In his Administration's latest initiative to ensure individuals dealing with mental illness and substance abuse are treated with the dignity and care they deserve, Governor Chris Christie announced that the committee that determines health benefits for the more than 200,000 members of the School Employees Health Benefit Program (SEHBP) and their dependents approved a plan today to create Mental Health Parity in provider benefits, a Wellness Program with financial incentives of up to $250 a year to employees to maintain healthy lifestyles and four new lower-cost health plan options that employees can choose. All of the changes will take effect in Plan Year 2014.
"This is a plan design that maintains long-term cost effectiveness and achieves my abiding commitment to dealing fairly and compassionately with those battling mental illness and substance abuse. Wellness programs like this have also become a proven method of maintaining healthy lifestyles and dealing with chronic, treatable illnesses such as diabetes, asthma and others through proper choices and consistent medication and treatment management," said Governor Christie. "I also applaud the labor-management cooperation of the plan design committee in hammering out this effective health care approach."
The School Employees Health Benefits Program Plan Design Committee voted unanimously to approve the plan changes and new plan options at its meeting today. The committee is made up of three management representatives from the State and three representatives of public employee labor unions. The joint labor-management plan design committees for both the SEHBP and the State Health Benefits Plan represent a new, cooperative approach to managing public employee health care costs and benefit offerings. They were created as part of the comprehensive, bipartisan package of pension and health benefit reforms that Governor Christie signed into law in June 2011. The SEHBP serves more than 190,000 members and their nearly 200,000 dependents.
The committees have provided a forum for joint decision-making by all interested parties on how limited health care dollars will be spent and how benefits can best be tailored to the needs of all plan participants.
Governor Christie has made significant public policy steps to ensure that individuals dealing with mental illnesses and substance-abuse disorders are treated with dignity and given the support they deserve. Providing Mental Health Parity to SEHBP members continues that commitment. Parity means that non-biologically-based mental illness will be treated in the same way as biologically-based conditions. The SEHBP already provides coverage for biologically-based mental illness on the same basis as other illnesses. However, limits have been in place on the coverage levels and number of days of treatment available on both an in-patient and out-patient basis for non-biologically-based mental illnesses.
While those limits will no longer apply, all benefits for biologically and non-biologically-based mental illnesses will be subject to medical necessity and physician review and the additional cost to the SEHBP of providing expanded mental health coverage is expected to be less than $4 million per year.
Starting next year, SEHBP's active employee members and their spouses will also be able to participate in a comprehensive, incentive-based wellness program that will offer them a broad array of options for improving their overall health by joining exercise programs, diet, medical screenings and education programs and adopting positive action plans.
The incentives for participation will include gift cards worth up to $100 that will be available to employees and spouses in their first year of participation in a wellness program and that can be worth up to $250 per person in the third year of the program.
The Committee also approved two new health plan options for active SEHBP members that will offer them a choice of 2035 Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans from both Aetna and Horizon. The new plans will carry higher copays and deductibles than other coverage options but could reduce employees annual premium costs by as much as 15 percent compared to the lowest cost plan currently offered.
The members of the SEHBP Plan Design Committee are Kenneth Kobylowski, Commissioner of the Department of Banking and Insurance, Jim Leonard, Treasury Department Chief of Staff, David Ridolfino, Associate Deputy State Treasurer, Kevin Kelleher, Director of the Research and Economic Services Division for the NJEA and Wendell Steinhauer, the organization's incoming President, and Jean Pierce, Public Policy Staff Member for Health Professionals and Allied Employees for the American Federation of Teachers/AFL-CIO.