Benefits Department

The Passaic Public Schools recognizes the importance of maintaining a comprehensive Benefits Program. The following is an overview of what we offer our employees.

Please note: The particular plans available to individual members will vary depending upon one’s Employment Status.

Benefits Information

State Health Benefits Program or School Employees’ Health Benefits Program (SHBP/SEHBP)

Important: DUAL ENROLLMENT IS PROHIBITED – State statute specifically prohibits two employees/retirees who are both enrolled in the SHBP/SEHBP and who are married to each other, civil union partners, or eligible domestic partners from enrolling under both the SBHP and SEHBP’s plans. One member can waive the plan or both can elect single coverage on the plan.  Furthermore, two SHBP/SEHBP members cannot both cover the same children as dependents under both of the plans.

Eligible Dependent Children Duration of Medical Coverage:  An eligible dependent child will be eligible to remain under the medical coverage until the end of the calendar year (December 31st) in which he/she turns 26 years old whether they are in college or not.

Mailing Address
P.O. Box 295
Trenton, NJ 08625-0295
Client Services: (609) 292-7524
Hours: 8:00 a.m. – 4:00 p.m. Monday through Friday (except State holidays)

Qualifying Events during the Year

  • To change your coverage during the year it must be due to a qualifying event and you must complete the Health Benefits Enrollment Form listed below and attach supporting documentation. Once completed, please forward the completed forms to the Division of Human Resources, Health Benefits Department. Enrollment should be made within 60-days of the qualifying event (marriage, enters into a civil union, birth, adoption and changes in family status involving the loss of job, divorce or changes in dependent status).
  • Otherwise, you must wait until the next Open Enrollment which is in the month of October

Additional information regarding medical benefits can be found here

Forms

Important Information

The Employee Coverage Waiver/Reinstatement Form should be completed by the employee who is declining/reinstating health benefits.

Adding Spouse:

A copy of the marriage certificate and a copy of the front page of the employee’s federal tax return. Please note copies of the marriage certificate and front page of the most recent 1040 form are the only documents that will be accepted by the State.

 

Adding Newborn:

·       For a natural child – copies of child’s birth certificate that includes the covered parent’s name is required for enrollment, along with a copy of the social security card.

·       For a stepchild – a copy of the child’s birth certificate showing the spouse/partner’s name as a parent and a copy of marriage/partnership certificate showing the names of the employee and spouse/partner are required.

·       Foster children and children in a guardian-ward relationship under age 26 are also eligible – a copy of the child’s birth certificate and additional legal documents are required.  Documents must prove the legal guardianship by the covered employee.

Additional Resources

Contact Horizon Member Services: (800) 414-7427
Access medical plan contact information (NJ Direct and Horizon Plan) through Horizon Blue’s website by clicking here.

Express Scripts Form: pdf Express Scripts Enrollment Form placed here
Member Services (1-877-265-2929)
For more information, please visit their website here.

NJWELL is a wellness program offered to active employees of the public sector who participate in the State Employee Health Benefits Program (SEHBP) and their covered spouses/partners. NJWELL is a free program administered by the Division of Pensions and Benefits through SEHBP health insurance carrier – Horizon Blue Cross/Blue Shield of New Jersey. You can take advantage of a wide variety of health and wellness tools by visiting their website here.

Non-reps

Additional information regarding dental benefits can be found here

Forms

Plan Summary

Important Information

Dental coverage is through Delta Dental of New Jersey. Your Delta Dental ID card is available online as Delta Dental will no longer be providing member ID cards. Log on to Delta Dental’s website at www.deltadentalnj.com, click on sign in and print your card. If you have not registered, please do so in order to access your member ID card.

 

Please note the following for Eligible Dependent Children Duration of Dental Coverage:  An eligible dependent child will be eligible to remain under the dental coverage until the age of 23 with NO Student Re-Verification required.  Termination of dependent coverage will be at the end of the month of their 23rd birthday.

Dental Plan Contact Information: 

Delta Dental of New Jersey
P.O. Box 222
Parsippany, NJ 07054
Main Number: 800-452-9310
Fax: 973-285-4141

Delta Dental PPO Plus Premier

For information on Dental Premier, Click here.

Flagship (DeltaCare HMO available only in NJ)

For information on Flagship, Click here.

Additional information regarding dental benefits can be found here

Forms

Important Information

Vision coverage is through Vision Services Plan (VSP). VSP does not provide member ID cards as it is not required for employees to receive services or care. Employees simply call a VSP network provider to schedule an appointment and let them know they are a VSP member. The network provider and VSP handles the rest. If an employee wishes to have an ID card, they can create an account and log on at www.vsp.com and print your card.

 

Eligible Dependent Children Duration of Vision Coverage:  An eligible dependent child will be eligible to remain under the VSP coverage until the age 23 with NO Student Re-Verification required.  Termination of dependent coverage will be at the end of the month of their 23rd birthday.

 

VSP Plan Contact Information: 

Customer Service:  1-800-877-7195

Information regarding Short and Long Term Disability Benefits can be found here

Short and Long Term Disability Benefits

Madison National Life Insurance Company

Short and Long Term Disability benefits for Passaic Public Schools District is provided by Madison National Insurance Company.  Short term and long term disability insurance provide replacement income if you are unable to continue working due to an illness or accident.  Short term disability insurance provides replacement income for shorter periods of time when you cannot work.  Short term disability also covers time off due to pregnancy and childbirth.  If your medical condition keeps you from returning to work after the short term disability period ends, then you can transition to long term disability insurance benefits (please refer to your respective Union Enrollment Kit

Madison National Life Insurance Contact Information: 

P.O. Box 2865
Clinton, IA 52733

Customer Service:  1-800-356-9610

File a Claim, please click on this link or download the following forms here.

Other Voluntary Disability Benefits

NJEA Income Protection Plus Plan

The NJEA Income Protection Plus Plan, which is available to any member actively employed in education for at least 15 hours per week, provides disability income coverage and is designed for maximum flexibility: You may apply for coverage up to two-thirds of your monthly salary or $6,500, whichever is lower.  Also, NJEA is one of the only disability insurance companies that also covers behavioral health as well as accident, illness, and Maternity leave. All coverages are issued by The Prudential Insurance Company of American (Prudential).

NJEA Disability Contact Information:

Megan Ray

Educators Insurance Services, Inc.

Voice:  (732) 757-9135

www.educators-insurance.com

Aflac – Voluntary Insurance Benefits Contact Information

AFLAC-NJ

Dylan Monteforte, Regional Sales Coordinator

411 Hackensack Avenue, 2nd Floor

Hackensack, NJ 07601

 

Cell:  (908) 692-2029

Fax:  (866) 243-9573

Customer service: 1 (800) 992-3522

File a Claim, please click on link:  https://www.aflac.com/

 

For more information about Aflac benefits, please click on this link.

Colonial Life Short Term Disability (Voluntary Benefits)

Colonial Life Short Term Disability fills the gap of the lost income public school employees experience when they are out of work for any reason.  You do not need to burn sick time in order to receive a claim.  Guaranteed Issue, and portable upon leaving the district.  For more information and rates, please contact Lisa Perri at (856) 983-9600, or Lisa@colonialnj.com.

Information about Life Insurance can be found here

Life Insurance

MassMutual Group – Whole Life Insurance

 

MassMutual Group Whole Life Insurance provides coverage at a set premium, builds cash value over time you can borrow from and pays a death benefit to your loved ones.  For more information, please click on the following link:  https://mm.benselect.com/enroll

 

MassMutual Group Whole Life Insurance

Creative Financial Strategies

Robert K. DeScherer, Financial Advisor

David Sharpe, Financial Advisor

30 Two Bridges Road, Suite 320

Fairfield, NJ  07004

 

Enrollment website: https://mm.benselect.com/enroll

 

David Sharpe  (973) 575-3254 (dsharpe@financialguide.com);  or

Robert DeScherer (973) 882-7548 (rdescherer@financialguide.com); click here to visit my website

Fax:  (973) 882-7565

New York Life Insurance – Whole Life Insurance

 

New York Life Guaranteed Issue Whole Life is the only permanent life insurance option available with no medical questions asked for you and your family.  Fills the gap of the lost life insurance benefit all NJ public school employees experience upon retirement.  100% portable at the same coverage amount and rate upon retirement.  For more information and rates, please contact Daniel Giusti at (609) 412-4165 or dgiusti@legacybenefitsgroup.com

 

For information on Whole Life Insurance, please click here.

Flexible Spending Account

The district offers the Flexible Spending Account Plan options for all full-time, benefit-eligible employees through Benefits Analysis, Inc. Flexible Spending Account allow employees to contribute funds on a pre-tax basis.  Funds can be used to reimburse out-of-pocket health and/or dependent day care expenses.  Employees can elect any amount within the minimum and maximum limit set by the district and permissible by law.  The yearly contribution limit is $500 minimum and $2,000 maximum for the medical FSA and $500 minimum and $5,000 maximum for dependent care.  Participation in the plans is voluntary.  Plan year runs from January 1st to December 31st.  Use it or lose it provision applies.  Enrollment happens if you are a new employee or during open enrollment.

Forms

New Jersey Division of Pensions

As a New Jersey State-Administered Pension member, you may now access the Member Benefits Online System (MBOS). MBOS is a set of Internet based applications that allow registered members access to their pension and, if applicable, health benefit account information.  Available online resources include member account information, pension loans (estimates and online loan application), retirement calculator, payroll certifications, state deferred compensation plan information (if applicable), State Health Benefits Program account information (if applicable). Applications for retirement, purchase of service credit and withdrawal from pension must all be filed online. Before you can begin using the system, you must first register with MBOS. Accessible from your computer, tablet or smartphone, the following websites provide all the information you need to make informed decisions as well as contact information.

 

Access online Member Services-MBOS, calculate retirement estimates, view seminar, workshops and other information as it related to the Pension on their website:  https://www.state.nj.us/treasury/pensions/.

Pension Enrollment Contact Information

Client Services (609) 292-7524

 

TPAF and PERS Members Information & Guidebook:

Teachers’ Pension and Annuity Fund (TPAF)

TPAF Member Guidebook 

Public Employees’ Retirement System (PERS)

PERS Member Guidebook

Beneficiary Information – Must go through MBOS

It is very important to keep your beneficiary information up to date.  You should update your “Designation of Beneficiary” any time you experience a major life event such as marriage, civil union, divorce, birth or adoption of a child, or the death of a family member.  You can view, change, or update your Designation of Beneficiary through MBOS at https://www.state.nj.us/treasury/pensions/mbos-kit.shtml#bene.

 

Information on Defined Contribution Retirement Program Administration (DCRP)

Established under the provisions of P.L. 2007, c. 92 and P.L. 2007, c. 103, and expanded under the provisions of P.L. 2008, c. 89 and P.L. 2010, c. 1, provides eligible members with a tax-sheltered, defined contribution retirement benefit, along with life insurance and disability coverage.  The Defined Contribution Retirement Program Board oversees the DCRP, which is administered for the New Jersey Division of Pensions and Benefits by Prudential Financial at https://www.state.nj.us/treasury/pensions/dcrp-admin.shtml.

 

 

  • Employers and members can contract Prudential Financial by phone using Prudential’s Toll Free Number: 1 (866) 653-2771

 

DCRP Enrollment Application

DCRP Fact Sheet

Worker’s Compensation

An employee who sustains a work-related injury or accident shall be presumed eligible for workers’ compensation and should seek the workers’ compensation benefits to which he/she is entitled by law. The Passaic Board of Education will permit, in accordance with law, the absence without loss of pay or of annual or accumulated sick leave benefits for the injured employee. Any employee who qualifies for work-related disability pay under this policy shall receive full pay during the period he/she is on disability leave of absence, up to one (1) calendar year. Employees who sustain work-related injuries must immediately notify their Administrator and school nurse. The school nurse or injured employee should contact the workers’ compensation hotline provided by our Third-Party Administrator, Bergen Risk, at 1-888-525-3454.  Bergen Risk will direct the injured employee to a medical facility, if it is not an emergency.

Forms

PlanConnect Retirement Plans

The Passaic Public Schools District has selected PlanConnect as our Third-Party Administrator for our 403(b) and 457(b) Plans.  The 403(b) and 457(b) Plans are a valuable benefit to our employees.  Whether you are just starting out or have been working many years, the 403(b) and 457(b) Plans can be an excellent way to help you build up your retirement savings.  It offers the convenience of automatic payroll deductions and gives you the ability to save with pre-tax dollars which means your contributions and any investment earnings can be tax-deferred until withdrawn.  For more information regarding Plan Connect, including 403(b) and 457(b) retirement plans and a list of the Financial Advisors, please click here.

Plan Connect contact information:

PlanConnect

P.O. Box 4940 Syracuse, NY 13221

Express:  PlanConnect, 100 Madison Street, Syracuse, NY 13202

 

General Service: (800) 923-6669

Hours:  9:00 a.m. – 5:00 p.m. Monday through Friday

Fax at (800) 657-2826 or email

 

Homepage and Account Login: www.planconnect.com

Other Forms & Benefits Information

This form must be completed for a change of address and/or last name* change.

* Must provide a copy of your social security card.

Employees who find themselves in need of a leave of absence must submit this form to the Division of Human Resources detailing the type of leave requested, the start and end dates of the leave, whether it is with pay or without pay.  If it is a medical leave a doctor’s note documenting the medical necessity for the leave must be submitted with the form. The request will be placed on the Board agenda to be approved

Certification of Health Provider Forms

Family Member with Serious Health Condition Form – Click Here

 

Employee with serious Health Condition Form – Click Here

New Jersey Family Leave Insurance Application

For information on New Jersey Family Leave Insurance, or to apply for Family Leave Insurance,  Click here.

Beginning July 1, 2020, employees will be able to claim up to 12 consecutive weeks of Family Leave Insurance benefits during a 12-month period (up from the current maximum of six weeks).

Loan Recertification Request Form must be completed when an employee is returning from a leave of absence without pay.

Our Employee Assistance Program (EAP) is a counseling and consultation service that provides confidential support for employees that are navigating life issues that may impact their ability to come to work and be productive in the workplace, customized resources and referrals.  Under EAP, you can receive no-cost, confidential help for a wide variety of needs and concerns available to you.  Help is just a phone call away!

Chapter 375 – Coverage of Children Until Age 31

The State of New Jersey has enacted legislation that extends eligibility for medical and prescription drug coverage only.  Under this regulation, your dependent may be eligible to maintain coverage under your benefit plan to their 31st birthday.  Your dependent may be eligible for these extended benefits (called “Chapter 375 Dependent” benefits).  If you have a dependent child who will be turning 27 next year, their coverage will terminate at the end of this calendar year (December 31st).

 

NOTE:  For All Over-Age Dependent Children the cost to continue their health and prescription coverages shall be the SOLE responsibility of the covered parent or the over-aged dependent child.  The employee must complete the necessary applications to continue health and prescription coverage effective January 1st.   When Chapter 375 coverage is elected, the covered parent will be billed directly by the New Jersey Division of Pensions and Benefits for medical coverage and prescription coverage will be managed through Benefits Analysis, Inc. (BAI) for the cost of the coverage.

 

To enroll in this coverage, please complete the Chapter 375 Health Enrollment Form below and submit the form to:  New Jersey Division of Pensions and Benefits, Health Benefits Bureau, P.O. Box 299, Trenton, NJ 08625-0299.

 

To enroll in prescription coverage, please complete the form below and submit the form to:  Passaic Public Schools, Division of Human Resources, Attn.: Brenda Wheeler, Benefits Manager, 663 Main Avenue, P.O. Box 388, Passaic, NJ  07055-0388.

 

Chapter 375 Fact Sheet:  https://www.state.nj.us/treasury/pensions/documents/factsheets/fact74.pdf

 

Continuation of Over Age Children with Disabilities:

If your child is physically and/or mentally unable to provide for him or herself, you may request an Application for Continued Enrollment for Dependents with Disabilities. The application and proof of the child’s condition must be received by the New Jersey Division of Pensions & Benefits’ (NJDPB) Health Benefits Bureau no later than 31 days after December 31st of the year your child turns 26.  Once continued coverage is approved, it will generally be reinstated retroactively to the date coverage terminated due to turning age 26.

 

To obtain this application, call the NJDPB at (609) 292-7524, or write to:  New Jersey Division of Pensions & Benefits, Attn: Health Benefits Bureau, P.O. Box 299, Trenton, NJ 08625-0299. The Application for Continued Enrollment for Dependents with Disabilities includes a section to be completed by a physician describing the dependent’s disability. The Medical Review Board must assess each case, and may request that the member provide additional medical documentation that the Board finds necessary to make an informed determination; prior approval from a previous insurer is not acceptable.

 

Continuation of Over Age Children with Disabilities Fact Sheet:   https://www.nj.gov/treasury/pensions/documents/factsheets/fact51.pdf

 

New Jersey Chapter 375 (overage dependent) applies to Medical and Prescription coverages only.

Certified Load Request

If you have questions about a Certified Loan Request, please call the New Jersey Division of Pensions and Benefits (NJDPB) Office of Client Services at (609) 292-7524.  Before submitting an application, please be certain you read and understand the loan provisions and the IRS Requirements.  Loan Request Form – https://www.state.nj.us/treasury/pensions/documents/forms/cl0822.pdf.

Staff

Brenda Wheeler

Benefits Manager

Ext. 8881

Yazmin Centeno

Administrative Clerk (Human Resources)

Ext. 6049