Monmouth University offers the following medical insurance plans through Horizon Blue Cross Blue Shield of New Jersey. Full-time employees are eligible for coverage, as well as their spouse, Civil Union Partner, and dependent children.
New Plan Options for January 1, 2023
Note: Any new plan options published on this webpage are available to non-union employees at this time. Healthcare plans and employee contributions for union employees are governed by the terms of their respective collective bargaining agreements (CBA). Any changes in the CBA regarding healthcare for union members must be negotiated by their respective union representatives.
Enrollment can occur only when an employee is hired at their initial benefit eligibility date, when a qualifying event occurs, or during the annual open enrollment period.
If an employee declines medical coverage due to enrollment in another eligible medical plan, he or she is eligible to enroll in the University’s Medical Voluntary Financial Incentive Program.
Employee premium contribution costs vary according to plan and contract type.
The University’s medical plan includes a formulary Prescription Plan. For a comparison of the Prescription Plan in the new plan offerings for 2023 please refer to the Plan Comparisons of the Prescription Plans.
Horizon Blue Cross Blue Shield has partnered with Davis Vision to provide an improved vision benefit. Employees should continue to use Horizon for all medical eye related conditions and injuries. For routine eye examination and hardware, please refer to the Davis Vision Summary of Benefits
A copy of the Summary Plan Description is available in the Office of Human Resources.
To be an eligible dependent under Monmouth University’s Medical Plan and Voluntary Incentive Plan, the family member must be one of the following;
- the natural-born child or stepchild, under the age of 26, of you, your spouse or civil union partner
- a child, under the age of 26, who is either legally adopted by you, your spouse or civil union partner OR placed with you for adoption
- your spouse or civil union partner as defined under the Civil Union Partner Policy
Coverage may continue beyond the limiting age of 26 for a child who immediately prior to reaching that age was enrolled under the Medical Plan and is incapable of self-sustaining employment by reason of developmental disability of physical handicap. Such continued coverage is subject to approval by the medical insurance carrier.
Adult Child Under 31 Medical Coverage
The University provides for certain adults under the age of 31, pursuant to Chapter 375 of the State of New Jersey Law, the chance to continue coverage as a dependent on their parent’s group health coverage. The eligible under age 31 dependent will be responsible for the full cost of this coverage, plus a 2% administration charge. Dependents will be directly billed by the current healthcare carrier at a monthly rate which is subject to change at our annual renewal period.
The following conditions must be met for a dependent under the age of 31 to be eligible to make a Chapter 375 election. A dependent must:
- Have already aged out of a parent’s group health benefit plan issued in NJ
- Not be married
- Have no children of his/her own
- Not be covered under an individual health benefits plan, group health plan or Medicare
- The adult’s parent must be covered under the Monmouth University group health benefit plan
- Be younger than 31 years of age
- Be a resident of NJ OR be a full-time student at an accredited public or private institution of higher education
A dependent who continues coverage as a Chapter 375 dependent will lose coverage if the dependent marries; or if dependent becomes a parent; or if the dependent is no longer a full-time student and does not reside in New Jersey. Additionally, the dependent will lose coverage at the end of the month in which they turn 31 or when obtaining individual or group health coverage. The carrier reserves the right to cancel coverage for non-payment of premiums. If the dependent’s parent is no longer covered under Monmouth University’s group health benefits, the dependent’s coverage will also terminate.
BlueCard@Worldwide – When Traveling Outside of the United States
BlueCard Worldwide provides Blue Cross and Blue Shield members with access to a network of traditional inpatient, outpatient and professional healthcare providers around the world. The program includes a range of medical assistance and claim support services for members traveling or living in countries outside their Home Plan service area.
Horizon Blue Cross Blue Shield Representative on Campus
In an effort to provide enhanced customer service, a Horizon representative will be on campus the second Tuesday of each month from 9 a.m. to 4 p.m. to assist employees with such issues as claim resolution, understanding explanation of benefits, and plan benefit questions. Call the Office of Human Resources to schedule an individual appointment. A Spanish speaking Horizon representative is available to our employees. Please let us know if you prefer to meet with our Horizon Spanish speaking representative when scheduling your appointment.