/UserFiles/Servers/Server_252233/File/Faculty and Staff/Employee Benefits/2023-2024/2023-24 DA15 (1).pdf
Open Enrollment: May 19,2023 - June 2, 2023
Hired Before 07/01/2020
Waive Coverage
Change Coverage
Hired ON or After 07/01/2020
If you were hired on or after July 1, 2020, you are required to enroll in this plan if you are not waiving coverage.
Waive Coverage
Change Coverage
2023-2024 Plans
2023-2024 NJ Educators Health Plan : Plan Design l Employee Cost Chart
2022-2023 Plans for Comparison
2022-2023 NJ Educators Health Plan : Plan Design | Employee Cost Chart
The Egg Harbor Township School District offers full time employees hired before July 1, 2020 medical/vision and prescription benefits for the employee and the employee’s family at a cost dictated by the State of NJ under the provisions of Chapter 78, PL 2011. The employee benefit contribution is a percentage of the Board’s cost of your medical and prescription benefits utilizing a sliding scale based on your salary. There are Employee Cost Charts posted just above to assist you in determining the amount of employee benefit contributions that will be deducted from your pay. The district offers seven different medical plans. You can find the plan designs in detail above as well (click on plan designs). The Board will pay the cost of the Direct 15 plan (less employee benefit contributions). If you select a plan with a higher cost to the Board you will also be responsible to pay cost of the plan upgrade, in addition to your increased mandated benefit contributions. The plan upgrade cost would be the difference between the cost of the plan you chose and the cost of the Direct Access 15 plan. You can find the costs of the plans in the Employee Cost Chart as well. If the plan costs less there is no fee.
Chapter 44 requires all school districts to implement a plan called the New Jersey Educators Health Plan (EHP). If you were hired ON or AFTER July 1, 2020, or eligible to receive benefits as of that date, you will have the option to enroll in EHP only or waive coverage.
The medical plan that you select will include vision insurance through Horizon Davis Vision. You will receive separate cards for Davis Vision. Your Davis Vision member ID will be the same as your Horizon member ID, but will be through the affiliated company, not Horizon directly.
The District offers all full time employees, and their family members, dental insurance through Delta Dental of NJ at no cost to the employee. Children cannot be enrolled in the dental insurance program until they reach two years of age. You may enroll children within 60 days of their second birthday, or during any subsequent open enrollment period.
Important Information regarding benefits, retirement, FSA, Option to Waive Benefits Program and Safety!!! - Click HERE
Frequently used benefits forms:
Medical: Horizon Group Enrollment/Change Request Form
Prescription: Benecard PBF Enrollment/Change Form
Dental: Delta Dental Enrollment/Change Form
Documentation Required: When submitting the forms above to enroll or make changes you must submit necessary documentation.
Add a baby to your insurances: You have 60 days from the birth date to enroll your baby; the insurance will be retroactive to the date of birth. Your employee benefit contributions will be increased as of that date as well, therefore you may owe back deductions.
1. Please complete the Horizon (Medical/Vision) and Benecard (Rx) forms; adding your new dependent, sign and date and return to me. You must list each dependent already on your plan if you wish them to remain covered.
2. You must submit the birth certificate with your enrollment forms.
3. Please wait until you receive a social security number for the baby to submit your forms.
4. Your dependent cannot be enrolled in the Delta Dental of New Jersey dental insurance plan until he or she reaches two years of age.
Add a spouse to your insurances: The State of NJ allows 60 days from the date of your marriage to enroll your spouse. Your spouse will be added retroactive to the date of your marriage. Your employee benefit contributions will be increased as of that date as well, therefore you may owe back deductions. It is recommended that you complete the documents and submit them to the business office within 30 days of the event.
1. You will need to attach a copy of your marriage certificate to the enrollment forms
2. If you have been married a year or more, you must also submit a copy of your most recently filed Federal 1040 form that indicates you filed jointly (you may black out/white out the financials).
3. If you are adding new step children, you will need to include copies of their birth certificates, which must include parents' names on them.
4. Complete and sign all three forms: Horizon, Benecard and Delta Dental of NJ. All dependents must be listed. Do not be concerned with completing areas that are not self-explanatory, as district personnel will be entering this into the respective databases.
Change your name: If you are adding your spouse to your insurances you may change your name on those enrollment forms.
1. Complete and sign all three forms: Horizon, Benecard and Delta Dental of NJ. All dependents must be listed. Do not be concerned with completing areas that are not self-explanatory, as district personnel will be entering this into the respective databases.
2. To change your name within the school district, you must complete a new W4 form with your new information. Send the completed W4, along with a copy of your social security card with your new name on it to Jane Rainear, Human Resources.
Add a child to dental insurance: Children may be added to the dental insurance within 60 days of their second birthday. If you missed that opportunity, the next time the child could be enrolled is during open enrollment period. Open enrollment period is during the month of October to submit the paperwork which takes effect on January 1 or during the month of May to submit the paperwork which take effect on July 1.
1. Complete and sign Delta Dental of NJ Enrollment/Change Form.
2. Include the birth certificate, which must include parents’ names on them, unless submitted when adding to medical/prescription insurance.
Divorce: It is incumbent upon the employee enrolled in the district's insurance benefits to inform the employer of changes that will affect your type of insurance coverage. These changes include, but are not limited to, divorce. An employee who becomes divorced, has sixty days to process the documents to remove their ex-spouse from the district's insurance coverage. The date of termination of the ex-spouse will be the first of the month following the divorce. If Horizon verifies that claims were paid for a divorced spouse, they may recapture all those payments from the covered employee.
1. Employees are required to submit an updated address to the district so that we can offer the ex-spouse COBRA benefits.
2. Complete and sign all three forms: Horizon, Benecard and Delta Dental of NJ. All dependents must be listed. Do not be concerned with completing areas that are not self-explanatory, as district personnel will be entering this into the respective databases.
3. Proved a copy of your court documents verifying your divorce is final and the date of the divorce.
Access to Telehealth and Nurse Advice Hotlines
Horizon members will have no cost, 24/7 access to licensed nurses who can assess and assist members with symptoms that are consistent with suspected COVID-19 infection. Those service are available through the company’s free “Horizon Blue” app, the www.HorizonBlue.com online portal, or by phone at 1-888-624-3096. Members may also use those services to consult with a nurse about other health concerns and potentially avoid a visit to a physician office or urgent care facility.
Horizon: Free Identity Protection Services
Horizon: Doctor Finder - Link - App for iPhone
Horizon: Blue365 Discount Program
Horizon: Getting Care on the Road
Horizon: bFit Overview ActiveFit Overview Link
Horizon: Update to bFit to Include Walking
Horizon: Member Online Services
Horizon: 24/7 Access to Nurse Line 
Davis Vision: Website for Davis Vision
The district provides vision coverage through Horizon Vista/Davis Vision. Employees who are enrolled in Direct Access 15 or the Horizon POS are automatically enrolled in Horizon Vista/Davis Vision XV. Employees who are enrolled in Direct Access 10 or the Horizon 15/25 are automatically enrolled in Horizon Vista/Davis Vision X. Those employees who are enrolled in the Omnia Plan have vision insurance within that plan. Horizon Vista/Davis Vision View Network mailed cards to everyone's home in July 2017. Unfortunately many employees assumed that they received junk mail and destroyed them. The member ID number for Davis Vision is the same as your Horizon member ID number on your health insurance card. So if you do not have your Davis Vision card you may inform your eye doctor of your member ID number and let them know that it is through Davis Vision.
Click below for detailed information regarding your Davis Vision Plan. Davis Vision provider services can be reached at 1-800-773-2847. Davis Vision customer service can be reached at 1-800-278-7753.
Horizon Vista X/Davis Vision 10
Horizon Vita XV/Davis Vision 15
Benecard PBF:
Your Prescription Benefit Program is administered through Benecard. The Benecard Prescription Benefit Program provides you with access to more than 99% of pharmacies within New Jersey and approximately 95% nationwide. Therefore, you will be able to have your prescriptions filled whether you are at home, on vacation or have a dependent away at school. You have access to a pharmacy locator, preferred medication list, and program-specific details online at www.benecardpbf.com.
If you have additional questions or concerns you may contact Benecard directly at 1-877-723-6005 or if you would prefer you can contact our brokers at Brown and Brown Benefit Advisors at 800-811-4122.
Brochures
Group 1000-1100 BENECARD PBF - Click Here
Group 4000-4100 NJEHP - Click Here
Delta Dental of NJ- Website for Dental Insurance
Flexible Spending Plan (Section 125):
We are now participating through Health Equity. Health Equity provides 24/7 US-based member services and a mobile app for easy account management, notifications, and reimbursements.
To learn more, choose the link below or review attached presentation:
https://healthequity.com/learn
Health Care FSA:
- Contribute a Maximum of $2,850
- Pays for eligible medical, dental and vision care expenses that are not covered by an insurance plan
- Funds are withheld pretax
- The participant’s total annual election amount is available on day one of your plan year
- HealthEquity FSA Debit Card
Dependent Care FSA:
- Contribute a Maximum of $5,000
- Pays for dependent care services, such as preschool, summer day camp, before or after school programs, and child or elder daycare
- Funds are withheld pre-tax
- As soon as the account is funded, the participant can use their balance to pay for eligible dependent care expenses
Please note that if you are an existing participant, you must re-enroll annually.
Click HERE for an enrollment application.