shamong township school district AWS
SHAMONG TOWNSHIP SCHOOL DISTRICT Dr. Christine Vespe, Superintendent 295 Indian Mills Road Shamong, NJ 08088-9478 609-268-0120/FAX 609-268-1229
Ms. Robyn Klim Director of Pupil Personnel Services 112 Indian Mills Road, Shamong, NJ 609-268-0318/FAX 268-9535
Indian Mills Memorial School Timothy Carroll, Principal 295 Indian Mills Road Shamong, NJ 08088-9478 609-268-0440/ FAX 609-268-1229
Indian Mills School Nicole Moore, Principal 112 Indian Mills Road Shamong, NJ 08088-9590 609-268-0220/FAX 268-9535
**Important Health Insurance Coverage Information** September, 2017 Dear Parents, In 2008, Governor Corzine signed into law P.L. 2008 Chapter 38, which mandates that all children age 18 and under have health insurance. Enrollment in school insurance only does not satisfy this new mandate. The Governor charged all relevant state agencies to engage in outreach strategies to help families meet this requirement. This summer, in one outreach strategy, parents of more than 450,000 children across the state received in the mail a yellow envelope marked NJ Family Care Express Lane Application for Health Insurance Enclosed. You received this mailing if your household checked a box on the New Jersey tax return that you have a child without health insurance. The mailing included an application to get free or low-cost insurance for your children. If your children are not covered by health insurance and you have not completed this application, we urge you to do so. Your privacy is assured. NJ Family Care is committed to covering uninsured children and protecting families’ privacy. Information provided to NJ Family Care is used only to enroll children for health insurance. If you need help or information, contact NJ Family Care at www.njfamilycare.org or 800-701-0710, or call the Association for Children of New Jersey at 973-643-3876. Parents or guardians who earn too much to qualify for NJ Family Care can purchase health insurance for their children at reasonable rates through another program called the NJ Family Care Advantage Program, which is administered through Horizon NJ Health. For more information about this program, please call NJ Family Care Advantage at 800-637-2997 or visit www.horizonNJhealth.com. To comply with the state requirement, parents/guardians must complete the form on the reverse side of this letter regarding health insurance coverage for your child and parental permission to share the information with NJ Family Care. This information is being requested so we may remain in compliance with FERPA requirements and N.J.A.C. 6A:32-7.1(g). Please complete the form on the reverse side of this letter and have your child return it to their homeroom teacher. Sincerely, Nicole Moore Principal, IMS
Timothy Carroll Principal, IMMS
SHAMONG TOWNSHIP SCHOOL DISTRICT Health Insurance Coverage Questionnaire Please complete this form and have your child return it to the homeroom teacher as soon as possible. ALL parents are asked to return this form whether or not your child(ren) has health insurance. Child’s Name ______________________________________ Grade ______ HR ______ Does your child have Health Insurance? Yes ______ If Yes, name of insurance company _________________________________ No ______ NJ Family Care provides free or low cost health insurance for uninsured children and certain low income parents. For more information call 800-701-0710 or visit www.njfamilycare.org to apply online.
Parent Permission for Release of Information The State of New Jersey has asked school districts to provide the information above for all families who have uninsured children. Pursuant to 20 U.S.C. & 1232g(b)(1) and 34 C.F.R. 99.30 (b) the district needs your written consent to release your name and address to the NJ Family Care Program to contact you about health insurance.
We will not release your name or address to the NJ Family Care Program without your signature below.
Signature:
_______________________________________
Printed Name:
_______________________________________
Date:
_______________________________________
Ms. Robyn Klim Director of Pupil Personnel Services 112 Indian Mills Road, Shamong, NJ 609-268-0318/FAX 268-9535
Indian Mills Memorial School Timothy Carroll, Principal 295 Indian Mills Road Shamong, NJ 08088-9478 609-268-0440/ FAX 609-268-1229
Indian Mills School Nicole Moore, Principal 112 Indian Mills Road Shamong, NJ 08088-9590 609-268-0220/FAX 268-9535
**Important Health Insurance Coverage Information** September, 2017 Dear Parents, In 2008, Governor Corzine signed into law P.L. 2008 Chapter 38, which mandates that all children age 18 and under have health insurance. Enrollment in school insurance only does not satisfy this new mandate. The Governor charged all relevant state agencies to engage in outreach strategies to help families meet this requirement. This summer, in one outreach strategy, parents of more than 450,000 children across the state received in the mail a yellow envelope marked NJ Family Care Express Lane Application for Health Insurance Enclosed. You received this mailing if your household checked a box on the New Jersey tax return that you have a child without health insurance. The mailing included an application to get free or low-cost insurance for your children. If your children are not covered by health insurance and you have not completed this application, we urge you to do so. Your privacy is assured. NJ Family Care is committed to covering uninsured children and protecting families’ privacy. Information provided to NJ Family Care is used only to enroll children for health insurance. If you need help or information, contact NJ Family Care at www.njfamilycare.org or 800-701-0710, or call the Association for Children of New Jersey at 973-643-3876. Parents or guardians who earn too much to qualify for NJ Family Care can purchase health insurance for their children at reasonable rates through another program called the NJ Family Care Advantage Program, which is administered through Horizon NJ Health. For more information about this program, please call NJ Family Care Advantage at 800-637-2997 or visit www.horizonNJhealth.com. To comply with the state requirement, parents/guardians must complete the form on the reverse side of this letter regarding health insurance coverage for your child and parental permission to share the information with NJ Family Care. This information is being requested so we may remain in compliance with FERPA requirements and N.J.A.C. 6A:32-7.1(g). Please complete the form on the reverse side of this letter and have your child return it to their homeroom teacher. Sincerely, Nicole Moore Principal, IMS
Timothy Carroll Principal, IMMS
SHAMONG TOWNSHIP SCHOOL DISTRICT Health Insurance Coverage Questionnaire Please complete this form and have your child return it to the homeroom teacher as soon as possible. ALL parents are asked to return this form whether or not your child(ren) has health insurance. Child’s Name ______________________________________ Grade ______ HR ______ Does your child have Health Insurance? Yes ______ If Yes, name of insurance company _________________________________ No ______ NJ Family Care provides free or low cost health insurance for uninsured children and certain low income parents. For more information call 800-701-0710 or visit www.njfamilycare.org to apply online.
Parent Permission for Release of Information The State of New Jersey has asked school districts to provide the information above for all families who have uninsured children. Pursuant to 20 U.S.C. & 1232g(b)(1) and 34 C.F.R. 99.30 (b) the district needs your written consent to release your name and address to the NJ Family Care Program to contact you about health insurance.
We will not release your name or address to the NJ Family Care Program without your signature below.
Signature:
_______________________________________
Printed Name:
_______________________________________
Date:
_______________________________________
