SPECIAL OPEN ENROLLMENT 2026

( April 1 – 30, 2026)

Pursuant to the State Health Benefits Program (SHBP) Plan Design Committee (PDC) resolutions unanimously approved on September 24, 2025, the New Jersey Division of Pensions and Benefits is implementing significant plan updates to health plan offerings for 2026.

There will be new “26” plans that will be effective July 1, 2026. These new plans will see changes to in-network deductibles, copayments, and out-of-pocket maximums. Prescription drug plans will require mail order for maintenance drugs and will see changes to copayments and out-of-pocket maximums. The change of the copayments for nondiabetic GLP-1 drugs (Wegovy, Saxenda, and Zepbound) that took effect January 1, 2026, will continue under the new “26” plans.

SHBP PDC Resolution #2025-12 stipulates that specific procedures listed in the resolution that can be performed at an Ambulatory Surgical Center (ASC) will result in a cost share of 50% coinsurance if not performed at an in-network ASC (with some exceptions).

SPECIAL OPEN ENROLLMENT PERIOD 

There will be a Special Open Enrollment period from April 1, 2026, to April 30, 2026. Members will have their current medical plan automatically converted to the corresponding new “26” medical plan with the same carrier.

Members will have the opportunity to change their medical plan during the Special Open Enrollment. Plan changes will take effect on July 1, 2026.

The addition of dependents or changes to dental plans will not be permitted. Any change to enrolled dependents should be submitted using the applicable qualifying life event.  

No action is required on your part. You will automatically be enrolled in the updated version of your current plan effective   July 1, 2026. You will also receive a new insurance card reflecting an updated group number.

DROP-IN INFORMATION SESSIONS

To help you better understand these changes and answer any questions you may have, we encourage you to stop by an in person information session and speak with vendors during the times listed below. No registration required!

April 8 | 12:00 PM – 4:00 PM
Horizon Representative

April 9 | 11:00 AM – 2:00 PM
Aetna Representative

Location: Padovano Commons

ADDITIONAL RESOURCES

April 2026 Special Open Enrollment
Q & A

Overview of Plan Choices
Horizon | Aetna

Horizon will also be hosting live webinars throughout the month of April. You may register using the link below: Horizon Live Webinar Registration Link

Aetna will be hosting a live webinar throughout the month of April. You may register using the link below: Aetna Live Webinar Registration Link

If you have any questions, please contact Ivy Payne at ipayne@ramapo.edu or Franklin Jaime at fjaime@ramapo.edu.