1 *Retirees not enrolled in Medicare 13 State Health Benefit Plan esentation for Active and *R
Dec 23, 2015
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*Retirees not enrolled in Medicare
2013 State Health Benefit Plan Presentation for Active and *Retirees
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MissionThe Georgia Department of Community HealthWe will provide access to affordable, quality health care
to Georgians through effective planning, purchasing and oversight.
We are dedicated to A Healthy Georgia.
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2013 Open Enrollment (OE) Retiree Option Change Period (ROCP)
• 2013 OE/ROCP Dates• 2013 Options• Benefit Changes for the HRA, HMO and HDHP
Plans• 2013 Wellness Promise• SHBP Going Green• How to Make your 2013 Election
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Making Your 2013 Benefit Election
• Online Election - Members must make their health election at
www.myshbp.ga.gov
• Website Open & Close Dates– Website opens at 4 a.m. on October 9, 2012– Website closes at 4:30 p.m. on November 9, 2012
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2013 Open Enrollment (OE)Retiree Option Change Period (ROCP)
• You may go online as many times as you like
but the last election confirmed at the time OE/ROCP closes will be your election for the 2013 Plan Year
• You should print and keep a copy of the confirmation page which will contain a confirmation number - once OE/ROCP is closed, you will be able to go online at www.myshbp.ga.gov and view your 2013 election
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2013 Benefit Options(non-MA Plans)
Cigna and UnitedHealthcare will again offer members a choice of either a Standard or Wellness Plan option:
• Health Reimbursement Arrangement (HRA)• Health Maintenance Organization (HMO)• High Deductible Health Plan (HDHP)
TRICARE Supplement is also available if you are enrolled in TRICARE.
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2013 Benefit and Plan Changes(overview)
• Elimination of the Spousal Surcharge • Increase in deductibles and co-insurance for the HRA,
HDHP and HMO Standard and Wellness Plans• Increase in co-payments under the HMO Standard Plans-
PCP & Urgent Care- $55; Specialist - $65 • Change in HRA credits in the Standard Plan• Increase in premiums for most plan options and tiers• Elimination of $125.00 HRA credit for annual physical and
health assessment
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Plan Changes: Spousal Subsidy Policy
Policy Change - Move members to paying approximately 30%of the cost of covering a spouse and eliminate spousal surcharge
• Currently, the rate at which spouses are subsidized varies substantially based on plan and tier selection and whether the member is subject to the spousal surcharge
• Eliminates the spousal surcharge• Applies to all plans except Medicare Advantage
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Plan Changes: Childhood Obesity Initiative
For children, ages 3 – 18• Coverage for 4 in-network primary care doctor visits
with diagnosis of obesity• Coverage for up to 4 visits with a in-network registered
dietician as determined by their physician
In support of the State of Georgia’s strategic goals and the Governor’s Office, State Health Benefit Plan will now expand coverage to include:
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Affordable Care Act
In 2013, there is an expansion of women's preventive care coverage.
Go to http://www.healthcare.gov for a complete list.
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2013 Wellness Promise
• Members re-electing a Wellness Plan must complete two (2) health actions(those that met their 2012 Wellness Promise)
• All members and spouses (if covered) must complete an online SHBP Member Education module at www.AHealthierSHBP.com between January 1, 2013 and 4:30pm on May 31, 2013
• Members and spouses (if covered) must also complete an online health assessment between January 1, 2013 and 4:30pm on May 31, 2013Note: If you did not keep your 2012 Wellness Promise you will not be offered a Wellness Plan for 2013 .
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2013 Wellness Promise
Members new to a Wellness Plan must complete three (3) health actions:
• All members and spouse( if covered) must complete an online SHBP Member Education module between January 1, 2013 and 4:30pm on May 31, 2013
• Members and spouses (if covered) must complete an online health assessment between January 1, 2013 and 4:30pm on May 31, 2013
• Members and spouses (if covered) must obtain their biometric screenings between July 1, 2012 and May 31, 2013 and have their physician fax a completed Screening Form between November 1, 2012 and 4:30pm on May 31, 2013
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All members and spouses (if covered) enrolled in a 2013 Standard Plan or enrolled in a Wellness Plan option for the first time will each be eligible to earn a $240 HRA incentive fund contribution for 2014 if they complete all of the three actions listed below. Second year Wellness Plan members and spouses (if covered) need to only complete the first two actions number one (1) and two (2) to earn a $240 HRA incentive fund contribution.
1. Complete health education module through the new SHBP Member Education Portal at www.AHealthierSHBP.com between January 1, 2013, and 4:30pm on May 31, 2013
2. Complete vendor’s online Health Assessment through www.mycigna.com or www.myuhc.com between January 1, 2012 and 4:30pm on May 31, 2013
3. Complete a biometric screening (including body mass index (BMI), blood pressure, cholesterol, and glucose) between July 1, 2012 and May 31, 2013 and have their physician fax the Screening Form office between November 1, 2012, and 4:30pm on May 31, 2013
HRA Incentives
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Going Green-Important Information
• Active employees go on-line to make your elections• Retirees - Last year for paper materials• April 2013 – SHBP will mail out Postcards for those
who still need to receive paper forms • All materials are available on line in late September
2013 at www.myshbp.ga.gov
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Making Your 2013 Election
• Active Employees: Online at website www.myshbp.ga.gov• Retirees: Online at website www.myshbp.ga.gov
Complete Personalized Change Form (PCF) only if youdo not have access to a computer
The PCF form is included in the 2013 Retiree Packet
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Questions or Additional Information
• Cigna - HMO, HRA, HDHP - 800-633-8519www.mycigna.com/shbp
• UnitedHealthcare – HRA, HMO & HDHP 877-246-4189 or 800-396-6515
www.welcometouhc.com/shbp• Refer to www.myshbp.ga.gov for additional information • TDD – Cigna 800-576-1314 • TDD UnitedHealthcare – 800-255-0056 / TTY 711
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Important Notice
• The information provided in this presentation is a summary of changes for the 2013 Plan Year. It is intended only to highlight principle benefits
• Please refer to the Active members or Retiree Decision Guide for more details
• Rates, decision guides and other information will be available at www.dch.georgia.gov/shbp and www.myshbp.ga.gov by October 1, 2012
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• Cigna has helped SHBP lower it’s healthcare spending
Why Cigna? Make your paycheck go farther by choosing the Cigna Wellness Plans for 2013
18Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna
What does this mean for YOU?
when you choose any Cigna plan
in 2013
SAVE $84
• So SHBP has lowered its Cigna premiums
Every SHBP employee or early retiree choosing Cigna for 2013 will pay $7 less per month, that’s $84 less from your paychecks in 2013
Switch to Cigna for 2013:• Same copays, coinsurance, deductibles, benefits, out-of pocket-maximums as United
• Broad access to doctors and hospitals
Georgia network has over 18,000 doctors and 153 hospitals
Our national network has over 650,000 doctors and 5,600 health care facilities
• The difference is that Cigna plans can save you money
Switch from a Standard HRA Plan to Cigna’s Wellness HRA Plan and:
Family Coverage
• If you have unused dollars in your United Healthcare HRA the money will transfer to your Cigna HRA
• Save an additional $164 in premiums by switching from the Standard Plan to the Wellness Plan
• Save $84 in premiums annually• Save up to $500 in annual out-of-pocket costs
• Get $1,500 added into your HRA fund instead of the $500 if you were in the Standard HRA
• Save $84 in premiums annually
• Save an additional $120 in premiums by moving from the Standard Plan to the Wellness Plan
• Save up to $500 in annual out-of-pocket costs by choosing the Wellness Plan
Switch from a Standard HMO Plan to Cigna’s Open Access Plus In-Network (HMO) Plan and:
Single Coverage
• Save $20 on copays by choosing the Wellness Plan
Primary care $55 to $35
Specialist $65 to $45
Ready to switch – and put more money in your pocket?
Call us at 800.633.8519
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Access to the care you need with our large Georgia and national network of doctors, hospitals and pharmacies.
We want to help you meet all of your health care needs by providing integrated and dedicated wellness, clinical, behavioral and pharmacy support.
Now is the time to live well
with UnitedHealthcare
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
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Now is the time to live well
with UnitedHealthcare24/7 Support • Access to the myNurselinesm support program• Exclusive member website: myuhc.com®
– See your plan details and view your current claims and claims history
– Find a network doctor or participating retail pharmacy near you – Telephonic & online coaching programs – Health and Wellness Library – Tools and resources, including the myHealthcare Cost Estimator,
Personal Health Record, price a medication and additional pharmacy resources
Smartphone and tablet users — your family’s health, in your hands: UnitedHealthcare Health4Mesm app
Get in the Game!Play the Benefits Bootcamp game and learn about your benefits, tools and resources and earn chances to win valuable prizes such a Samsung Galaxy Tab 2. Get started at:welcometouhc.com/shbp
96.6% member satisfaction rate*
* Based off 2012 member customer service survey
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State Health Benefit Plan
Thank you