Letters Regarding Facility No Longer Accepting Aetna Medicare Adavantage Plans

Some retirees have received letters from their healthcare providers and/or healthcare facilities stating they are no longer accepting The Aetna MA plan effective July 1, 2024 due to contract negotiations. If your healtcare provider and/or healthcare facility has not renegotiated with Aetna, you can switch your plan to the Horizon BCBS NJ Direct plan. This can be done through your Benefitsolver account and BOTH the Medicare eligible retiree or spouse will need to be enrolled in the same health plan. Meaning the person who is 65 is enrolled in the MA plan and the retiree or spouse not yet 65 is enrolled in the non-MA plan until they turn 65.

Some have received letters from their healthcare providers and/or healthcare facility that they have renegotiated and will BE accepting the plan. If that is the case for you, no action is needed on your part.

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Split Insurance/Retirees or Spouse Turning 65

Many of you have received letters letters from Pensions and Benefits regarding health insurance programs no longer being split once the retiree or spouse turns 65. What this means is, if you are both presently enrolled in an Aetna non Medicare program, once the retiree or spouse turns 65 (whoever is first), the person turning 65 will be enrolled in the Aetna Medicare Advantage plan and the other (not yet 65), will be enrolled in a non Medicare Aetna plan.

If you are enrolled in the Horizon NJ Direct plan and wish to stay with Horizon upon turning 65, both the person turning 65 and spouse, need to enroll in the Horizon plan through your Benefitsolver account. The State is now allowing the retiree to choose which plan they prefer.

You can compare both programs before enrolling, but you must select a plan prior to turning 65. Plan comparisons can be found here: https://www.nj.gov/treasury/pensions/documents/hb/oe2024/hr0898.pdf

Please note: If you are enrolled in a plan with a $15 co-pay, and decide to switch from Aetna to NJ Horizon BC/BS of NJ Direct, or vice versa, please select the NJ Direct 15/25 plan or corresponding Aetna plan. The 10 plan is for those folks that have a $10 co-pay. You cannot go from a $15 co-pay to a $10 co-pay.

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Questions?

Feel free to reach out to me at any time at 609-649-3221 or bjones@ftanjsp.org.

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Info for Change of Address and Beneficiary

Pension Information for Retirees

https://www.nj.gov/treasury/pensions/pension-retirees.shtml

 

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Pension & Benefits Contact Info and Hours

Contact Information

Mailing AddressP.O. Box 295
Trenton, NJ 08625-0295

Call Center

609-292-7524

7:00 a.m. – 4:30 p.m. Monday through Friday (except State holidays).

If you require the services of a relay operator, please dial 711 and provide the operator with the following phone number: 609-292-6683. You will then be connected to a Client Services phone representative for assistance.

Email

Send your Questions by email

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FACT SHEETS

You can find info on many subjects through the list of Fact Sheets found here:

https://www.nj.gov/treasury/pensions/fact-sheets.shtml

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Information regarding Reimbursement of Medicare Parts A, B and D

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

Due to the Windfall Act, some retirees are required to pay a higher premium for Medicare Parts B and D due to higher income limits. For those who are required to pay more than the standard monthly premium, you are to pay these premiums directly to Socoal Security. The State reimburses MONTHLY in your pension check, the standard monthly premium (2024 $174.70), for both you and your spouse (if applicable). Additional premiums paid are reimbursed by the State ANNUALLY. At the beginning of the following year, the State notifies retirees of the process to be reimbursed for any ADDITIONAL premiums paid above the standard monthly amount. The process is completed through your Benefitsolver account.

Please note: Once the retiree passes, the Medicare premium is NO longer reimbursed to the surviving spouse.

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State Police Group Life Insurance Benefit

Group life insurance benefits are reduced for most members. The amount of group life insurance available to your beneficiaries is shown on your Quotation of Retirement Benefits, sent to you when you first retired. See your plan Guidebook for details.

SPRS Certificate of Group Life Insurance 

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Reminder for Retirees Turning 65

Approximately 3 months before the retiree turns, 65, you must enroll in Medicare Parts A and B. The State will automatically enroll you in Medicare Part D, (prescription, also administered by OptumRx). 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, please upload to your Benefitsolver account. It will guide you through the enrollment process.

Enrollment in Medicare can be done online, as in person appointments can take weeks to get, therefore creating the possibility of not being enrolled prior to turning 65.  Please be sure to enroll on the OFFICIAL Social Security website (FREE) and not a third party website., (who will try to charge you and enroll in products not needed).  The website is:

https://www.ssa.gov/

Enrolling through a third party website, or enrolling in other programs can jeopardize your health benefits through the State.

If you need additional assistance or information, please contact me at 609-649-3221 or bjones@ftanjsp.org.


© Former Troopers Association
http://www.ftanjsp.org

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NEW Aetna Medicare Advantage Plan Info

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.

*Not all State retirees will be eligible for Aetna Medicare Advantage PPO ESA 10

Spouse or Partner with Different Medicare Eligibility than the Member

Medicare-eligible retirees enrolled in a non-Medicare Advantage plan and 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 non-Medicare-Advantage plan. Similarly, retirees who are not eligible for Medicare but have a spouse or partner who is Medicare eligible will remain in their non-Medicare-Advantage plan (along with any covered children) while the spouse/partner is transferred to the Aetna MA plan.

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