Special Eligibility rules for plans (Single Only first 4 years, Buy up option offered)

The District can utilize the Dynamic  Staff List and / or the Restriction Rules for Open Enrollment to limit plans that are available to a staff member to have access to select a plan in open enrollment. 

This example will illustrate how to use either the Dynamic Staff List and / or the Restriction Rules to limit the availability of a plan.  

For the sample, the District offers its teachers Single Only coverage for the first 4 years of employment.  In the first three years, the teacher has the option to buy-up to coverage other than single by paying 100% of the premium difference from the coverage selected and single coverage.  

How to Utilize the Restriction Rules

In this example, only newly hired teachers (4 years experience or less) will have the Single Only Plan available for either the NJEHP or the NJGSP plan.  Teachers with more than 4 years experience in the District will have the option for the "regular"  NJEHP or the NJGSP plan with no charges for coverage other than single.  

The District has created separate NJEHP and NJGSP plans and labeled them "Single Only" and "Any Membership".  

Utilizing the Plans Available type 

The following settings can be used for the NJEHP / NJGSP plan for the "Single Only" and will only be accessed by a teacher whose Chapter 44 start date is between 9/2/2020 and 8/31/2024.

The following settings can be used for the NJEHP / NJGSP plan for the "Any Membership" and will only be accessed by a teacher whose Chapter 44 start date is on, or before, 9/1/2020.

Utilizing the Staff List and the Years in LEA field

The following staff list settings can be used for the NJEHP / NJGSP plan for the "Single Only" and will only be accessed by a teacher who has less than 4 years of service in the District.

The following settings can be used for the NJEHP / NJGSP plan for the "Any Membership" and will only be accessed by a teacher who has 4 years of service or more in the District.