Frequently Asked Questions
Pompton Lakes School District
What health plans are available to me as an eligible Board of Education employee?
The District currently offers medical and prescription benefits through Horizon Blue Cross and Blue Shield of New Jersey (BCBSNJ) and BeneCard respectively. Dental coverage is placed with Delta Dental. Visit the Plan Options page for information.
How can I get a new ID card?
If you've lost your ID card, use your carrier's online tools and contacts to order a new one--here's how:
Horizon BCBSNJ: Log into Online Member Services and order or print a new ID card. Or use the Horizon Blue app; download the app from the App Store or Google Play or text GetApp to 422-272. Learn more here.
Delta Dental: Use the mobile app to view, save, or send your ID card at any time. Or call Delta Dental directly at (800) 452-9310 for help.
The waiver (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 email the Business Office 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 (Fall 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 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 update 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 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 update within the given window, complete the appropriate enrollment forms and forward to the Business Office immediately after the event.
What are the rules for dependents who "age out"?
Eligible dependents are your spouse, civil union partner, eligible same-sex domestic partner, or your eligible children (this can include natural children under age 26 regardless of marital, student, or financial dependency status, stepchildren, foster children and those in a guardian ward relationship). Supporting documention is required for enrollment.
The Affordable Care Act (ACA) provides for medical and prescription coverage through the Pompton Lakes Board of Education for your eligible dependent up to age 26. Coverage ends upon the earliest of the following:
* The last day of the benefit month in which the child dependent marries
* The last day of the month in which the child reaches the age limit
* The date on which the child becomes employed and eligible for health coverage available as a result of that employment
Dental coverage for your dependent child typically ends upon the end of the year in which he/she turns age 19; however, full-time students are eligible for coverage under your plan though the end of the year in which he/she turns 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 or the <31 Dependent plan (see below).
What is the Dependent Under 31 (DU31) plan?
The New Jersey Overage Dependent (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. Click on the Dependent Coverage section of this website for more information.
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:
Where can I get help if I have questions about claims or benefits?
If you have questions about your plans, visit the Important Contacts page for help reaching the carriers through toll-free phone numbers, websites, or e-mail. You can find help with questions about your benefits, providers, claims, and more. When you contact either carrier, be sure to have your ID card and birth dates handy.
How can I find out about mail-order pharmacy?
Our prescription carrier, BeneCard, fills your mail-order prescriptions through BeneCard Central Fill. Save time and money with fewer trips to the pharmacy. Visit the Prescription Drugs page for more information.Does our plan include a vision benefit?
Eligible members have access to a vision benefit through VSP. See the below materials to learn more:VSP Benefits Summary
VSP Program Flyer
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 within 60 days of loss of coverage due to, for instance, 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 COBRA page or your plan booklet.
What are my rights under federal and state FMLA?
You are entitled for family leave benefits under certain circumstances. The State of New Jersey and the federal government mandate these benefits. See below for details:State of New Jersey Fact Sheet
U.S. Department of Labor Fact Sheet
Pompton Lakes School District FMLA Q&A