NEW EMPLOYEE BENEFITS

Health BenefitsDentalLong Term DisabilityFlexible Spending PlanNJ State Pension EnrollmentDirect Deposit AuthorizationTax Sheltered Annuity 403b/457 plansPrivacy Notice-Please sign and return the acknowledgement of receipt.

Health Benefits There are 13 plans to choose from:

NJ Direct-8 Plans including a high deductible plan This plan is through Horizon and is similar to Blue Cross/Blue Shield. It does not require

referrals. Aetna HMO-8 Plans including a high deductible plan

Requires you to choose a primary care doctor in the Aetna network and get referrals.For a list of plans go to: http://www.state.nj.us/treasury/pensions/pdf/hb/active-ed-chart-shaded.pdfFor a plan comparison go to:http://www.state.nj.us/treasury/pensions/hb_open_enrollment_2010/hb-0798-local-ed-comparison-booklet.pdf

In order to determine an estimate of the cost to you go to the Percentage of Premium Calculator at http://www.state.nj.us/treasury/pensions/hb-percentage14-ed.shtml Enter salary-Click # of pays-Select level of coverage and Select Prescription Drug Included in SEHBP medical plan.(If you have

a problem with the calculator use Mozilla Firefox as your browser instead of Internet Explorer)

If you wish to enroll in health benefits please complete the attached enrollment form. Complete Section 1, in Section 2 choose the plan and the level of coverage, do not complete Section 3 (we do not offer a separate prescription plan..it is part of the Health Benefits plan, list everyone to be covered in Section 4, sign & date. PLEASE NOTE THE DOCUMENTATION REQUIREMENTS ON PAGE 3.

Please be advised that the new NJEA contract states that the Board will pay for the cost of the NJ Direct 15 Plan less the state mandated portion required to be paid by the employee. If you choose a more expensive plan, you will be required to pay the full difference in the cost of the plan in addition to the state mandated portion of the cost of benefits.

If you do not wish to enroll in health benefits and choose to waive them complete the 2 waiver forms as well as the enrollment/change form. On the enrollment/change form Complete Section 1, In Section 2 check the box that says you wish to waive benefits, sign and date.

Dental BenefitsYou must work at least 25 hours per week to be eligible for dentalbenefits.Bus drivers are not eligible to enroll in dental benefits.Aides are eligible purchase benefits through the district.

There are 3 plans to choose from: Horizon Dental Option

This plan does not require the selection of a primary dentist. Horizon Dental Choice

This plan requires the selection of a primary care dentist. Horizon Total Care

You must select a primary care dentist for this plan.

Please see the dental plan comparison to determine thedeductible/coverage for each plan to assist in the selection of plans. If you are eligible and enrolling in dental benefits pleasecomplete the Dental enrollment form. If you wish to waive dental benefits complete the dental waiver form.

To select your dentist go to http://www.horizon-bcbsnj.com/members/dental.html

Long Term Disability

You are eligible to enroll in Long Term Disability after 30 days of employment if you work a minimum of 30 hours a week.

Long Term Disability will begin 90 days after you become disabled and will continue until age 62 if you are permanently disabled whether or not you are employed by the district.

The amount of monthly coverage is explained in the attached Guardian Booklet.

The cost to the employee for this coverage is $5.00 per pay for all employees except administrators. Administrator cost will be the full cost of coverage.

If you are interested in enrolling in the Long Term Disability

insurance complete the Guardian enrollment form. If you are not interested in enrolling in the Long Term Disability

insurance complete the Long Term Disability waiver form.

FLEXIBLE SPENDING PLAN

You may put aside up to $1,000 for unreimbursed medical expense and up to $5,000 for dependent care.

The amount you elect is deducted in 20 equal installments from your pay check and deposited into the flexible spending account. You must submit a claim form along with your receipts to be reimbursed for these expenses.

This is a pre-tax deduction. However, if you do not use all of the money

put aside you will lose it.

Please complete the FSA Election Form by either entering the amounts you want to have deducted or checking the box that says you elect not to participate at this time.

This will be offered in May, 2012 for the plan year beginning 7/1/2012 though 6/30/2013. If you elect not to participate at this time you can elect to participate for the next school year.