Sehbp Educators Medicare PlanThese retirees will move from traditional Medicare supplements to Medicare Advantage, called the SEHBP Educators Medicare Plan. Enrollment in HIC Medicare products depends on contract renewal. The purpose of this Summary Program Description is to provide an overview of the plans provid-ed through the SHBP and SEHBP. All employees who are covered under the SEHBP are eligible to choose this program. For districts offering benefits through the SEHBP, starting in the plan year that begins on Jan. All 2023 SHBP/SEHBP medical plans include: Well Care and Preventive Care: Services such as annual physical and annual gynecological exams, well baby/child medical care and preventive care immunizations are covered 100% when using an in-network doctor. Educator Health Plan is approximately a 4. Whether a district participates in the SEHBP or not, effective January 1, 2021, all new employees in a district will ONLY be offered the NJ Educators Health Plan described below. Read about the features and benefits of your plan. With our medical and dental plan offerings, you'll get award-winning customer service that always puts you first. The New Jersey State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) offer employees and their covered dependents the opportunity to join a Direct Primary Care doctor's office at no additional cost. Welcome to the State of New Jersey for SHBP and SEHBP members We’re working extra hard for the health of members like you. All 2023 SHBP/SEHBP medical plans include: Well Care and Preventive Care: Services such as annual physical and annual gynecological exams, well baby/child. If you enroll in another Medicare Part D plan, you will lose your prescription drug benefits provided by the SHBP/SEHBP; however, your medical benefits will continue. All 2023 SHBP/SEHBP medical plans include: Well Care and Preventive Care: Services such as annual physical and annual. We have previously reported that all Medicare eligible retirees under the SEHBP (teachers) who are enrolled in traditional Medicare with either the NJ Direct 10 or NJ Direct 15 plans will be automatically enrolled into. Spouse or Partner with Different Medicare Eligibility than the Member. 8 million in Plan Year 2022. o The Medicare Retiree medical increase for Plan Year 2022 is 2. These retirees will move from traditional Medicare supplements to Medicare Advantage, called the SEHBP Educators Medicare Plan. For the plan year beginning January 1, 2021 until December 31, 2021, SEHBP plan offerings will include the current NJ Direct 10 or Direct 15, if available under member contract, at the Chapter 78 contribution level or other locally negotiated premium level, or a new health plan the NJ Educator Health Plan (NJEHP) where member contributions will. Much of the savings the governor’s office announced on Monday comes from the new Medicare Advantage plan, with the switch expected to save the state $162 million in 2019 and $110 million in 2020. Questions? Just call Aetna Concierge at 1-877-782-8365 (TTY:711) They're available Monday through Friday, 8 AM to 6 PM ET. Additional uncaught exception thrown while handling exception. For self-funded plans, coverage is offered by your employer and administrative services are provided by Aetna Life Insurance Company (Aetna). Welcome to the State of New Jersey for SHBP and SEHBP members We’re working extra hard for the health of members like you. Plan year 2022. State law requires the School Employees’ Health Benefits Program (SEHBP) to reimburse these eligible retirees and their dependents for the cost of enrolling in Medicare Part B. School Employees’ Health Benefits Program (SEHBP) MEDICAL PLAN DESIGN - PLAN YEAR 2021 MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENTAL GROUP PLANS HR-0996-0121 Physician visits for Medicare Advantage Plan Options will be reimbursed up to $250 each visit. Retired members of the SHBP or SEHBP who are enrolled in Medicare are automatically enrolled in the OptumRx Medicare Part D Prescription Drug Plan (PDP). For self-funded plans, coverage is offered by your employer and administrative services are provided by Aetna Life Insurance Company (Aetna). SEHBP Plan Offerings Effective January 1, 2021, the SEHBP can offer only three plans for medical and prescription drug benefits for active employees. You can reach them at 1-877-782-8362 (TTY:711). It is our understanding that the term “new” employees include employees who leave one school district to begin employment in a new district. All three Horizon SEHBP plans cover the same eligible medical services AND you can receive services outside of New Jersey. 2 6million in P lan Year 2022 and reduce Local EducationActive prescr iption drug claims by $0. Educator Health Plan is approximately a 4. com/shbp to: Learn about your plan options. With the SEHBP Educators Medicare Plan, you’ll have the option to use doctors and hospitals that are in or out of the Aetna Medicare network. However, any eligible covered dependents you have who are under age 65 will remain under their current plan. 8 million in Plan Year 2021 and $. In Florida and Minnesota, it is approved as a group Medicare Supplement product. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. State and local retirees agreed to this change two years ago. com/shbp to: Learn about your plan options. Find forms and other administrative materials. PPO Plan Options NJ EDUCATORS HEALTH PLAN (NJEHP) NJ DIRECT10 NJ DIRECT15 Eligibility All Active Employees and non-Medicare Retirees Active Employees hired prior to 7/1/20 IN-NETWORK (IN): Service Area Available Nationwide Nationwide Nationwide Specialist Referral No referral required No referral required No referral required. All employees who are covered under the SEHBP are eligible to choose this program. You may enroll in a Medicare Advantage plan during your Initial Enrollment Period or during the Open Enrollment Period for Medicare Advantage and Medicare Part D from October 15 through December 7. The Direct Primary Care Program is offered to active employees and non-Medicare retirees who are enrolled in SHBP/SEHBP’s NJ DIRECT Plan or OMNIA℠ Health Plan. You may waive the OptumRx Medicare PDP only if you are enrolled in another Medicare Part D plan. State law requires the School Employees’ Health Benefits Program (SEHBP) to reimburse these eligible retirees and their dependents for the cost of enrolling in Medicare Part B. The School Employees Health Benefits Program is launching a new health benefits plan called the Garden State Health Plan (GHSP). 2% decrease for the prescription drug premium rates, for a total increase of 2. 44 (“Chapter 44”), which overhauls health benefits plans offered to school employees. State of New JerseyAetna MedicareSM Plan (PPO)SEHBP Educators Medicare Plan Benefits and Premiums are effective January 1, 2023 through December 31, 2023. As of April 4, 2022, Medicare covers up to eight over-the-counter COVID-19 tests each month, at no extra cost to you if you have Medicare Part B. The New Jersey State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) offer employees and their covered dependents the opportunity to join a Direct Primary Care doctor's office at no additional cost. What happens when my spouse becomes eligible for Medicare?. o The Medicare Retiree medical increase for Plan Year 202 is 2. NJ EDUCATORS HEALTH PLAN (NJEHP) Eligibility All Active Employees and non-Medicare Retirees Active Employees hired prior to 7/1/20 IN-NETWORK (IN): Service Area Available Nationwide Nationwide Nationwide 2021 NJ School Employees’ Health Benefits Program (SEHBP) Local Education Employee Plans. The individual plan’s member handbooks provide detailed information about each plan and should be used to assist you in making informed health care decisions for you and your family. If you are age 65 or over, or Medicare eligible, and you are currently covered by a SEHBP Medicare plan, you will be enrolled in the SEHBP Educators Medicare Plan starting January 1, 2019. To waive coverage, you must submit a written request. The New Jersey State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) offer employees and their covered dependents the opportunity to join a Direct Primary Care doctor's office at no additional cost. If you’re an active employee hired on or after July 1 st 2020 or a retiree (or their spouse) who’s not Medicare eligible, then you’re eligible for the New Jersey Educators’ Health Plan. Plan Benefits The prescription drug plans can be used at any a par-ticipating pharmacy, through the OptumRx Home De-. If you are paying the full cost of your SHBP/SEHBP coverage, that cost generally decreases when you and/oryour dependent enroll in Medicare Parts A and B because most medical plans charge lower premiums forMedicare eligible members. This program is estimated to reduce Local Education Active medical claims by $2. Medicare Advantage Plans (Aetna) Retirees who are enrolled in a Medicare Advantage Plan may only waive their prescription drug coverage for another group Medicare Part D plan. 1, 2021, the SEHBP will offer only three medical and prescription drug benefit plans to non-Medicare-eligible employees and retirees and their dependents. With our medical and dental plan offerings, you’ll get award–winning customer service that always puts you first. The Aetna Supplemental Retiree Medical Plan is a fully insured, non-network-based commercial retiree group health product. Achieve your best health – and earn $250 or more in Visa prepaid card(s) each wellness year (November 1 to October 31) – with NJWELL, a wellness program for eligible members and their covered spouses/partners. All 2023 SHBP/SEHBP medical plans include: Well Care and Preventive Care: Services such as annual physical and annual gynecological exams, well baby/child medical care and preventive care immunizations are covered 100% when using an in-network doctor. Log in to your member website or use the Aetna Health℠ app. Authorization to release Information. Chapter 44, which applies to boards of education participating in the School Employee Health Benefits Program (SEHBP), as well as non-participating districts, was passed with the goal of reducing costs for districts and employees by. For districts offering benefits through the SEHBP, starting in the plan year that begins on Jan. For the plan year beginning January 1, 2021 until December 31, 2021, SEHBP plan offerings will include the current NJ Direct 10 or Direct 15, if available under member contract, at the Chapter 78 contribution level or other locally negotiated premium level, or a new health plan the NJ Educator Health Plan (NJEHP) where member contributions will. School Employees’ Health Benefits Program (SEHBP) MEDICAL PLAN DESIGN - PLAN YEAR 2021 MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENTAL GROUP. Early Retiree premium rates in Plan Year 2021 for the New Jersey Educator Health Plan are approximately 21. Achieve Your Best Health & Earn Rewards. Eligibility for Retired Group SEHBP coverage is available to qualified retirees of local education employers, as determined by the School Employees’ Health. landing | Optum RX: Manage Your Prescriptions Online Anytime. 8M for Local Education Actives,$22. 1, 2021, the School Employees’ Health Benefits Plan (SEHBP) will begin its new plan year offering only the following options: Horizon Direct 10 Horizon Direct 15 A NEW. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc. Reward yourself for healthy living. In August, the SEHBP released the rates for Plan Year 2022, effective 1/1/2022. SEHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Educators Medicare Advantage 10 and Aetna Educators Medicare Advantage Plan 15 (SEHBP); Aetna Medicare Advantage HMO 10; and. All other health benefit plans offered by the SEHBP prior to that date are to be terminated. • What happens when my spouse becomes eligible for Medicare?. This plan is limited to only New Jersey providers and facilities and comes at a lower cost for most members. If you are age 65 or over, or Medicare eligible, and in the SHBP or SEHBP enrolled in the Aetna Medicare Advantage PPO ESA plan, any eligible covered dependents you. SHBP/SEHBP Home - Horizon Blue Cross Blue Shield of New Jersey - NJ Health Insurance Plans. Spouse or Partner with Different Medicare Eligibility than the Member. In all states but Florida and Minnesota, it is offered as a supplementary medical plan, not a Medicare plan. Here when you need us most. On July 1, 2020, Gov. Additional uncaught exception thrown while handling exception. Note: ICR sessions are limited to a series of 72 one-hour sessions, up to 6 sessions per day, over a period of up to 18 weeks. Access NJWELL and other health and wellness programs. Most members and their dependents will qualify for Medicare benefits under one of the following four conditions: Have reached age 65. When is the special open enrollment? Who is administrating the GSHP? What does the plan look like? How do I learn more about the plan?. For assistance with an IRMAA claim, retirees should contact mynjbenefitshub at (833) 929-1101. January 1, 2021 NJ School Employees’ Health Benefits Program (SEHBP) Local Education Employee Plans Reward yourself for healthy living. For the plan year beginning January 1, 2021 until December 31, 2021, SEHBP plan offerings will include the current NJ Direct 10 or Direct 15, if available under member contract, at the Chapter 78 contribution level or other locally negotiated premium level, Non-Medicare Retirees- NJ Educator Health Plan Only. TypeError: Argument 1 passed to domain_alias_domain_request_alter() must implement interface. In August, the SEHBP released the rates for Plan Year 2022, effective 1/1/2022. SEHBP Plan Offerings Effective January 1, 2021, the SEHBP can offer only three plans for medical and prescription drug benefits for active employees. You must be logged in to view this. This includes new employees hired on or after July 1, 2020 and non-Medicare retirees. SEHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Educators Medicare Advantage 10 and Aetna Educators Medicare Advantage Plan 15 (SEHBP); Aetna Medicare Advantage HMO 10; and Aetna Medicare Advantage HMO 1525. Prior authorization or physician's order may be required. The purpose of this Summary Program Description is to provide an overview of the plans provid-ed through the SHBP and SEHBP. Just call Aetna Concierge at 1-877-782-8365 (TTY:711) They're available Monday through Friday, 8 AM to 6 PM ET. Need help with Medicare enrollment? Call a licensed agent at 1-855-335-1407 (TTY: 711) , Monday to Friday, 8 AM to 8 PM. Direct Primary Care Managed Health. Chapter 44, which applies to boards of education participating in the School Employee Health Benefits Program (SEHBP), as well as non-participating districts, was passed with the goal of reducing. 9M for Local Education Early Retirees, and $33. These buttons changes created significantly savings for our additionally schools boards identical. It offers medical, prescription drug, and dental coverage to qualified lo- cal education public employees, retirees, and eligible dependents. If you are age 65 or over, or Medicare eligible, and in the SHBP or SEHBP enrolled in the Aetna Medicare Advantage PPO ESA plan, any eligible covered dependents you have who are under age 65 will remain under their current plan. You can visit doctors and hospitals of your choice, as long as they both are contracted and eligible to receive payment from Original Medicare and accept Aetna. It offers medical and prescription drug coverage to qualified local education public employees, retirees, and eligible dependents. To determine if the GSHP is right for you, please review the Q&A below as well as the premium contribution. Plan year 2022. SEHBP Plan Offerings. School Employees' Health Benefits Program (SEHBP) MEDICAL PLAN DESIGN - PLAN YEAR 2021 MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENTAL GROUP PLANS HR-0996-0121 Physician visits for Medicare Advantage Plan Options will be reimbursed up to $250 each visit. 23 The SHBP/SEHBP has partnered with SSDC Services Corporation to provide eligible Non-Medicare retirees with Social Security Disability (SSDI) benefits and Medicare coordination services. o The Medicare. 9 million in Plan Year 2021 and $1. It offers medical and prescription drug coverage to qualified local education public employees,. Annual rate changes are based on actual past and present claim history of the retiree group along with actuarial assumptions about group use. For districts offering benefits through the SEHBP, starting in the plan year that begins on Jan. Aetna Medicare SM Plan (PPO) SEHBP Educators Medicare Plan Routine Hearing Screening $0 One exam every 12 months. 1, 2021, the School Employees’ Health Benefits Plan (SEHBP) will begin its new plan year offering only the following options: Horizon Direct 10 Horizon Direct 15 A NEW PLAN, the Horizon NJ Educators Health Plan (NJEHP) Another new plan, the Garden State Health Plan (GSHP), will be developed and will be available July 1, 2021. Horizon Insurance Company (“HIC”) has a Medicare contract to offer HMO, HMO-POS, PPO and Part D Medicare plans, including group-Medicare Advantage plans and group Part D Prescription Drug plans. SHBP/SEHBP For Member Services, call 1 -800-414-SHBP (7427) Sign in. When we know who your provider is, we can better support your care. 1, 2021, the School Employees' Health Benefits Plan (SEHBP) will begin its new plan year offering only the following options: Horizon Direct 10 Horizon Direct 15 A NEW PLAN, the Horizon NJ Educators Health Plan (NJEHP) Another new plan, the Garden State Health Plan (GSHP), will be developed and will be available July 1, 2021. State of New JerseyAetna MedicareSM Plan (PPO)SEHBP Educators Medicare Plan Benefits and Premiums are effective January 1, 2023 through December 31, 2023 SUMMARY OF BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY Primary Care Physician (PCP): You have the option to choose a PCP. With the SEHBP Educators Medicare Plan, you'll have the option to use doctors and hospitals that are in or out of the Aetna Medicare network. DENTAL SERVICES This is what you pay for network & out-of-network providers Medicare Covered Dental $10 Non-routine care covered by Medicare. Welcome to the State of New Jersey for SHBP and SEHBP members We’re working extra hard for the health of members like you. Most members and their dependents will qualify for Medicare benefits under one of the following four conditions: Have reached age 65. SEHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Educators Medicare Advantage 10 and Aetna Educators Medicare Advantage Plan 15 (SEHBP); Aetna Medicare Advantage HMO 10; and Aetna Medicare Advantage HMO 1525. Llame al 1-800-365-2223 (TTY 711). If you are age 65 or over, or Medicare eligible, and you are currently covered by a SEHBP Medicare plan, you will be enrolled in the SEHBP Educators Medicare Plan starting January 1, 2019. Just call 1-877-782-8365 (TTY:711) Chat with Member Services for more information. As of April 4, 2022, Medicare covers up to eight over-the-counter COVID-19 tests each month, at no extra cost to you if you have Medicare Part B. You must get the tests at participating providers or pharmacies. ployees rather than one of the SHBP/SEHBP prescrip - tion drug plans. January 1, 2021 NJ School Employees’ Health Benefits Program (SEHBP) Local Education Employee Plans Reward yourself for healthy living. The New Jersey State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) offer employees and their covered. Consistent with Medicare policy, Aetna will cover intensive cardiac rehabilitation programs delivered virtually until the later of December 31, 2021 or the end of the calendar year the public health emergency (PHE) ends. Read about the features and benefits of your plan. Pre-65-year-old members (not eligible for Medicare) are eligible for DPCMH. If your local employer has chosen a private prescription drug plan, it must be substantial-ly similar to the prescription drug plans offered by the SHBP/SEHBP. Looking for information on your State Health Benefit Program (SHBP) or School Employees’ Health Benefits Program (SEHBP)? Visit HorizonBlue. may only enroll in the New Jersey Educator Health Plan as of January 1, 2021. 1, 2021, the SEHBP will offer only three medical and prescription drug benefit plans. For Plan Year 2020, it is estimated the cost of COVID-19 will be approximately $56. If you are age 65 or over, or Medicare eligible, and in the SHBP or SEHBP enrolled in the Aetna Medicare Advantage PPO ESA plan, any eligible covered dependents you have who are under age 65 will remain under their current plan. 23 Retirees and/or spouses who receive the full Medicare Part B reimbursement in their pension check will be receiving the correct standard reimbursement for 2023 of $164. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. State law requires the School Employees’ Health Benefits Program (SEHBP) to reimburse these eligible retirees and their dependents for the cost of enrolling in Medicare Part B. If you’re an active employee hired on or after July 1 st 2020 or a retiree (or their spouse) who’s not Medicare eligible, then you’re eligible for the New Jersey Educators’ Health Plan. The School Employees’ Health Benefits Program (SEHBP) was established in 2007. The amount is based on this year’s monthly Part B. Virtually all members of those plans are expected to be. Call SHIIP for more information Toll-free 1-855-408-1212 Monday through Friday from 8am to 5pm. Learn more Welcome to your Medicare plan A suite of benefits just for State of New Jersey retirees. 44 (“Chapter 44”), which overhauls health benefits plans offered to school employees. SEHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Educators Medicare Advantage 10 and Aetna Educators Medicare Advantage Plan 15 (SEHBP); Aetna Medicare Advantage HMO 10; and Aetna Medicare Advantage HMO 1525. State of New JerseyAetna MedicareSM Plan (PPO)SEHBP Educators Medicare Plan Benefits and Premiums are effective January 1, 2023 through December 31, 2023 SUMMARY OF BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY Primary Care Physician (PCP): You have the option to choose a PCP. The retiree rates saw a modest increase as indicated in the chart below. Eligibility for Retired Group SEHBP coverage is available to qualified retirees of local education employers, as determined by the School Employees' Health Benefits Program (SEHBP). DENTAL SERVICES This is what you pay. Medicare Part D. Welcome to the State of New Jersey for SHBP and SEHBP members We're working extra hard for the health of members like you. School Employees’ Health Benefits Program (SEHBP) MEDICAL PLAN DESIGN - PLAN YEAR 2021 MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENTAL GROUP PLANS HR-0996-0121 Physician visits for Medicare Advantage Plan Options will be reimbursed up to $250 each visit. Need help with Medicare enrollment? Call a licensed agent at 1-855-335-1407 (TTY: 711) , Monday to Friday, 8 AM to 8 PM. Looking for information on your State Health Benefit Program (SHBP) or School Employees' Health Benefits Program (SEHBP)? Learn about your plan options. If you're an active employee hired on or after July 1 st 2020 or a retiree (or their spouse) who's not Medicare eligible, then you're eligible for the New Jersey Educators' Health Plan. They're available Monday through Friday, 8 AM to 6 PM ET. Just call Aetna Concierge at 1-877-782-8365 (TTY:711) They're available Monday through Friday, 8 AM to 6 PM ET. The School Employees’ Health Benefits Program (SEHBP) was established in 2007. Find a Doctor Search for participating network doctors, hospitals and other healthcare professionals. Local education employers must adopt a resolution to participate in the SEHBP. PPO Plan Options NJ EDUCATORS HEALTH PLAN (NJEHP) NJ DIRECT10 NJ DIRECT15 Eligibility All Active Employees and non-Medicare Retirees Active Employees hired prior to 7/1/20 IN-NETWORK (IN): Service Area Available Nationwide Nationwide Nationwide Specialist Referral No referral required No referral required No referral required. State of New JerseyAetna MedicareSM Plan (PPO)SEHBP Educators Medicare Plan Benefits and Premiums are effective January 1, 2023 through December 31, 2023 SUMMARY OF BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY Primary Care Physician (PCP): You have the option to choose a PCP. The new plan will being called the SEHBP Instructor Medicare Plan. Looking for information on your State Health Benefit Program (SHBP) or School Employees’ Health Benefits Program (SEHBP)? Visit HorizonBlue. Note: If you are enrolled in a Medicare Advantage Plan, you can only waive your prescription drug cov-erage for another group Medicare Part D plan. Aetna Medicare SM Plan (PPO) SEHBP Educators Medicare Plan Routine Hearing Screening $0 One exam every 12 months. Whether a district participates in the SEHBP or not, effective January 1, 2021, all new employees in a district will ONLY be offered the NJ Educators Health Plan described below. 6% lower than the PPO10 Plan in Plan Year 2020. The new offering, called SEHBP Educators Medicare Plan, will cover those currently enrolled in the PPO 10 and PPO 15 plans. The Direct Primary Care Program is offered to active employees and non-Medicare retirees who are enrolled in SHBP/SEHBP’s NJ DIRECT Plan or OMNIA℠ Health Plan. Local education employers must adopt a resolution to participate in the SEHBP. With our medical and dental plan offerings,. The new offering, called SEHBP Educators Medicare Plan, will cover those currently enrolled in the PPO 10 and PPO 15 plans.