Health Benefits
We provide our employees with a comprehensive benefit package that comprises a valuable part of your total compensation.
The university is committed to attracting and retaining superior faculty and staff. We provide our employees with a comprehensive benefit package that comprises a valuable part of your total compensation. The information is intended to give you an overview of the benefits we offer our employees. The particular plans available may vary depending upon employment status, union affiliation and plan selection. Provisions of the plans will continue to be determined by law, contract and university policy.
Visit mynjbenefitshub.nj.gov to manage your benefits. For a step-by-step guide, please view the Login/Registration Instructions.
To make an appointment to discuss your benefits, please call 973-596-3140.
HIPAA Notice of Privacy Practices and HIPAA Forms
Updates
Effective February 3, 2022, the cost share waiver for telemedicine and telehealth visits not related to COVID-19 testing will end. If your SHBP or SEHBP-covered employees use Horizon CareOnlineSM or another telemedicine service from their provider for any care other than to determine the need for a COVID-19 diagnostic test, the employee will be subject to normal copayments along with any applicable coinsurance and/or deductibles for the covered services.
There are four types of medical plans for NJIT employees. A Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), High Deductible Health Plan (HDHP), Tiered-Network Plans. Plans are provided through Horizon Blue Cross and Blue Shield of NJ, 1-800-414-7427 Home - SHBP/SEHBP (horizonblue.com)
BenefitsSolver Access Instructions
HMO Plan: Horizon HMO
A HMO is a managed care plan that requires the selection of a Primary Care Physician (PCP) from the carrier’s HMO network, who will coordinate all medical care. PCP referrals are required to see Specialists, and there is no out-of-network coverage except for emergencies. A HMO plan has a deductible and co-insurance, as well as co-pays for doctor’s office and ER visits. HMO plans are best for members who prefer predictable, manageable costs for their health care.
PPO Plans: NJ DIRECT15, NJ DIRECT1525, NJ DIRECT2030, and NJ DIRECT2035
With a PPO (Participating Provider Organization) plan, there is no requirement to choose a PCP and no referrals are required to see a specialist. There are copayments for PCP and specialist visits, and some services require that coinsurance be paid; Using an out-of-network provider or service costs more out of pocket. PPO plans are best for members who prefer a wider range/variety of doctors over cost.
HDHP Plans: NJDirectHD4000, NJDirectHD1500
A High Deductible Health Plan (HDHP) is a point-of-service medical plan. The plan deductible must be met before the insurance begins to pay for services. The HDHP is combined with a tax-favored health savings account (HSA) that can be used to pay for qualified medical expenses now (including the medical plan’s deductible) or accumulate over time to pay for future expenses. You determine the amount to fund in your HSA (up to the annual IRS limit). A HDHP (High Deductible Health Plan) plan combines a point-of-service medical plan with a tax-favored health savings account that can be used to pay for qualified medical expenses. The funds in a HSA account may be used to pay for qualified medical expenses now (including the medical plan’s deductible) or accumulate over time to pay for future expenses. HDHP plans are best for members who want greater control over how they manage health care spending.
Tiered-Network Plans: Horizon Omnia
Tiered plans give employees the flexibility to visit practitioners in the carrier’s managed care network, significant premium share reductions and no referrals are required. When utilizing Tier 1 providers there will be lower member cost sharing, with copays as low as $5.00 for an office visit. Tier 1 refers to specific doctors, hospitals and other health care professionals who offer cost-effective care. Tier 2 provides flexibility to see any provider included in the managed care network, but with slightly higher cost sharing. There is no out-of-network coverage with either plan.
Horizon BCBS benefit summaries
Prescription Drug Plan
Prescription drug coverage begins and ends when health benefits start and terminate.
The prescription drug plans are administered for the SHBP by OptumRx. Employees may contact Optum directly by calling 1-844-368-8740 or visiting https://www.optumrx.com/.
Retail Pharmacy
Normally, retail pharmacy co-payment amounts are for a 30-day supply. However, you may obtain up to a 90-day supply of your prescription drug. To do so, you must pay two co-payments for a 31- to 60-day supply or three co-payments for a 61- to 90-day supply. Additional information can be found in the “Purchasing Prescription Drugs at a Pharmacy” section.
Click here for the Prescription Drug Member Handbook
Mail order Service - Mail order benefits are available for maintenance medications. Participants can receive up to a 90-day supply of prescription drugs for one co-payment. Cost savings, convenience and 24/7 access and reminders. Log in to your Optum Rx account to find more information.
Waiver of Coverage (Health)
If an employee wishes to waive health and prescription drug coverage, they may simply elect “Waive” when they make their benefit plan elections in Benefitsolver. Coverage through the SHBP may be resumed at the next Open Enrollment or through a Qualifying event enrollment.
The Employee Health and Dental Plans are available to all full-time NJIT staff and faculty employees and their eligible dependents. It is important that you review the services provided by each plan, and determine which Carrier meets the needs of you and your dependents.
There are two types of dental plans for NJIT employees: Dental Plan Organization (DPO) and Dental Expense Plan (DEP). Please review the plan rules including exclusions and limitations before selecting a plan. Enrollment in a dental plan is optional. If you do not enroll when first eligible, you will have the option to enroll each year during the annual SHBP Open Enrollment Period. Rate can be found here.
NOTE: You must remain in the dental plan you select for at least 12 months before you can transfer/change to another dental plan.
Dental Plan Organizations (DPO)
DPOs work like the HMOs in the health program. Members must use the provider selected in the DPO to receive coverage. When using a DPO dentist, most dental care is covered in full. There are no claim forms to file deductibles. There are several DPOs participating in the Employee Dental Plans from which you may choose.
When using a DPO dentist, diagnostic and preventive services are covered in full. Most other eligible expenses require a copayment. In addition, orthodontic treatment is covered for both children and adults, subject to a copayment. Before electing a DPO plan, please make sure your preferred provider is participating in the network of the plan you choose.
Metlife Metlife Website
Cigna http://www.cigna.com/stateofnj
Healthplex http://www.healthplex.com
Horizon Dental Choice http://www.horizonblue.com
Aetna DMO http://www.aetna.com/statenj
Dental Expense Plan (DEP)
The Dental Expense Plan is a true PPO. The plan allows members to choose any licensed dentist for dental care, however costs will be lower if using an in-network dentist. The Dental Expense Plan is administered by Aetna Dental. The annual plan deductible is $50 per person/$100 per family in-network and $75 per person/$150 per family out-of-network. The deductible does not apply to diagnostic, preventive, and orthodontic services.
If an employee does not enroll when first eligible, they have the option to enroll during the annual SHBP Open Enrollment Period (in the Fall with coverage effective the following January).
Benefitsolver access instructions
Waiver of Coverage (Dental)
If an employee wishes to waive Dental drug coverage, they may simply elect “Waive” when they make their benefit plan elections in Benefitsolver. Coverage through the SHBP may be resumed at the next Open Enrollment or through a Qualifying event enrollment.
Vision Care Plan
Employees enrolled in NJIT’s health plans are subsequently enrolled the vision plan provided by National Vision Administrators (NVA), at no additional cost.
This a full service vision plan with copays on eye exams, frame, lenses and contacts. There are also additional discounts on specialty lenses, hearing aids, and laser eye surgery.
For a full detail of the services please visit the NVA website and log in with your credentials from your NVA insurance card.
Vision Care Reimbursements - Ending May 31, 2022
The Vision Care Reimbursement Plan will be ending effective May 31, 2022, and any receipts submitted after May 31, 2022 will be returned to the employee.
The Vision Care Reimbursement Plan provides a reimbursement of up to $35.00 for an eye examination, in addition to $35.00 for single vision lenses or contacts and $40.00 for bifocal or progressive lenses. Frames are not covered. Faculty and staff and their eligible dependents are entitled to receive one reimbursement in a two-year period. Members may use their medical coverage for the eye examination.
To receive the reimbursement:
- Obtain an original itemized receipt for the purchase of corrective lenses.
- The original receipt should include the name of the person who received an eye examination, contacts or lenses; the date of purchase, and the type of lenses (e.g. single vision, bifocals, progressive, contacts).
- Forward the form along with the itemized receipt(s) to Human Resources
The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 requires that most employers sponsoring group health plans offer employees and their eligible dependents the opportunity to temporarily extend their group health coverage in certain instances where coverage under the plan would otherwise end. Examples include: termination of employment, death of an employee, loss of dependent status. For SHBP participants, COBRA is not a separate health program; it is a continuation of SHBP coverage under the provisions of the federal law. Click the link below for more information.
Benefits Solver - MyChoice - Utilize this site to manage your benefits and additional services provided.
http://mynjbenefitshub.nj.gov/
Summary of Benefits and Coverage
https://www.state.nj.us/treasury/pensions/hb-active-shbp.shtml
Benefits Guide
https://www.state.nj.us/treasury/pensions/documents/hb/oe2022/2022-shbp-state-overview.pdf
Health Benefits Premium Calculator
https://www.horizonblue.com/shbp/2022-open-enrollment/2022-premium-contribution-calculator
Optum Rx Prescription plans
https://www.state.nj.us/treasury/pensions/documents/guidebooks/hp0506.pdf
Horizon BCBSNJ Plans
https://www.state.nj.us/treasury/pensions/hb-active-shbp.shtml
Employee Dental Plans Information
http://www.state.nj.us/treasury/pensions/documents/factsheets/fact37.pdf
Participating Employee Dental Plans
http://www.state.nj.us/treasury/pensions/dental-plans.shtml
NJWELL is an employee wellness program designed to help actively employed members of the State Health Benefits Program (SHBP) live a healthy lifestyle and get rewarded for completing activities designed to promote healthy behaviors.