2015 SHBP Updates
View August 2014 newsletter with information regarding 2015 SHBP plan designs and premiums rates
What options are available to State Health Benefit Plan members in 2015?
To increase the number of vendors administering the SHBP plan design, and to expand the type of plan design options
in 2015, the following options are available to SHBP members for the 2015 Plan Year:
- Blue Cross Blue Shield of Georgia (BCBSGA) – statewide Gold, Silver, Bronze Health Reimbursement Arrangement (HRA) (exclusively), statewide Health Maintenance Organization (HMO), Medicare Advantage (standard and premium)
- UnitedHealthcare (UHC) – statewide High Deductible Health Plan (HDHP) (exclusively), statewide HMO, Medicare Advantage (standard and premium)
- Kaiser Permanente (KP) – fully-insured HMO for SHBP members who live or work in the 27 county metro Atlanta service area. Kaiser will administer the pharmacy and wellness benefits for all KP HMO participants. (Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Lamar, Meriwether, Newton, Paulding,Pickens, Pike, Rockdale, Spalding and Walton counties)
Express Scripts - Pharmacy benefits for participants in BCBS or UHC plans will continue to be administered by Express Scripts.
Healthways - Wellness benefits for participants in BCBS or UHC plans will continue to be administered by Healthways. Wellness benefits for 2015 are currently under review and will be posted when available.
SHBP ADP website
Go to www.mySHBPga.adp.com to register and set up User ID and password
You will need an email account or be required to set up an account in order to complete registration
See attached "Quick Reference Guide" for more complete instructions on registration and update procedures
You must bring your User ID and Password for the Benefits Counselor to assist you with SHBP enrollment
See attached "Member User Guide" for detailed instructions on using all features of the new ADP website
2014 Medical Plan Changes
See UPDATED Decision Guide for Plan Changes and Updates NEW!! 3-14-14
Blue Cross Blue Shield of Georgia (BCBSGA) is the new sole provider of the HRA type plan options using the BCBSGA's Open Access POS network of providers Summary of Plan
For a Provider Listing and other details: www.bcbsga.com/SHBP or 1-855-641-4862
Express Scripts will be the pharmacy provider, mail order, etc
Prescription Plan Information, Preferred Drug List
See www.express-scripts.com/GeorgiaSHBP for additional information or 1-877-841-5227
Healthways will be the new wellness provider
BeWell SHBP provides details on the Wellness incentive will increase $480 for employee and spouse
See www.bewellshbp.com or 1-888-616-6411 (after 12/15)
Wellness requirements must be started after January 1, 2014.
Base HRA Credit and 2013 earned credits will be available January 1 with roll-over from 2013 being transferred by April 2014.
Three plan designs will be offered - gold, silver, and bronze
2014 Monthly Employee Rates
Rates do not include the $80 per month surcharge for tobacco users. No spousal surcharges will apply in 2014
Medicare Advantage and Tricare plans mirror 2013 plans
PEACHCARE FOR KIDS®
PeachCare will be offered as a voluntary program to children eligible for SHBP coverage who meet the PeachCare for Kids ® requirements.
Current income eligibility requirements are 247% of the federal poverty level. See attached with 2014 poverty levels
PeachCare include dental, vision and health insurance at low premiums and low co-payments. Click here for Facts Sheet.
Employees may complete an application on-line or may call and request a paper application be mailed to them by calling PeachCare.
Employees should not drop children from the State Health Benefit Plan until they receive notice of coverage from PeachCare.
Information is available at 1-877-GA-PEACH (427-3224) and www.peachcare.org
Voluntary, member-pay-all supplemental health benefit
Available to SHBP eligible individuals who are also eligible for TRICARE, the military health benefit program
Ends when you turn 65
DEERS Number - Members must provide a Defense Enrollment Eligibility Reporting System (DEERS) number
No Split Option - Everyone covered under the contract must be in Tricare
At Age 65 SHBP will roll your coverage into the MA PPO Standard Plan with your previous health care vendor prior to Tricare Supplement if we have your Medicare Part B information. SHBP will put all family members in the Standard Plan of your previous option prior to Tricare Supplement at 100% of the premiums if SHBP does not have Medicare information.
Surviving Spouse/Adding New Born - members will have 31 days before or after a qualifying event to add a dependent (90 days for a newborn).
2014 Disease Management Program
As a State Health Benefit Plan member, if you enroll and actively participate in a Blue Cross and Blue Shield Personal Health Coaching program for asthma, diabetes or cardiac disease management (DM), you may be eligible to receive the products listed below at no cost. Please call the BCBSGa Member Services number 855.641.4862 for more details about program participation requirements.
Click here to see flyer with information on covered drugs
Mail Order or 90 Day Retail Pharmacy Drug Savings
Ordering your prescription drugs through the mail order service or from a 90 Day Retail Pharmacy can achieve savings of $40 to $160 per drug per year based upon the required co-payment.
Express Scripts mail order delivery pharmacy services
- 1. Ask your doctor to write a 90 day prescription with 1 year of refills
- 2. To fill the prescription, you may:
- Mail your prescription(s) along with the required form in the envelope provided with your Welcome Package.
- Ask your doctor to call 888.327.9791 for instructions on how to fax the prescription
- Your doctor must have your member ID number (your new SHBP member ID card) to fax your prescription
- Order through the Express Scripts website after registering at Express-Scripts.com.
Participating 90-day retail pharmacy
- More than 60,000 retail pharmacies in the 90-day retail network.
- Visit Express-Scripts.com/GeorgiaSHBP and click “Locate a pharmacy.”
- 90-day retail pharmacy have the following statement “Dispenses a maintenance supply: YES”.
- Locate participating pharmacies on the Express Scripts mobile app or call Express Scripts at 877.841.5227.
Generic Drug Savings Information
Many brand name drugs are coming off of patent protection and generic drugs at significant savings are available. The two links below provide information on the generic availability and potential savings.
Listing of Brand Name Drugs with new Generic Drug Availability
Discount Drug Lists
You may be able to save on prescription drugs without using your medical card by using the generic drug lists published below. In some cases, these drug prices are lower than the Medical Plan rates. SHOP and COMPARE!
Click here for a list of $4.00 drugs from Walmart
Click here for a list of $4.00 drugs from Kroger
Click here for Publix Pharmacy Information including some free drugs
Click here for Target Pharmacy list of $4.00 drugs