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Division of Pensions & Benefits

State Health Benefits Program

Eligibility for Retired Group SHBP coverage is available to qualified retirees from the State including State colleges and universities, and Participating Local Government Employers, as determined by the State Health Benefits Program.

Aetna Medicare Advantage Plans

Medicare Advantage plans, sometimes referred to as "Part C" or "MA plans," provide Medicare Part A (inpatient hospital insurance) and Medicare Part B (outpatient medical insurance) coverage. The Aetna MA plans offer access to providers nationwide, with the same benefits in or out of network, and no referrals required.

SHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Medicare Advantage PPO ESA 10;* Aetna Medicare Advantage PPO ESA 15; Aetna Medicare Advantage HMO and Aetna Medicare Advantage HMO 1525.

*Not all State retirees will be eligible for Aetna Medicare Advantage PPO ESA 10

Spouse or Partner with Different Medicare Eligibility than the Member

Medicare-eligible retirees enrolled in a non-Medicare Advantage plan and who have a spouse or partner who is not Medicare eligible will move to the Aetna MA plan while the spouse/partner and/or any covered children remain in the non-Medicare-Advantage plan. Similarly, retirees who are not eligible for Medicare but have a spouse or partner who is Medicare eligible will remain in their non-Medicare-Advantage plan (along with any covered children) while the spouse/partner is transferred to the Aetna MA plan.

Information for Plan Year 2024

Retiree Medical Rates

Rates for the new Aetna medical plans are currently equivalent to the rates for the corresponding Horizon medical plans. Please use the Horizon rate charts below to determine rates for the new Aetna plans.

  • Rates for State Retirees with Premium Sharing — If you worked for the State and earned 25 years prior to July 1, 2007 (or retired on a Disability Retirement on or before August 1, 2007), you share the cost of Aetna Freedom10 or NJ DIRECT10 coverage with the State.

Retiree Dental Rates

State and Local Government Retired Health Benefit Applications – All retirees MUST submit applications online using Benefitsolver. Log in through myNewJersey or navigate to mynjbenefitshub.

Retiree prescription drug coverage is included with retired group medical plan enrollment. OptumRx is the pharmacy benefits administrator for all Retired Group members of the SHBP.

Medicare Plan Rates for retirees enrolled in Private Medicare Part D Plans are available by request to the NJDPB's Office of Client Services

If you retired from the State and earned 25 years of service after June 30, 2007, but before June 28, 2011, or retired on a Disability Retirement on or after August 1, 2007, but before June 28, 2011, you are eligible to enroll in the Retiree Wellness Program (RWP). If you do not enroll and meet the yearly requirements, you have to pay 1.5 percent of your gross retirement check.*

  • If you are a new eligible retiree, you will receive information from the health plan with instructions and the deadline for enrollment within 30 days of retirement.
  • You must submit a Retiree Wellness Program Pledge Form to show acceptance of the terms and conditions of RWP participation.
  • You are also required, each year, to complete a Health Assessment Test (HAT); have an annual medical check-up and submit the Annual Physician Certification; obtain age and gender appropriate tests and screenings; and participate in disease management programs.
  • If you are not currently enrolled in the RWP, you have the opportunity to enroll each year between January 1 and October 31 during the RWP Open Enrollment. If you enroll and meet the requirements, the 1.5 percent contribution will stop as of January 1 of the following year. If you are currently enrolled and wish to continue enrollment for the following year, you have until December 31 to meet the requirements.

*ABP retirees pay a health contribution equal to 1.5 percent of 50 percent of the highest salary the retiree had in the 5 years prior to retirement.

Wellness Links

Wellness Program Forms

NJ DIRECT Forms – Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ):

Aetna Forms

Eligible active and retired members and their dependents can take advantage of these add-on health programs (copays or additional out-of-pocket costs may apply).

  • Forge  – Active, COBRA, and non-Medicare retirees enrolled in a Horizon medical plan who are 18 years of age or older can start their recovery journey with a personalized behavior health plan to help you achieve your goal.
  • AbleTo for Horizon members and AbleTo for Aetna members – Certain active, COBRA, and non-Medicare retirees who are enrolled in a Horizon medical plan or the Aetna Garden State Health Benefits Plan can get a personalized, behavior health-focused 8-week program to learn skills to help you enjoy more out of life.

Videos

More videos are available to view in our Video Library

Retirement Types, Eligibility & Calculations

Retired Benefitsolver Guide

Solving MBOS Login Issues Part 1


Last Updated: Tuesday, 09/03/24