State Health Benefits Program
2027 VIRTUAL BENEFITS FAIR
Explore your benefits, connect with experts, and make the most of your options for 2027.
2027 Annual Open Enrollment is October 1 – October 31, 2026
KNOW BEFORE YOU ENROLL
- Register to attend informative live webinars hosted by Aetna or Horizon
COMING FOR 2027
NEW! Centers of Excellence Pilot Program Available in Plan Year 2027
The State Health Benefits Program (SHBP) will implement a Centers of Excellence (COE) Pilot Program in accordance with State Health Benefits Program Plan Design Committee (SHBP PDC) Resolution 2024-7, as amended by Resolution 2025-13. The COE, administered by Carrum Health, will apply to all members enrolled in a PPO plan. This program will provide an opportunity to reduce your out-of-pocket costs for certain non-emergency procedures while keeping a high quality of care.
The non-emergency COE Covered Procedures include diagnostic colonoscopies, knee and hip replacements, and bariatric, spinal, and heart surgeries. Please note that diagnostic colonoscopies will continue to be an Ambulatory Surgical Center Covered Procedure until the COE program starts.
You must consult with Carrum Health prior to scheduling your COE Covered Procedure. After speaking with Carrum Health, a member will have three options:
- You can have the procedure performed by a provider in the COE Network and have no cost share.
- You can go to a provider in your medical carrier’s (i.e. Aetna or Horizon) network and pay a $300 copay.
- You can go to an out-of-network provider and be subject to all applicable member cost sharing as well as possible billing by the provider for costs not covered by the plan’s reimbursement (this is known as balance billing).
If you do not wish to participate in the COE Pilot Program, then you can enroll in an HMO, HDHP, or Tiered-Network plan during Open Enrollment for the Plan Year 2027. See your plan’s Summary of Benefits and Coverage for more information.
New “26” Plan Options
The State Health Benefits Program (SHBP) introduced new “26” plans effective 07/01/26 (or 06/27/26 for State employees paid biweekly through Centralized Payroll). These new plans will continue for Plan Year 2027.
During this Open Enrollment period, you can review your current coverage and select any of the new “26” plans.
Visit mynjbenefitshub to get information on each of your plan options, such as deductible and coinsurance amounts. You can use the Aetna or Horizon calculator to estimate your cost for each of your plan options.
All “26” prescription plans (except the High Deductible Health Plans) will require mandatory mail order through Optum Home Delivery for maintenance drugs. See the NJDPB (www.nj.gov/treasury/pensions/) or Optum (welcome.optumrx.com/sonjactiveee/landing) website for a comprehensive list of maintenance drugs.
Flexible Spending Account
Effective 01/01/27, the unreimbursed Medical Flexible Spending Account (FSA) annual contribution limit will follow the Internal Revenue Service (IRS) annual inflation limits (proposed $3,500 for 2027). The minimum yearly deposit remains the same at $100.
The unreimbursed Medical FSA allows members to put aside pre-tax money throughout the year to pay for eligible medical and dental expenses, which are determined by the IRS.
Employees must enroll annually to participate in the FSA during Open Enrollment and are not able to change their contributions once enrollment closes unless there is a qualifying life event.
For more information and access to the enrollment form, log in to mynjbenefitshub to view the Tax$ave page.
Ambulatory Surgical Centers (ASC) – applicable for “26” plans only
As of 07/01/26, rules went into effect for members with medical coverage through an Aetna or Horizon 26 plan for cost sharing of specific non-emergency procedures when not performed at an in-network Ambulatory Surgical Center (ASC).
An ASC is a facility that focuses on a limited number of lower-risk surgeries and tests, such as colonoscopy and carpal tunnel surgery. Beginning 01/01/27, the colonoscopy procedure will no longer be an ASC Covered Procedure and will become part of the COE pilot program described in the section above.
ASCs helps you to keep down your out-of-pocket costs while still getting the care you need. Members who use an in-network hospital, out-ofnetwork hospital, or out-of-network ASC instead of an in-network ASC will have to pay 50% of the coinsurance after their deductible.
For more information, such as details about the specific non-emergency procedures included and in-network providers, log in to mynjbenefitshub to view the ASC page.
Flexible Spending Account
Effective 01/01/27, the unreimbursed Medical Flexible Spending Account (FSA) annual contribution limit will follow the Internal Revenue Service (IRS) annual inflation limits (proposed $3,500 for 2026). The minimum yearly deposit remains the same at $100.
The unreimbursed Medical FSA allows members to put aside pre-tax money throughout the year to pay for eligible medical and dental expenses, which are determined by the IRS.
Employees must enroll annually to participate in the FSA during Open Enrollment and are not able to change their contributions once enrollment closes unless there is a qualifying life event.
For more information and access to the enrollment form, log in to mynjbenefitshub to view the Tax$ave page.
