This week, Rob Nixon, Director of Government Affairs and I met with Executives from Horizon to discuss the implementation of the Medicare advantage program. We were once again assured that there will be no modification to current coverage under this new model.

Horizon also has stated that they will be holding over 200 instructional sessions on the new process throughout the State.

Please also note that there is no modification to current prescription plans. They will be status quo.

Please keep check on this web site and PBA outlets for more information.

View Additional Information Here

Post Retirement Employment Restrictions:

The New Jersey State PBA has received the latest fact sheet regarding post retirement employment restrictions.  Fact sheet 86 (August 2015) does a good job informing our members of the many restrictions that pertain to post retirement employment.    The pension benefits that our members receive are governed by New Jersey Statutes as well as the Internal Revenue Code.  Our pensions are considered a qualified governmental defined benefit plan in accordance with Internal Revenue Code sections 401(a) and 414(d).  In order for the State of New Jersey to keep the qualified status and to protect retirees from a 10% early distribution tax penalty on monthly pensions, the Division of Pensions was required to adopt and enforce the regulations and compliance with the IRC requirements.

The Fact Sheet has confirmed what we have been advising our members;  if you return to work with the same employer in any capacity, the member would need to have a bona fide separation of service of 180 days. The Division of Pensions has done a good job explaining and using examples of what members of the pension system can and can not do. They also clearly inform our members of the penalties that we are subject to should our members violate the IRC/Pension restrictions.

This is the most frequently asked question we get at the NJSPBA office, so take a few moments to familiarize yourself with this fact sheet.  As always, if you have questions regarding this fact sheet please call or email me at the New Jersey State PBA Office.

Peter Andreyev
NJSPBA Pension Consultant

Click Here for Fact Sheet #86

On Friday, March 20th, the State Health Benefits Design Committee unanimously voted for a solution that finalized the Superior Court decision that unilaterally indexed retiree prescription copays in the years 2013, 2014 and 2015.

The committee was presented with three possible solutions to rectify the overpayment of copays in the aforementioned years. Unfortunately, the monumental task of calculating payments to members would have resulted in another year of delay in payments to our retirees and due to medicare regulations some members would have actually owed money to the federal government. This solution allows for compensation in that copays will be reduced or eliminated depending on the classification of the drug and the type of in which the member is enrolled for the period from July 1, 2015 through December 31, 2015 and will return to 2012 rates as a baseline for negotiating new plans for 2016.

The decision in superior court was a landmark decision, in that it gives the committee the authority on all levels to negotiate plans going forward which is especially important in this era of escalating costs in the health care realm. The committee, both labor and management have made a commitment to work together to create plans that provide better health care for both our retirees and active enrollees.

The terms of the retirees are as follows for the rest of 2015 are as follows:

For the period from now to June 30, 2015, copays will remain as they are currently.

For the period from July 1, 2015 through December 31, 2105 copays for $10 and $15 copay plans will be, see graphic.

The maximum out of pocket will be $1,351 per person which is the 2012 rate will apply for 2015.

Please notify your retired members of these pending changes.

Kevin C. Lyons Sr.