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)
A list of the documentation required for dependents can be found on the State website.
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 |
| 10-Month fired after 9/1 | Benefits (medical, prescription, dental) effective 60 days from hire date | Ex: Faculty/Staff hired 10/1, benefits effective 12/1 |
| 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 |
Available Medical Plans
- Health Maintenance Organizations (HMO)
- Health Maintenance Organization plans administered by Horizon and Aetna
- Preferred Provider Organization (PPO)
- Preferred provider organization plans administered by Horizon and Aetna
- Tiered Network (TN)
- Tiered network plans administered by Horizon and Aetna. 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 and Aetna
Find My Doctor
If you need to find a new doctor, specialist, or hospital that participates in one of our networks, simply visit our Doctor & Hospital Finder. Our Doctor & Hospital Finder makes it easy to find a health care professional who matches your needs.
Medical Plan Fact Sheets
The medical plans available to employees for Plan Year 2025 are listed below. Please note that not all plans are available to all employees.
Horizon: NJ DIRECT/CWA Unity Direct*, NJ Direct 2019/CWA Unity DIRECT 2019*; Horizon OMNIA Health Plan, Horizon HMO**, NJ DIRECT HDLow; NJ DIRECT HDHigh
Aetna: Freedom/Freedom 2019*, CWA Unity Freedom/CWA Unity Freedom 2019*; Liberty Plus Tiered Network, Aetna HMO**, Freedom HDLow; Freedom HDHigh
- Horizon Medical Plan Comparison Chart
- Aetna Medical Plan Comparison Chart
- Horizon Calculator
- Aetna Calculator
*Members hired prior to July 1, 2019, will be enrolled in NJ Direct/CWA Unity DIRECT or Freedom/CWA Unity Freedom. Members hired after July 1, 2019, will be enrolled in NJ Direct 2019/CWA Unity DIRECT 2019 or Freedom 2019/CWA Unity Freedom 2019.
**The service areas for Horizon/Aetna HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.
Horizon: NJ DIRECT/CWA Unity Direct*, NJ Direct 2019/CWA Unity DIRECT 2019*; Horizon OMNIA Health Plan, Horizon HMO**, NJ DIRECT HDHigh
Aetna: Freedom/Freedom 2019*, CWA Unity Freedom/CWA Unity Freedom 2019*; Liberty Plus Tiered Network, Aetna HMO**, Freedom HDHigh
- Health Benefit Coverage for Part Time Employees
- Health Benefits Coverage for State Intermittent Employees
- Horizon Medical Plan Comparison Chart
- Aetna Medical Plan Comparison Chart
- Rates for Part Time Employees
*Members hired prior to July 1, 2019, will be enrolled in NJ Direct/CWA Unity DIRECT or Freedom/CWA Unity Freedom. Members hired after July 1, 2019, will be enrolled in NJ Direct 2019/CWA Unity DIRECT 2019 or Freedom 2019/CWA Unity Freedom 2019.
**The service areas for Horizon HMO are limited to New Jersey and bordering counties of Pennsylvania, Delaware, and New York.
*** If you are a part time employee that would like to enroll in the SHBP, send an email to hr-benefits@dos5.net so your information can be added to the Benefitsolver portal to elect your health benefits.***
Certain children over age 26 may be eligible for coverage until age 31 under Chapter 375 of the State Health Benefits Program (SHBP).
A State Health Benefits Program covered employee may only enroll an over age child who is Chapter 375 eligible during the Annual SHBP Open Enrollment period — held during the month of October. Coverage for the over age child would begin in January with the start of the benefit plan year.
This includes a child by blood or law who is under the age of 31; is unmarried; has no dependent(s) of his or her own; lives in New Jersey or is a full-time student at an accredited public or private college or university; and is not covered in any way under a group or individual health benefits plan, church plan, or entitled to Medicare.
The covered parent or child is responsible for the entire cost of coverage. These children are not eligible for dental or vision benefits. See the Health Benefits Coverage of Children Until Age 31 Under Chapter 375 Fact Sheet for more information.
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.
How to Enroll
Enrollment Guide (PDF)
First time users:
1.Visit nj.gov/treasury/pensions
2. Click on Access Benefitsolver
3. Click on Register
4. Enter the requested registration information
5. Confirm your new password, then click “continue” to return to this page and login to Benefitsolver.
Already have an account:
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Visit my.state.nj.us
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Login by entering your username and password
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.
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.
View plan details, carrier specifics and benefit guides by clicking ‘Reference Center’ in the main navigation.
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.
Review, edit and approve your personal information, elections, dependents and beneficiaries.
Once you have reviewed your elections and they are accurate, click ‘Approve’ to continue.
Your enrollment isn’t complete until you confirm your benefit elections and cost.
Print your election information and confirmation number for future reference or save it to your Message Center.