State Health Benefits Program for Active Employees. A. Medical Coverage
1. The State Health Benefits Program (SHBP) is applicable to employees covered by this contract. Benefits and coverage provided under the SHBP shall conform to the requirements of P.L. 2011, c. 78, section 47, N.J.S.A. 52:14-17.29. Bargaining unit employees may select from any plan that the SHBP and/or the State health Benefits Plan Design Committee make available to employees of the Judiciary.
2. It is agreed that, as part of the SHBP, the Prescription Drug Benefit Program shall be continued during the period of this Agreement. The Prescription Drug Benefit Program may be modified by the State Health Benefits Plan Design Committee, pursuant to its authority under P.L. 2011, c. 78.
3. The State Health Benefits Plan Design Committee shall provide to employees the option to select one of at least three levels of coverage each for family, individual, individual and spouse, and individual and dependent, or equivalent categories, for each plan offered by the program to employees of the Judiciary, differentiated by out of pocket costs to employees including co-payments and deductibles. Pursuant to P.L. 2011, c. 78, the State Health Benefits Plan Design Committee has the sole discretion to set the amounts for maximums, co-pays, deductibles, and other such participant costs for all plans in the program and has the sole discretion to determine the plan design, plan components and coverage levels under the program. The premium rate for each plan is then established by the State Health Benefits Commission.
4. Consistent with law, active employees and/or their spouses shall not be reimbursed for Medicare Part B premium payments.
5. State statute specifically prohibits two employees/retirees who are married to each other, civil union partners, or same sex eligible domestic partners from both enrolling under the SHBP's plans and covering each other. An individual may be covered as an employee or as a dependent but not as both. Furthermore, two SHBP members cannot both cover the same children as dependents under the SHBP plans.
State Health Benefits Program for Active Employees. A. Medical Coverage
1. The State Health Benefits Program (SHBP) is applicable to employees covered by this contract. Benefits and coverage provided under the SHBP shall conform to the requirements of P.L. 2011, c. 78, section 47, N.J.S.A. 52:14-17.29.
2. It is agreed that, as part of the SHBP, the Prescription Drug Benefit Program shall be continued during the period of this Agreement. The Prescription Drug Benefit Program may be modified by the State Health Benefits Plan Design Committee, pursuant to its authority under P.L. 2011, c. 78.
3. The State Health Benefits Plan Design Committee shall provide to employees the option to select one of at least three levels of coverage each for family, individual, individual and spouse, and individual and dependent, or equivalent categories, for each plan offered by the program differentiated by out of pocket costs to employees including co-payments and deductibles. Pursuant to P.L. 2011, c. 78, the State Health Benefits Plan Design Committee has the sole discretion to set the amounts for maximums, co-pays, deductibles, and other such participant costs for all plans in the program and has the sole discretion to determine the plan design, plan components and coverage levels under the program. The premium rate for each plan is then established by the State Health Benefits Commission.
4. Consistent with law, active employees and/or their spouses shall not be reimbursed for Medicare Part B premium payments.
5. State statute specifically prohibits two employees/retirees who are married each other, civil union partners, or eligible domestic partners from both enrolling under the SHBP's plans and covering each other. An individual may be covered as an employee or as a dependent but not as both. Furthermore, two SHBP members cannot both cover the same children as dependents under the SHBP plans.
State Health Benefits Program for Active Employees. A. Medical Coverage
1. The State Health Benefits Program (SHBP) is applicable to employees covered by this contract. Benefits and coverage provided under the SHBP shall conform to the requirements of P.L. 2011, c. 78, Section 47, N.J.S.A. 52:14-17.29.
2. It is agreed that, as part of the SHBP, the Prescription Drug Benefit Program shall be continued during the period of this Agreement. The Prescription Drug Benefit Program may be modified by the State Health Benefits Plan Design Committee, pursuant to its authority under P.L. 2011, c. 78.
3. Through December 31, 2012, active eligible employees are eligible to participate in the prescription drug benefits coverage offered through Medco Health Solutions card program. Similarly, through December 31, 2012, active eligible employees are eligible to participate in the NJ DIRECT 15 Plan (as it existed on June 30, 2011). In the alternative, through December 31, 2012, active eligible employees may elect to participate in an HMO which existed in the program as of June 30, 2011.
4. Beginning January 1, 2012, the State Health Benefits Plan Design Committee shall provide to employees the option to select one of at least three levels of coverage each for family, individual and spouse, and individual and dependent, or equivalent categories, for each plan offered by the program differentiated by out of pocket costs to employees including co-payments and deductibles. Pursuant to P.L. 2011, c. 78, the State Health Benefits Plan Design Committee has the sole discretion to set the amounts for maximums, co-pays, deductibles, and other such participant costs for all plans in the program and has the sole discretion to determine the plan design, plan components and coverage levels under the program.
5. Effective January 1, 1996, consistent with law, the State will no longer reimburse active employees or their spouses for Medicare Part B premium payments.
6. State statute specifically prohibits two employees/retirees who are married to each other, civil union partners, or eligible domestic partners from both enrolling under the SHBP's plans and covering each other. An individual may be covered as an employee or as a dependent but not as both. Furthermore, two SHBP members cannot both cover the same children as dependents under the SHBP plans.
State Health Benefits Program for Active Employees. A. Medical Coverage
1. The State Health Benefits Program is applicable to employees covered by this contract. Subject to the conditions specified below, full-time employees may elect coverage through a PPO (NJ DIRECT15) or an HMO approved by the State Health Benefits Commission.
2. Effective the first full pay period of July 2008 and continuing through the term of the Agreement, employees will pay 1.5% of their annual base salary as a contribution to be used for the express purpose of sharing the cost of health benefits provided by the State. The parties agree that there shall be no open enrollment period triggered by this contribution. Should an employee voluntarily waive all coverage, including prescription drug, under the State Health Benefits Plan ("SHBP") and provide a certification to the State that he/she has other health insurance coverage, the State will waive the 1.5% contribution for that employee.
3. Active eligible employees will be able to enroll in a PPO (NJ DIRECT15), with a national network and the same benefit design as the previous NJ Plus plan, except as modified below. In the alternative, active eligible employees will be able to elect to participate in an HMO. As of the effective date of the new coverage, eligibility for the Traditional Plan and the NJ Plus plan will be discontinued.
4. State statute specifically prohibits two employees/retirees who are both enrolled in the SHBP and who are married to each other, civil union partners, or eligible domestic partners from enrolling under both of the SHBP's HMO plans. One member may belong to an HMO as an employee or as a dependent but not as both. For example, if two members are married to each other, each may enroll for single coverage under either of the HMOs, or one member can enroll the other as a dependent under an HMO if the other person enrolls in NJ DIRECT15. Furthermore, two SHBP members cannot both cover the same children as dependents under both of the SHBP HMO plans. In cases of divorce, dissolution of a civil union or domestic partnership, or single parent coverage of dependents, there is no coordination of benefits under two HMO plans.
5. Effective July 1, 2008, in-network doctor visit co-pays, including specialist co-pays, will increase from $10 to $15. There will be a co-pay of $15 for the first in-network prenatal visit; subsequent in-network prenatal visits are 100% covered. The emergency room co-pay will increase from $25 to $50, which is waived if the individual is ad...
State Health Benefits Program for Active Employees. A. Medical Coverage
1. The State Health Benefits program (SHBP) is applicable to employees covered by this contract. Benefits and coverage provided under the SHBP shall conform to the requirements of P.L. 2011, c. 78, section 47, N.J.S.A. 52:14-17.29. Bargaining unit employees may select from any plan that the SHBP and/or State Benefits Plan Design Committee makes available to employees of the Judiciary. Effective upon notice from the State that PPO plan established in 2019 (commonly called “NJ Direct 2019” or “Unity” plan) is made available to Judiciary employees for enrollment, active eligible employees shall be eligible to participate in that plan. The Judiciary and the Union shall cooperate to facilitate open enrollment as made available by the State.
2. It is agreed that, as part of the SHBP, the Prescription Drug Benefit Program shall be continued during the period of this Agreement. The Prescription Drug Benefit Program may be modified by the State Health Benefits Plan Design Committee, pursuant to its authority under P.L. 2011, c. 78.
3. The State Health Benefits Plan Design Committee shall provide to employees the option to select one of at least three levels of coverage each for family, individual, individual and spouse, and individual and dependent, or equivalent categories, for each plan offered by the program to employees of the Judiciary, differentiated by out of pocket costs to employees including co-payments and deductibles. Pursuant to P.L. 2011, c. 78, the State Health Benefits Plan Design Committee has the sole discretion to set the amounts of maximums, co-pays, deductibles, and other such participant costs for all plans in the program and has the sole discretion to determine the plan design, plan components and coverage levels under the program. The premium rate for each plan is then established by the State Health Benefits Commission.
4. Consistent with law, active employees and/or their spouses shall not be reimbursed for Medicare Part B premium payments.
5. State statute specifically prohibits two employees/retirees who are married to each other, civil union partners, or same sex domestic partners from both enrolling under the SHBP’s plans and covering each other. An individual may be covered as an employee or as a dependent but not as both. Furthermore, two SHBP members cannot both cover the same children as dependents under the SHBP plans.
