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Pensions and Benefits
EXPRESS SCRIPTS-MEDICARE D DISENROLLMENT LETTER
TO RETIREES ENROLLED IN THE STATE HEALTH BENEFITS PROGRAM or SCHOOL EMPLOYEES' HEALTH BENEFITS PROGRAM

If you are a retiree enrolled in the State Health Benefits Program (SHBP) or School Employees' Health Benefits Program (SEHBP) and received a letter from Express Scripts stating that you are to be disenrolled from their Medicare Part D prescription drug program as of January 1, 2013,; this occurred because the Division of Pensions and Benefits and Express Scripts were notified by the federal Center for Medicare & Medicaid Services (CMS) that you are enrolled in another Medicare Part D prescription drug program. 

In order to maintain your Express Scripts prescription drug coverage through the SHBP/SEHBP, you must obtain and provide the Division of Pensions and Benefits with a letter from CMS showing your disenrollment from the other Medicare Part D prescription drug plan and the effective date of disenrollment. 

To obtain the disenrollment letter regarding other Medicare Part D coverage, contact the Social Security Administration at 1-800-772-1213.  Once you have proof of disenrollment the letter can be faxed — along with a cover letter with your name and last four digits of your social security number — to the Division of Pensions and Benefits at (609) 341-3407.

Once the Division receives your letter, we will begin the process to reinstate your Express Scripts Medicare Part D coverage through the SHBP/SEHBP. 

 
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