Position of the Union side of the State Health Benefits Plan Design Committee

Every year, the State Health Benefits Plan (SHBP) Design Committee reviews the plans that are offered to the hundreds of thousands of participants.  This year, the Union side of the Plan Design Committee supported two major innovations:  a) a lower cost Tiered Network, and b) an “add on” Direct Primary Care Medical Home (DPCMH) program that we designed in concert with Senate President Steve Sweeney.

Below, please find a statement from Union leaders on the SHBP Design Committee on Tiered Network Plans being developed by Horizon and Aetna. It is signed by Hetty Rosenstein (CWA), Kevin Lyons (NJPBA), Dave Jones (NJSTA), Mary Meeker (AFSCME), Patrick Nowlan, (AAUP/AFT) and Abdur Yasin (NJFMBA):

“While there may be some continued issues with Horizon about which hospitals they designated as Tier 1, we believe the program they’ve laid out will provide some of our members with the option we were looking for with a Tiered Network plan.  We also note that some of the hospitals – not covered by Horizon – will be covered by the new AETNA tiered network, and we think that competition in this situation will benefit our members and the State. We never believed this was a Plan from which all of our members would benefit.  However, the Tiered Network option is an important part of the package of options that the Plan Design developed, and we are anxious to implement them.

“The pilot Direct Primary Care Medical Home program that we developed with Senator Steve Sweeney, as well as a Tiered Network program, are two innovative options to provide quality healthcare while substantially reducing costs for both the public and for our members.  Bidding is taking place on the DCPMH program and Horizon has rolled out its OMNIA Tiered Network and AETNA is also developing a Tiered Network.”


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