Frequently Asked Questions
Mansfield School District




What health plans are available to me as an eligible Board of Education employee?

The District currently offers medical coverage through AmeriHealth New Jersey. Our prescription coverage is through BeneCard/RxAlliance and dental is offered by Horizon Dental (BCBSNJ). Visit the Plan Options page to find overviews and summaries detailing available plans.

 

The health waiver, sometimes called a "cash-in-lieu-of-benefits" option, offers flexibility in creating a personalized package of benefits. This option is an alternative to selecting health care coverage through the District, but is available only to employees with other health coverage. For example, if you have coverage through your spouse's employer, you may be eligible to receive cash instead of the District's health coverage. If you lose your other coverage, you can immediately enroll in the District plan by completing an enrollment form and providing documentation of eligibility.

If you have questions about this option, contact the Business Office (lmccoy@mansfieldschool.com) for information. Visit the Waiver Incentive page for more details.


When can I make changes to my plan?

You can make changes to your plan at Open Enrollment (Spring of each year). However, if your family experiences a life change (such as marriage, adoption, birth, or death), you can make adjustments to your plans at that time. It is important to notify the Business Office (lmccoy@mansfieldschool.com) immediately (within 60 days to add a newborn; within 31 days for other events) when such an event occurs.

How can I add new dependents to my plan?

When an important event occurs in your life, such as marriage, adoption, or the birth of a child, you have a specified window of time to make changes to your health plans. It is important to enroll your new dependent within the given window or you may need to wait until the next Open Enrollment period.

Newborn children are automatically covered for 60 days from date of birth. To continue coverage beyond the initial 60 days, you must actively enroll your child in the District plans. All other new dependents must be enrolled within 31 days of eligibility. To make a smooth and timely change within the given window, complete the appropriate enrollment forms and forward to the Business Office (lmccoy@mansfieldschool.com) immediately after the event.

What are the rules for dependents who "age out"?

The Affordable Care Act (ACA) provides for medical and prescription coverage through the Mansfield Board of Education for your eligible dependent through the end of the calendar year in which he/she turns to age 26. Dental coverage for your dependent child typically ends on the last day of the calendar year in which he/she attains age 23.

You must notify the District when your dependent is no longer eligible for coverage or he/she could forfeit rights to continuing coverage options. Children no longer covered by your plan may be eligible to continue coverage under COBRA, the ACA Health Insurance Marketplace, or the New Jersey Chapter 375 (<31 Dependent) plan (see below).


What is the "Chapter 375" or <31 Dependent plan?

The New Jersey Chapter 375 (Dependent <31) plan gives eligible adults to age 31 the choice to elect health and/or prescription coverage under a parent's group health plan. Visit the Continuing Coverage section of this website for more information.

Where can I find a list of providers that participate in my plan?

Our carriers provide online search tools to help you locate primary doctors, specialists, facilities, and others that participate in your plan:

AmeriHealth / SHIF Medical: Search at Find A Provider
BeneCard / RxAlliance Prescription: Search at Online Services
Horizon BCBSNJ Dental: Doctor and Hospital Finder

How do I order additional AmeriHealth / SHIF ID cards?

If you need extra ID cards or wish to replace a lost card, log into myahatpa.com to order. They will be sent directly to your home.

Where can I get help if I have questions about claims or benefits?

When you have questions about your plans, visit the Get Help page for help reaching our carriers via toll-free phone numbers, online services, or e-mail. You can find help with questions about your benefits, providers, claims, and more. Be sure to have your ID card and birth dates handy.

Each carrier offers access to your plan information online. View your claims, benefits, order an ID card, and much more. If you are not yet registered, do so today!

AmeriHealth / SHIF Medical: myahatpa.com
BeneCard / RxAlliance Prescription: Online Services
Horizon BCBSNJ Dental: Member Online Services

When do services need precertification?
Certain services, such as hospitalization or outpatient surgery, require precertification from AmeriHealth. In-nework providers are responsible for obtaining precertification prior to treatment. If you are enrolled in a plan that offers an out-of-network benefit and you are obtaining services from an out-of-network provider, you are responsible for contacting AmeriHealth directly for precertification.

How can I find out about mail-order pharmacy?

When you order your prescriptions for maintenance drugs via BeneCard Central Fill, a licensed pharmacy fills and delivers your prescription to your home. Also known as "mail service pharmacy", mail-order pharmacy saves you time and money with fewer trips to the pharmacy--and you can usually fill your maintenance drugs for up to a three-month supply at a time.

Start by contacting BeneCard/Rx Alliance at (877) 723-6005, online at www.benecardpbf.com, or by mailing the Mail Service Form with your original prescription. 


How can I fill my prescription at the pharmacy without my BeneCard/Rx Alliance ID card?

If you've misplaced your BeneCard/Rx Alliance ID card and need to fill a prescription, follow the instructions on this letter. Ask the pharmacist to bill your prescription through the BeneCard PBF billing system.

To replace your ID card, call BeneCard/Rx Alliance at (877) 723-6005 or log into Online Services for instructions.


How can I find out about COBRA benefits?

If a qualifying event occurs, you and your enrolled dependents may be eligible to continue benefits under COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985).