Benefits-at-a-Glance
Shamong Township Schools

Medical/Prescription Plan Comparison
NJEHP Simplified Medical/Prescription Benefits Overview


Plan overviews and Summaries of Benefits and Coverage (SBCs) for offered health plans are below.


Horizon BCBSNJ Medical:
OMNIA Summary / SBC
Direct Access 15 Summary / SBC
Direct Access 15/25 Summary / SBC
Direct Access 20/30 Summary / SBC
POS 10 Summary / SBC
POS 15/25 Summary / SBC
Horizon BCBSNJ NJEHP Benefits Summary


BeneCard PBF Prescription:
Group 1 ($10 preferred / $3 generic retail copay)
Group 2 ($16 preferred / $7 generic / $35 non-preferred retail copay)
Group 3 ($18 preferred / $3 generic / $46 non-preferred retail copay)

NJEHP members: confirm coverage for your prescriptions by contacting BeneCard PBF customer service at (877) 723-6005.
NJEHP 2021 Prescription Formulary
NJEHP Plan Brochure


Delta Dental: Plan Summary


Vision Benefit: refer to your medical booklet at the Plan Booklets page. If you are enrolled in the Horizon OMNIA plan, note the below about the Pediatric Vision benefit:

- Davis Vision administers the Pediatric Vision benefit on behalf of Horizon BCBSNJ.
- This is an in-network benefit; members must visit a provider in the Davis Vision network to have services covered.
- Dependents up to age 19 are eligible for the benefit.
- Benefits renew every 12 months.
- A routine eye exam, including dilation, is available with $0 copay.
- The Davis Vision collection of frames is included with this benefit.
- If a member obtains frames elsewhere, there is a maximum allowance of $150 for frames or contacts.
- The benefit includes clear plastic, single-vision, lined bifocal, trifocal, or lenticular lenses.
- Present your Horizon BCBSNJ medical ID card to the provider, who will call Davis Vision to confirm eligibility.
- Go to www.davisvision.com/members and insert Client Code 3164 to access the Member Portal.
- Search for in-network providers, find benefits and forms, and more at the Member Portal.