Participants (full-time employees) in the Alternate Benefit Program (ABP) who retire with at least 25 years of credited ABP service or those who are on a long-term disability will be offered enrollment in the State Health Benefits Program (SHBP) upon retirement for themselves and their eligible dependents. Eligible dependents include spouses, civil union partners, domestic partners, children, dependent children with disabilities and continued coverage for over-age children.
Enrollment into a retired state health plan is not automatic. You need to meet with your Human Resources representative to discuss the enrollment application process and the required documentation needed to process your application. There are three different applications, Non-Medicare Retired Enrollment Application, Medicare Eligible Retired Coverage Enrollment Application and Retired Coverage Enrollment Application for High Deductible Plans.
If you or any of your dependents are eligible for Medicare, you must submit with your application proof of Medicare A and B (copy of your Medicare A and B card signed) or a letter from the Social Security Administration confirming your effective date of enrollment in Medicare Parts A and B. If you do not have a Medicare A and B card, you need to contact Social Security Administration and apply for parts A and B ninety days prior to your retirement date.
Below is the link to the required documentation for SHBP enrollment:
If you elect to waive coverage because you are covered under another plan, you must submit a waiver and an application indicating that you are waiving health insurance coverage at this time. You need to complete the application in case you lose the other coverage, if the application and waiver are not submitted within 60 days of your retirement date, you will not be permitted to enroll at a later date.
Your prescription drug coverage is included with all retired medical plans. Retired members of the SHBP who are enrolled in Medicare are automatically enrolled in Express Scripts’ Medicare Part D prescription drug coverage (the Express Scripts Medicare Prescription Plan).
Currently, the state is offering Aetna and Horizon health plans. The link to the State Retired Group – SHBP Design for 2017:
You can elect to enroll in dental care coverage in retirement. The current plans that New Jersey Division of Pensions offers retirees are the Dental Expense Plan and DPOs – Cigna, Healthplex, Horizon Dental Choice, Aetna DMO and MetLife. There are monthly charges for each of these plans; the Division will bill the retiree on a monthly basis. Be sure you confirm that the dentist or dental facility you select is taking new patients and participates with the SHBP/SEHBP Retiree Dental Plans (since DPOs also service other organizations).
Be sure you confirm that the dentist or dental facility you select is taking new patients and participates with the SHBP/SEHBP Retiree Dental Plans (since DPOs also service other organizations).
Below is the link to the dental rates:
Regarding the cost of enrollment in the SHBP, the State and certain employers have negotiated to pay all or some of the cost of coverage. The Division of Pensions and Benefits will send you a letter prior to your retirement date indicating your health benefit cost in retirement.
There is a Medicare B reimbursement if you had 25 or more years of service credited in one pension system before July 1, 1997, the State of New Jersey agreed to reimburse you at retirement for the standard cost of any Medicare Part B premium paid by you and/or your spouse, civil union partner or eligible same-sex domestic partner.
If you attained 25 years of service credit after July 1, 1997, any reimbursement of Medicare Part B premiums paid by your and/or your spouse, civil union partner or eligible domestic partner may be limited by the terms of the bargaining unit agreement in place at the time of your retirement or by legislation (Chapter 8, P.L. 1996). State employees who began employment after July 1, 1995 will not be eligible for Medicare Part B reimbursement.
It is your responsibility to notify the Division of Pensions and Health Benefits of any change in family status, a qualifying event including marriage, civil union, domestic partnership, birth, adoption of a child or change in your spouse’s/partner’s employment that significantly affects the health benefits coverage provided by your spouse’s/partner’s employer.
When the status change application is received by the Health Benefits Bureau within the 60-day window, the family member will be enrolled retroactively to the date of eligibility. There are three different retired change of status applications, Non-Medicare Retired Enrollment Application, Medicare Eligible Retired Coverage Enrollment Application and Retired Coverage Enrollment Application for High Deductible Plans.
Coverage for your spouse ends at the end of the month in which you divorce. If you dissolve a civil union or domestic partnership, ABP retirement benefits coverage for your partner ends at the end of the month in which the partnership terminates.
Coverage of your spouse/partner terminates at the end of the month in which you die. However, the Division of Pensions and Benefits will notify your spouse/partner that they are able to continue coverage in the plan of their choice at their own cost.
Resources – New Jersey Division of Pensions and Benefits, Fact Sheet #11