Medical Insurance

2014 Medical Insurance

Click here to see a copy of the Points of Contact presentation on 9/26/13

2014 Disease Management Program Update

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

New 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              

Medical Changes Video

 

2014 Medical Plan Changes

NEW!!!  February 20, 2014 Update on recent changes to SHBP Medical Plans. Click here.

See FAQ's provide by SHBP discussing 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

See attached Plan Summary and Employee Contribution comparison

Enroller SHBP Waiver Form

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

Tricare Supplement

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.

Eligibility Changes

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).

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

           Ask your doctor to write a 90 day prescription with 1 year of refills

           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

Savings available by using Generic Drugs Versus Brand Name Drugs

Discount Drug Lists

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

Enroller Waiver Form