Frequently Asked Questions
South Brunswick School District
What health plans are available to me as an eligible Board of Education employee?
The District currently offers medical and prescription plans through Aetna. Our dental plans are placed with Delta Dental. Visit the Plan Options page to find plan overviews 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 our Benefits Coordinator at (732) 297-7800 x3122 / benefits@sbschools.org. Visit the Waiver Option page for more details.
When can I make changes to my plan?
You can make changes to your plan at Open Enrollment (during Fall 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 adjust your plans immediately at the bswift online portal (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 plan. 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, it is important to adjust your plans immediately at the bswift online portal when such an event occurs.
What are the rules for dependents who "age out"?
The Affordable Care Act (ACA) provides for medical and prescription coverage through the South Brunswick School District for your eligible dependent through the end of the year in which he/she turns to age 26. Dental coverage for your dependent child typically ends at the end of the month of his/her 19th birthday (or 23rd birthday if attending an accredited school, college, or university as a full-time student).
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 ACA Health Insurance Marketplace. Refer to the Continuing Coverage webpage for more details.
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 Find-a-Doctor
Delta Dental Find A Dentist
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!
Aetna Member Website
Delta Dental Online Services
When do services need precertification?
Certain services, such as hospitalization or outpatient surgery, typically require precertification from Aetna. 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 Aetna directly for precertification.
How can I find out about mail-order pharmacy?
Our Aetna prescription plan is administered through CVS Caremark. You can opt to have new or continuing prescriptions delivered to your home; visit the Prescription Drugs webpage to learn more. Once your prescription is on record, you can order refills by mailing a completed Mail Service Form, online when you sign in / register for services at aetna.com, or call toll-free at (888) 792-3862.
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.
State of New Jersey Fact Sheet
U.S. Department of Labor Fact Sheet
How can I find out about COBRA, Medicare, and other continuing coverage options?
You must notify our Benefits Coordinator at (732) 297-7800 x3122 / benefits@sbschools.org within 60 days if you/your dependent is no longer eligible for District coverage due to, for instance, a divorce or your child reaching specified age limitations. If a qualifying event such as these occurs, you and your enrolled dependents may be eligible to continue benefits under COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) or another options.
Visit the Continuing Coverage webpage or refer to your plan overview for more information.