Welcome Spring!

Image result for spring

Looks like the warmer weather is trying to move in! Want to wish everyone a happy and healthy Easter and a wonderful Spring. I want to take a moment to thank you all for allowing me to be of service for another year. It is truly my pleasure to be able to provide assistance.

Please feel free to continue to reach out to me either by telephone: 609-649-3221 or by email: bjones@ftanjsp.org. Email is usually the fastest way to reach me, depending on where I’m flying, I may not have access to phone messages. Feel free to leave a message and I will get back to you as soon as I can. Remember, I do not have set “office hours,”

Posted in Uncategorized | Comments Off on Welcome Spring!

Don’t have an MBOS Account? Sign up NOW!

MEMBER BENEFITS ONLINE SYSTEM (MBOS) FOR RETIREES

Privacy is a big concern for all and release of information to an unauthorized party is unallowable. In order to ensure a person’s privacy is not violated, the Division of Pension and Benefits will neither release information to an unauthorized third party, nor fax any documents that contain personal information. As they have no way of knowing who is in the other end or has access to the fax machine.

Calling the Division of Pension and Benefits can be both time consuming and frustrating with wait times upwards of 30 minutes or more to speak with a representative. If you have a computer, or access to one, I cannot stress enough the convenience of setting up a Members Benefit Online System (MBOS) account online with Pensions and Benefits. Your MBOS account will allow you to see all of your information relating to health benefits coverage, beneficiary information, as well as various important information and documents relating to your pension. If you don’t have an account, why not set one up now? Most requested changes and needed documents can be changed or downloaded right from the site. To set up your account, click here for step by step instructions:
link to info

Now is a good time to make sure all of your paperwork is in order and up to date. Do your loved ones know where to locate all your important documents and information? If not, why not take the time now to get it all together and advise folks where it can be found. Is the information up to date and current? Correct beneficiaries, contacts and addresses? It’s best to correct it now, rather than to wait.

Posted in General Information, Pension Information | Leave a comment

HEALTH BENEFITS CONTRIBUTION — PERCENTAGE OF PREMIUM FOR RETIRE

Below is information for retirees who pay a portion of their health benefits coverage;

You must use the rate charts for retirees who pay the full cost of their coverage to first determine the full
cost premium for the plan and coverage level you select. Then, use this chart to determine the percentage of
the full cost for which you will be responsible.*

https://www.state.nj.us/treasury/pensions/documents/forms/hr1016.pdf

Posted in Health Benefits | Comments Off on HEALTH BENEFITS CONTRIBUTION — PERCENTAGE OF PREMIUM FOR RETIRE

Aetna Medicare Advantage Plan Info

Medicare Advantage Plans
Effective January 1, 2019, the SHBP will no longer offer Medicare Advantage (MA) plans through Horizon’s NJ DIRECT10 (PPO) or NJ DIRECT15 (PPO) plans. Retirees previously enrolled in these plans will be automatically transferred to a corresponding Aetna Medicare Advantage PPO ESA plan. No application is necessary and no other action is required by retirees. Affected members will receive correspondence directly from the plans.

Effective January 1, 2019, the SHBP will no longer offer Medicare Advantage (MA) plans through Horizon’s NJ DIRECT10 (PPO) or NJ DIRECT15 (PPO) plans. Retirees previously enrolled in these plans will be automatically transferred to a corresponding Aetna Medicare Advantage PPO ESA plan. No application is necessary and no other action is required by retirees. Affected members will receive correspondence directly from the plans.

Spouse or Partner with Different Medicare Eligibility than the Member
Retirees enrolled in one of the NJ DIRECT MA plans who have a spouse or partner who is not Medicare-eligible will move to the Aetna MA plan while the spouse/partner and/or any covered children remain in the NJ DIRECT10 or 15 plan.

Similarly, retirees who are not eligible for Medicare but have a spouse or partner who is Medicare-eligible will remain in their NJ DIRECT10 or 15 plan (along with any covered children) while the spouse/partner is transferred to the Aetna MA plan.
These rules will also be in effect for members, spouses, or partners whose Medicare effective date is 1/1/19 or after. Non-Medicare-eligible retirees enrolled in NJ DIRECT 10 or 15 will be transferred automatically to an Aetna MA plan once enrolled in Medicare Parts A and B.

Aetna Medicare Advantage Plans
Medicare Advantage plans, sometimes referred to as “Part C” or “MA plans,” provide Medicare Part A (inpatient hospital insurance) and Medicare Part B (outpatient medical insurance) coverage.

The Aetna MA plans offer access to providers nationwide, with the same benefits in or out of network, and no referrals required.

SHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Medicare Advantage PPO ESA 10;* Aetna Medicare Advantage PPO ESA 15; Aetna Medicare Advantage HMO and Aetna Medicare Advantage HMO 1525.

Aetna Medicare Advantage website: http://www.aetnastatenj.com/
Frequently Asked Questions: https://www.state.nj.us/treasury/pensions/documents/pdf/aetna-ma-faq-shbp.pdf

Posted in Uncategorized | Comments Off on Aetna Medicare Advantage Plan Info

2019 Health Benefit and Dental Rates

For more information regarding the various health plans, dental plans and 201 rates for retirees, please click here:

Information regarding 2019 rates for those who pay full cost: https://www.state.nj.us/treasury/pensions/documents/hb/oe2018/state-retired-including-rx.pdf

Information regarding 2019 health plan designs: https://www.state.nj.us/treasury/pensions/documents/hb/oe2018/hr0898.pdf

2019 Dental Rates: https://www.state.nj.us/treasury/pensions/documents/hb/oe2018/retiree-dental.pdf

Information for Retiree Dental Plans: https://www.state.nj.us/treasury/pensions/documents/factsheets/fact73.pdf

Posted in Health Benefits | Comments Off on 2019 Health Benefit and Dental Rates

Reminder for Retirees Turning 65

Approximately 3 months before the retiree turns, 65, you must enroll in Medicare.  Failure to enroll will result in the retiree being dropped from the State Health Benefits program you are enrolled in.  Once you receive your Medicare Card for A & B make a photo copy and send it certified mail to:

Division of Pensions & Benefits
P.O. Box 299
Attn: Retired Health Benefits
Trenton, NJ 08625


© Former Troopers Association
http://www.ftanjsp.org
Posted in General Information, Health Benefits | Leave a comment

Aetna Medicare Advantage for Plan Year 2019

Mike Zanyor from the STFA/NCO Associations is on the Plan Design Committee for the State Health Benefits and has been in regular contact with the FTA and me specifically as the Association Liaison regarding the changes in the Medicare Advantage plans.

Due to the volume of information he has provided me and associated attachments, I am asking you to post this information on the FTA website bulletin board in a manner that would make it user friendly to members accessing it.

Mike Zanyor took the time out to come to our open meeting on November 3rd to explain much of this information to the members in attendance and was very well received. He then attended a meeting/conference call this last week to get additional information for us retirees and ask the questions many of us had. The e-mail I am forwarding answers many of those questions.

SHBP_retiree_change

SHBP_AetnaMA_2019_Costs

SHBC_AetnaMA_SummarySheet

Medicare-StateofNJBrochure

 

Subject: Aetna Medicare Advantage for Plan Year 2019

Date: 11/15/18 09:40:41 PM

From: “Michael Zanyor” <Mzanyor@nco1921.org>

All,

I apologize in advance for the delay, but I was waiting on some clarification from Aetna and Pensions before sending this email out.  I will attempt to be as clear as possible, but if there are any questions please ask.

First, a few main points you should know:

 

  1.  Medicare Advantage (MA) Plans are also known as Medicare Part C plans and “Eggwhips” (EGWP: employer group waiver plans) – it is a generic term that describes the type of plan but not extend of coverage, different MA plans have different coverage.  This MA plan is specifically for NJ public employees.  THIS DOES NOT PERTAIN TO MEMBERS COVERED UNDER THE EDUCATORS’ PLAN (SEHBP) – THAT MA IS SLIGHTLY DIFFERENT.

 

  1.  The changeover will ONLY impact current medicare enrollees or members&spouses who become medicare eligible in 2019.  Medicare enrollment is mandatory at age 65.

 

  1.  ALL medicare covered employees will be moved from their current plan into the Aetna MA PPO Extended Service Area plan on January 1, 2019 unless they “opt-out”.

 

  1. Referrals ARE NOT needed under this plan.

 

  1.  There is no open enrollment period for any retiree (regardless of whenther medicare or non-medicare).  Instead, the following rule applies: any elective change is binding for one year from date of selection; an involutnary change can be changed at any time.  This is an important item to consider if opting out.

 

  1.  The only plans available if a member opts out of MA and instead chooses medicare and a SHBP plan are Horizon products and they are: NJ DIRECT1525, NJ DIRECT2030, Horizon HMOHorizon HMO1525Horizon HMO2030; Direct 15 is not an option.  Opt outs must be submitted before the end of December 2018.  REMEMBER THIS DECISION WILL BE BINDING FOR ONE YEAR.  However, if they are rolled over in January and don’t like the coverage, they can then ELECT to go to different plan and then be locked-in for one year from the date of the elective change.

 

  1.  In speaking to several retirees and other unions, going with MA or staying status quo is very much a personal decision that is truly case by case.

 

  1.  The selling point of the MA plan is only one card is needed and Aetna handles all the paperwork.

 

  1.  This doesn’t affect prescription coverage. OptumRx is still handling that aspect.

 

How Aetna MA works and covered services:

 

  1.  There is no in-netowrk/out-of-network issue.  If a provider accepts payment from Medicare, the plan will cover services from the provider.  HOWEVER, if the provider does not accept Medicare – even if in the Aetna network – services are not covered.  This was true even before MA was offered – you couldn’t use Direct15 if you have medicare and the provider doesn’t accept Medicare.

 

  1.  The MA plan covers some things differently from the Direct15 and Aetna Freedom Plans.  For example, the MA copay is $15 for all doctors (regular and speciality), max out of pocket (OOP) is $1000 per person, ER visit is $75, and medical transportation and hospital are fully covered.  The non MA plans have higher max OOP’s, $15 copay regular, $25 specialist, co-insurance (cost sharing) for hospitalization, medical transporation, and other items.  I’ve attached PDF’s with cost breakdowns.

 

  1.  Some hospitals and providers will say they don’t take Aetna MA even thought they take Medicare.  Per Aetna, if this happens, a member should call customer service and they will clarify it with the provider.  Sloan Kettering and Hospital For Specialized Surgery in NYC were identified by Aetna as examples that have told patients they don’t take the plan but they do since they take Medicare.  Aetna also advised if a member is billed, the member should forward it to Aetna.

 

  1.  Chriopractic visits covered under Medicare do not require a Prior Authorization (PA)-it is waived; non-medicare covered chriopractic visits are limited to 30 per year.  You may have heard or seen commercials and mailings say to not enroll in Aetna MA -some of these are sponsored by the Association of NJ Chiropractors.  I have a copy of a letter they have sent out – it is misleading propoganda.

 

  1.  Preventitive OGBYN visitis covered at 100% go from once every 12 months to once every 24 months.  Any other visits subject to $15 copay.

 

Summary:

 

I personally see no benefit of opting out – the opt-out coverage is similar and the members’ OOP is higher.

 

THERE IS NO REASON TO SWITCH TO THE MA HMO – THE MA PPO IS BETTER AND CURRENT NJSP RETIREES AREN’T SUBJECT TO PREMIUM COST SHARING.  THE PPO IS DEFAULT.

 

Since it is a forced change, I would recommend trying the new coverage starting in January and then switching if unsatisified.  If a member opts-out, he or she can’t return until a year from now.  However, I’m sure there are individual circumtances in which opting-out is prudent.

 

Finally, I have attached a comparison charts, a coverage summary sheet, a list of copays for the Aetna MA, a brochure from Aetna, and and change form for your reference.  I have also included a link to the NJ DOPB website and the Aetna NJ MA website.

 

https://www.state.nj.us/treasury/pensions/hb-retired-shbp.shtml

 

http://www.aetnastatenj.com/state/medical-retiree.php

Posted in Uncategorized | Comments Off on Aetna Medicare Advantage for Plan Year 2019

State Police Group Life Insurance Benefit

Also, were you aware that as a retiree, you have a LIFE INSURANCE BENEFIT through the State of NJ? This life insurance benefit is provided through Prudential and the benefit is equal to 50% of the last year of your salary. This benefit is payable to the individual(s) you listed at time of enrollment. For many, this was a very long time ago and the person(s) you originally listed as beneficiary may no longer be around, or your life circumstances have changed and the beneficiary should be changed. Again, if you have a MBOS account, you can see who you have listed as beneficiary, and if it needs to be changed, you can do it right online. If you do not have an MBOS account, you can download a change form from Pensions website here:
link to info

If you do not have computer access, you will need to contact Pensions and Benefits at 609-292-7524 and have them send you a form to change.

For more information regarding this benefit and the Certificate of Group Life Insurance, click here:
link to info

Posted in Uncategorized | Comments Off on State Police Group Life Insurance Benefit

Information regarding Reimbursement of Medicare Part A

Some retirees are required to pay for Medicare Part A, these costs are reimbursable. A recent retiree contacted Pensions and Benefits and was told they are not, that is NOT true. Please see NJSA: 53:SA-44.1, Introduced on February 23, 1987 and PASSED on January 19, 1988. You can view the document here:
link to info

Posted in General Information, Health Benefits | Comments Off on Information regarding Reimbursement of Medicare Part A

Post Retirement Employment Restrictions

The State revised fact Sheet #86 in August 2015 regarding Post Retirement Employment Restrictions for each retirement system. See this link:
link to info

Posted in General Information, Pension Information | Comments Off on Post Retirement Employment Restrictions