NJ SHBP-LG Mid-Year Report Confirms Continued Financial Plights

Published on April 1, 2026

On March 30th, the New Jersey Department of Treasury released Aon’s Midyear Experience Analysis Report for the State Health Benefit Program Local Government (SHBP-LG). The report reveals that the SHBP-LG continues its troubling financial position despite significant rate increases implemented on January 1, 2026. It also indicates that, following those increases, the claim stabilization reserve (CSR) was expected to improve to $340 million. However, the updated analysis suggests the SHBP-LG CSR is expecting a deficit of more than $200 million by the end of this year.

The report documents various factors for the SHBP-LG’s continued financial deterioration including but not limited to:

Trends continue to run high with the most recent 12-month period reflecting 10.7% and 21.7% increases in medical and prescription, respectively for the Actives population.
Enrollment decline in the SHBP, as groups continue to leave the state and enter into direct contracts with private carriers in favor of more affordable coverage.

The main cost drivers for the SHBP-LG Actives prescription plan comes from GLP-1 and anti-inflammatory drugs. GLP-1 drugs account for four of the top five drugs in terms of drug spend, while anti-inflammatory drugs make up three of the top 11 drugs based on drug spend.

Although the report does not implicitly forecast exact rate actions for January 1, 2027, it does imply by the negative CSR forecast, continued double digits of trends, and loss of membership a possible need for another significant high increase and/or major changes to existing plan designs.

Benecard remains actively engaged in monitoring this situation and will continue to keep you informed of any updates related to the NJ SHBP-LG. If you have questions or would like to discuss, please reach out to us at talktous@benecard.com.