HISTORIC NJEA-BROKERED AGREEMENT LEADS TO PASSAGE OF CH. 44!
This landmark law has the capacity to help you save nearly half of your current premium sharing costs. The law creates a new state insurance plan and reduces the state plan options to three. For us, who are not in the SEHBP (state plan), it requires that private plans like ours also offer a new, equivalent to the new NJ Educators Health Plan. We will have this new plan option as part of our existing Aetna/S.J. Coastal Health Insurance Fund. For details please see the Powerpoint from our August 26 presentation of the new law and plans by clicking here: Health Insurance Powerpoint. You can also view video of our August 26 Zoom for a detailed explanation of the plan and its options here (you'll need a video player on your device or download it).
What does the new plan do?
- The new plan is essentially the same PPO 15 and Aetna network plan, just like we currently have.
- It saves you thousands of dollars in premium costs by decreasing premiums by increasing your share of OUT OF NETWORK costs. (You should never go out of network anyway.)
- It limits reimbursement costs to chiropractors, physical therapists and acupuncturists WHO ARE OUT OF NETWORK, some of whom have significantly over-charged insurance providers at many times above your cost and comparable costs.
- The only other increase is the co-payment for Emergency Room care, which increases to $125 from $25. However, if you are admitted to the hospital, that copayment is WAIVED. It a possible savings of $100 worth paying several thousands of dollars more in premium costs?
- Given that you should always avoid out of network providers, emergency room care is not considered out of network and the copayment is waived for those admitted, that you'll essentially have the same network and plan as you have now, we recommend members seriously consider opting in to the new plan.
- You can find the full plan details and frequently asked questions here on njea.org. You can view a webinar here.
- You will save about 40% of your current premium sharing deductions. The savings become extra money in your pocket - likely a few thousand dollars.
- The new plan year will begin on January 1, 2021. You will have to make your decision during the open enrollment period which is scheduled for October 1 and October 9.
- DON'T WAIT TO FIGURE OUT YOUR CHOICE. WORK ON IT NOW, ASK QUESTIONS NOW. You won't have long during open enrollment.
To calculate your premium sharing contribution and see how much you'll save with the new plan, watch Tara Myerson's short 'how-to' instructional video here.
Use the Excel/Google Sheets Calculator below. It contains the current premium rates, premium sharing charts, and all the information necessary to calculate your current and future costs if you elect the Ch. 44 new plan. Directions are on the file. Click "file" and "MAKE A COPY" OR DOWNLOAD IT TO YOUR COMPUTER: Excel Calculator. Google sheets version. Delete any numbers and start over with your own level of coverage, % and the newest rates.
We highly recommend opting in to this new plan option; it is what we've been fighting for over several years since Ch. 78. You will get the same coverage for much less cost. You can, thanks to the extensive lobbying effort of NJEA and our members, give yourself a significant raise without suffering any loss of coverage. It is highly unlikely that any increases in out of pocket costs is more than the premium savings unless you insist on keeping out of network providers who are significantly over-charging your insurance and expect you to pay the balance. If you have concerns or questions, please contact us rather than follow misinformed or under-informed opinion from social media. It would be foolish to allow these opinions to cost you thousands of dollars of your own money; but you are entitled to make your own decision.
All V.E.A. members are entitled to health insurance (Aetna 15 PPO, prescription, vision, and dental) for self and family dependents. N.J. law, Chapter 78, requires all public employees to pay a portion of the yearly costs. That amount differs based on level of coverage and salary. The Premium Sharing chart, linked above, shows the % of premiums you must pay - use the Year 4 %'s. Some or all insurances can be dropped in order to avoid paying if you are covered as a dependent under a family member's insurance. Changes or additions of dependents to your plan can be done during the annual open enrollment period, unless they are major qualifying life events (birth, marriage, loss of other coverage). The full plan details are here. The district's Human Resources / Health Insurance page has more information here.
Members on unpaid leave of absences are still required to pay their premium sharing. Contact Personnel to make arrangements. We pay for July and August during the following September-June.
If you have any coverage related issues, please call the insurance broker, Allen Associates at 692-2250. Identify yourself as an employee of the Vineland Board of Education and have your insurance card on hand.