9/23/20 - NEW HEALTH PLAN WEBINAR DATES & INFO - MORE DATES ADDED! REGISTER NOW! THERE ARE OCTOBER DATES! SIGN UP NOW!
The dates, times, and registration information for the New Jersey Educators Health Plan are found in the attached document. (below)
Please communicate this information to your members as soon as possible through email and/or post on your website.
The same details will be posted on the NJREA website, and an email blast from NJEA is anticipated. Thank you for your assistance.
9/23/20 - DID YOU MISS YOUR AETNA REWARD FROM COMPLETING YOUR PHYSICAL OR OTHER EXAM? This may have happened...
I hope this information can be helpful to other members. I called Aetna to get paid for my yearly physical ($75.) They told me my debit card would come in a "plain white envelope."
I am in the habit of throwing out "junk mail" on my way in from the mailbox--it never hits the house. So, I was a bit anxious about missing the envelope and in fact, thought that I had thrown it out. I was about to call Aetna, but I realized there was no way to prove that I didn't get the payment. Ironically, I received the "plain white envelope" the next day.
The envelope is not business sized. It looks more like a greeting card envelope. The return address is:
217 Country Club Park #112, Birmingham, AL 35213. It is posted in Las Vegas, Nevada. This is exactly the type of mail that would go straight to the recycling bin.
I wonder if others have missed their payment. What is the reason for not including "Aetna" on the envelope? Thanks. I hope you and your family are well.
6/11/20 - Chapter 78 relief law - What retirees need to know
Recently, there have been many questions about the new Chapter 78 relief law. As you know, the NJ Legislature passed legislation creating a new health insurance plan in the School Employees Health Benefits Program (SEHBP). This new plan, called the New Jersey Educators Health Plan (NJEHP) is intended to address the rising costs of health care and its impact on public school employees.
The following is what retirees need to know:
This new plan, NJEHP, will cover all non-Medicare-eligible retirees who receive health benefits from the state, as well as their spouses/partners and dependents who are also non-Medicare eligible. The plan will go into effect on January 1, 2021.
To better understand the new plan, please view this Q and A, as well as this chart which compares the NJEHP to the current Direct 10 plan that nearly all non-Medicare retirees use today. You will see the plans are very similar; the main difference is the new plan incentivizes the use of in-network providers. Even though it’s a new plan, the network of health care providers is the same large national network that is utilized by the Direct 10. Any doctors or facilities that accept the Direct 10 will also accept the NJEHP, meaning you will not need to change your in-network providers because of this new plan.
For non-Medicare retirees who pay for any portion of their health insurance premium, this new plan may be less expensive as well. Rather than paying a percentage of a rising premium, you will pay a percentage of your pension. We urge you to view the contribution chart below to see the new costs. For most members, that will result in a lower contribution. IMPORTANT: Members who would have paid less under the previous contribution requirement will continue to pay that lower amount.
Medicare-eligible retirees will see no change to their coverage or costs under this plan. They will continue to be covered under their current plans, Medicare Advantage or Medicare Supplemental. However, any spouses or dependents of Medicare-eligible retirees who are not yet eligible for Medicare themselves will be covered under NJEHP.
While this change has caused disconcertion for some members, we must remember that – for nearly 13 years—there have been minimal changes to the level of benefits available to retired public school employees through the SEHBP. This new plan guarantees that retirees will continue to have access to the high-quality benefits they deserve.
I urge you to be on the lookout for upcoming issues of the NJREA Newsletter and NJEA Review for more information in the next few months, as well as be a frequent visitor to NJREA’s webpage. If you still have some immediate questions after reviewing the chart and Q&A provided, please email NJREAHealthBenefitsChair@
I hope you and your loved ones continue to stay safe and healthy.
HEALTH INSURANCE UPDATES FOR OUR RETIREES
5/7/20 - from Barbara Satz, Health Benefits Chair
Health Benefits Committee Information...
I know that many members have gotten their Aetna Co-pay reimbursement checks.
If you have any members that did not, please have them call Aetna at 1- 866-816-3662 and tell the representative in member services that they did not receive their co-pay check. The person should verify their information and notify the task team that the member did not receive their co-pay reimbursement.
It is my understanding that the team should contact them in 3 - 5 days.
3/2020 - I hope this finds you all well and not too stir crazy yet, especially with the rains of the day. So far, a good walk or a little while on the balcony when there is some sun has helped me. I will have to come up with a new strategy today. If you have a cell phone try to FaceTime someone each day.
On Friday I was able to join approximately 40 people on a conference call with Kevin Kelleher from NJEA. He and Steve Beatty thanked all of the Retired for all their lobbying efforts to get the Chapter 78 and ESP bills passed out of committee. One more vote necessary (probably a phone vote) and then Governor Murphy’s signature! Hopefully, that will happen this week.
Here is what I learned – and then I will give you the website for you to look at on your own.
1. Medicare Retiree: NO CHANGE TO YOUR PLAN except for acupuncture, physical therapy, and chiropractic care. There are dollar limits on out of network coverage (which will bring down the cost overall).
2. We are keeping OPTUM RX mail in the drug program.
3. If a retiree is not yet on Medicare, they will receive a new health care card in the mail. The year will run from July 1 to June 30th. There will be some coverage changes. Check the website: www.njea.org/justice.
4. If you were paying for retired health care, you will now be paying a percentage of your pension, NOT a percentage of the premium. Your cost will go down and the plan is still a “platinum plan” Those not paying for healthcare will continue to not pay for their healthcare. This will save the state another $30,000,000. The plan will not change for the next 7 years. Then you will have some choices. CO-PAY REIMBURSEMENT CHECKS are to go out on APRIL 1st. That was the plan. Hopefully, this will actually happen.
Please take care of yourselves and call at least one MCREA friend today. They will appreciate it and so will you.
NJEA/NJREA indicate that Aetna reimbursement checks should be expected by the end of March. Members should be vigilant and open any mailing that they receive from Aetna between now and that time. If you believe that you entitled to and did not receive a reimbursement check by the end of March you should contact Aetna (number on the back of your ID card) prepared with the proper documentation to support your claim.
The Aetna SEHBP Medicare Advantage program of reimbursing up to $250.00 for co-pays will continue for the calendar year 2020. Save your receipts and check your EOB’ s during the year.
During the month of February, the Division of Pensions and Benefits will send a notice to retirees who qualify for reimbursement for the full cost of Medicare
Part B and Part D coverage from the State of New Jersey and paid more than the
Standard monthly premiums. The notice will explain what you need to send to the state as proof that you paid more and the address to send all documentation.
You should send in no later than April 1, 2020. Any questions should be directed to NJDPB at 609-292- 7524.
***1/16/20 Memo from Susan Beekman, MCREA President
HEALTH & MEMBER BENEFITS (By Barbara Satz)
OptumRx is in the process of mailing “your 2020 Annual Notice of Changes” for the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP) Medicare Prescription Drug Plan.
It is important you read the Annual Notice of Changes as well as the Evidence of Coverage to see if other benefits or cost changes affect you.
The list of covered drugs is called a Formulary or “Drug List.” It is important to review the drug list to make sure your drugs will be covered next year and to see if there will be any additional restrictions.
To get a copy of the Pharmacy Directory, Formulary and/or Evidence of Coverage mailed to you call OptumRx Member Services at 1-844-368-8765 or visit Optumrx.com and download copies from the “Forms” page.
The Aetna Medicare Advantage reimbursement will not take effect until after
December 31, 2019. We have not yet received any information about how Aetna is completing the reimbursement. As soon as we know we will put it in the NJREA Newsletter.
BE PRO-ACTIVE WITH YOUR MEDICAL COVERAGE----
Read your Evidence of Coverage. The information about what is covered, what is not, co-pays, prior authorization, pre-certification, etc. is all in this document. You can also call the number on the back of your ID card and ask questions
NJDPB- New Jersey Division of Pensions and Benefits http://www.nj.gov/treasury/pensions
Pension inquiries-including those related to health benefits: 609-292-7524
call center hrs 7:00 AM-4:30 PM M-F 6:45 PM on Thursdays, call early for less wait time. Automated Information System: 609-292-7524 (24hours /7days a week)
Can also send an e-mail, go to contacts on website and fill in the form
Mail address: Division of Pensions and Benefits, PO Box 295, Trenton, NJ 08625-0295 Medicare: 800-633-4227
Social Security: 800-772-1234 or online at http://www.SSA.gov
OptumRX: 1-844-368-8740 www.optumrx.com OptumRXMedicare: 1-844-368-8765
NJDirect/Horizon Plans: 800-414-7427
Aetna Member Services: 1-877-782-8365
Aetna Medicare Advantage PPO or HMO for SHBP members (state and local govt) 1-866-234-3129
Aetna Medicare Advantage PPO or HMO for SEHBP members (education) 1-866-816-3662
sign-in information on the back of the membership card
NJEA/NJREA Headquarters: 609-599-4561
NJEA Confidential Helpline: 866-AID-NJEA (866-243-6532)
NEA Member Benefits: www.neamb.com or 800-637-4636