Employee Page

Benefits to the Employee

Employee benefits insurance represents 8-10% or more of the typical municipal budget and is the second largest item after wages.

Prior to the formation of the NJ HIF in 1993, annual health insurance rate increases typically ranged between 20-35% and consumed a large portion, if not the entire, state-mandated maximum allowable municipal budget cap increase.

Needless to say, money spent unnecessarily or unwisely for healthcare creates budgetary constraints that leave less money available for wages and other services, effecting you as both an employee and a taxpayer. The creation of the HIF has helped its members gain control of their healthcare expenditures.
A number of factors have led to this success:
  • more efficient claims processing
  • implementation of systems to detect fraud and/or abuse
  • lower fixed costs via the elimination of insurance company overhead, profit, premium, taxes, etc.
  • A major accomplishment was the group purchasing power that led to very favorable discounted fee arrangements with healthcare providers in the region.

The HIF's Goals and Objectives

The goal of the HIF is to continue to provide quality benefit plans to its members, and to provide the necessary support and guidance to do so in the most cost-effective manner possible. Managed care plans such as the various Select Plans and the Aetna QPOS Plan have been made available. These plans provide employees with higher levels of reimbursement when utilizing contracted network providers. Some plans provide the additional support of a primary care physician and other medical case management personnel who will offer advice and assistance to employees in selecting and establishing the appropriate level of care for their needs.

It is our hope that employees will play a more active role in their healthcare purchases, treating benefit dollars as they do any other household expenditure.

Whenever possible, you should report to the HIF any suspected areas of abuse. Recently, a trade magazine indicated that fraud/abuse may be responsible for up to 25% of the cost of healthcare.
The HIF publishes a periodical newsletter entitled "For Your Benefit" in an effort to provide you with more information designed to increase your benefits awareness and help you make better-educated decisions regarding your healthcare needs. Additionally, these newsletters stress the importance of preventing illness in the first place by living a healthier lifestyle. The newsletters also provide information on the HIF's claims administration, procedural matters and other articles of importance to you. Please take a moment to read your newsletter .

The "Team Approach", including you, your Municipal Employer and your HIF professionals, is essential in meeting these goals. Let's work together with "A Healthier You in Mind."
-David J. Vozza
Program Manager
NJMEBF

Some ways to assure cost effective benefits include:

  • Using network providers
  • Avoiding unnecessary hospital days (admitting on Friday for testing on Monday)
  • Questioning providers regarding services being proposed or that you feel may be rendered unnecessarily or inappropriately
  • Reviewing explanation of benefits (EOB) submitted for accuracy
  • Understanding the difference between name brand and generic drugs

Generic drugs can be as much as 80 to 85 percent less expensive than their brand-name counterparts!

Please click the link below to access your member specific benefits through Benefits Express

Newsletter

Here are the average costs for each type of visit:
  • Emergency room visit

    - $786.12
  • Primary care physician visit

    - $137.87

Work with Us!

Dave Vozza is ready to work with you and help you navigate the program.
  • ¬© 2003 - 2018 North Jeresey Municipal Municipal Employee Benefits Fund