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Jersey City Public School Medical Plan

Information on the transition to a JCBOE Self-Insured Plan

 

As of July 1, 2018, the Jersey City Board of Education will leave the State Employee Benefits Plan and will provide Health Insurance to its employees itself through a Self-Insured Plan.  The District will still offer Horizon BCBS to employees.  It will also offer a second option through Homestead's Open Access Plan so that employees have a choice.  Between now and June 26, 2018, Benefits Counselors will be in schools and Central Office to help employees navigate the changes.  Because the vast majority of our employees will be able to keep their current health insurance company, most should find the transition easy.  Below we provide some information to further assist employees in understanding the changes and what they will need to do before July 1 to ensure that the transition is smooth for everyone.

 

New: Health Benefits Fair (October 2018)

Health Benefits Fair 1st Annual 2018 - October 1 -5th, locations to be announced near you.  Locations 

 Dependent Eligibility Verification Audit (DEVA)

All employees need to provide documentation to prove that all dependents are eligible for coverage in the District's health plans by November 15, 2018.  Counselors will be coming to your schools to assist in this process.  Below is more information about the upcoming audit.

FAQ about the DEVA

Required documentation for eligibility

Schedule for Benefits/DEVA counselors

Need access to the HR/Benefits Intranet or password reset contact: jvillamater@jcboe.org

 

Update on Insurance Cards

 

Posted: July 7, 2018: 

The JCPS has confirmed that Horizon ID cards have been mailed out and you should be receiving yours any day now.  Please note in some cases, JCPS members enrolled in Horizon who elected to buy-up to Direct 10 may receive an ID reflective of Direct 15.  The District is diligently working with Horizon to continue to process the hundreds of request to buy-up.   The account team from Horizon has assured us that all claims during the transition will be recalibrated and a revised EOB will be submitted on behalf on the JCPS if you are one of the affected.
Thank you for your continued patience and understanding.  If you have any specific questions or concerns, please forward them directly to regina.robinson@jcboe.org.

 

Update on getting started with your new plan

 

Starting today, a "live" person from Horizon will be in District to handle telephone calls and provide member resolution, in addition to calling the 1-800#.   

TELEPHONE CALLS ONLY, NO IN-PERSON APPOINTMENTS or WALK-INS


JCPS number (201) 309-1631 

Tuesday, July 3rd  from 10:00 - 3:00pm  
Monday,  July 9th  from 8:30 - 3:00pm 
Tuesday, July 10th from 8:30 - 3:00pm

Or contact: 1-800-355-BLUE (2583) 
Monday through Wednesday and Friday 8:00 - 6:00 
Thursday, 9:00 - 6:00

 

Information for former Aetna Subscribers: 

Cost Calculation Tools (figure out the amount of savings for moving to Direct15, the cost of buying up to Direct10 based on your salary and the kind of plan you have).

Click on instructions on How to connect to the JCPS Intranet for the HC Calculator                                   JCPS Intranet Sign-On

Direct10 Buy-Up form JCEA members who wish to "buy up" to Direct10 should sign this form and scan or fax it to reginarobinson@jcboe.org or fax to 201-938-1142.  If you met with a counselor you do not need to sign again.

Finance Update  Clarification on Retro Pay, Holiday Check and other financial questions

Message from Dr. Lyles--Information on Plans 

Enrollment Call Center: 1-844-506-2833  available Monday through Friday, 9-5

If you'd like to speak to an Horizon Representative:  1-800-722-BLUE (2583), M-F 8 am to 6 PM (9 am on Thursday)

If you'd like to speak to a representative from Homestead, call: 888-446-3327, M-F 8:30 AM to 4:30 PM

New: More information on the Homestead Plan Option

Updated 6-21:  Benefit Counselors Schedule:  Benefits Counselors will be visiting your schools and Central Office.  See this schedule to know when they will be at your school.  We will update this schedule regularly so check back if your school hasn't been scheduled.

Frequently Asked Questions(FAQ):  This document was sent to employees on June 15 and addresses the most commonly asked questions we have received from staff.

Frequently Asked Questions Part II:  This document was sent to employees on June 18 and addressed additional questions raised by employees.

Added 6-25: Frequently Asked Questions Part III

FAQ Glossary:  A quick guide to terms you may not know.

Side-by-Side Comparison of Plans: One page summary of the plan descriptions for both Horizon options and Homestead.

Direct 10 Buy up for JCEA members: Cost to buy up from Direct 15 to Direct 10 for JCEA members.

Health Benefits message--June 11, 2018Email sent to all staff from Dr. Lyles on June 11.  Below are the documents she references in the letter:

Health benefit message--June 12, 2018

 

Dental, Prescription Drug and Vision Plans are not impacted by the transition to Self-Insurance for Healthcare Plans. 

 

Prescription, Dental and Vision Plans:

  • Medco Express Scripts: 1-866-220-6512 orvia the web at 
  • Horizon Dental Insurance:  1-800-4336825 or via the web at 

                                          JCBOE Dental Benefits Summary      Horizon Dental Claim Form

  • Vision Service Plan:  1-800-877-7195 or via the web at 

                                       VSP Summary   VSP Reimbursement Form

 

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