2/1/21 - Deceased Member Health Insurance Issues & other Info...

Several times since I have been your President we have had spouses of our members with a particular health insurance issue.  PLEASE BE AWARE……. If YOU, the member, have a spouse on your health insurance plan (both Aetna and SHBP/SEHBP) and you pass away, your surviving spouse is only covered until the end of the month in which you pass away.  You pass away on the 1st of the month, your spouse needs new insurance by the 30th. If you pass away on the 29th of the month, they only have 1 day to get new health insurance. One would think it would be 30 days total to get new insurance. THAT IS NOT THE CASE. This is a health insurance policy…..not NJREA or NEA or NJEA. You cannot always plan ahead, however, you need to know this and be proactive. Who is going to be thinking about health insurance when one’s spouse passes away?

Pension Problems

As many of you know there were some problems coming out of the Division of Pensions just before the new year:

1.     New Insurance cards have finally been sent out and as of 1/26 they should all have arrived. ONLY members who changed their plans would need a new card. Your old AETNA cards are still good for most of us.

2.     Pre-Medicare retirees with their 25 years of active service were charged a percentage of their pension payment for their insurance. A MISTAKE!!!!! The charge will not be on the February pension check AND a reimbursement for the charge from January will be reimbursed by February 18th. Let me know if this does not happen.

Optum Rx Letter

Letters were erroneously sent out to members about certain prescriptions no longer being covered by Optum Rx. Two-thirds of those letters were sent in error. Medicare changed the formulary, as it does every year, and one-third of those letters were correct. However, NJEA got Optum Rx to offer a 30 day additional supply of those medications while our members go to their doctors to choose a different drug. One week’s notice of the change was not right and some will no longer be covered or will change tiers. Please check your medications and speak to your doctor.

If you feel the need to appeal this action from MEDICARE, you need to contact OptumRx first with your appeal. Then you would go to Medicare next.

Medicare Reimbursement Checks

Seventy-five percent of Medicare reimbursement checks from last spring have gone out. Twenty-five percent should get to those who are owed this money by the end of February. Don’t give up! Please know that NJEA has been reminding them frequently that this is owed to our members.


Feeling anxious, depressed, just need to talk with someone -

Contact NJEA’s 24/7 Helpline 866-AID-NJEA (1-866-243-6532 ) Call for a 24/7 Member Support helpline focused on you!


State law requires that a member or dependent spouse/partner/child who is eligible for Medicare by reason of age (65 or older)or disability must be enrolled in both Medicare Part A(hospital) and Part B(medical) and maintain Medicare Part A and Part B coverage to remain eligible for state-paid, post-retirement medical benefits through the School Employees’ Health Benefits Program (SEHBP).

Acceptable proof includes a photocopy of your Medicare card showing Part A and B enrollment or a letter from Medicare indicating the effective dates of Parts A and B coverage. Send evidence of enrollment to the Health Benefits Bureau, Division of Pensions and Benefits, PO Box 299, Trenton, New Jersey 08625-0299.

If you are collecting Social Security, they will send you notification of Medicare approximately 3 months before the month you turn 65 and collect payment for Part B out of your Social Security check.

If you are not collecting Social Security, you must apply for Medicare yourself approximately 3 months before the month you turn 65 and make payments to Medicare for Part B yourself. Not making payments can result in loss of state-paid, post-retirement medical benefits.

If you are retired from a board of education with 25 years or more of pension credit you will receive full Medicare Part B reimbursement. This reimbursement will be added directly to your monthly pension check.

Retirees enrolled in SEHBP should not sign up for any alternate supplemental Medicare coverage. Enrollment in another plan would result in the loss of SEHBP.


“Unlocking Member Benefits” meeting:
February 1, 2021 at !0:00am
Find out about the many, many benefits your dues money affords you.
REGISTER: tinyurl.com/y3s9wxv9 or email Lorraine Jones at ljones@njea.org or (609)599-4594 x2222

Feeling anxious, depressed, just need to talk with someone -

Contact NJEA’s 24/7 Helpline 866-AID-NJEA (1-866-243-6532 ) Call for a 24/7 Member Support helpline focused on you! 

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.



Hi Susan,
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.