The NJ State and School Health Plan Changes

Beginning January 1, 2019, some of the supplemental coverage options within SHBP and SEHBP are being replaced.  While coverage is alleged to be similar, there are differences that could affect your insurance coverage details.  Some of these details, like pre-certifications and authorizations, can have a significant impact on the care you receive and from whom.  Therefore, it is important to understand the changes and the choices you have – because you DO have options until November 30th, 2018



Horizon NJ Direct 10 and Horizon NJ Direct 15 Medicare supplemental plans will be removed and replaced.  If you have Horizon NJ Direct 10 as your Medicare supplemental plan, you will automatically be transferred to the Aetna Medicare 10.  If you are presently enrolled in Horizon NJ Direct 15, you will automatically be transferred to Aetna Medicare 15.  However, there are four Aetna Medicare Advantage and five Horizon BCBS Medicare replacement plans available. 



If you are enrolled in a plan that is being eliminated and are not happy with the plan you will be transferred to, you can choose another plan!  However, you must submit for the change by November 30th, 2018.  To do so, you need to complete an Enrollment/Change Form and return it to the NJ Division of Pensions and Benefits. You can download the form from the NJ Division of Pensions and Benefits website at


If you are in a plan other than Horizon NJ Direct 10 and Horizon NJ Direct 15 and do not want to change plans, you do not have to do anything.  For more information and relevant contacts, visit


Contributed by APE Marketing

November 26, 2018


*Disclaimer:  This article should not be used in place of legal or medical advice.  

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