This page is for team members who work at HMH Residential Nursing & Rehab – Red Bank, who are participating in an active Open Enrollment from November 16 to November 30.
Click the following links for details for team members at Carrier Clinic locations or at all other HMH locations.
Decision Guide & Enrollment Checklist
How To Enroll With Baker Tilly
Baker Tilly
1-800-307-0230
Monday-Friday – 8:00 a.m. – 8:00 p.m. ET
HMHEnroll2021.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.
When is Open Enrollment?
Open Enrollment for team members at HMH Residential Nursing & Rehab – Red Bank will take place from November 16 through November 30, 2020. This enrollment period is to enroll in benefits for the 2021 benefit year, starting on Januray 1, 2021.
This year’s Open Enrollment for HMH Residential Nursing & Rehab – Red Bank is an active enrollment, meaning that you must take action in order to enroll in benefits for 2021. You will not be automatically enrolled in any benefit plan unless you actively enroll during Open Enrollment.
What do I need to do to prepare for Open Enrollment?
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.
I want to keep the same benefits I had last year. Do I have to participate in Open Enrollment?
Yes, you must participate in this year’s active open enrollment. This year, team members at HMH Residential Nursing & Rehab – Red Bank will be enrolling in the same benefits plans as team members throughout the rest of HMH, which means you will be enrolling in new benefits.
Due to enrolling in new benefits, team members at HMH Residential Nursing & Rehab – Red Bank will be participating in an active Open Enrollment, meaning that you must take action in order to enroll in benefits for 2021. You will not be automatically enrolled in any benefit plan unless you actively enroll during Open Enrollment.
What is the OMNIA Health Plan?
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®.
Why is HMH switching to the OMNIA Health Plan for this plan year?
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.
How does the OMNIA Plan differ from other health plans?
The new OMNIA Health Plan is very similar to previous benefit plans offered except there are no out-of-network benefits covered under this 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.
Do I need to select a plan during open enrollment, or will I be automatically enrolled in a certain plan if I do nothing?
This year’s enrollment is an Active Enrollment for team members at HMH Residential Nursing & Rehab – Red Bank, meaning that you must take action in order to enroll in benefits. You will not be automatically enrolled in any benefit plan unless you actively enroll during Open Enrollment. We recommend taking the time to review your options before selecting your benefit plan, as this is an important decision that cannot be changed after Open Enrollment.
I live outside of New Jersey or a substantial distance away from my work location. Is there a health plan that takes this into consideration?
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:
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.
I want to waive coverage this year and do not want to be automatically enrolled in a new plan. How do I do that?
More detailed instructions will be provided on how to complete this process in the coming weeks.
How do I participate in this year’s Open Enrollment?
Team members at HMH Residential Nursing & Rehab – Red Bank will enroll in benefits for 2021 via Baker Tilly’s online platform. For guidance on how to navigate the process, check out our Decision Guide specifically designed for Red Bank team members. The last page is a roadmap that you can use to enroll at HMHEnroll2021.com.
Will I be able to enroll from home?
Yes! Check out our Decision Guide specifically designed for Red Bank team members. The last page is a roadmap that you can use to enroll at HMHEnroll2021.com.
Will there be virtual support to help me enroll? If so, when will they take place and how would I access them?
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.
How do team members on a leave of absence complete Open Enrollment?
Team members on leave will receive a letter from Baker Tilly with additional details and will need to take action based on instructions included in the letter. Be sure to check out our Decision Guide specifically designed for Carrier team members. The last page is a roadmap that you can use to enroll at HMHEnroll2021.com.
What Voluntary Benefits are being offered in 2021?
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.
How do I enroll in Voluntary Benefits for 2021?
You will not be able to enroll in Voluntary Benefits through Baker Tilly. To enroll in Voluntary Benefits, you must call Farmington toll-free at 1-844-428-6688 Monday through Friday from 8:00AM-5:00PM.
Can I enroll in voluntary benefits by phone?
Yes, to enroll in Voluntary Benefits, you must call Farmington toll-free at 1-844-428-6688 Monday through Friday from 8AM-5PM.
What do I do if I am having trouble enrolling my dependents?
If you’re having trouble enrolling your dependents, please contact Baker Tilly at 1-800-307-0230, Monday – Friday from 8:30AM-5:30PM ET.
How do I update my beneficiaries? Will they carry over from last year?
No, beneficiaries will not carry over from the previous year because you are participating in an active enrollment. Please designate your beneficiaries during the enrollment process with Baker Tilly. If you’re having trouble designating your beneficiaries, please contact Baker Tilly at 1-800-307-0230, Monday – Friday from 8:30AM-5:30PM ET.
How can I obtain my benefits confirmation statement?
You will update or confirm your surcharge certifications during the enrollment process with Baker Tilly. If you’re having trouble doing so, please contact Baker Tilly at 1-800-307-0230, Monday – Friday from 8:30AM-5:30PM ET.
What is a Health Savings Account (HSA)?
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.
What happens if I do not accept the terms and agreements for my HSA?
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 completing the enrollment process via Baker Tilly’s online enrollment.
What is the difference between a Limited Purpose Flexible Spending Account (Limited Purpose FSA) and a General FSA?
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.
I have money in a Flexible Spending Account (FSA) scheduled to rollover into 2021. Can I still contribute to a Health Savings Account (HSA) account?
If you are currently enrolled in a General FSA (from the 2020 year) and want to enroll in an 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.
What is the spousal surcharge?
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.
What is the tobacco surcharge?
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.
If I am on a Leave of Absence (LOA) during Open Enrollment, how will I enroll?
HMH partner Baker Tilly will mail letters to the homes of team members on an LOA, which will include instructions on how to enroll online. Please review your coverage options and detailed rates on TeamHMH.com/OpenEnrollment.
How will I know if I am eligible for the Out-of-Area Plan?
When you enroll, your zip code determine if you to see the Out-of-Area plan in your options. Only team members who reside outside of New Jersey or in the following remote NJ counties are eligible for the Out-of-Area plan. NJ counties include: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Hunterdon, Mercer, Sussex, Warren.
What if I already enrolled in benefits, but I change my mind and want to amend my selections?
You can make changes to your enrollment selections until midnight on the last day of Open Enrollment, November 20.
What are Inner Circle providers?
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.
What is the difference between Inner Circle Prime and Inner Circle?
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.
How will Inner Circle be different if I choose the Basic/High Deductible Plan or Out-of-Area Health Plan for 2021?
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.
For more details about how to utilize the Inner Circle for all plans, visit TeamHMH.com/OPENENROLLMENT and review the plan details.
How can I find out if my doctor is a part of the Inner Circle?
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.
What is the difference between OMNIA Tier 1 and Tier 2?
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.
What is BlueCard®?
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.
What happens if I need to get emergency care?
If you experience a life-threatening emergency, such as chest pain or difficulty breathing, call 911 or go to your nearest emergency room.
How do I find the doctors/providers/hospitals that will save me the most money?
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.
Starting in early September, you’ll be able to access information about Inner Circle providers for the 2021 plan year.
There are three easy ways to find an in-network doctor or hospital:
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.
Where can I find a list of Inner Circle Prime/Inner Circle providers for my health insurance plan?
Visit HorizonBlue.com/HackensackMeridianHealth for a searchable database of Inner Circle providers or click here 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.
Where can I find more information on the medical plan for 2021?
Click here for details on the 2021 medical plan. To see your rates, visit TeamHMH.com/OpenEnrollment/RedBank.
Where can I find more information on the dental plan for 2021?
Click here for details on the 2021 dental plan. To see your rates, visit TeamHMH.com/OpenEnrollment/RedBank.
Where can I find more information on the vision plan for 2021?
Click here for details on the 2021 vision plan. To see your rates, visit TeamHMH.com/OpenEnrollment/RedBank.
My provider would like to join the Hackensack Meridian Health Inner Circle Prime/Inner Circle. What do they need to do?
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:
Where can Team Members find the formulary?
The formulary for 2021 is posted online here.
What is Horizon Behavioral Health
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:
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.
How much will behavioral health services cost with the new OMNIA Plan?
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.
How many behavioral health providers will there be to choose from in 2021?
We have expanded the Inner Circle for all plans to include approximately 3,300 new behavioral health providers for 2021.
What if I am already under the care of a behavioral health practitioner who is out of the Horizon Managed Care Network and I do not want to change my provider?
There are two options available to you:
Which plan provides coverage when I travel within the United States?
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.
Which plan provides coverage when I travel outside of the U.S.?
Every health plan option comes with access to doctors and hospitals around the world through Global® Core.
To use Global Core:
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.
Where can I get information about what’s covered under my health plan?
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.
Is dental coverage available?
There are three options available to you for dental coverage:
Is vision coverage available?
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:
See plan details at davisvision.com/HorizonBase and davisvision.com/HorizonBuyUp.
Is Invisalign covered under the dental plans?
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.
