Hopewell Valley Regional School District Health Benefits Plans 2021-2022
Employees of the Hopewell Valley Regional School District have health benefits plans for 2021-2022, with options based on hire date. Those hired before July 1, 2020, can choose from district plans or NJEHP/GSHP, while those hired after must select NJEHP/GSHP. Contributions vary based on salary percentage. The plans include coverage for prescription drugs, out-of-network services based on Medicare costs, and certain therapies. Rates effective from July 1, 2020, to June 30, 2021, are detailed for different medical plans and premiums.
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Hopewell Valley Regional School District Health Benefits Plans 2021-2022
Employees hired prior to July 1, 2020 have the option of selecting from various district plans, as per their collective bargaining agreement. Employees hired on July 1, 2020 or after select either the NJEHP (New Jersey Educators Health Plan) or the GSHP (Garden State Health Plan) Employee contributions are based on percentage of salary. Employees hired prior to July 1, 2020 can continue to follow existing collectively bargained plans; employee contributions will be based on Chapter 78. Employees hired on or after July 1, 2020 must be enrolled in the NJEHP (or GSHP once available). Employees must remain in one of these plans until January 1, 2028 Current and future pre-Medicare retirees follow same rules.
New Jersey Educators Health Plan and Prescription Drug Coverage - Summaries *For Non-Preferred Brand Name or Specialty Prescription Drugs with Generic equivalent, Member will pay the applicable Brand Name copay plus the cost difference. 1. Prescription Drug Out of Pocket Maximum: $1,600 / $3,200 2. Horizon Prescription Drug benefits valid at participating pharmacies only
Out of Network Allowable Charge Schedule based on 200% of Medicare Cost of services based on allowed amount, not actual charges from provider Can result in increased costs/balance billing to member Balance billing does not count towards Deductibles or Out of Pocket Maximums Physical Therapy, Acupuncture, Chiropractic Services on separate Out of Network Allowable Charge Schedule After annual deductible, pay coinsurance plus any amount exceeding Out of Network benefit limits, balance billing may occur Prescription Drug coverage includes Mandatory Generic, Prior Authorizations and Step Therapy Management
RATES EFFECTIVE JULY 1, 2020 - JUNE 30, 2021 MEDICAL PLANS MONTHLY PREM MEDICAL PLANS MONTHLY PREM TO CALCULATE YOUR MEDICAL & PRESCRIPTION PREMIMUM COST (EXCEPT NJEHP PLAN) Horizon Direct Access 15 Horizon Omnia Single $857.50 $1,414.87 $1,715.01 $2,272.38 Single $623.39 $1,028.59 $1,246.80 $1,652.00 Employee & Child(ren) Employee & Child(ren) Two Adults Family Two Adults Family Horizon Open Access HMO $10 Single $835.58 $1,378.70 $1,671.16 $2,214.28 Add together your medical plan and prescription plan premiums this equals your total premium cost Employee & Child(ren) Two Adults Family Horizon Direct Access 15/25 PRESCRIPTION PLAN Single $832.23 $1,373.17 $1,664.45 $2,205.40 Single $208.64 $281.61 $417.30 $617.83 Find your plan and salary from the Health Benefits Contribution form - your percentage is under YEAR 4 Employee & Child(ren) Employee & Child(ren) Two Adults Family Two Adults Family Horizon Direct Access 20/30 To calculate your yearly annual contribution take your total premium cost above and multiply by your YEAR 4 percentage and then multiply by 12 Single $782.13 $1,290.53 $1,564.27 $2,072.66 CoPay 30 brand name/15 generic/15 mail order Employee & Child(ren) Two Adults Family DENTAL COMPOSITE Horizon Open Access HMO 15/25 Dental Option Dental Choice Total Care $55.34 $39.39 $65.11 10 month employees need to divide their annual contribution by 20 pays to get a per pay contribution Single $771.57 $1,273.11 $1,543.14 $2,044.66 Employee & Child(ren) Two Adults Family 12 month employees need to divide their annual contribution by 24 pays to get a per pay contribution Horizon Open Access HMO 20/20 Single $725.54 $1,197.14 $1,451.06 $1,922.70 Employee & Child(ren) Two Adults Family
District Contact Information: John Agourides Health Benefits Coordinator 609-737-4000, ext. 2204 For help with health benefits questions: ICG Insurance Consultants 609-737-4313
