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SHBP/SEHBP NEWS | MEDICAL PLANS | GENERAL
INFORMATION | ELIGIBILITY AND ENROLLMENT
ACTIVE GROUP | RETIRED
GROUP | EMPLOYEE PRESCRIPTION DRUG PLAN
DENTAL
PLANS | COBRA | ABOUT
THE PROGRAMS
SHBP and SEHBP NEWS
ACTIVE EMPLOYEES
RETIRED MEMBERS
PROGRAM DESCRIPTIONS AND MEDICAL PLANS
Medical Plans
NJ DIRECT Plans
Aetna Plans
Cigna HealthCare Plans
Provider Information
Find a participating doctor or hospital
To find a participating doctor or hospital contact your medical plan directly:
GENERAL
INFORMATION
Privacy Practices
Health Benefit Bills
Other Resources
ELIGIBILITY GROUPS AND ENROLLMENT
Employer Based Groups
Over Age Children between Age 26 and 31
Coverage Under Chapter 375, P.L. 2005
Chapter 375 Rate Charts — Plan Year 2012
Chapter 375 Cost Comparison — Chapter 375 vs. COBRA
New Jersey Civil Unions
New Jersey Domestic
Partnerships
ACTIVE GROUP
State Employees, Participating Local Government Employees,
Participating Local Education Employees
Plan Information for Active Group Members
Applications
Health Benefits Applications for Full-Time Active Employees
Health Benefits for Part-time
Employees — Under Chapter 172, P.L. 2003
Health Benefits for Intermittent State Employees
Employee Prescription Drug Benefits
Medco Health Solutions is the pharmacy
benefits administrator for the State Health Benefits
Program and
School Employees’ Health Benefits Program
Newsletters
State Active Group Rates
State Monthly and Biweekly Active Employee Group Rates — Plan Year 2012
Local Employer Active Group Rates
Local Government Employer Group Rates — Plan Year 2012
Local Education Employer Group Rates — Plan Year 2012
RETIRED
GROUP
Retirees from the State including State colleges and universities,
and
Participating
Local Government Employers, or
Local Education Employers
Medical Plan Information for Retired Group Members
Enrollment Applications for Retired Group Members
RETIRED GROUP MEDICAL PLAN RATES
Rates for retirees who pay the full cost of their coverage — Plan Year 2012
Rates for State Retirees who share the cost of their coverage with the State — Plan Year 2012
- 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, and share the cost of NJ DIRECT10 coverage with the State, click
here Adobe PDF (29K)
OR
- If you worked
for the State, retired on a disability retirement on or before August 1, 2007, and share the cost of 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.
Rates for Chapter 330 Enrollees
Information about Chapter 330 — for Retired Law Enforcement and Firefighters
Chapter 330 Rates — Plan Year 2012
- If you are
a former law enforcement officer/firefighter covered under Chapter 330,
Click
here Adobe PDF (18K)
RETIREE PRESCRIPTION DRUG COVERAGE
Retiree Prescription Drug Coverage is included with retired group Medical Plan enrollment
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 2012
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
- 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
EMPLOYEE PRESCRIPTION
DRUG PLANS
The Prescription Drug Plans are available to employees of the State including State colleges and universities,
and participating local government and education employers
(Go to Information about Retiree Prescription Drug Coverage!)
Prescription Drug Plans Administrator
Medco Health Solutions is the pharmacy
benefits administrator for all members of the State Health Benefits
Program and
School Employees’ Health Benefits Program.
Medco Order and Claim Forms
EMPLOYEE DENTAL
PLANS
The Employee Dental Plans are available
to employees of the State including State colleges and universities,
and employees of local employers participating that elect to participate in the plans.
Employee Dental Plan Rates
State Active Employee Dental Plan Rates — Plan Year 2012
Local Government and Education Employee Dental Plan Rates — Plan Year 2012
RETIREE DENTAL EXPENSE PLAN
The Retiree Dental Expense Plan is available
to retirees of the State including State colleges and universities,
and retirees of local employers participating in the SHBP or SEHBP
COBRA COVERAGE
COBRA Applications
NOTE: COBRA Applications must be certified by the employer before sending it
to the Division
of Pensions and Benefits.
COBRA
Rates
COBRA Active Group Rates — Plan Year 2012
COBRA Dental Rates — Plan Year 2012
COBRA
Part-Time Chapter 172 Rates — Plan Year 2012
COBRA
Retiree Rates — Plan Year 2012
ABOUT THE SHBP and SEHBP
The State Health Benefits Program (SHBP) was established in 1961 under N.J.S.A.
52:14-17.25 et seq. to provide health benefits to State
employees, retirees, and their dependents. The SHBP
was extended to employees, retirees, and dependents
of participating local public employers in 1964. Local
employers must adopt a resolution to participate in
the SHBP. Rules governing the operation and administration
of the program are found in Title 17, Chapter 9 of the
New Jersey Administrative Code.
The State Health Benefits Commission is the executive body established by statute to be
responsible for operation of the SHBP. The Commission
meetings are open
to the public and are conducted at the Division of
Pensions and Benefits in Trenton. Plan members are
entitled to appeal to the Commission for resolution
of any complaints after they have completed the formal
grievance procedure of their plan administrator.
The School Employees' Health Benefits
Program (SEHBP) was established by Chapter
103, P.L. 2007. It offers medical and prescription
drug coverage to qualified school employees and retirees,
and their eligible dependents. Local employers must
adopt a resolution to participate in the SEHBP. The
School Employees’ Health Benefits Program Act
is found in the N.J.S.A. 52:14-17.46 et seq.
Rules governing the operation and administration of
the program are found in Title 17, Chapter 9 of the
New Jersey Administrative Code.
The School Employees' Health Benefits
Commission is the executive body established
by statute to be responsible for operation of the
SEHBP. The Commission meetings are open to the public
and are conducted at the Division of Pensions and
Benefits in Trenton. Plan members are entitled to
appeal to the Commission for resolution of any complaints
after they have completed the formal grievance procedure
of their plan administrator.
The Division of Pensions and Benefits, specifically the Health Benefits Bureau and the Bureau
of Policy and Planning, are responsible for the daily
administrative activities of the SHBP and the SEHBP.
The Division provides news and updates to participating
employees and retirees through its newsletters
and publications. |
