SHBP/SEHBP Active Employees - Town of Phillipsburg, Warren County
Dear New Jersey Department of the Treasury,
This is a request for public records made under OPRA and the common law right of access. I am not required to fill out an official form. Please acknowledge receipt of this message.
Records requested:
Active employee health benefits cost, monthly alpha list for each monthly billing period for years 2017, 2018 and 2019. Please include the waiver report for the same time period.
Yours faithfully,
Meliss Paulus
Dear Treasury Government Records Access Unit,
In response to your request for clarification, I am looking for the “Town of Phillipsburg”, the municipality located in Warren County. Only the municipal employees, not the board of education or the police.
Yours sincerely,
Meliss Paulus
SYSTEM : S343 S T A T E O F N E W J E R S E Y RUN DATE : 12/20/17
PROGRAM NO: PN815AP2 DEPARTMENT OF THE TREASURY RUN TIME : 22:27:26
FREQUENCY : MONTHLY DIVISION OF PENSIONS AND BENEFITS REPORT NO: 815AP2-1
STATE HEALTH INFORMATION PROCESSING SYSTEM PAGE NO : 3298
MONTHLY ALPHA LIST FOR BILLING PERIOD 01/01/2018 - 01/31/2018 (201801)
LOCAL/ACTIVE/MONTHLY
0897-00 - PHILLIPSBURG TOWN
HEALTH---------- RX-------------- DENTAL---------- -HEALTH- ---RX--- -DENTAL-
--NAME---------------------- ---SSN--- --DOB--- SRV L EFF DATE SRV L EFF DATE SRV L EFF DATE --COST-- --COST-- --COST--
AMEY MATTHEW M *****6600 19810611 150 P 20150301 201 P 20150301 1350.06 351.55 0.00
ANDERSON THOMAS A *****8347 19600902 150 S 20110401 201 S 20110401 754.23 196.39 0.00
ANTHES KRISTI L *****7635 19821227 019 F 20160101 201 F 20160101 2064.43 547.94 0.00
ANTHES LAWRENCE E *****7578 19820820 ( SPOUSE INFO )
ANTHONY MICHAEL J *****8635 19790714 150 P 20170301 201 P 20170301 1350.06 351.55 0.00
BELCASTRO DOMINIC D *****2737 19820617 150 F 20121201 201 F 20121201 2104.28 547.94 0.00
BELCASTRO KRISTEN M *****2681 19820525 ( SPOUSE INFO )
BERRIGAN BRIAN N *****4259 19620213 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
BERRIGAN DINA *****7986 19630528 ( SPOUSE INFO )
BESS MICHAEL D *****5160 19761102 050 F 20140402 201 F 20140402 2209.79 547.94 0.00
TAMPIER DANIELLE T *****5801 19820608 ( SPOUSE INFO )
BITTENMASTER CHRIS *****8226 19741115 150 F 20111008 201 F 20111008 2104.28 547.94 0.00
BITTENMASTER TANYA M *****5107 19720318 ( SPOUSE INFO )
BROTONS CRAIG R *****4528 19650821 150 F 20111101 201 F 20111101 2104.28 547.94 0.00
BROTONS LAURIE A *****8653 19661104 ( SPOUSE INFO )
BRUNETTI MAUREEN L *****6658 19500814 150 M 20140101 201 M 20140101 1508.45 392.79 0.00
BRUNETTI BRUCE W *****0360 19530518 ( SPOUSE INFO )
BURGER TIMOTHY L *****8845 19870505 050 P 20160101 201 P 20160101 1417.75 351.55 0.00
CALLERY SANDRA A *****1806 19560916 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
CALLERY JOHN F *****5751 19550319 ( SPOUSE INFO )
CONNAUGHTON MICHAEL S *****8635 19810324 150 F 20121201 201 F 20121201 2104.28 547.94 0.00
CONNAUGHTON KELLI M *****8365 19850304 ( SPOUSE INFO )
CONNORS COREY M *****1681 19920804 150 P 20140225 201 P 20140225 1350.06 351.55 0.00
CROUSE LORI M *****5809 19661210 150 P 20150301 201 P 20150301 1350.06 351.55 0.00
DAVIS STEVEN A *****2207 19670826 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
DAVIS ANNMARIE *****8902 19690808 ( SPOUSE INFO )
DUCKWORTH KRISTOPHER R *****0599 19900317 150 S 20130817 201 S 20130817 754.23 196.39 0.00
DUDDY KEVIN R *****4369 19531130 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
DUDDY MARYELIZ *****1726 19580130 ( SPOUSE INFO )
DUGEY THOMAS *****9085 19550728 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
DUGEY SHIRLEY *****1416 19590726 ( SPOUSE INFO )
FEY GINA I *****2193 19710716 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
FEY BERNARD F *****9252 19690103 ( SPOUSE INFO )
GAL SANDOR *****6413 19800612 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
CURTISS-GAL SHARON E *****0338 19750615 ( SPOUSE INFO )
HOADLEY ANGELA M *****3996 19700826 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
HOADLEY JOHN *****6483 19640604 ( SPOUSE INFO )
HOYD ROBERT D *****3157 19760417 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
HOYD BRANDY L *****4086 19800801 ( SPOUSE INFO )
HULL BRANDON E *****9193 19931029 150 S 20170825 201 S 20170825 754.23 196.39 0.00
HULSE KEVIN I *****0469 19761004 150 S 20150101 201 S 20110401 754.23 196.39 0.00
HUXTA PATRICIA M *****3229 19720504 150 M 20160101 201 M 20160101 1508.45 392.79 0.00
HUXTA CHRISTOPHE H *****2776 19710913 ( SPOUSE INFO )
JOHNSON KEVIN R *****6251 19780125 150 F 20161104 201 F 20161104 2104.28 547.94 0.00
JOHNSON STACIE L *****9723 19780325 ( SPOUSE INFO )
KISSELBACH BRAD M *****0215 19810926 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
KISSELBACH JACQUELINE L *****9267 19780814 ( SPOUSE INFO )
SYSTEM : S343 S T A T E O F N E W J E R S E Y RUN DATE : 12/20/17
PROGRAM NO: PN815AP2 DEPARTMENT OF THE TREASURY RUN TIME : 22:27:26
FREQUENCY : MONTHLY DIVISION OF PENSIONS AND BENEFITS REPORT NO: 815AP2-1
STATE HEALTH INFORMATION PROCESSING SYSTEM PAGE NO : 3299
MONTHLY ALPHA LIST FOR BILLING PERIOD 01/01/2018 - 01/31/2018 (201801)
LOCAL/ACTIVE/MONTHLY
0897-00 - PHILLIPSBURG TOWN
HEALTH---------- RX-------------- DENTAL---------- -HEALTH- ---RX--- -DENTAL-
--NAME---------------------- ---SSN--- --DOB--- SRV L EFF DATE SRV L EFF DATE SRV L EFF DATE --COST-- --COST-- --COST--
KOELLER JUSTIN M *****1325 19850731 150 P 20170401 201 P 20170401 1350.06 351.55 0.00
LACEY BRADLEY S *****2088 19830426 150 F 20141108 201 F 20141108 2104.28 547.94 0.00
LACEY RACHAEL L *****7662 19831005 ( SPOUSE INFO )
LANCE WILLIAM J *****2293 19710131 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
LANCE ANNMAR *****8989 19771005 ( SPOUSE INFO )
MACZKO JOHN M *****3882 19710205 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
MACZKO STEPHANIE A *****1925 19721002 ( SPOUSE INFO )
MARINO BRETT M *****2967 19780131 150 F 20150327 201 F 20150327 2104.28 547.94 0.00
MARINO KARYSSA J *****3166 19830121 ( SPOUSE INFO )
MARINO LARRY L *****2819 19761007 150 P 20110401 201 P 20110401 1350.06 351.55 0.00
MARINO ROBERT A *****4617 19740430 150 S 20171101 201 S 20171101 754.23 196.39 0.00
MCDONALD JAMES *****9917 19801128 150 F 20160101 201 F 20160101 2104.28 547.94 0.00
MCDONALD KRISTEN L *****7404 19830516 ( SPOUSE INFO )
MCGINLEY CHAD *****3271 19640601 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
MCGINLEY STEPHANIE *****3669 19640529 ( SPOUSE INFO )
MECCA CHRISTOPHE A *****9196 19810924 150 S 20140201 201 S 20140201 754.23 196.39 0.00
MECCA MARC A *****1205 19850307 150 S 20141101 201 S 20141101 754.23 196.39 0.00
MERLO ROBERT J *****2639 19640615 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
MERLO PATRICIA M *****8555 19600612 ( SPOUSE INFO )
MESSINA DONNA *****3596 19540527 180 S 20170710 201 S 20170710 761.75 196.39 0.00
MESSLING DEBBIE L *****6060 19551010 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
HERTZ RONALD W *****9419 19520315 ( SPOUSE INFO )
MONTILONE DEREK *****4761 19900207 150 P 20140825 201 P 20140825 1350.06 351.55 0.00
MOORE TIMOTHY *****8006 19780726 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
MOORE LAUREN A *****6398 19811209 ( SPOUSE INFO )
OLOUGHLIN SANDRA J *****0735 19590810 150 P 20110401 201 P 20110401 1350.06 351.55 0.00
PAPOVICH BRENDA J *****0486 19690712 150 S 20110401 201 S 20110401 754.23 196.39 0.00
PATTI VALERIE *****3749 19530505 150 S 20171001 201 S 20171001 754.23 196.39 0.00
PETERS WILLIAMS G *****3207 19680628 150 P 20110401 201 P 20110401 1350.06 351.55 0.00
PFLUGH ERICH J *****6531 19900417 050 S 20170722 201 S 20170722 792.04 196.39 0.00
PURSELL PAUL E *****6960 19531103 150 M 20160101 201 M 20160101 1508.45 392.79 0.00
PURSELL BRENDA M *****5498 19621130 ( SPOUSE INFO )
QUICK SHANNON *****6605 19830729 150 S 20170724 201 S 20170724 754.23 196.39 0.00
RATH-TICKLE STEPHANIE *****2207 19821130 051 F 20160311 205 F 20160311 2041.24 496.96 0.00
TICKLE GLEN P *****0602 19830427 ( SPOUSE INFO )
REED CHRISTOPHE H *****0713 19640404 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
REED CYNDEE S *****6770 19610324 ( SPOUSE INFO )
REPPERT RALPH A *****1327 19670227 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
REPPERT JANICE L *****1892 19720310 ( SPOUSE INFO )
RICKER GARY A *****2215 19800101 050 S 20170101 201 S 20170101 792.04 196.39 0.00
SERRANO THEODORE K *****9737 19660617 150 P 20170701 201 P 20170701 1350.06 351.55 0.00
SLATON BARBARA J *****0861 19560215 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
SLATON JON C *****4488 19560725 ( SPOUSE INFO )
SLIFER JOSHUA M *****0733 19740907 150 P 20140823 201 P 20140823 1350.06 351.55 0.00
SMITH PAUL R *****2903 19530623 150 M 20150101 201 M 20150101 1508.45 392.79 0.00
SMITH PHYLLIS A *****3997 19530209 ( SPOUSE INFO )
SNYDER MARTIN *****9036 19900313 011 F 20170701 201 F 20170701 2043.77 547.94 0.00
SYSTEM : S343 S T A T E O F N E W J E R S E Y RUN DATE : 12/20/17
PROGRAM NO: PN815AP2 DEPARTMENT OF THE TREASURY RUN TIME : 22:27:26
FREQUENCY : MONTHLY DIVISION OF PENSIONS AND BENEFITS REPORT NO: 815AP2-1
STATE HEALTH INFORMATION PROCESSING SYSTEM PAGE NO : 3300
MONTHLY ALPHA LIST FOR BILLING PERIOD 01/01/2018 - 01/31/2018 (201801)
LOCAL/ACTIVE/MONTHLY
0897-00 - PHILLIPSBURG TOWN
HEALTH---------- RX-------------- DENTAL---------- -HEALTH- ---RX--- -DENTAL-
--NAME---------------------- ---SSN--- --DOB--- SRV L EFF DATE SRV L EFF DATE SRV L EFF DATE --COST-- --COST-- --COST--
SNYDER NATASHA L *****0976 19910515 ( SPOUSE INFO )
SOSNOVIK MATTHEW *****7482 19811121 150 S 20111101 201 S 20111101 754.23 196.39 0.00
STETTNER JAMES P *****1237 19770422 050 F 20140708 201 F 20140708 2209.79 547.94 0.00
VACCARO BETTINA C *****2684 19800819 ( SPOUSE INFO )
STIRES MICHAEL F *****2117 19820811 150 F 20150101 201 F 20150101 2104.28 547.94 0.00
STIRES TRICIA M *****2758 19780516 ( SPOUSE INFO )
SUTTON BRIAN S *****3423 19641214 150 M 20110401 201 M 20110401 1508.45 392.79 0.00
SUTTON LISA B *****2736 19650129 ( SPOUSE INFO )
THOMPSON RASHEEDAH M *****0962 19891203 090 F 20170924 290 F 20170924 1070.65 325.60 0.00
THOMPSON PRINCE A *****9059 19881218 ( SPOUSE INFO )
VAUGHN DONALD J *****4866 19580809 150 M 20160101 201 M 20160101 1508.45 392.79 0.00
VAUGHN LAURA *****7463 19620623 ( SPOUSE INFO )
VINE WILLIAM R *****6357 19681015 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
VINE STEPHANIE A *****2460 19711109 ( SPOUSE INFO )
WARGO JEANNINE R *****5910 19760107 050 F 20110401 201 F 20110401 2209.79 547.94 0.00
WARGO ROBERT J *****1030 19750710 ( SPOUSE INFO )
WEIGAND KYLE M *****9730 19891015 150 M 20170902 201 M 20170902 1508.45 392.79 0.00
WEIGAND LINDSAY S *****3082 19910731 ( SPOUSE INFO )
WIDEMOND MARVIN *****3774 19810221 150 F 20160101 201 F 20160101 2104.28 547.94 0.00
PAUL SAMARIA *****1072 19810621 ( SPOUSE INFO )
ZECHMAN TRAVIS J *****7936 19770218 150 F 20110401 201 F 20110401 2104.28 547.94 0.00
ZECHMAN SHERRI A *****1061 19770317 ( SPOUSE INFO )
TOTAL EMPLOYEES - 71 TOTAL BILL - 142,312.17
TOTAL HEALTH ENROLLED - 71 TOTAL HEALTH COST - 112,977.08
TOTAL RX ENROLLED - 71 TOTAL RX COST - 29,335.09
SYSTEM : S343 S T A T E O F N E W J E R S E Y RUN DATE : 12/20/17
PROGRAM NO: PN815AP2 DEPARTMENT OF THE TREASURY RUN TIME : 22:27:26
FREQUENCY : MONTHLY DIVISION OF PENSIONS AND BENEFITS REPORT NO: 815AP2-1
STATE HEALTH INFORMATION PROCESSING SYSTEM PAGE NO : 3301
MONTHLY ALPHA LIST FOR BILLING PERIOD 01/01/2018 - 01/31/2018 (201801)
LOCAL/ACTIVE/MONTHLY
0897-00 - PHILLIPSBURG TOWN
HEALTH SERVICES
SRV **S** *M/S* *M/P* *F/S* *F/P* **P** *TOT* *TOT AMT**
--- ----- ----- ----- ----- ----- ----- ----- ----------
011 0 0 0 1 0 0 1 2043.77
019 0 0 0 1 0 0 1 2064.43
050 2 0 0 3 0 1 6 9631.20
051 0 0 0 1 0 0 1 2041.24
090 0 0 0 1 0 0 1 1070.65
150 11 13 0 25 0 11 60 95364.04
180 1 0 0 0 0 0 1 761.75
RX SERVICES
SRV **S** *M/S* *M/P* *F/S* *F/P* **P** *TOT* *TOT AMT**
--- ----- ----- ----- ----- ----- ----- ----- ----------
201 14 13 0 30 0 12 69 28512.53
205 0 0 0 1 0 0 1 496.96
290 0 0 0 1 0 0 1 325.60
SYSTEM : S343 S T A T E O F N E W J E R S E Y RUN DATE : 12/20/17
PROGRAM NO: PN815AP2 DEPARTMENT OF THE TREASURY RUN TIME : 22:27:26
FREQUENCY : MONTHLY DIVISION OF PENSIONS AND BENEFITS REPORT NO: 815AP2-1
STATE HEALTH INFORMATION PROCESSING SYSTEM PAGE NO : 3302
MONTHLY ALPHA LIST FOR BILLING PERIOD 01/01/2018 - 01/31/2018 (201801)
LOCAL/ACTIVE/MONTHLY
0897-00 - PHILLIPSBURG TOWN
HEALTH SERVICES LOG
-------------------
011 - HORIZON HMO
019 - AETNA HMO
050 - NJ DIRECT10
051 - NJ DIRECT1525
090 - NJ DIRECT HD4000
150 - NJ DIRECT15
180 - AETNA FREEDOM15
RX SERVICES LOG
---------------
201 - EMPLOYEE RX (LOCAL & EDUC-ACVP
205 - STATE 1525 PRESCRIPTION PLAN
290 - RX HD4000 HZN(STATE LOC-ACVP)
HEALTH CONTRACT LEVEL LOG
-------------------------
**S** SINGLE
*M/S* MARRIED/SPOUSE *M/P* MARRIED/DOM PARTNER/CIVIL UNION PARTNER
*F/S* FAMILY/SPOUSE *F/P* FAMILY/DOM PARTNER/CIVIL UNION PARTNER
**P** PARENT/CHILD
Dear Treasury Government Records Access Unit,
Thank you for the activity lists. I do not see the Waiver reports as requested.
Please advise to the availability of this report.
Yours sincerely,
Meliss Paulus