State Health Benefits Plan Update

13 Oct 2015 1:20 PM | Candace Sarges

After carefully evaluating the situation with the State Health Benefits Plan, we have been advised that pursuing legal action is not the best use of our resources. The union reps and the state reps who comprise the State Health Benefits Planning Design Committee negotiated a contract and came to an agreement which was done within their legal purview. 

We are currently engaged with the PT/dry needling issue for which we think our resources will be used to much greater effect.

 Please remember that the Benefits Planning Design Committee renegotiates their contract annually. We can and will make an impact next year.  At this point, acupuncture is still covered out of network for pain management at $60 per visit or 75% of the in-network reimbursement rate, whichever is lower.  

Our understanding is that the union reps agreed to this because there were other benefits they wanted more and they had to give up something.  Further, this Planning Design Committee, has, historically, made decisions without the members input and in the past, no decision has been reversed due to the dissatisfaction of the members with the outcome.  

 Our Plan:

 1) In order to prevent any further harm, we are addressing the teacher’s health plan coverage to prevent this same thing from happening with them.  We will be distributing a petition that the NJAAOM members can distribute to their patients who are teacher, superintendents and principals.  Each town has a different time frame for when their contracts come up for renegotiation so this could be a lengthy process.

 2) We will continue to monitor the State Health Benefits Planning Design Committee and communicate with them as possible.  We hope to make an impact at next's year's negotiations, but bear in mind, the State of NJ is trying to cut costs to balance the budget.  

Please click the link for the Horizon BCBS NJDirect15 State Health Benefits Updated health plan coverage.  It is already being offered and open enrollment in this plan is occurring now until November 2nd. 

NJDirect15 - State Health Benefits PlanUpdated health benefit plan coverage.pdf

We hope this clarifies the issue and our position.

NJAAOM

Comments

  • 22 Dec 2016 11:47 AM | Galina Morris
    WE are being Ripped off. Maybe these people who are making these decisions would like to pay our $3000.00 a month lease! plus expenses.
    Link  •  Reply
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