As we wrote yesterday, the State of New Jersey has extended the open enrollment period for health insurance through the end of the business day on Friday, November 4, giving you more time to decide if you want to change health plans to avoid a large increase in health care deductions from your paycheck. We’ve planned additional health benefits town hall meetings; click here to RSVP for them:
- Wednesday, November 2, at 5 p.m.
- Thursday, November 3, at 2 p.m.
- Friday, November 4, at 9 a.m.
Our union’s executive director, Patrick Nowlan, will discuss the different health plans, how they compare, and how to change plans. Below is a step-by-step guide, based on Patrick’s presentations, for understanding your options and the factors you should consider in making a decision. Please take advantage of this resource—and, again, click here to RSVP for one of the town hall meetings.
Becky and Todd
Rebecca Givan, President, Rutgers AAUP-AFT
Todd Wolfson, General Vice President, Rutgers AAUP-AFT
Understanding Your Health Plan Options
Start by confirming your current health plan. You should look in the Rutgers portal to be sure; your medical card confusingly lists all plans as “NJ Direct.” You need to know whether you are in the older Direct PPO plans or the newer NJ Direct/NJ Direct 2019 or Omnia plans.
- If you are in the NJ Direct (NJ Direct 2019 if you were hired recently) plan, your cost increase on January 1, 2023, is capped at 3 percent. If you are in the Omnia tiered network plan, your increased cost is capped at 2.25 percent. You can look up your annual contribution on this table; to see how much will be deducted from your paycheck twice a month, divide the annual contribution by 24. These are the least expensive plans available to us; you probably have no reason to change plans, but see the section below comparing the coverage advantages and disadvantages and specific plan changes.
- If you are in the Direct 15, Direct 1525, Direct 2030, or Direct 2035 PPO plans, the High Deductible Plans, or the Horizon HMO, your premium contributions will increase by 18.4 percent (or 18.3 percent for the HMO) starting in January 2023. You may want to consider changing plans. See the instructions below for: 1) Comparing the costs of the different plans, and 2) Comparing the coverage advantages and disadvantages. Both comparisons are important.
Comparing the Costs of the Different Health Plans
Method 1 – Compare the health care deduction in each paycheck (this involves some math!)
- Look at a recent paycheck, see how much is currently being deducted for “health” and “drug,” and add them together. Multiply this figure by 1.184 (1.183 if you are in Horizon HMO. That is how much will be deducted from your paycheck twice a month starting in January 2023.
- Click here to look up your annual contribution if you switched to the NJ Direct/NJ Direct 2019 or the Omnia tiered network plan. To see how much would be deducted from each paycheck, divide the annual contribution by 24.
- Subtract figure 2 from figure 1: that’s how much you would save in each pay period if you switched to NJ Direct/NJ Direct 2019 or Omnia.
Method 2 – Compare the annual cost of health care contributions
Use the Horizon Premium Contribution Calculator. This does the math for you, but you have to run the calculator twice to see your full range of options. This video from Roman Sohor of our sibling union CWA Local 1031 explains very clearly how to use the calculator. Here are the step-by-step instructions:
- Open the Horizon Premium Contribution Calculator in two different tabs. In one tab, select “State All Other” for “Employee Type” and fill in the rest of the fields (the “Prescription Plan” is auto-completed for you). Click the blue button to “Compare Annual Contribution Amounts.” The “State All Other” calculation shows the correct annual costs of the older Direct PPO plans, the High Deductible Plans, and the Horizon HMO, but the figures for NJ Direct/NJ Direct 2019 and Omnia are inaccurate in this tab.
- In the second tab, select “State Union Negotiated” for “Employee Type” and fill in the rest of the information as above. Clicking the blue button will show the correct annual costs of the NJ Direct/NJ Direct 2019 and Omnia tiered network plans.
- Be sure to compare the annual costs you see for NJ Direct/NJ Direct 2019 and Omnia in the second tab to the costs of the other plans you see in the first tab.
- To see how much will be deducted from your paycheck twice a month under any of the plans, divide the results by 24.
Comparing the Coverage Advantages and Disadvantages
The coverage details of the different plans are compared side by side in this document. Look for the advantages and disadvantages of the different plans based on your and your families’ health care needs. We would draw your attention to two main considerations.
The chief difference with the NJ Direct and NJ Direct 2019 plans is that they have a higher co-pay for specialist appointments ($30 compared to $15 for Direct 15) and urgent care and emergency room visits ($45/$150 compared to $15/$100). Prescription co-payments are also somewhat higher. If you have regular appointments with specialists or visit urgent care more often, you will want to estimate whether the greater out-of-pocket expenses outweigh the savings from premium contributions if you switch into one of these plans.
The Omnia tiered network plan has the lowest premium contribution of the available plans, but it is built for physicians and health care services in New Jersey (Tier 1 and Tier 2 providers). If you or a family member live out of state or are concerned about having health coverage when you travel out of state, Omnia may not be the best option for you since all providers are Tier 2, and there are no out-of-network benefits.
How to Change Your Health Plan
If you decide you want to change to another health plan before Friday, November 4, you need to make that change at the state portal. You can log in at MyNewJersey or at the MyNJBenefitsHub. If you haven’t enrolled before, follow the instructions to set up a new account. You should have received an email from the state around 1 p.m. yesterday (Tuesday) with instructions on accessing the portal.