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SHBP UPDATE. Presentation to : GASBO Attendees Presented by : Bill Tierney, Employer Services Manager. Date : November 2013 . Mission The Georgia Department of Community Health
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SHBP UPDATE Presentation to: GASBO Attendees Presented by: Bill Tierney, Employer Services Manager Date: November 2013
Mission The Georgia Department of Community Health We will provide Georgians with access to affordable, quality health care through effective planning, purchasing and oversight. We are dedicated to A Healthy Georgia.
Discussion Items • 2014 Options • Benefit Changes for the 2014 Plan Year • 2014 Wellness Incentives • Transition of Care • Affordable Care Act • Open Enrollment-Where are we? • Q&As
New Plan Vendors • Blue Cross and Blue Shield of Georgia is the TPA Plan Administrator beginning January 1, 2014, which includes Medical Management for all SHBP Plans • Express Scripts is our new Pharmacy Benefit Manager (PBM) beginning January 1, 2014 • Healthways is our new Wellness vendor beginning January 1, 2014
New Plan Vendors • Blue Cross and Blue Shield of GA, Express Scripts and Healthways will all be working closely together on an ongoing basis • Each covered family member will receive their own ID card which will be valid for all three of our vendors • United Healthcare and CIGNA will no longer be offered as their contracts end December 31, 2013
2014 Plan Options • Members will choose from three levels of benefit coverage: • Gold HRA • Silver HRA • Bronze HRA • The above plans are HRA plans. The HMO and HDHP plans have been eliminated • TRICARE Supplement will also be available
Employee Rates: Impact to SHBP Members Three new plan options that impact SHBP members; actuarially determined member rates: • If selecting the Bronze plan – reduced premiums • If 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
The Benefits of an HRA • Your HRA is funded by SHBP and any unused funds roll over for future health expenses • HRA dollars can assist you in paying health expenses that go towards your deductible • Initial HRA dollars vary depending on the option/tier chosen • Any remaining HRA dollars from previous years will rollover in March 2014
HRA Incentives • 2014 Wellness incentives – increases up to a maximum of $480 for member; plus up to an additional $480 for covered spouse, combined maximum of $960 • Additionally, for those members/spouses who completed their wellness requirements in 2013, the $240 will be credited to their HRA on January 1, 2014
Transition of Care • If a Member is currently receiving or anticipates the need to continue certain covered services and/or medical treatments beyond 2013, and the provider is not participating in the BCBSGa provider network he/she may request transition of care services. Transition of care services allows a member to continue to obtain certain ongoing services and/or treatments from his/her out-of-network provider for an approved period of time • The member will need to contact BCBSGa customer service no later than December 31, 2013, to obtain specific instructions for requesting transition of care services.
Affordable Care Act • Anyone enrolled in SHBP coverage will meet the Affordable Care Act’s (ACA) requirements to maintain health coverage with essential benefits • Any employer that offers the SHBP will be able to meet the Act’s requirement to offer minimum value health coverage. This protects SHBP members from ACA tax Penalties
Open Enrollment-Where are We • As of 11/5/13 180,000 members have enrolled, including retirees. About another 100,000 still need to enroll • The deadline to enroll is 11/8/13 at 5pm at www.myshbpga.adp.com • Members should print a copy of their confirmation page which will contain a confirmation number • SHOEUPDT Report available around 11/15/13
Open Enrollment-Where are We • Active members who do not make an election at the ADP portal and are currently covered will default to the Bronze Plan • Retirees who do not make an election and are currently covered will default to the Bronze Plan (under 65) or keep the same Medicare Advantage Plan (over 65) • No coverage in 2013, no coverage in 2014 if there is no action taken at the ADP Portal
Questions or Additional Information Blue Cross Blue Shield-855-641-4862 www.bcbsga.com/shbp Healthways-888-616-6411 (live phone line available 12/15) www.bewellshbp.com Express Scripts-877-841-5227 www.dch.georgia.gov/shbp SHBP Eligibility-800-610-1863
State Health Benefit Plan Thank You