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Seton Hall University
Presidents Hall

Open Enrollment

Open enrollment begins Monday, October 28 and ends Friday, November 15, 2019. The benefit elections you make during Open Enrollment are effective January 1, 2020.

All benefit eligible employees must complete their open enrollment benefits elections online via Banner Self-Service.

Open Enrollment elections are in effect for the entire calendar year unless you experience an IRS “qualifying event” (i.e. change in marital status, birth/adoption of a child) and your change must be completed with the Department of Human Resources within 31 days of the event. Refer to the 2020 Open Enrollment Notices document for additional information.

During Open Enrollment, you can:

  • Make changes to, or enroll, in Medical and Dental benefits. If you have no changes, your health benefits will continue as is.
  • Enroll or re-enroll in the health care and/or dependent care Flexible Spending Accounts (FSA). If you do not wish to participate in flexible spending accounts for 2020, you do not need to take any action.
  • Enroll in the Long-Term Disability Buy-Up coverage.

2020 Plan Year Highlights

  • Dental benefits will now be administered through Delta Dental.
    • Carry over max benefit – 25% of unused maximums can carry over each year until two times maximum is reached.
    • Oral Health Enhancement – 4 cleanings per year for periodontal patients.
    • Orthodontic coverage for dependents increased to age 26.
    • If you are currently enrolled in a Cigna dental plan, you will be enrolled in the equivalent Delta Dental plan.
    • For those who participate in the Cigna DHMO, you will be provided a primary dentist in the Delta Care USA – DHMO plan based upon your home zip code.  You will be able to change the dentist provided on January 1, 2020.
  • New Medical and Dental rates can be viewed by clicking: New Medical and Dental Rates
  • Adult hearing aids:
    • Unlimited dollar maximum per device
    • Maximum of 2 devices (one per ear) per 24 months
    • Includes testing and fitting of hearing aid devices at Physician Office Visit cost share
  • Acupuncture benefit (based on medical necessity)
    • Maximum 60 days per year

Open Enrollment Fairs

Open enrollment fairs have been scheduled so that you can come and speak directly with our plan representatives. There will be massage chairs available (first come, first serve).  Smoothie bar also available (while supplies last).

IHS Campus
Date: Wednesday, October 30
Time: 11 a.m. to 2 p.m.
Location:  Winter Garden

South Orange Campus
Date: Tuesday, November 5
Time: 11 a.m. to 2 p.m.
Location:  Chancellor's Suite

Law School Campus
Date: Tuesday, November 12
Time: 11 a.m. to 2 p.m.
Location:  Faculty Library, 5th Floor

Seton Hall Benefit Offerings


Medical Insurance

Seton Hall University offers two medical plans through Cigna Healthcare. Both plans provide in-network and out-of-network coverage. Review the quick comparison of the plans to help with your decisions.

  • Point-Of-Service - Summary of Benefits and Coverage. This plan is a traditional HMO, where you select a Primary Care Physician (PCP) at the time of enrollment and you must receive a referral from your PCP to access a specialist physician or service. The network of physicians is restricted to NJ, NY, CT, DE and PA. Click here to learn how the POS Network works. 
  • Open Access Plus - Summary of Benefits and Coverage. This plan does not require a Primary Care Physician (PCP) or referrals to see specialists. The network of physicians is nationwide. Click here to learn how the OAP Network works

Prescription Drug Coverage
Included in the medical coverage is prescription drug coverage through Cigna Rx; you will receive a separate ID card to purchase your prescription drugs.  The plan provides coverage at retail network pharmacies and through home mail delivery.

Medical Rates per Paycheck 
(includes Cigna Medical, Cigna Prescription and EyeMed Vision)
Coverage Point of Service Open Access Plus
  Faculty and
Administrators
Staff Faculty and
Administrators
Staff
EE Only $115.40 $53.26 $147.67 $68.16
EE + Children $197.99 $91.38 $331.71 $153.10
EE + Spouse $226.57 $104.57 $376.89 $173.95
EE + Family $336.47 $155.29 $564.22 $260.41

Dental Insurance

Seton Hall University offers two dental plans through Delta Dental. Review the quick comparison of the plans to help with your decision.

If you are currently enrolled in a Cigna dental plan, you will be enrolled in the equivalent Delta Dental plan.  For those who participate in the Cigna DHMO, you will be provided a primary dentist in the Delta Care USA – DHMO plan based upon your home zip code.  You will be able to change the dentist provided on January 1, 2020.

ID Cards will be issued for both plans and received at your home address by mid-January, 2020.

  • Dental Care USA - DHMO - This dental plan provides in-network coverage only. You must select a Primary Dentist (PD) at the time of enrollment and you must receive a referral from your PD to access a specialist dentist or service. Click HERE to learn how this plan works. This plan has no deductibles and no annual maximums but you must refer to a Patient Charge Schedule for coinsurance amounts.
  • PPO Plus Premier - Summary of Benefits. This dental plan provides in-network and out-of-network coverage and does not require a primary dentist or referrals. The reimbursement for services is based on reasonable and customary charges. Click HERE to learn more about this plan.
Dental Rates per paycheck
Coverage Dental Care USA - DHMO PPO Plus Premier
  Faculty and
Administrators
Staff Faculty and
Administrators
Staff
EE Only $6.39 $2.95 $14.29 $6.60
EE + Children $13.69 $6.32 $33.35 $15.39
EE + Spouse $13.69 $6.32 $33.34 $15.39
EE + Family $19.18 $8.85 $46.68 $21.54

Flexible Spending Accounts (FSA) 
The FSA plans are administered by Cigna.

  • The health care spending account limit, per the IRS, is $2,700. You will be allowed to carryover up to $500 of your unused 2019 health care FSA funds into Plan Year 2020; you must re-enroll for 2020 or your eligible carryover funds will be forfeited.  If your spouse is also eligible for a health care spending account as an employee of Seton Hall or another employer with FSA benefits, then you can each elect up to the $2,700 limit but cannot submit a claim for reimbursement for the same expenses.
  • Click the following links for more information about the Health Care FSA and Eligible FSA Health Care Expenses.
  • You can use the following FSA Calculator to assist in calculating your estimated annual election.
  • The Dependent Care FSA account limit is $5,000 (IRS limit per household).  You cannot carryover unused 2019 dependent care funds into Plan Year 2020. 

Telehealth
Cigna provides access to two telehealth services as part of your medical plan – Amwell and MDLIVE. You can connect with a board-certified doctor via video chat or phone, without leaving your home or office. You can register for this service through mycigna.com.


Health Advocate
Health Advocate is a one-stop source for answers and assistance in resolving complicated health and insurance related issues, including Medicare, for you and your family members at no cost to you.


Vision Coverage – Summary of Benefits

Included with the medical coverage is new vision coverage through EyeMed.  The vision benefits are covered under the Insight Network. 

Enjoy a $0 out-of-pocket cost on any frames at Sears Optical® or Target Optical®.  Access frames from top fashion brands such as: Coach, Ray-Ban, Vogue, Oakley, DKNY and Armani Exchange.


Qualifying Dependents

  • Are you adding a new dependent to your coverage this year?  Please confirm that your dependent qualifies as an Eligible Dependent prior to adding him or her to your coverage.  You will be required to complete a Dependent Eligibility Verification Form and submit it to the Benefits Department along with the supporting documentation no later than Friday, November 29th.
  • Are you changing medical plans and wish to add your dependents?  You need to re-enroll your dependents under the new plan.

You will need to have the following information on hand to process their enrollments:

  • your dependent's date of birth
  • your dependent's social security number

Please be informed that by not providing this information at this time, you may experience issues processing your health care claims. 


Countrywide -- Legal, Identity Theft, and Financial Well-Being Services

The plan covers each employee and their dependent(s) who voluntarily enrolls in the services such as face-to-face legal consultation, preparation of living wills, simple wills and medical powers of attorney, unlimited telephone advice, 24/7 -  3 bureau daily credit monitoring and e-mail alerts, ID theft insurance of $1,000,000, fraud alerts and assistance, lost wallet protection and replacement assistance, student loan counseling, budget counseling, asset inventory management, and much more.


PetAssure -- Pet Discount Program

A pet benefit discount program which offers services at in-network veterinary offices, wholesale pricing on pet health products, including prescriptions, 24/7 pet help line, and lost pet recovery. 


Ready to process your Open Enrollment Benefits Elections?

You must complete your medical, dental and/or FSA benefits elections through Banner Self-Service. No paper enrollments will be accepted. Open Enrollment begins on Monday, October 28th. The deadline to complete your open enrollment elections is end of day Friday, November 15th. To ensure IRS compliance, Human Resources is not able to offer extensions or grace periods.


After you have completed your enrollment, Banner will send you an e-mail confirming your benefits elections for 2020. Please verify that your new elections are shown in this confirmation e-mail. Do not return to the open enrollment portal if the information is correct.
 

Questions?
Should you have any questions regarding Benefits, please contact the Benefits Team by e-mail at benefits@shu.edu or by telephone at (973) 275-2755 or (973) 761-9176.

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