A Harry Moore / Jersey City Open Enrollment 2027

Open Enrollment for CWA contracted employees in the State Health Benefits Program runs from October 1 – October 31

  • Members may enroll in health insurance for 2027, add/remove dependents, change medical or dental plans, and contribute to FSA accounts

Medical Plan Premiums for 2027

  • Total costs for all plans in the State Health Benefits Program have increased approximately 13% for 2027
  • CWA has come to terms with the state where they will be absorbing 100% of the increase for employees in plans with UNION NEGOTIATED PREMIUM RATES. 
  • Plans with premiums set by Chapter 78 Law will still see large increases for 2027
  • Avoid premium increases and save by switching to a plan with union negotiated rates!
    • Members making $45,000 with Single Coverage
      • HMO – $2702 (annual) for 2027
      • CWA Unity Direct – $1162 (annual) for 2027
    • Members making $45,000 with Family Coverage
      • HMO – $4968 (annual) for 2027
      • CWA Unity Direct – $1695 (annual) for 2027
Chapter 78 Plans Premiums Will Increase 1/1/27
Horizon Aetna
26 Horizon HMO
26 Horizon HDLow
26 Horizon HDHigh		 26 Aetna HMO
26 Aetna HDLow
26 Aetna HDHigh
Union Negotiated Rate Plans Premiums will not change
  Horizon Aetna
  26 CWA Unity Direct
26 OMNIA		 26 CWA Unity Freedom
26 Liberty Plus

Tax$ave Flexible Spending Account (FSA)

FSA participation is voluntary and will allow you to set aside up to $3400 of pre-tax income (taken in equal installments across your 2027 paychecks) to spend on qualifying medical expenses. FSA participation does not automatically roll over year-to-year, and funds not used by March 2028 will be lost. 

FSA Funds for the entire year are available immediately in January and are taken from your paycheck in equal installments. Funds must be used by March 2028 or they will expire, so don’t put more than you need in your account.

To Enroll for 2027:

  • Members currently enrolled for 2026 can log in to their FSA and select the “Enroll Now” button to enroll for the 2027 plan year.
  • Call 1-877-765-8809 and follow the prompts.
  • Download an enrollment form and return via one of the three ways below:
    • Fax to: 1-833-710-5544
    • Send via secure email only to: HorizonMyWay@healthaccountservices.com
    • Mail to: Horizon MyWay, P.O. Box 2340, Fargo, ND 58108-2340
    • Please verify that your medical and payroll information (first name, last name, social security number and date of birth) match through your employer. Only sign up using your legal name.
    • For more information, contact Customer Service at 1-877‑765-8811, Monday through Friday, from 8 a.m. to 8 p.m. ET.

Ambulatory Surgical Centers & Centers of Excellence

For Members Enrolled in CWA Unity Direct & Aetna Unity Freedom

Ambulatory Surgical Centers (ASC)

    • Certain procedures now must be performed at an In-Network Ambulatory Surgical Center (ASC) or member will be responsible for paying 50% of the TOTAL COST of the procedure.
    • Exceptions apply when the procedure:
      • Is an emergency
      • Is a medical necessity to be performed in a hospital setting
      • No ASC within 50 miles of the member’s residence
    • Preventive screenings, such as Colonoscopies, that must be done at an ASC costs will be:
      • $0 when done at an In-Network ASC
      • 50% of Total Cost done at an in-network hospital
    • Ambulatory Surgical Centers FAQ & Instructions (PDF)
      • Includes full list of applicable procedures
      • Instructions on how to search for an in-network ASC in Aetna & Horizon plans
  • Centers of Excellence Program
    • Certain surgical procedures will require prior authorization before being performed. Horizon or Aetna will not authorize the procedure until the case is reviewed by Carrum Health, the state’s new CoE provider.
      • Carrum will refer members to a surgical center in the Centers of Excellence program, which can perform the procedure for standard co-pay
      • Member may elect to have the procedure done at another in-network provider of their choice for a $300 co-pay
      • Member may elect to have the procedure performed out-of-network, subject to all out-of-pocket costs associated with their plan.

PRESCRIPTION DRUG INFORMATION

All health plans, on both Aetna and Horizon, come paired with a prescription plan managed by OptumRX.

PRESCRIPTION CO-PAYS (ALL HEALTH PLANS)

30 Days at Retail Pharmacies 90 Days by Mail-Order
Generic Drugs $10 $10
Brand Name Drugs $20 $50
Non-Preferred Brand Name Drugs $75 $150
Specialty Drugs $75 $150
  • Mandatory generic substitution when available
  • Mandatory mail order for maintenance medications (90-day supply)
  • If the retail cost of a drug is less than the copay, members pay the retail cost
  • Out of Pocket Maximum – $2120 (individual) / $4240 (family)
  • Applies to all plans (including HMO)
GLP-1 Drugs
  • Such as Ozempic, Wegovy, ZepBound, Mounjauro, etc:
  • For diabetes treatment: $20 (retail) / $50 (mail) (Standard Co-pay for name brand drugs)
  • For other conditions (effective 1/1/2026): $45 per 30-day supply
    • Future change: The State will launch a lifestyle management program for members using GLP-1s for non-diabetic conditions. Members who choose not to participate will pay $125 per 30-day supply. THIS PROGRAM HAS NOT YET BEEN IMPLEMENTED, DATE TBA.

Benefitsolver

All changes to your health insurance benefits are done through the Benefitsolver website.

Programs for CWA members enrolled in the NJ State Health Benefits Programs (NJ SHBP)

NJ WELL – Earn $350

Your well-being matters. NJ Well provides inclusive and holistic experiences to meet members’ needs through activities and educational programming to support healthy lifestyles. Obtain 800 points and earn a reward.

Horizon bFit / Aetna Fitness

Earn a $20 monthly reward for going to the gym or getting your steps in. Available to members and their dependents over age 18.

Marathon Health  – Direct Primary Care

Primary care doctor visits at $0 copay for members enrolled in the CWA Unity and Tiered Network plans