Group of faculty

Medical Plans

All covered employees must have access to prescription drug coverage. The type of prescription coverage provided and costs are determined by the option offered by your employer and the medical plan you select.

Medical Plan Eligibility for Dependents

Dependents of Employees may be eligible for medical coverage if they fall into one of the following categories:

  • Legal spouse
  • Same-sex domestic partner or civil union partner
  • Eligible children under age 26 (including stepchildren, foster children, adopted children or children an employee is legally required to support)

When Medical Plan Coverage Begins

Employee Type Coverage Example
10-Month Faculty hired 9/1 Benefits (medical, prescription, dental) effective 9/1 Ex: Faculty hired 9/1, benefits effective 9/1
12-Month Faculty hired 9/1 or after,
Regular Full-Time Staff
Benefits (medical, prescription, dental) effective 60 days from hire date Ex: Faculty/Staff hired 10/1, benefits effective 12/1
10/12-Month, Temporary, Part-Time Staff

*ACA eligible – working 30 hours per week within the first 2 months of employment

*Benefits (medical, prescription) if eligible, effective 60 days from hire/eligibility date Ex: 10/12-Month, Temporary, Part-Time Staff hired 8/5, benefits effective 10/5 (if eligible)

Available Medical Plans

Health Maintenance Organizations (HMO)
Health Maintenance Organization plans administered by Horizon
Preferred Provider Organization (PPO)
Preferred provider organization plans administered by Horizon
Tiered Network (TN)
Tiered network plans administered by Horizon. Members have the flexibility to visit practitioners in the carrier’s managed care network as well as significant premium share reductions, with no referrals required. Learn more about the Tiered Network Incentive Program.
High Deductible Health Plans (HDHP)
Preferred provider organization plans administered by Horizon

Medical Plan Fact Sheets

The medical plans available to employees for Plan Year 2020 are listed below. Please note that not all plans are available to all employees.

CWA Employees

Medical Plans: CWA Unity DIRECT/CWA Unity DIRECT 2019*; Horizon OMNIA Health Plan, Horizon HMO**, NJ DIRECT HD1500; NJ DIRECT HD4000

*Members hired prior to July 1, 2019, will be enrolled in CWA Unity DIRECT. Members hired after July 1, 2019, will be enrolled in CWA Unity DIRECT 2019.

**The service areas for Horizon HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.

IFPTE/ AFSCME Employees

Medical Plans: NJ DIRECT/NJ DIRECT 2019*, Horizon OMNIA Health Plan, Horizon HMO**, NJ DIRECT HD1500; NJ DIRECT HD4000

*Members hired prior to July 1, 2019, will be enrolled in NJ DIRECT. Members hired after July 1, 2019, will be enrolled in NJ DIRECT 2019.

**The service areas for Horizon HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.

AFT Employees
Medical Plans: NJ DIRECT/NJ DIRECT 2019*, Horizon OMNIA Health Plan, Horizon HMO**, NJ DIRECT HD1500; NJ DIRECT HD4000

*The service areas for Horizon HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.

**Members hired prior to July 1, 2019, will be enrolled in NJ DIRECT. Members hired after July 1, 2019, will be enrolled in NJ DIRECT 2019.

Non-Aligned/Managerial Employees

Medical Plans: NJ DIRECT/NJ DIRECT 2019*, Horizon OMNIA Health Plan, Horizon HMO**, NJ DIRECT HD1500; NJ DIRECT HD4000

*The service areas for Horizon HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.

**Members hired prior to July 1, 2019, will be enrolled in NJ DIRECT. Members hired after July 1, 2019, will be enrolled in NJ DIRECT 2019.

Other Employees

Medical Plans: NJ DIRECT15; NJ DIRECT1525; NJ DIRECT2030; NJ DIRECT2035; Horizon OMNIA Health Plan*, Horizon HMO*, NJ DIRECT HD1500; NJ DIRECT HD4000, NJ DIRECT/NJ DIRECT 2019**

*The service areas for Horizon HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.

**Members hired prior to July 1, 2019, will be enrolled in NJ DIRECT. Members hired after July 1, 2019, will be enrolled in NJ DIRECT 2019.

How to Apply

Step 1
Get started

Visit my.state.nj.us and login by entering your user name and password.
If you are a first-time user, visit http://nj.gov/treasury/pensions and click on Register under State Employees: Access Benefitsolver to set up your user name, password and security questions.
  1. Enter your social security number, company key and date of birth.
  2. Answer your Security Phrase.
  3. Enter and confirm your new password, then click ‘Continue’ to return to this page and login.
Step 2
Begin enrollment

Click ‘Benefitsolver’ and follow the instructions to enroll in your benefits or waive coverage.
You must make your elections by the deadline shown on the calendar. If you miss the deadline you will waive any electable benefit coverage, and have to wait until the next annual enrollment period to enroll.
Step 3
MyChoice Mobile App

Enroll in your benefits from your mobile device. Visit mychoice mobile app on your smart phone or tablet, download one from your device’s app store. You can simply log on to my.state.nj.us on your laptop, home computer and tap your way through your elections.
Step 4
Looking for more information?

View plan details, carrier specifics and benefit guides by clicking ‘Reference Center’ in the main navigation.
Step 5
Want to review your current benefits?

You have year-round access to your benefit summary and specific benefit elections at www.benefitsolver.com. Click ‘Benefits Summary’ on the homepage to review your current benefits.
Step 6
Review your elections

Review, edit and approve your personal information, elections, dependents and beneficiaries.
Step 7
Approve

Once you have reviewed your elections and they are accurate, click ‘Approve’ to continue.
Step 8
Confirm your choices

Your enrollment isn’t complete until you confirm your benefit elections and cost.
Step 9
Print

Print your election information and confirmation number for future reference or save it to your Message Center.

Medical Plan Contacts

For more information about any participating plan, speak with a plan representative. Contact information can be found on the New Jersey Division of Pensions and Benefits Plan Contacts page.