Court Decision On OPTUMRx Selection by State-

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On May 11, 2018 the NJ Superior Court, Appellate Division, ruled in favor of Express Scripts who had filed an appeal of the SEHBP/SHBP award for the Prescription Benefit Management (PBM) to OPTUMRx on June 29, 2017 – effective January 1, 2018. This award was made after a reverse auction was completed and the cost savings analysis was presented to both State Health Commissions.

The court had awarded a stay on December 21, 2107 based on the merits of Express Scripts filing, but permitted the changeover in consideration of the disruption that halting the change would cause to the members at that late date.

The Courts May 11th decision has now forced the state to rebid the contract as expeditiously as possible.


For now, if you are in the State plan as an active member or retiree, and your Rx plan is through OPTUMRx, there will be no change.  We will keep you up to date as this process progresses.