Are there any changes to those who have NJ Direct or Cigna health insurance?

No, the only change is to those with SHBP Aetna Retiree health insurance.

How is the plan changing?

Effective January 1, 2009, the plan is changing from the Aetna Select HMO plan to the Aetna Medicare Open Private Fee for Service Medicare Advantage plan.

If I am not a retiree or have Medicare, does this affect me?

No, only those age 65 and older that are enrolled in Medicare and have the SHBP Aetna health benefits are affected.

If I currently have Aetna Retiree health and I am Medicare eligible, what action is required?

No action is required as the new plan provides automatic enrollment for you and your covered dependants if you are already enrolled in the Aetna HMO plan. Those eligible will automatically receive additional information from Aetna about this new plan including a summary of benefits.

What are the benefits to the new plan?

  • It provides retirees with greater national access to physicians and facilities than the Aetna HMO (Select) network.
  • Includes $0 copayments for certain preventive services
  • Includes benefits that generally meet or exceed the current Aetna HMO level of benefits
  • Provides access to any licensed provider that is eligible to receive payment from Medicare, agrees to provide covered services, has reasonable access, and agrees to the plan’s terms and conditions of participation.
  • Provides easier claims processing
  • Includes a Personal Health Record at no cost
  • Provides for a wellness coach

When does this plan take effect?

January 1, 2009.

Where can I find more information about this new plan?

Visit the State of New Jersey Division of Pensions and Benefits website or contact Aetna at 866-234-3129.

Who is eligible to participate in this plan?

Medicare-eligible SHBP retirees and their spouses/partners in most areas who are currently enrolled in SHBP Aetna’s HMO plan.

Who is Medicare eligible?

Anyone who is age 65 and older.