State Health Benefit Plan
DECISION GUIDE, SUMMARY, RATES AND INFORMATION
WHAT IF YOU DO NOT TAKE ANY ACTION?
If SHBP does not receive an election from you through the website, or by contacting SHBP Member Services, you have made a decision to take the default coverage below:
Previously Enrolled in a SHBP Commercial Plan Option: If you were enrolled in a Commercial Option, you will remain in your current Plan Option and Tier with your current Medical Claims Administrator for the next Plan Year.
Previously Enrolled in TRICARE Supplement: If you were enrolled in the TRICARE Supplement, you will remain enrolled in the TRICARE Supplement for the next Plan Year.
NOTE: If you paid a Tobacco Surcharge, it will continue to apply. If you did not pay a Tobacco Surcharge, you will not pay one if you default coverage.
ENROLLMENT FOR MEDICAL THROUGH ADP
Due to expected heavy call volume and online traffic, SHBP strongly encourages all members to:
1) confirm your access to the enrollment portal in advance of the Open Enrollment (OE) election start date, and
2) make your election early.
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).
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
FOR A LIST OF $4.00 DRUGS FROM WALMART
Publix discontinued it free medication program on June 1, 2022. All medications that are now free through the program, such as amoxicillin, lisinopril, metformin and amlodipine, would now cost $7.50 for a 90-day or 14-day supply where appropriate, with many already covered by health insurance, various news outlets reported.
STATE HEALTH BENEFIT PLAN
https://shbp.georgia.gov/ – Decision Guides and Information.
Enrollment is through the ADP Website myshbpga.adp.com
PROVIDERS AND PLAN OPTIONS
www.anthem.com/shbp
Health Reimbursement Arrangement (HRA): Gold, Silver and Bronze
Health Maintenance Organization (HMO)
www.welcometouhc.com/shbp
High Deductible Health Plan (HDHP)
Health Maintenance Organization (HMO)
Medicare Advantage (standard and premium)
https://my.kp.org/shbp
Health Maintenance Organization (HMO) for SHBP members who live or work in the 27 county metro Atlanta service area. Included is the Prescription Plan.
WELLNESS PROVIDER: SHARECARE
Wellness benefits for participants in BCBS or UHC plans.
Wellness Incentive Credits can be earned between January 1 – November 30
How to Enroll, Earn and Use Points
PRESCRIPTION PROVIDER: CVSCAREMARK
2023 Drug List
- 2023 Georgia State Health Benefit Plan Preferred Drug List
- 2023 State Health Benefit Plan Co-payment/Co-Insurance Waiver Medication List
- 2023 Retail 90 Pharmacies in Georgia by Alphabet
PEACHCARE FOR KIDS
1-877-GA-PEACH (427-3224)
PeachCare include dental, vision and health insurance at low premiums and low co-payments.
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.
Eligibility and Income Levels
TRICARE SUPPLEMENT
Contact Tricare
Available to SHBP eligible individuals who are also eligible for TRICARE, the military health benefit program
In general, to be eligible for the TRICARE Supplement Plan Option, eligible members and their Dependents must each be under age 65, ineligible for Medicare and registered in the Defense Enrollment Eligibility Reporting System (DEERS)
No Split Option – Everyone covered under the contract must be in Tricare
DEERS Number – Members must provide a Defense Enrollment Eligibility Reporting System (DEERS) number