2021 Open Enrollment – HMH

2021 Open Enrollment

Click the following links for details for team members at Carrier Clinic or Nursing & Rehab at Red Bank locations. 

Enrollment Help

Decision Guide & Enrollment Checklist
MyWay-PeopleSoft Enrollment Instructions
Duo Enrollment Instructions
New Hire Enrollment

Medical, Dental & Vision Plan Rates – Contributions Per Paycheck

Medical Plan Comparison – 2021 vs. 2020 (Full-Time)

Medical Plan Comparison – 2021 vs. 2020 (Part-Time)

Dental Plan Comparison – 2021 vs. 2020 (Full-Time)

Dental Plan Comparison – 2021 vs. 2020 (Part-Time)

Vision Plan (Full-Time & Part-Time)

Contact Information

Benefits Advocate Center (BAC)
TMSC: 1-551-996-2877
Monday – Friday: 8:00 am – 6:00 pm
BAC.TEAMHMH@AJG.COM

Horizon Landing Page
PHONE: 1-844-383-2327
LIVE CHAT: HorizonBlue.com/hmh
HOURS: Monday, Tuesday, Wednesday and Friday – 8 a.m. to 6 p.m., ET
Thursday – 9 a.m. to 6 p.m., ET.

FAQs – Open Enrollment

For FAQs in Spanish, please click here.

2021 Plan Year Benefits

Open Enrollment for HMH team members will take place from October 26 through November 20, 2020.

Please review our Open Enrollment Decision Guide for a list of steps you should take to select a new health plan or confirm that your current benefit selections still work for you and your family and to add any new benefit options for 2021, like Flexible Spending Accounts (FSAs) and Voluntary Benefits.

The OMNIA Health Plan is the newest plan offered to Hackensack Meridian Health team members for plan year 2021. HMH’s OMNIA Health Plan gives you access to leading doctors, low copays and deductibles. You’ll enjoy the highest level of benefits at the lowest out-of-pocket costs when you use facilities, doctors and health care professionals that participate in Hackensack Meridian Health’s (HMH) Inner Circle programs. As part of this plan, you’ll also have access to in-network coverage outside of New Jersey through BlueCard®.

We believe in the care we provide to each other and to our communities. This is a big reason why we have more top-ranked hospitals than any other health system in NJ and why HMH always steers us “home” first for our own care. We also recognize there are times when you and your family need options, so we worked with Horizon, our health insurance partner, to create coverage tiers that provide flexibility and affordable options to choose from.

The need to offer the most flexible care at the most affordable costs is the other important reason why we are moving to the OMNIA plan. Globally, healthcare priorities have changed, and HMH is no different. We are placing your needs in the forefront, where they belong, and streamlining as a network where we can. Delivering meaningful, cost effective health insurance options is imperative to our future sustainability.

If you enrolled last year, your selections, including Voluntary Benefits, will carry over if you choose not to participate in this year’s Open Enrollment. For health plans, if you do not select a new plan, you will be automatically enrolled in the 2021 health plan that is comparable to your current 2020 health plan selection:

  • Premium/Premium Plus Plan–> OMNIA Plan
  • Basic/High Deductible Plan –> Basic/High Deductible Plan
  • Out-of-New Jersey Plan –> Out-of-Area Plan

We encourage all team members to double check their current dependent, beneficiary and surcharge selections to ensure everything is still accurate. Additionally, if you wish to enroll in a Flexible Spending Account for 2021, you will need to do so during this year’s Open Enrollment, as FSAs do not roll over from year to year. Please see our Open Enrollment Decision Guide to make sure all of your bases are covered.

Our new OMNIA Health Plan is very similar to both of these plans except, like the 2020 Premium Plan, there are no out-of-network benefits covered under this plan. Please note, neither the Premium Plus Plan nor the Premium Plan will be offered by Hackensack Meridian Health for the 2021 plan year. If you are in either of these plans, you will need to choose a new plan.

While the OMNIA Health Plan has a large network of providers, including BlueCard providers across the country, it does not offer out-of-network benefits. If having access to providers who do not participate in our provider network is important to you, then you can consider the Basic/High Deductible Plan. However, if you don’t anticipate having a need for an out-of-network doctor or hospital, you might consider enrolling in the OMNIA Health Plan.

If you do not select a plan, you will be automatically enrolled in the 2021 health plan that is comparable to your current 2020 health plan selection:

  • Premium/Premium Plus Plan–> OMNIA Plan
  • Basic/High Deductible Plan –> Basic/High Deductible Plan
  • Out-of-New Jersey Plan –> Out-of-Area Plan

If you were previously enrolled in the Premium Plus or Premium plan and you do not select a new plan during this year’s Open Enrollment, you will be enrolled automatically in the OMNIA 4-tier health plan. However, we recommend taking the time to review your options and making an active selection, as this is an important decision that cannot be changed after Open Enrollment.

In 2020, Hackensack Meridian Health created a health plan developed specifically for its team members who live outside of New Jersey. In 2021, HMH has expanded the eligibility rules for this plan (now referred to as the “Out-of-Area” plan) to also include remote New Jersey counties, as follows:

  • Atlantic
  • Burlington
  • Camden
  • Cape May
  • Cumberland
  • Gloucester
  • Hunterdon
  • Mercer
  • Sussex
  • Warren

If you reside outside of New Jersey, or in one of the above NJ counties, you may want to consider the Out-of-Area health plan option. It combines the ability to utilize Inner Circle providers, which allow for the highest level of cost savings, with BlueCard®, which provides access to thousands of doctors, specialists, urgent care facilities and hospitals across the country.

If you wish to waive coverage for 2021, you will need to login to MyWay-PeopleSoft and click on “benefits enrollment event” and select “waive coverage” for the plan you wish to opt out of. More detailed instructions will be provided on how to complete this process in the coming weeks.

If you do not complete this step, you will be automatically enrolled in the 2021 health plan that is comparable to your current 2020 health plan selection:

  • Premium/Premium Plus Plan–> OMNIA Plan
  • Basic/High Deductible Plan –> Basic/High Deductible Plan
  • Out-of-New Jersey Plan –> Out-of-Area Plan

Yes, please refer to the Decision Guide for instructions on how to enroll. Click here for a step-by-step guide that walks you through the enrollment process on MyWay-PeopleSoft.

We are offering the following Voluntary Benefits for 2021: accident insurance, whole life insurance with long-term care, critical illness insurance, hospital indemnity insurance, pet insurance, and legal insurance. Click here for more information about our Voluntary Benefits.

Enrollment Process

Login to MyWay-PeopleSoft to enroll in benefits for 2021. Click here for a step-by-step guide that walks you through the enrollment process. Be sure to also check out the Decision Guide for help understanding the benefit options and enrollment process.

You will not be able to enroll in Voluntary Benefits through MyWay – PeopleSoft. To enroll in Voluntary Benefits, you must call Farmington toll-free at 1-844-428-6688 Monday through Friday from 8:00AM-5:00PM.

Yes! But only if you download the DUO app, which adds an additional layer of security if you’re not enrolling from your work location. It only takes a few minutes and ensures that your information is secure if you access it from home. You can download step-by-step instructions for accessing MyWay – PeopleSoft from home by clicking on the DUO links at the top of this page.

As always, new hires should select their new hire benefit elections first and then select their changes for the 2021 plan year via the Open Enrollment process. For more information on how to get started with this process, click here.

Yes! There will be live webinars to help guide you through the process. We recommend that benefit-eligible team members take advantage of a webinar session if they have any questions or if this is their first time enrolling in benefits at HMH.

The webinar schedule will be updated regularly at TeamHMH.com/OpenEnrollment.

Team members on leave can complete Open Enrollment via MyWay – PeopleSoft, as long as they have downloaded the DUO app. These team members will also receive a letter from Baker Tilly with additional details and will need to take action based on instructions included in the letter.

You will not be able to enroll in Voluntary Benefits through MyWay – PeopleSoft. To enroll in Voluntary Benefits, you must call Farmington toll-free at 1-844-428-6688 Monday through Friday from 8:00AM-5:00PM.

Please visit the “Team Member Self Service” section on MyWay – PeopleSoft to ensure your dependents are entered correctly. If your dependents are marked as “other,” you will need to change the designation to spouse, child, etc., in order to enroll them. If you’re still having trouble after you’ve confirmed their status, please contact TMSC at 551-996-2877.

From the MyWay – PeopleSoft homepage, click the My Benefits tile, then click the Add/Review Dependents (or Beneficiaries) button. To update information for an existing person, click the person’s name. At the bottom of the page, click the Edit button, make the updates, and click Save. Each beneficiary entry must include a relationship type, date of birth and social security number.

The spousal surcharge is an additional, per paycheck fee added if the team member has a spouse who is eligible to receive health care coverage through his/her own employer, but chooses to receive coverage under the HMH plan, instead. Click here to view the full spousal surcharge policy.

In an effort to bring the highest level of cost savings to as many team members as possible, we couldn’t ignore the fact that smokers carry greater risk and costs to the plans that support you. The tobacco surcharge is an additional, per paycheck fee added if either the team member or spouse use tobacco products. However, we’ll remove the tobacco surcharge if the applicable team member and/or spouse completes the tobacco cessation program. This is consistent with industry-wide practice.

Please confirm that your spousal and tobacco surcharges certifications are accurately reflected in MyWay – PeopleSoft. If any questions are left blank, surcharges will be assessed for the 2021 year.

After making changes to your benefit plan, a benefit confirmation statement will be available in your MyWay – PeopleSoft profile within 24 to 48 hours. You are responsible for reviewing this statement and confirming all elections are accurate.

To access:

  • Log in to MyWay – PeopleSoft
  • Click on the “My Benefits” tile
  • On the menu on the left hand side, click on “Confirmation Statements”
  • Click the “Select” button next to the Open Enrollment event with the event date of 01/01/2021
  • Please review your statement and confirm your selections are accurate

A Health Savings Account (HSA) is a companion to the Basic Plan. You, and in most cases your employer, can contribute money that can be used to pay for eligible medical, dental and vision expenses.

Upon enrollment into the Basic Plan, our HSA vendor, Baker Tilly, will send you a welcome kit designed to walk you through the set-up and maintenance of your HSA. You must accept the terms and agreements in order to open the HSA. If you do not complete this important step, you will forfeit any of your own contributions and those from HMH. Please be sure to review the decision guide for important information regarding setting up your HSA.

Please Note: If you choose to participate, you must open an account even if you don’t contribute your own funds. This allows any HMH contributions to be linked to your account.

The Basic/High Deductible Plan is paired with an HSA. If you enroll in this plan and do not accept the terms and agreements for the HSA, you will forfeit any contributions from HMH or your own. To accept the terms and agreement, please attest to the terms and agreement by logging into MyWay-PeopleSoft and completing the enrollment process.

A Limited Purpose FSA is a pre-tax FSA for participants in HSA accounts. Similar to an FSA, a Limited Purpose FSA allows you to contribute money that can be used for eligible health-related expenses. Because it is prohibited under federal regulations to “double dip” (in other words, to use two pre-tax accounts for medical reimbursements), the Limited Purpose FSA allows reimbursement for dental and vision expenses only.

If you are currently enrolled in a General FSA (from the 2020 year) and want to enroll in a HSA account for 2021, you can. However, employees are prohibited from participating in both a General FSA and HSA account at the same time, per federal guidelines. Because of this, you must use all of your General FSA funds before you are able to make contributions (from yourself or HMH) to your HSA.

If you have not exhausted your General FSA funds by March 31, 2021, those funds will be rolled over (up to $550) to something called a “Limited Purpose FSA” and contributions to your new HSA account will begin the following day (April 1, 2021).

Please Note: Once funds have been moved into a Limited Purpose FSA they can be used for eligible dental and vision expenses, but not medical.

Yes, to enroll in Voluntary Benefits, you must call Farmington toll-free at 1-844-428-6688 Monday through Friday from 8:00AM-5:00PM.

HMH partner Baker Tilly will mail letters to the homes of team members on an LOA, which will include instructions on how to enroll using one of the following two methods. Regardless of the method you choose, you are encouraged to view your coverage options and detailed rates on TeamHMH.com/OpenEnrollment.

  • Fill out the form that Baker Tilly includes in the mailing – once completed, you should mail it back using the instructions provided.
  • Enroll online using instructions that Baker Tilly includes in the mailing.

When you log in to MyWay – PeopleSoft to enroll, your zip code allow you to see the Out-of-Area plan in your options. Only team members who reside outside of New Jersey or in the following NJ counties are eligible for the Out-of-Area plan: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Hunterdon, Mercer, Sussex, Warren.

You can make changes to your enrollment selections until midnight on the last day of Open Enrollment, November 20.

On TeamHMH, visit TeamHMH.com/Benefits/Health-Wellbeing to review the 2020 medical benefits.

Provider Networks

Inner Circle providers are Hackensack Meridian Health facilities, doctors and other health care professionals. You and your eligible dependents will receive the highest level of benefits at the lowest out-of-pocket costs when you get care from Inner Circle health care professionals and facilities.

Inner Circle offers the greatest opportunities to save you money. When you choose to receive care from an Inner Circle Prime health care professional, you will pay nothing – no deductible, no copay! If you receive care from an Inner Circle provider who is not part of Inner Circle Prime, you will pay no deductible, and your copayments will be as low as $5 for PCPs and $15 for specialists. To increase your opportunities to save, we have also expanded the Inner Circle to include additional behavioral health care professionals.

Regardless of the plan you select in 2021, you will be able to utilize Inner Circle providers, thus allowing you more opportunities to save money while accessing the best care.

  • With the OMNIA health plan, the Inner Circle has two tiers: Inner Circle Prime, which includes providers in the HMH network and the highest level of savings (no deductibles or copays), and the Inner Circle, which includes other HMH designated providers and a similarly high level of savings (no deductible and low copays).
  • With the Basic/High Deductible plan and the Out-of-Area plan, you have access to all the same providers, but they are not split into two Inner Circle tiers. The deductible and out-of-pocket criteria for Inner Circle differ depending on the plan selection.

For more details about how to utilize the Inner Circle for all plans, visit TeamHMH.com/OPENENROLLMENT and review the plan details.

HorizonBlue.com/hmh will provide simple and easy to use tools to find a doctor, specialist, facility or hospital who participates in Hackensack Meridian Health’s Inner Circle in 2021. More information regarding 2021 Inner Circle providers will be available to team members in early September. It is important to us that this information is available to you so you can make an informed decision for you and your family.

In addition to Inner Circle and Inner Circle Prime doctors and specialists, the OMNIA Health Plan offers another way to keep your out-of-pocket costs low. When you get care from a doctor designated as OMNIA Tier 1 you will pay less than when you get care from a Tier 2 provider.

BlueCard is a national program that gives Horizon Blue Cross Blue Shield of New Jersey members access to health care services while traveling or living outside of New Jersey.

If you experience a life-threatening emergency, such as chest pain or difficulty breathing, call 911 or go to your nearest emergency room.

With your coverage, you have access to Inner Circle Prime, Inner Circle and in-network doctors, hospitals and health care professionals in New Jersey and across the country. By choosing Hackensack Meridian Health facilities, doctors and other health care professionals, your Inner Circle benefits give you and your eligible dependents the highest level of coverage at the lowest out-of-pocket costs.

There are three easy ways to find an in-network doctor or hospital:

  • From the Horizon Blue mobile app, you will be able to tap Doctor and Hospital Finder.
  • Visit HorizonBlue.com/hmh. From the tools menu, you’ll choose Find a Doctor in NJ. Click here for a step-by-step guide.
  • Email or chat live with a Member Services Representative once signed in to the secure member portal at HorizonBlue.com/hmh.

Need more help?

Call 1-844-383-2327 to reach a dedicated Member Services Representative, Monday through Wednesday and Friday, from 8 a.m. to 6 p.m., Eastern Time (ET), and Thursday, from 9 a.m. to
6 p.m., ET.

Visit HorizonBlue.com/HackensackMeridianHealth for a searchable database of Inner Circle providers or for instructions on how to access the database. Please continue to check the database throughout the year as providers and facilities will continue to be added.

It is also a good idea to verify with the provider as well as with Horizon that they are still participating in the HMH Inner Circle before your appointment. Click here to contact Horizon directly.

Click here for details on the 2021 medical plan. To see your rates, visit TeamHMH.com/OpenEnrollment/HMH.

Click here for details on the 2021 dental plan. To see your rates, visit TeamHMH.com/OpenEnrollment/HMH.

Click here for details on the 2021 vision plan. To see your rates, visit TeamHMH.com/OpenEnrollment/HMH.

We have heard from several team members who would like to work with their current provider to bring them into the inner circle. If this is something you’re interested in pursuing, the following is information you can give to your provider:

The formulary for 2021 is posted online here.

Behavioral Health Coverage

Horizon Behavioral Health offers a full range of support and services to make sure you get all the care and support you need. Whether you or a loved one is dealing with daily challenges related to stress or anxiety, or serious chronic conditions, such as substance use, we can help connect you with the right type of care.

Our network covers treatment for:

  • ADHD
  • Alcohol and substance use disorder
  • Anxiety
  • Autism spectrum disorder
  • Depression
  • Eating disorders
  • Emotional health and wellness
  • Family care and education
  • Grieving after loss
  • Serious mental illness
  • Suicide prevention
  • And more

Horizon Behavioral Health also provides educational information and tools to find in-network providers, community resources and support. Behavioral health services are available to you and your covered dependents 24 hours a day, seven days a week.

For information about Horizon Behavioral Health, visit HorizonBlue.com/hmh or call
1-800-626-2212. We’re here to help members find the care and support they need.

When enrolled in OMNIA, you have access to several tiers of care. For practitioners in “Inner Circle Prime”, which consist of HMH-owned practices, there will be no copay or out-of-pocket costs. For practitioners in the “Inner Circle”, there will only be a $5 copay.

We have expanded the Inner Circle for all plans to include approximately 3,300 new behavioral health providers for 2021.

There are two options available to you:

  • If you select the Basic/High Deductible Plan, it has coverage for out-of-network providers after you hit your deductible. This option would allow you to continue to see your chosen provider, regardless of their network status.
  • If you select the OMNIA 4-tier plan or the Out-of-Area plan, continuation of care may be provided to team members who are currently under the care of an out-of-network provider. Under these circumstances, the team member must submit a formal “continuation of care” request to Horizon, which may allow you to continue care with your current provider for a specific period of time or a specific number of visits in order to give you time to transition to a network provider. More information about that process will be shared in the coming weeks.

Coverage When Traveling

All Hackensack Meridian Health plans include the BlueCard Program, which provides coverage outside the state of New Jersey. BlueCard, the premier national Blue Cross and/or Blue Shield Preferred Provider Program, links more than 1.3 million network doctors and hospitals across the country.

Every health plan option comes with access to doctors and hospitals around the world through Global® Core.

To use Global Core:

  • Before you travel, call Horizon BCBSNJ at 1-844-383-2327 for coverage details, as coverage may vary outside the United States.
  • Always carry your current Horizon BCBSNJ member ID card. Your member ID card is available when you register for the Horizon Blue app.
  • If you need care, call the Service Center at 1-800-810-2583 (BLUE) or collect at
    1-804-673-1177.
  • An assistance coordinator, working with a medical professional, will arrange for your care.
  • You should also call Horizon BCBSNJ at 1-844-383-2327 for precertification or preauthorization.

In most cases, you will not need to pay up front for inpatient care except for the out-of-pocket expenses (non-covered services, deductible, copayment and coinsurance) you would normally pay. The hospital should submit the claim to Horizon BCBSNJ on your behalf, but if you need one, claim forms are available on bcbsglobalcore.com.

Additional Information

Connect to care, benefits and support any time. Get instant access to your benefit details and

answers to your coverage questions when you sign in at HorizonBlue.com/hmh or sign in using the Horizon Blue mobile app. To get the app, text GetApp to 422-272 or download from the App Store or Google Play.

Need more help?

Call 1-844-383-2327 to reach a dedicated Member Services Representative, Monday through Wednesday and Friday, from 8 a.m. to 6 p.m., ET, and Thursday, from 9 a.m. to 6 p.m., ET.

There are three options available to you for dental coverage:

  • Hackensack Meridian Health offers the Horizon Dental Option plan, which gives you the freedom to get dental services from any dentist. Using a dentist who participates with the Horizon Dental Option plan will get you the most from your benefits and maximize savings.
    • When you use a dentist that participates in the Horizon PPO Network, you receive deeper discounts and may save even more. You have the option of selecting from more than 200,000 office locations nationwide.
    • If you use an out-of-network dentist, you will still receive a benefit for eligible services. Out-of-network dentists may charge up to their normal fees. Horizon Dental reimburses up to plan allowances. Charges above the plan allowance will be your responsibility.
  • The Horizon Dental Choice Plan covers 100 percent of all eligible preventive and basic services with no copayments, maximums or deductibles when receiving those services from your primary Horizon Dental Choice dentist. Care must be coordinated through the in-network Horizon Dental Choice dentist you select as your primary care dentist.
  • The HealthPlex plan provides a small network of selected family dentists and dental facilities to choose from. The plan allows you to select one primary dental provider who will provide or coordinate all of your dental care within the HMH network. A list of providers available under this plan in 2021 will be provided in the coming weeks.

Horizon Vision offers access to high-quality products and services for little to no out-of-pocket cost. Choose from hundreds of frame and lens options at fixed member pricing, so you can get the look you want at a low price.

Plus, when you purchase frames from Horizon Vision through Visionworks®, you’ll receive a $50 additional allowance above your plan benefit. Visionworks carries an array of designer and exclusive brands, so you can save money without sacrificing quality.

Horizon Vision plans offer:

  • An annual eye exam, including dilation.
  • Coverage for eyeglasses and contact lenses (including mail-order contact lenses).
  • A one-year breakage warranty.

See plan details at davisvision.com/HorizonBase and davisvision.com/HorizonBuyUp.

Under the Horizon Dental Option plan (PPO), team members receive a fixed amount of $1,000 per lifetime, which can be used for Invisalign or standard braces. Under this plan, team members are responsible for treatment beyond the $1,000 lifetime maximum.

Under the Horizon Dental HMO plan, team members will be responsible for an additional co-pay. Your provider can advise you on this additional cost.

Under the HealthPlex Dental HMO plan, only standard braces are covered up to the specific limits.

We are required by law to negotiate about mandatory subjects of bargaining with the unions that represent a small number of Hackensack Meridian Health team members. We are committed to negotiating in good faith as required by law, and we will not engage in any direct dealing with union-represented team members. Union-represented team members should contact their respective union about any questions they have.

COPYRIGHT © 2020 HACKENSACK MERIDIAN HEALTH. ALL RIGHTS RESERVED.
Subject to union negotiations. We are required by law to deal with the unions on behalf of unionized team members, and we will continue to do so. We will only negotiate with the unions, not with individual unionized team members.
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