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Welcome to Open Enrollment 2014. Benefits Life Dental Health PPACA. Life. Term Life Policy Date of Hire Date of Separation Can convert to Retiree Life if you retire from JCBOE. Dental. First Year Limit: Evaluation Cleaning Fluoride Treatment. $25.84 $70.94.
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Life Term Life Policy Date of Hire Date of Separation Can convert to Retiree Life if you retire from JCBOE
Dental First Year Limit: Evaluation Cleaning Fluoride Treatment $25.84 $70.94
State Health Benefit Plan (Medical)
Making Your 2014 Benefit Election Online Election - Must have email address - Members must make their health election at www.myshbpga.adp.com Website Open & Close Dates - Website opens at 12:00 a.m. on October 21, 2014 - Website closes at 5:00 p.m. on November 8, 2014
2014 Open Enrollment Members may go online as many times as they like but the last election confirmed at the time OE closes will be the election for the 2014 Plan Year Members should print and keep a copy of the confirmation page which will contain a confirmation number - once OE is closed, members will be able to go online at www.myshbp.ga.gov and view their 2014 election
2014 Open Enrollment Members who do not make open enrollment election are defaulted to Bronze plan (w/tobacco if in 2013) Members who wish to discontinue in 2014 must go online and elect no coverage or will be defaulted to Bronze plan Members with no coverage in 2013 will be defaulted to no coverage in 2014
New Plan Vendors • Blue Cross and Blue Shield of Georgia (BCBSGA) will be the Health Plan administrator • Express Scripts will be the Pharmacy Benefit administrator • Healthways will be the Wellness administrator
2014 Benefit and Plan Changes • Elimination of HDHP and HMO Plans • Elimination of Standard and Wellness options • Change in HRA Wellness Incentive awards • Increase in some premiums, decrease in some premiums • New-year round online ADP system
2014 Benefit Option • BCBSGA will offer a Health Reimbursement Arrangement (HRA) with three levels of coverage • Gold • Silver • Bronze • TRICARE Supplement is also available if member is enrolled in TRICARE.
HRA PLAN • No copays • HRA credits pay the first billed claims • HRA credits apply against deductible and out-of-pocket limits • Doctors can ask for payment if deductible has not be met
HRA Credit Rollover • Unused HRA credits rollover and ADD to plan year beginning credits • Former HMO plans have no rollover • Rollover credits are available in March 2014 Claim run out period • 2013 Wellness Incentives available on January 1, 2014
2014 Wellness Incentive Members, and covered spouse, have two options, must complete in 2014 and receive within 30 days: Earn $240.00 Complete an online Healthways Well-being Assessment Complete biometric screening Earn up to $240.00Telephonic pathway coaching - $240.00 Online pathway coaching - $40.00 each * Worksite Biometric screening will begin in February 2013 (Includes: body mass index, blood pressure, cholesterol & glucose)
Pharmacy Benefits • Benefits are paid not subject to deductible • HRA credits can pay for prescription drugs • HRA credits must be used if you file a claim • Retailer drug programs can be used without filing a claim * 90 day mail order prescription drug plan remains
Pharmacy Benefits * 90 day mail order prescription drug plan remains
JCBOE Contribution • Certified employees$945.00 = $11,340.00 • Classified employees$633.00 = $7,596.00 • Classified employeesare eligible in 2014
Affordable Care Act • SHBP meets the minimum essential coverage mandate • SHBP meets the affordability mandate • Health Insurance Marketplace Notice contains information for inquiry • Individual mandate current law
PeachCare for Kids Enroll in PeachCare for Kids www.Peachcare.org Call 1-877-427-3224
Can I choose HMO or HDHPNo. HRA plan only, three levels of coverage Can I choose CIGNA & UHCNo. Blue Cross/Blue Shield only
Why only one vendorSHBP is able to increase negotiating effectiveness, achieve administrative effectiveness, and provide high-quality health care at competitive prices
Will I need to change doctorsApproximately 97% of in-network covered CIGNA and UnitedHealth Care providers are in-network covered BCBSGA providers. Any member or covered dependent currently receiving care from a provider that is out-of-network with BCBSGA, which will not end in 2013, may request transition of care from BCBSGA. Transition of care allows one to continue to obtain certain services from out-of-network providers for an approved period.The member must call BCBSGA directly at 855-641-4862 no later than December 31, 2013 to request transition of care.
Will premiums increaseIf selecting the Bronze plan– reduced premiumsIf selecting the Silver plan:• HMO members – reduced premiums • HDHP members – increased premiums in all but one tier • HRA members – reduced premiums in some tiers; higher premiums in other tiers If selecting the Gold plan – increased premiums
Questions or Additional Information Blue Cross/Blue Shield – 855-641-4862 www.bcbsga.com/shbp Healthways – 888-616-6411 (12/15/13) www.bewellshbp.com Express Scripts – 877-841-5227 www.dch.georgia.gov/shbp SHBP – 800-610-1863
Information is on Personnel/Payroll webpage at:http://jasperga.schooldesk.net/Departments/PersonnelPayroll/tabid/14081/Default.aspx
Important Notice The information provided in this presentation is a summary of changes for the 2014 Plan Year. It is intended only to highlight principle benefits Please refer to the Active members Decision Guide for more details Rates, decision guides and other information is available at www.dch.georgia.gov/shbp