welcome to open enrollment 2014. benefits life dental health ppaca
TRANSCRIPT
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Welcome toOpen
Enrollment2014
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Benefits
LifeDentalHealthPPACA
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Term Life Policy
Date of HireDate of Separation
Can convert to Retiree Lifeif you retire from JCBOE
Life
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$25.84$70.94
First Year Limit:
EvaluationCleaningFluoride Treatment
Dental
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State Health Benefit Plan(Medical)
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Making Your 2014 Benefit Election
• Online Election - Must have email address - Members must make their health election at
www.myshbpga.adp.com
• Website Open & Close Dates- Website opens at 12:00 a.m. on October 21,
2014- Website closes at 5:00 p.m. on November 8,
2014
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2014 Open Enrollment
• Members may go online as many times as they like but the last election confirmed at the time OE closes will be the election for the 2014 Plan Year
• Members should print and keep a copy of the confirmation page which will contain a confirmation number - once OE is closed, members will be able to go online at www.myshbp.ga.gov and view their 2014 election
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2014 Open Enrollment
• Members who do not make open enrollment election are defaulted to Bronze plan (w/tobacco if in 2013)
• Members who wish to discontinue in 2014 must go online and elect no coverage or will be defaulted to Bronze plan
• Members with no coverage in 2013 will be defaulted to no coverage in 2014
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New Plan Vendors
• Blue Cross and Blue Shield of Georgia (BCBSGA) will be the Health Plan administrator
• Express Scripts will be the Pharmacy Benefit administrator
• Healthways will be the Wellness administrator
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• Elimination of HDHP and HMO Plans
• Elimination of Standard and Wellness options
• Change in HRA Wellness Incentive awards
• Increase in some premiums, decrease in some premiums
• New-year round online ADP system
2014 Benefit and Plan Changes
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2014 Benefit Option
• BCBSGA will offer a Health Reimbursement Arrangement (HRA) with three levels of coverage
• Gold• Silver• Bronze
• TRICARE Supplement is also available if member is enrolled in TRICARE.
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HRA PLAN
• No copays
• HRA credits pay the first billed claims
• HRA credits apply against deductible and out-of-pocket limits
• Doctors can ask for payment if deductible has not be met
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HRA Credit Rollover
• Unused HRA credits rollover and ADD to plan year beginning credits
• Former HMO plans have no rollover
• Rollover credits are available in March 2014 Claim run out period
• 2013 Wellness Incentives available on January 1, 2014
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2014 Wellness Incentive
Members, and covered spouse, have two options, must complete in 2014 and receive within 30 days:
Earn $240.00Complete an online Healthways Well-being AssessmentComplete biometric screening
Earn up to $240.00Telephonic pathway coaching - $240.00Online pathway coaching - $40.00 each* Worksite Biometric screening will begin in February 2013
(Includes: body mass index, blood pressure, cholesterol & glucose)
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$80.00 Tobacco Surcharge not included
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$80.00 Tobacco Surcharge not included
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Pharmacy Benefits
• Benefits are paid not subject to deductible
• HRA credits can pay for prescription drugs
• HRA credits must be used if you file a claim
• Retailer drug programs can be used without filing a claim* 90 day mail order prescription drug plan remains
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Pharmacy Benefits
* 90 day mail order prescription drug plan remains
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JCBOE Contribution
• Certified employees$945.00 = $11,340.00
• Classified employees$633.00 = $7,596.00
• Classified employeesare eligible in 2014
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Affordable Care Act
• SHBP meets the minimum essential coverage mandate
• SHBP meets the affordability mandate
• Health Insurance Marketplace Notice contains information for inquiry
• Individual mandate current law
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PeachCare for Kids
Enroll in PeachCare for Kids
www.Peachcare.orgCall 1-877-427-3224
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Frequently
AskedQuestions
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Can I choose CIGNA & UHC
No. Blue Cross/Blue Shield only
Can I choose HMO or HDHP
No. HRA plan only, three levels of coverage
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Why only one vendor
SHBP is able to increase negotiating effectiveness, achieve administrative effectiveness, and provide high-quality health care at competitive prices
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Will I need to change doctors
Approximately 97% of in-network covered CIGNA and UnitedHealth Care providers are in-network covered BCBSGA providers.
Any member or covered dependent currently receiving care from a provider that is out-of-network with BCBSGA, which will not end in 2013, may request transition of care from BCBSGA. Transition of care allows one to continue to obtain certain services from out-of-network providers for an approved period.
The member must call BCBSGA directly at 855-641-4862 no later than December 31, 2013 to request transition of care.
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Will premiums increase
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
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Questions
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Questions or Additional Information
• Blue Cross/Blue Shield – 855-641-4862
www.bcbsga.com/shbp• Healthways – 888-616-6411 (12/15/13)
www.bewellshbp.com• Express Scripts – 877-841-5227
www.dch.georgia.gov/shbp• SHBP – 800-610-1863
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Information is on Personnel/Payroll webpage at:
http://jasperga.schooldesk.net/Departments/PersonnelPayroll/tabid/14081/
Default.aspx
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Important Notice
• The information provided in this presentation is a summary of changes for the 2014 Plan Year. It is intended only to highlight principle benefits
• Please refer to the Active members Decision Guide for more details
• Rates, decision guides and other information is available at www.dch.georgia.gov/shbp
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Thank you