Healthcare Ombudsperson Program

A Negotiated Benefit Through Our CWA-State of NJ Contract

The Healthcare Ombudsperson Program is a joint venture between CWA and the State of New Jersey to provide education and counseling to employees, to resolve employee issues effectively and efficiently, and to work collaboratively to create better healthcare outcomes.

 

If you have a healthcare question or assistance with your benefits, please reach out to your branch president or other representative, and they will get you in contact with the CWA Local 1031 Healthcare Ombudsperson.

Open Enrollment 2025

Open Enrollment for all members in the State Health Benefits Program (SHBP) runs from October 1 through October 31.

During this period, members may:

Open Enrollment is optional, and if you do not choose to make any changes, you do not need to do anything. FSA enrollment must be done annually and does not automatically renew. For plan year 2025, there will be significant changes to some of the dental health benefits, so please make sure you look at your options before the enrollment period expires.

Webinars:

The State of New Jersey in conjunction with Horizon Blue Cross Blue Shield & Aetna will be presenting webinars throughout the month of October for members interested in hearing more about the plans available to them. Webinars are listed here:

CWA Local 1031’s Healthcare Ombudsperson will also be presenting at membership meetings. Contact your branch president to find out if you have a meeting scheduled.

If you need assistance, please contact your branch president or email healthcarequestions@cwa1031.org

Active Employees Medical Plan Information

NJ State Workers in CWA have access to several medical plans across the Horizon Blue Cross Blue Shield and Aetna Networks (Aetna availability begins July 1, 2024). In each network, employees can select an PPO Plan, a Tiered Network Plan, an HMO plan, or one of two high deductible plans. Corresponding plans offer identical coverage levels, but different networks of providers. Regardless of network, prescription benefits will be managed through OptumRX for all plans.

For 2025, there will be no changes to the medical plans offered, co-pays charged, or coverage levels. Paycheck deduction costs will be changing, and calculators will be available soon to see your individualized rates for your salary.

2025 Plan Information 

Rutgers & University Hospital Employee Information

  • RU & UH employees have access to certain legacy plans
    • Additional plan information is available here

Important changes to Dental Plans in SHBP

  • Cigna, MetLife, and Horizon Dental Choice DPO plans are sunsetting at the end of 2024
    • If you are currently enrolled in one of these plans, you may select a new plan for 2025.
    • If you take no action, you will automatically be moved into the Aetna DPO plan for 2025.
  • Aetna DPO will remain as the sole DPO-style plan
  • Aetna DEP will remain and members will have access to a new DEP plan offered by Horizon Blue Cross Blue Shield
  • Comparison of DEP and DPO Plans for 2025
    • Further information and costs will be released by the Divisions of Pensions and Benefits and will be linked here as soon as it is available.
    • 2025 Dental Plan Prices

Flexible Spending Account (FSA)

  • Members enrolled in SHBP may deposit up to $2500 annually into a Flexible Spending Account to spend on qualifying medical expenses during the year
  • Funds are withdrawn tax free via payroll deduction, spread out across the year
  • Enrollment does not renew, you must sign up each year
  • Enroll at www.HorizonBlue.com/EnrollFSA
    • FSA program is administered by Horizon Blue Cross Blue Shield for all members, even those enrolled in Aetna health plans
Division of Pensions and Benefits

Our health plans are administered by the NJ Division of Pensions & Benefits, to go directly to their website use the links below.

Benefitsolver

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

 

Select 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.

myChoice Find A Provider

A fast, easy, and smart way to find and book healthcare. Formerly known as Amino Health.

  • Log in through the MyNewJersey Portal and click the “Benefits Solver” link
  • Use the “My Choice Find a Provider” Link on the right hand side of the screen

Horizon Health Guides

You’ll get the most from your benefits because your Horizon Health Guide knows your benefits inside and out — and they want to get to know you too!

Horizon bFit

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

Horizon Blue365 Deals

Blue365 is a free health and wellness discount program offered to you as a member of the Blue Cross and Blue Shield System. We offer year-round discounts on gym memberships, fitness gear, healthy eating options and more.

 

Other Horizon Health Programs

Everside Health

New Jersey SHBP and SEHBP members and covered family members have access to a Direct Primary Care doctor’s office with Everside Health (formerly Paladina Health and R-Health) with no co-pays, no out of pocket costs, and no changes to your health benefits. Everside Health doctors provide comprehensive, personalized primary care (both in person and virtually) with a full range of services including preventive care, urgent and sick care, health and wellness coaching, chronic disease management, care coordination, and much more. Other benefits include:

  • Same- and next-day sick and urgent appointments
  • 24/7 virtual care access with the Everside Everywhere™ mobile app for online scheduling, prescription refills, online messaging, and virtual appointments
  • Little to no wait to see your Everside Health doctor
  • Onsite labs, medications, and immunizations at no additional cost

Everside Health offers many convenient locations including:

  • Cherry Hill
  • Clifton
  • Ewing
  • Hamilton
  • Jersey City
  • New Brunswick
  • Tom’s River
  • Voorhees
  • West Orange
  • Willingboro

The Direct Primary Care program is available to employees, non-Medicare retirees, and dependents covered under the following SHBP plans:

  • Horizon CWA Unity / Aetna Freedom
  • Horizon Omnia / Aetna Liberty Plus Tiered Network Plans

For questions or to get started call 866-808-6005 or visit www.eversidehealth.com/newjersey.