed Choice POS (Open Access)
Aetna NJ Garden State Plan (NJ GSP)
(NJ) Aetna Whole Health New Jersey Choice POS II 4
Aenta Enrollment Form - The completed form should be emailed to Manal Fouad by 11/9/2022. 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
-
Prescription Plan Information
-
Aetna’s pharmacy network is a broad national network that includes 66,000 pharmacies nationwide and includes most chains and many independent pharmacies. The formularies with Aetna are comparable to those with Optum Rx, but they may differ from one pharmacy benefit manager to another. It is important to attend one of the educational meetings or watch the recording that will be made available to ensure you have everything you need to properly search for your medication and understand how it’s covered. Please follow these important steps:
- Attempt to fill your current medication one final time prior to 12/31/22.
- 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 - 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”.
- 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”.
- Click "View Pharmacy Plan" to find your medication or to download the guide.
- The first time you visit your pharmacy on or after 1/1/23 be sure to confirm with the pharmacy they are using your new Aetna member ID.
Mail Order Form
Search for a Pharmacy (use the "Find a Pharmacy" option)
Cost Information
-
-
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
-
Waiving Coverage
-
-
Medical Coverage Waiver Form (updated 10/18/22)
-
The waiver form must be completed and submitted to Manal Fouad by 11/9/2022. It must be accompanied by a copy of your insurance card.
-
Dental Plan Information
-
-
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