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Welcome to Open Enrollment 2014. Benefits Life Dental Health PPACA.

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Presentation on theme: "Welcome to Open Enrollment 2014. Benefits Life Dental Health PPACA."— Presentation transcript:

1 Welcome to Open Enrollment 2014

2 Benefits Life Dental Health PPACA

3 Term Life Policy Date of Hire Date of Separation Can convert to Retiree Life if you retire from JCBOE Life

4 $25.84 $70.94 First Year Limit: EvaluationCleaning Fluoride Treatment Dental

5 State Health Benefit Plan (Medical)

6 Making Your 2014 Benefit Election Online ElectionOnline Election - Must have address - Must have address - Members must make their health election at - Members must make their health election atwww.myshbpga.adp.com Website Open & Close DatesWebsite Open & Close Dates - Website opens at 12:00 a.m. on October 21, Website closes at 5:00 p.m. on November 8, 2014

7 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 YearMembers 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 and view their 2014 electionMembers 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 and view their 2014 election

8 2014 Open Enrollment Members who do not make open enrollment election are defaulted to Bronze plan (w/tobacco if in 2013)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 planMembers 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 2014Members with no coverage in 2013 will be defaulted to no coverage in 2014

9 New Plan Vendors Blue Cross and Blue Shield of Georgia (BCBSGA) will be the Health Plan administratorBlue Cross and Blue Shield of Georgia (BCBSGA) will be the Health Plan administrator Express Scripts will be the Pharmacy Benefit administratorExpress Scripts will be the Pharmacy Benefit administrator Healthways will be the Wellness administratorHealthways will be the Wellness administrator

10 Elimination of HDHP and HMO PlansElimination of HDHP and HMO Plans Elimination of Standard and Wellness optionsElimination of Standard and Wellness options Change in HRA Wellness Incentive awardsChange in HRA Wellness Incentive awards Increase in some premiums, decrease in some premiumsIncrease in some premiums, decrease in some premiums New-year round online ADP systemNew-year round online ADP system 2014 Benefit and Plan Changes

11 2014 Benefit Option BCBSGA will offer a Health Reimbursement Arrangement (HRA) with three levels of coverageBCBSGA will offer a Health Reimbursement Arrangement (HRA) with three levels of coverage GoldGold SilverSilver BronzeBronze TRICARE Supplement is also available if member is enrolled in TRICARE.TRICARE Supplement is also available if member is enrolled in TRICARE.

12 HRA PLAN No copaysNo copays HRA credits pay the first billed claimsHRA credits pay the first billed claims HRA credits apply against deductible and out-of-pocket limitsHRA credits apply against deductible and out-of-pocket limits Doctors can ask for payment if deductible has not be metDoctors can ask for payment if deductible has not be met

13 HRA Credit Rollover Unused HRA credits rollover and ADD to plan year beginning creditsUnused HRA credits rollover and ADD to plan year beginning credits Former HMO plans have no rolloverFormer HMO plans have no rollover Rollover credits are available in March 2014 Claim run out periodRollover credits are available in March 2014 Claim run out period 2013 Wellness Incentives available on January 1, Wellness Incentives available on January 1, 2014

14 2014 Wellness Incentive Members, and covered spouse, have two options, must complete in 2014 and receive within 30 days: Earn $ Complete an online Healthways Well-being Assessment Complete biometric screening Earn up to $ Telephonic pathway coaching - $ Online pathway coaching - $40.00 each * Worksite Biometric screening will begin in February 2013 (Includes: body mass index, blood pressure, cholesterol & glucose) (Includes: body mass index, blood pressure, cholesterol & glucose)

15 $80.00 Tobacco Surcharge not included

16

17 Pharmacy Benefits Benefits are paid not subject to deductibleBenefits are paid not subject to deductible HRA credits can pay for prescription drugsHRA credits can pay for prescription drugs HRA credits must be used if you file a claimHRA credits must be used if you file a claim Retailer drug programs can be used without filing a claimRetailer drug programs can be used without filing a claim * 90 day mail order prescription drug plan remains

18 Pharmacy Benefits * 90 day mail order prescription drug plan remains

19 JCBOE Contribution Certified employees $ = $11,340.00Certified employees $ = $11, Classified employees $ = $7,596.00Classified employees $ = $7, Classified employees are eligible in 2014Classified employees are eligible in 2014

20 Affordable Care Act SHBP meets the minimum essential coverage mandateSHBP meets the minimum essential coverage mandate SHBP meets the affordability mandateSHBP meets the affordability mandate Health Insurance Marketplace Notice contains information for inquiryHealth Insurance Marketplace Notice contains information for inquiry Individual mandate current lawIndividual mandate current law

21 PeachCare for Kids Enroll in PeachCare for Kids Call

22 Frequently Asked Questions

23 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

24 Why only one vendor SHBP is able to increase negotiating effectiveness, achieve administrative effectiveness, and provide high-quality health care at competitive prices

25 Will I need to change doctors 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 no later than December 31, 2013 to request transition of care.

26 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

27 Questions

28 Questions or Additional Information Blue Cross/Blue Shield – Blue Cross/Blue Shield – www.bcbsga.com/shbp Healthways – (12/15/13)Healthways – (12/15/13)www.bewellshbp.com Express Scripts – Express Scripts – www.dch.georgia.gov/shbp SHBP – SHBP –

29 Information is on Personnel/Payroll webpage at: Information is on Personnel/Payroll webpage at: PersonnelPayroll/tabid/14081/Default.aspx

30 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 benefitsThe 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 detailsPlease refer to the Active members Decision Guide for more details Rates, decision guides and other information is available at decision guides and other information is available at

31 Thank you


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