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0 HEALTH INSURANCE – STATE HEALTH BENEFIT PLAN FLEX SPENDING – C.A.S. SHARED SAVINGS PROGRAM Date: October 2013 2014 OPEN ENROLLMENT
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1 2014 Open Enrollment Open Enrollment Dates –Opens at 12:00 a.m. October 21, 2013 –Closes at 5:00 p.m. November 8, 2013 Online Enrollment for State Health and Flex Spending www.mygscsbenefits.com
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2 New Plan Vendors UHC and CIGNA will no longer be offered as their contracts end December 31, 2013 Blue Cross and Blue Shield of Georgia will be the Plan administrator which includes Medical Management and claims for all SHBP Plans Express Scripts will be the new Pharmacy Benefit Manager Healthways will be the new Wellness Vendor
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3 New Plan Vendors Blue Cross and Blue Shield of GA, Express Scripts and Healthways will all be working closely together on an ongoing basis Each covered family member will receive their own ID card which will be valid for all three of our vendors No HMO’s or HDHP plans, only HRA
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4 The Benefits of an HRA HRA dollars can assist you in paying health expenses that go towards your deductible Initial HRA credits vary depending on the plan option that is chosen Your HRA is funded by SHBP and any unused funds roll over from year to year Any remaining HRA credits from previous years will rollover in March 2014
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5 2014 Plan Design Gold PlanSilver PlanBronze Plan Network ProviderOut-of-NetworkNetwork ProviderOut-of-NetworkNetwork ProviderOut-of-Network Medical Benefits Deductible* You$1,500$3,000$2,000$4,000$2,500$5,000 You + Child(ren) or Spouse$2,250$4,500$3,000$6,000$3,750$7,500 You + Family$3,000$6,000$4,000$8,000$5,000$10,000 Plan Pays85%60%80%60%75%60% ACA Preventive Care100%Not covered100%Not covered100%Not covered Out-of-Pocket Limit* You$4,000$8,000$5,000$10,000$6,000$12,000 You + Child(ren) or Spouse$6,000$12,000$7,500$15,000$9,000$18,000 You + Family$8,000$16,000$10,000$20,000$12,000$24,000 Base HRA Contribution You$400$200$100 You + Child(ren) or Spouse$600$300$150 You + Family$800$400$200 Pharmacy Benefits Tier 1 15%, Min $20, Max $50 Tier 2 25%, Min $50, Max $80 Tier 3 25%, Min $80, Max $125 What’s covered and not covered are the same for all 3 plans
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6 STATE HEALTH BENEFIT PLAN RATES JANUARY 1 - DECEMBER 31, 2014 You YOU + CHILD(REN) YOU + SPOUSE YOU + FAMILY BCBS Gold $166.08 $300.38 $405.52 $539.84 BCBS Silver $108.64 $202.74 $284.90 $379.00 BCBS Bronze $66.28 $130.74 $195.96 $260.40
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7 HRA Incentives 2014 Wellness incentives – increases up to a maximum of $480 for member; plus up to an additional $480 for covered spouse Additionally, for those members/spouses who completed their wellness requirements in 2013, the $240 will be credited to their HRA on January 1, 2014
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8 2014 Wellness Incentives 8 What to DOWhat you EARN 1. Assess Your Health Complete your Healthways Well-Being Assessment® (WBA), a confidential, online questionnaire that will take about 20 minutes. Complete both and earn $240 in HRA fund contributions 2. Know Your Numbers Complete a biometric screening and submit results (body mass index, blood pressure, cholesterol, glucose). The biometric screening must be completed at an SHBP sponsored screening event or by your physician or other providers identified by SHBP in published materials. 3. TAKE Action It’s your choice! Complete the coaching or online pathway or a combination of both. Coaching Pathway Create your Well-Being Plan. Actively engage in telephonic coaching. Online Pathway Create your Well-Being Plan. Record 5 online well-being activities using the same tracker in a month and earn $40 HRA funds. You can earn this for up to 6 months. Sample activities: track exercise five times, record daily steps five times, track food five times. Earn up to $240 in HRA fund contributions
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9 Where can I find Information? www.mygscsbenefits.com Informational Videos-Decision Guides -Design Plans -Rates Self Enrollment - from the homepage select the “State Health” portal You must Register first The Password is posted along with a Member User Guide Save your username and password Members may go online as many times as they like, the last election that is confirmed at the time of closing will be the election for 2014 If you are currently enrolled in State Health and you do not go through open enrollment, you will be defaulted to the “BRONZE” plan Be sure to click “FINISH” Save your confirmation page.
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