Frequently Asked Questions
Jackson School District
What health plans are available to me as an eligible Board of Education employee?
The District currently offers medical, prescription, and dental plans through Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Visit the Plan Options page to find overviews for 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 and are eligible, 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 Health Benefits Department for information. 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 (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 Health Benefits Department immediately (within 31 days; within 60 days for birth) when such an event occurs.
When an important event occurs in your life, such as marriage or adoption, you have 31 days to update your health plans (60 days upon the birth of a child). It is important to enroll your new dependent within the given window or you may need to wait until the next Open Enrollment period.
To make a smooth and timely update, complete the appropriate enrollment forms and forward to the Health Benefits Department immediately after the event.
The Affordable Care Act (ACA) provides for medical and prescription coverage through the Jackson 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 month in which he/she marries or the birthday on which he/she attains age 19, whichever is first (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, the ACA Health Insurance Marketplace, or the New Jersey Chapter 375 / <31 Dependent (DU31) plan (see below).
The New Jersey Chapter 375 / Dependent <31 (DU31) 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 Chapter 375 <31 Dependent (DU31) webpage for more information.
Horizon BCBSNJ provides a helpful search tool to help you locate primary doctors, specialists, facilities, and others that participate in your plan:
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 individual plan data online. View your claims, benefits, order an ID card, and much more. If you are not yet registered, do so today!
Horizon BCBSNJ Member Online Services
Certain services, such as hospitalization or outpatient surgery, require precertification from Horizon BCBSNJ. 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 Horizon BCBSNJ directly for precertification.
How can I find out about mail-order pharmacy?
Horizon BCBSNJ partners with Prime Therapeutics / AllianceRx Walgreens Prime to manage our prescription plans. AllianceRx Walgreens Prime can help you begin a new mail-order prescription or have renewals delivered to your home. Just call AllianceRx Walgreens Prime at (866) 525-1590 and speak with an associate or mail your prescription with the Home Delivery Registration and Prescription Order Form to get started.
Once your prescription is on record, you can order refills by mailing a completed Order Form or online when you sign in / register for services at alliancerxwp.com.
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).
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You must notify the Health Benefits Department within 60 days in the event of, for instance, a divorce, legal separation, or your child no longer qualifying as a dependent.
For more details on COBRA, visit the Continuing Coverage page or refer to your plan overviews.