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This handbook provides detailed information about the New Jersey State Health Benefits Program and School Employees’ Health Benefits Program, focusing on prescription drug plans, member rights,
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How to fill out NEW JERSEY STATE HEALTH BENEFITS PROGRAM AND SCHOOL EMPLOYEES’ HEALTH BENEFITS PROGRAM PRESCRIPTION DRUG PLANS MEMBER HANDBOOK

01
Obtain a copy of the MEMBER HANDBOOK.
02
Review the table of contents to identify sections relevant to you.
03
Fill out personal information accurately in the designated forms.
04
Review the prescription drug plans offered to understand coverage options.
05
Follow the instructions for enrolling in a specific plan.
06
Familiarize yourself with the claims process for reimbursement.
07
Check the section on how to access pharmacies and obtain medications.
08
Read about the appeals process for denied claims or coverage.
09
Keep the handbook accessible for future reference.

Who needs NEW JERSEY STATE HEALTH BENEFITS PROGRAM AND SCHOOL EMPLOYEES’ HEALTH BENEFITS PROGRAM PRESCRIPTION DRUG PLANS MEMBER HANDBOOK?

01
Employees participating in the New Jersey State Health Benefits Program.
02
School employees enrolled in the School Employees’ Health Benefits Program.
03
Individuals seeking information on prescription drug coverage options.
04
Members needing guidance on filing claims related to prescription drugs.
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People Also Ask about

Your copay for prescription drugs depends on what plan you're in. Members under age 21, those who are pregnant, and members in long-term care don't have copays. If you are a NJ FamilyCare member in Plan A, B, or ABP, you don't have a copay for prescriptions.
78. Set new health benefit contribution amounts towards the cost of employee coverage. Effective all public employees were required to contribute a certain percentage of their health benefit premiums.
The Pharmaceutical Assistance to the Aged and Disabled (PAAD) program is a state-funded program that helps eligible older adults and individuals with disabilities save money on their prescription drug costs.
As a teacher at the Newark Board of Education, you'll receive a robust benefits package in addition to your salary, including medical, dental, vision, and prescription drug plans. Teachers can select between two healthcare plans (NJ Educators Plan or Garden States Health Plan) for themselves and their dependents.
School Employees' Health Benefits Program must go through your employer. To be eligible, you must be a full-time employee or an appointed official from a local board of education employer that participates in the SEHBP.
OptumRx provides convenient and flexible options for the prescription drugs you and your family may need. We are here to help you understand your plan options, so that you can save time and money when your benefit plan starts.
For years, boards had struggled to contain the escalating cost of providing employee health coverage. The landmark law, effective beginning with the 2011-2012 school year, requires school employees to pay a portion of health insurance premiums.
Healthfirst is a common health insurance in New Jersey, and individuals who have Healthfirst may wish to find therapists who are in-network with their health insurance.

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The New Jersey State Health Benefits Program and School Employees’ Health Benefits Program Prescription Drug Plans Member Handbook is a comprehensive guide that outlines the benefits, eligibility, coverage options, and procedures related to the prescription drug plans available to members of the New Jersey State Health Benefits Program and School Employees’ Health Benefits Program.
All members enrolled in the New Jersey State Health Benefits Program and School Employees’ Health Benefits Program who utilize the prescription drug plans are required to review and adhere to the guidelines set forth in the Member Handbook.
The Member Handbook does not require filling out forms; however, members must read it thoroughly to understand their benefits, coverage, and procedures. Any required forms or claims should be completed separately as directed within the handbook.
The purpose of the Member Handbook is to provide members with essential information regarding their prescription drug coverage, including how to access benefits, file claims, and understand their rights and responsibilities within the program.
Members must report personal information such as their name, address, insurance details, and any changes in eligibility status, as well as any necessary documentation related to prescription drug expenses as specified in the handbook.
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