STATE HEALTH BENEFITS PROGRAM (SHBP)
and
SCHOOL EMPLOYEES' HEALTH BENEFITS PROGRAM (SEHBP)
HEALTH BENEFITS FOR
RETIRED MEMBERS
RETIRED GROUP ELIGIBILITY | PLAN INFORMATION | ENROLLMENT | APPLICATIONS AND FORMS
PRESCRIPTION DRUG PLANS | RETIREE DENTAL
PLAN | PLAN RATE CHARTS | CHAPTER 330 ENROLEES
HEALTH BENEFITS HOME | DEPENDENTS | EMPLOYEES | COBRA | EMPLOYERS
RETIRED GROUP ELIGIBILITY
Eligibility for Retired Group SHBP/SEHBP coverage is available to qualified retirees from the State including State colleges and universities, and Participating
Local Government Employers, or
Local Education Employers, as determined by the State Health Benefits Program (SHBP) or School
Employees’ Health Benefits Program (SEHBP).
Note: If you are eligible to enroll for coverage in SHBP or SEHBP at the time of retirement, you
cannot enroll for health benefit coverage under COBRA.
If you
have any questions concerning eligibility in the SHBP/SEHBP, contact the Division of Pensions
and Benefits.
PLAN INFORMATION AND PROGRAM DESCRIPTIONS
HANDBOOKS AND PUBLICATIONS
PROVIDER INFORMATION — Find a participating doctor or hospital
PRIVACY PRACTICES
OTHER RESOURCES
ENROLLMENT
You are not covered as a retiree until you qualify for and enroll in Retired Group the SHBP or SEHBP.
If eligible, you must enroll within
60 days of being offered enrollment — normally as of the date of retirement, or if waived for other coverage upon loss of that other coverage. See the SHBP/SEHBP Summary Program Description Adobe PDF (597K) for eligibility criteria.
APPLICATIONS AND FORMS
Be sure to provide all of the information requested on the Enrollment Application and any required supporting
documentation.
COVERAGE OF DEPENDENTS AND CHILDREN
If an eligible dependent is not enrolled within 60 days of the time they first become eligible for coverage, a Retired Group member may enroll them on a timely basis — normally 60 days after receipt by the Division of Pensions and Benefits of of a properly conpleted Enrollment Application and supporting diocumentation.
RETIREE PRESCRIPTION DRUG COVERAGE
Retiree Prescription Drug Coverage is included with retired group Medical Plan enrollment
(Medicare Eligible Retirees please also see the Express Scripts (Medco) Medicare Prescription Drug Plan information below)
Express Scripts (formerly Medco Health Solutions) is the pharmacy
benefits administrator for all Retired Group members of the State Health Benefits
Program and
School Employees’ Health Benefits Program.
Retiree Prescription Drug Copayment and Out-of-Pocket Costs
PRESCRIPTION DRUG BENEFITS FOR ALL PLANS — Plan Year 2013
Medicare
Part D Prescription Drug Coverage
SHBP/SEHBP Medicare
Part D Prescription Drug Coverage — for Medicare-Eligible Retirees
Private Medicare
Part D Prescription Drug Coverage and Rates
- Medical Plan Rates for retirees enrolled in Private Medicare Part D Plans are available by request to the Division's Office of Client Services
RETIREE DENTAL EXPENSE PLAN
RETIRED GROUP MEDICAL PLAN RATES
The cost of Retiree Prescription Drug Coverage is included with the Medical Plan Rates
RATES FOR RETIREES WHO PAY THE FULL COST OF THEIR COVERAGE — Plan Year 2013
Health Benefit Personal Billing — Most retirees who pay for health benefits coverage have the premium deducted from the monthly retirement allowance. If there is no monthly retirement allowance, or it is insufficient to cover the premium, members are billed monthly.
RATES FOR STATE RETIREES WHO SHARE THE COST OF THEIR COVERAGE WITH THE STATE — Plan Year 2013
- Retiree Wellness Program — If you worked
for the State and attained 25 years on or after July 1, 2007 and before
June 28, 2011 (or retired on a disability retirement on or after August 1, 2007 and before June 28, 2011) and are enrolled in a SHBP medical
plan, click here.
- Premium Sharing —If you worked
for the State, attained 25 years prior to July 1, 2007 (or retired on a disability retirement on or before August 1, 2007) and share the cost of Aetna Freedom10 or NJ DIRECT10 coverage with the State, click
here Adobe PDF (29K)
Note: State Premium Sharing arrangements are based on these labor bargaining groups
- If you or a dependent are enrolled in a private Medicare Part D plan, click here.
CHAPTER 330 RATES
OVER AGE CHILDREN
COBRA RATES
INFORMATION and RATES FOR CHAPTER 330 ENROLEES
ABOUT CHAPTER 330, P.L. 1997 — for Retired Law Enforcement and Firefighters
CHAPTER 330 RATES — Plan Year 2013
- If you are
a former law enforcement officer/firefighter covered under Chapter 330, Click
here Adobe PDF (18K)
HEALTH BENEFITS HOME | DEPENDENTS | EMPLOYEES | COBRA | EMPLOYERS |
Pensions and Benefits: Home | Employer
Manual | Health Benefits | Forms and Publications | Counseling Appointments