Frequently Asked Questions
Maple Shade Schools
What health plans are available to me as an eligible Board of Education employee?
The District medical benefits are offered through Aetna and Horizon OMNIA and administered by the Schools Health Insurance Fund (SHIF). Our prescription plans are placed with BeneCard and dental plans are with Delta Dental. Refer to the your plan booklets or summaries for details about our plans.
The health waiver, or "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 can choose 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 loss documentation.
If you have questions about this option, please contact the Business Office (cdudley@msemail.org / x5280) for instructions. Visit the Waiver Option page for 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 change your plan at that time. It is important to notify the Business Office (cdudley@msemail.org / x5280) immediately when such an event occurs. See the next question for more information on adding a dependent to your plan.
How can I add new dependents to my plan?
When an important event occurs in your life, such as marriage, adoption, or birth of a child, you have a specified window of time to make updates 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, complete the appropriate enrollment forms and forward to the Business Office (cdudley@msemail.org / x5280) immediately after the event.
What are the rules for dependents who "age out"?
The Affordable Care Act (ACA) provides for medical and prescription coverage for your eligible dependent child through the last day of the calendar year he/she reaches age 26. Dental coverage for your dependent child typically ends at the end of the calendar month of his/her 23rd birthday.
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 or the Chapter 375 (<31 Dependent) plan (see below).
Refer to the Dependent Coverage page for more details.
What is the "Dependent <31" (DU31) 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. See Dependent Coverage and your Plan Booklet for specifics.
How can I find information about the Family Medical Leave Act (FMLA) / leave of absence?
For information about FMLA / leaves of absence, visit the below sites. Contact the Business Office (cdudley@msemail.org / 5280) for more details.
Fact Sheet
DOL Website
Where can I find a list of providers that participate in my plan?
Our carriers provide helpful search tools to help you locate primary doctors, specialists, facilities, and others that participate in your plan:
Aetna Plans: Provider Search
Horizon BCBSNJ OMNIA Plan: Doctor & Hospital Finder
Delta Dental: Find a Dentist
Where can I get help if I have questions about claims or benefits?
If you have questions about your plans, visit the Get Help page for a list of contacts you can reach through toll-free phone numbers, websites, or e-mail. You can find help with questions about your benefits, providers, claims, and more. When you make contact, be sure to have your ID card and birth dates handy.
How can i find out about mail-order pharmacy?
You can obtain mail-order prescriptions through BeneCard Central Fill. To manage your online prescriptions, access the member portal at benecardpbf.com or mail your prescription with the Mail Service Order Form.
How can I find out about COBRA benefits?
If any of the below qualifying events occurs, you and your enrolled dependents may be eligible to continue benefits under COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985):
* Your death
* Your hours of employment are reduced or your employment is terminated
* Your divorce or legal separation
* Your entitlement to Medicare
* Your child no longer qualifies as a dependent
* A proceeding under the United States Bankruptcy Code involving the employer from which you have retired
You must notify the Business Office (cdudley@msemail.org / x5280) within 60 days of a divorce, legal separation or when a child no longer qualifies as a dependent. You are responsible for paying the required amount to continue coverage for a maximum of 18 or 36 months, depending on circumstances. Additionally, an extension of up to 29 months may be granted to qualified disabled beneficiaries.
For more details on COBRA, visit the website COBRA page or your plan booklet.
What are my rights under federal and state FMLA?
You are entitled to family leave benefits under certain circumstances. The State of New Jersey and the federal government mandate these benefits. See below for details:
Maple Shade School District: FMLA Q&A
State of New Jersey: Fact Sheet
Department of Labor: Fact Sheet