Make your next coverage review productive

• Current coverage summary and renewal notice showing the next effective date and premium.
• Next year’s benefit summary, full plan name, network and formulary.
• A list of people needing coverage and any changes in location or employer eligibility.
• Your own summary of planned care and prescription needs, kept in your private records.
• For Marketplace coverage, the household and expected annual income information needed to update your application.

Checks and notes stay in this page and are not submitted or saved by SJI. Avoid entering account numbers or medical details. Print for your records.

• Premiums after any applicable savings or employer contributions, using the same household assumptions.
• Deductibles, copays, coinsurance and out-of-pocket maximums for the same person or family.
• Doctor and hospital participation for the new plan year.
• Prescription tiers, restrictions and pharmacies.
• Benefit exclusions, authorization requirements and any services you expect to use.
• Enrollment, documentation and first-payment deadlines. Ask how automatic renewal works rather than assuming nothing needs attention.

Checks and notes stay in this page and are not submitted or saved by SJI. Avoid entering account numbers or medical details. Print for your records.

• The exact plan being considered and why it fits the priorities you identified.
• Any unanswered coverage question and who will verify it.
• The selection deadline, expected effective date and next required action.
• Written confirmation and payment instructions before replacing the current plan.

Checks and notes stay in this page and are not submitted or saved by SJI. Avoid entering account numbers or medical details. Print for your records.