In September, the School Employees’ Health Benefits Commission (SEHBC) approved rates for the School Employees’ Health Benefits Program (SEHBP), from which many of our retired members receive their benefits, for Plan Year 2022.
Rates will take effect January 1. You may view the rates by visiting the following website on or before that date: https://www.nj.gov/treasury/pensions/hb-retired-sehbp.shtml
Non-Medicare retirees
There will be no change in the levels of medical benefits for Plan Year 2022. Retirees who are not required to pay for health benefits will continue to receive premium-free benefits. However, retirees who, under Ch. 44, must contribute to their health benefits will continue to do so. For 2022, non-Medicare retirees’ rates will increase by 4.3 percent.
Additionally, non-Medicare retirees may take advantage of the following enhancements to the SEHBP:
- Wondr (formerly Naturally Slim)—A program to assist members to learn weight loss skills based on behavioral science.
- SSDC Services Corporation—A program designed to help members file for Social Security Disability Benefits. For more information, visit https://www.nj.gov/treasury/pensions/documents/hb/oe2021/SSDC-NJDPB.pdf
- Amino—A fast, easy and smart way to find and book healthcare. Skip the phone tag, search online and get back to what matters. To learn more, visit https://partners.amino.com .
- Hinge Health—A program to assist with back or joint pain relief. The programs offer personal exercise therapy plans, a one-on-one expert health coach and pain management education (plus, a free tablet!) To learn more, visit https://www.hingehealth.com/for/new-jersey1 .
Everside Health and R-Health are the Direct Primary Care Medical Homes (DPCMH) providers for non-Medicare retirees enrolled in the New Jersey Educators Health Plan (NJEHP.) These programs provide primary care services for patients nationwide—in very different ways from a typical primary care practice. Retirees receive convenient, personalized care with no copays and no out-of-pocket costs. Retirees also receive direct access to their doctors, unhurried appointments that give you the time necessary to address your health concerns and a broad scope of services that can eliminate or minimize costly specialist visits. To learn more, visit http://www.r-health.md/nj or http://www.eversidehealth.com
Medicare-eligible retirees
There will be no change in the level of medical benefits. However, Medicare-eligible retirees will see a 2.1 percent increase in premiums for 2022. The Aetna Educators Medicare Advantage plan will continue to use Medicare providers and still require members to use a Medicare-eligible doctor.
Members who use the Aetna Educators Medicare Advantage plan will have the following additional benefits:
NJWELL—Retirees and their spouses/partners will be able to take advantage of the incentives offered to all members who strive to stay healthy.
Copay reimbursement—Members and their covered spouses/partners will be reimbursed their $10 copay for up to 25 physician visits each year. This unique benefit can provide each with an additional $250 in returned out-of-pocket expenses.
Optional care—Members and their covered spouses/partners may have an optional home visit by a nurse practitioner to set up a personal care plan. The plans will include access to a 24/7 registered nurse helpline to assist members with their healthcare needs and questions.
Members who wish to use traditional Medicare and Horizon BCBS as a supplement may choose from NJ Direct 15/25 or the other options available. If you want to make this switch, you must fill out the health insurance change form found on the Division’s website at https://www.state.nj.us/treasury/pensions/documents/forms/hr0984.pdf
Additionally, beginning Jan. 1, 2022, members who are eligible to make health benefits changes can use Benefitsolver to make their changes right online. To take advantage of this opportunity, visit the Division of Pensions and Benefits website and click on the “Access Benefitsolver” button.
Prescription drug plans
Optum Rx continues to be the SEHBP prescription benefit manager (PBM) in 2022 for both non-Medicare and Medicare-eligible retirees. However, these plans will also see rate changes. Non-Medicare retirees will see a rate decrease of 4.2 percent, while Medicare-eligible retirees will see a rate increase of 6.8 percent. The charts on this page indicate the respective applicable rates.
Dental coverage
Retirees who elect dental coverage through the state in the dental expense plan (DEP) will see a slight decrease in their premiums—1.5 percent—beginning Jan. 1.
The state of New Jersey will continue to offer additional dental options for retirees through the Dental Provider Organization (DPO) plans. The 2022 rates for the retiree DPO plans can be viewed on the charts provided.
Retirees who wish to switch their current plans can do so at any time, so long as they have been in their current dental plan for at least 12 months. Please contact the NJ Division of Pensions and Benefits directly if you would like to make a change in your plan, or, beginning Jan. 1, 2022, members who are eligible to make changes can use Benefitsolver to make these changes right online. To take advantage of this opportunity, visit the Division of Pensions and Benefits website and click on the “Access Benefitsolver” button.