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members health plan COVID updates

Members Health Plan COVID Updates

Members Health Plan NJ is committed to ensuring that their membership has access to the care that they need but also provide valuable plan information and resources so their employers can focus on their business and employees.

Important Information about a new COVID surcharge

Members Health Plan NJ is concerned for the health and well-being of our families, friends, neighbors and coworkers who are impacted by the ongoing COVID-19 pandemic. As vaccines and new treatments offer hope for improved health outcomes, we want you to know that Members Health Plan NJ is taking steps to ensure the Plan’s continued service and long-term viability for their members.

Since the beginning of the pandemic, the Board has been monitoring the claims volume to see what effect, if any, COVID-19 would have on the Plan. After holding their healthcare fees relatively flat with no or little increases for most of 2019 and a portion of 2020, they have since experienced a significant rise in claims related to the pandemic. This cost includes a significant increase in COVID-19 testing costs for claims when enrollees are not symptomatic or exposed, and for work-related testing. The Plan has spent an estimated $10 million in COVID-19 claim expenses, in addition to normal anticipated claim volume. 

Based on these significant medical costs associated with the COVID-19 pandemic and no decrease in utilization, the Plan needs to apply a COVID-19 monthly surcharge of 5.5 percent to help partially cover these unexpected costs. It is their hope that this surcharge can be removed once the pandemic draws to a conclusion. 

This measure will go into effect on February 1, 2021. The COVID-19 surcharge will be calculated on your total monthly healthcare fees and will be added to your invoice each month and could be adjusted at any time if needed. This measure is permitted as outlined in our contract.

MHPNJ Members will not be charged for any COVID-19 vaccination as stated in the recent New Jersey Department of Banking and Insurance Bulletin No. 21-01.

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