On Wednesday, November 12, the State Health Benefits Commission (SHBC) held its regularly scheduled November meeting and heard presentations from Horizon, Optum, and HMS, the third-party administrator.
Optum presented information on new formulary changes on various prescription drugs; however, the presentation was not publicly available.
HMS, the third-party administrator, presented information concerning claims oversight and pre-claim and post-claim payments. They reported that they have identified a 70% savings to the State through payment analytics and claims review. Their report was not publicly available.
Horizon presented information concerning cost drivers for the plan for both State and Local Governments; however, their presentation was not available to the public.
The Division of Pension and Benefits reported an additional open enrollment after March 2026, but did not provide an exact date. The Division reported approximately 2,500 employees have made changes to their plans so far, but not all the data has been received and calculated. Additionally, Division staff stated that an additional 73 municipalities have left the State Health Benefits Plan to date.
The SHBC announced the 2026 meeting schedule, but it has yet to be released.
Contact: Erin Knoedler, Legislative Analyst, eknoedler@njlm.org, 609-695-3481, x116.