Governor Chris Christie • Lt.Governor Kim Guadagno  
The Official Web Site For The State of New Jersey - Department of Treasury
Global Navigation
FAQs Departments/ Agencies Services A to Z NJ Home Page
Disclaimer
Twitter YouTube Facebook
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. 

 
spacer

Pensions and Benefits: Home | Employer Manual | Health Benefits | Forms and Publications | Counseling Appointments
Treasury: Home | ServicesPeopleBusinesses | Divisions/AgenciesFormsContact Us
Statewide:
NJ Home | Services A to Z | Departments/Agencies | FAQs
Copyright © State of New Jersey, 1996 -
This site is maintained by the Division of Pensions and Benefits.
 

Reports Accessibility Statement Legal Statement Privacy Notice Contact Us Open Public Records Act Proposed Rules and Amendments Comment or Petition for new Rule Division/Ageny Statutes and Rules Electronic Notification Twitter YouTube Facebook