Making Your 2017 Benefit Election

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Presentation transcript:

2017 State Health Benefit Plan Annual Open Enrollment (OE) Presentation to Active Employees and pre-65 Retirees

Making Your 2017 Benefit Election Open enrollment is from October 17, 2016 thru November 4, 2016! Online Election - Members must make their health election at www.mySHBPga.adp.com Website Open & Close Dates Website opens at 12:00 a.m. on October 17, 2016 Website closes at 11:59 p.m. on November 4, 2016 1

2017 Open Enrollment (OE) Dates Open enrollment is from October 17, 2016 thru November 4, 2016 You may go online as many times as you like but the last election confirmed at the time OE/Retiree Option Change Period (ROCP) closes will be your election for the 2017 Plan Year You should print and keep a copy of the confirmation page which will contain a confirmation number - once OE is closed, you will be able to go online at www.mySHBPga.adp.com and view your 2017 election

SHBP Enrollment Portal – mySHBPga. adp. com Save Time SHBP Enrollment Portal – mySHBPga.adp.com Save Time! Update Your Password Before Open Enrollment Your Password expires every 45 days. Log in to the SHBP Enrollment Portal now to set up your new Password. Log in using your current Password If it’s been over 45 days since the last time you logged in, you’ll be prompted to create a new Password (which will expire every 45 days) If you do not know your current User Name or Password: Click the Forgot User ID? or Forgot Password? from the Login page Links are located to the right of the User Name and Password blocks  

Open Enrollment (OE) and Your Responsibilities Read and make sure you understand the plan materials posted at www.dch.georgia.gov/shbp and other information provided by your employer and take the required actions Confirm that you answered the Tobacco Surcharge question appropriately Check your payroll deduction to verify that the correct deduction amount has been made. If you are not being charged the correct amount, immediately contact your Payroll Location/HR Department To update any changes in your address, notify your Benefit Coordinator or HR Department Notify SHBP whenever you have a change in covered dependents (within 31 days of a Qualifying Event)

What Happens If No Action is Taken? Members who do not make an election, either through the web portal or by calling the SHBP Member Services Center, will be defaulted to the same plan option previously selected for 2016 If you do not make an election and are currently paying the Tobacco Surcharge, your coverage will default and the Tobacco Surcharge you are paying in 2016 will continue to apply

Plan Options 2017 2017 Vendors and Plan Option Offerings SHBP will continue to offer Blue Cross and Blue Shield of Georgia (BCBSGa), UnitedHealthcare and Kaiser Permanente (KP) plan options for 2017. However, please keep in mind that if you are retired and over age 65, you will pay the full cost of the unsubsidized premium for these plans as the State will only subsidize the MA Plan Options. Express Scripts (ESI) administers prescription drug pharmacy benefits for members who choose BCBSGa or UnitedHealthcare (non-MA). Healthways provides well-being resources and incentive programs for members who choose BCBSGa or UnitedHealthcare (non-MA). Health Maintenance Organization (HMO) High Deductible Health Plan (HDHP) BCBSGa (Statewide/In-Network only plan) UnitedHealthcare (Statewide/In-Network only plan) UnitedHealthcare Health Reimbursement Arrangement (HRA) Medicare Advantage (MA) Preferred Provider Organization (PPO) Standard and Premium BCBSGa UnitedHealthcare BCBSGa *Additional Options: TRICARE Supplement, PeachCare for Kids®

Plan Options 2017, continued Enhanced Benefits Telemedicine/Virtual Visits SHBP will continue to provide access to physicians through telemedicine/virtual visits in 2017 Face-to-face consultations with physicians will be available 24/7, 365 days a year Services will be available from home, office or on the go from a computer, tablet or smartphone that has a web camera There is a Co-Pay for the BCBSGa and UnitedHealthcare HMO Plan Options, Co-Insurance for the HRA-Gold, Silver and Bronze Plan Options, Co-Insurance subject to Deductible for the UnitedHealthcare HDHP. Wellness Incentive Credits Rollover Continuance Wellness incentive credits will continue to roll over to both the vendor and Plan Option you select during Open Enrollment for 2017 These credits will be available in April 2017; this allows for processing of any claims submitted at the end of 2016 to apply credits This means that regardless of the SHBP Plan Option and/or vendor you choose to enroll, you can take your credits (includes any unused HRA base credits and previously earned well-being credits) with you Children’s Hearing Aids Benefit Increase The benefit allowance for hearing aids for children (up to age 19) has increased from $3,000 to $6,000 every five (5) years.

Understanding Your Plan Options for 2017 How the Health Reimbursement Arrangement (HRA) Works The HRA provides first-dollar coverage for eligible medical and pharmacy expenses and is funded by SHBP. When going to the doctor, you will not pay a co-pay. Instead, you pay the applicable deductible and co-insurance. If you have remaining credits in your current HRA account, those credits will roll over to the Plan Option and/or vendor you select during OE Plan Features Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care”. You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums You are not required to select a Primary Care Physician (PCP) or obtain referrals to a Specialist (SPC) The credits in your HRA account are used to help meet your deductibles and out-of-pocket maximums The medical and pharmacy out-of-pocket maximums are combined Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma and/or coronary artery disease

Understanding Your Plan Options for 2017, continued How the High Deductible Health Plan (HDHP) Works The HDHP offers in-network and out-of-network benefits and has a low monthly premium. However, you must satisfy a high deductible ($3500) that applies to all covered medical and pharmacy expenses (except preventive care). If you have any dependents, the entire family deductible no longer has to be met before benefits are payable for any family member. Additionally, once the out-of-pocket maximum has been satisfied for that individual family member, all covered medical and pharmacy expenses will be paid at 100% for that family member. You may qualify for a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses. If you have remaining well-being incentive credits in your current Health Incentive Account (HIA), those credits will roll over to the Plan Option and/or vendor you select during OE Plan Features Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care” Before you can use well-being incentive credits, members must meet a threshold ($1,300 individual; $2,600 other tiers) You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums You pay co-insurance after meeting the entire deductible for covered medical and pharmacy expenses The medical and pharmacy out-of-pocket maximums are combined There are no co-pays The HSA cannot be combined with a Flexible Spending Account (FSA)

Understanding Your Plan Options for 2017, continued How the Statewide Health Maintenance Organization (HMO) Works A HMO allows you to receive covered medical services from in-network providers only (except for emergency care). It is important to verify your current provider is in-network when selecting an HMO Plan Option. If you have remaining well-being incentive credits in your current BCBSGa MyIncentive Account (MIA) or UnitedHealthcare Health Incentive Account (HIA), those credits will roll over to the Plan Option and/or vendor you select during OE Plan Features Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care” Certain services are subject to a deductible and co-insurance You are not required to obtain referrals to see a Specialist (SPC), but are encouraged to select a Primary Care Physician (PCP) to help coordinate your care The medical and pharmacy out-of-pocket maximums are combined Co-pays count toward your out-of-pocket maximum Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma and/or coronary artery disease

2017 Pharmacy Benefits For Blue Cross and Blue Shield of Georgia (BCBSGa) and UnitedHealthcare Elections Express Scripts will continue to administer the prescription drug pharmacy benefits for members who choose BCBSGa and UnitedHealthcare. Express Scripts provides benefits for retail prescription drug products, mail order, home delivery and specialty pharmacy services Get up to a 90-day supply of your maintenance medication either through Express Scripts home delivery pharmacy services or at a participating 90-day retail pharmacy Express Scripts offers several programs for managing your prescriptions: The My Rx Choices Prescription Savings Program lowers out-of-pocket prescription costs The Worry-Free Fills Program offers automatic refills for long-term medications and will be automatically shipped to you The Extended Payment Program extends home delivery payments over three installments

2017 Wellness For Blue Cross and Blue Shield of Georgia (BCBSGa) and UnitedHealthcare Elections SHBP will continue to partner with our Wellness vendor, Healthways®, to provide members who elect BCBSGa and UnitedHealthcare with well-being resources and incentive programs Health actions must be completed between January 1, 2017 and December 15, 2017 in order to earn the well-being incentive credits Members who elect BCBSGa and UnitedHealthcare will have access to a variety of Healthways’ tools, activities and services such as the Well-Being Assessment (WBA), wellness incentives, Well-Being Coaching, Biometric Screenings, and onsite activities Members can earn up to 480 well-being incentive credits toward eligible medical and pharmacy expenses, plus up to an additional 480 for a covered spouse (total of 960 per household)

Wellness 2017, continued What to Do What You Will Earn* 1 Assess Your Health Complete BOTH and earn 240 well-being incentive credits Complete your 2017 Healthways Well-Being Assessment (WBA) – a confidential, online questionnaire that will take about 20 minutes. Know Your Numbers 2 Complete a biometric screening (body mass index, blood pressure, cholesterol and glucose). • At a SHBP-sponsored screening event or, • With your Physician using the Healthways 2017 Physician Screening Form Take Action 3 Complete your WBA, then use the tools that make sense to you. Phone Coaching Get support to eat better, lose weight, stress less, get active, feel happier, or quit tobacco with a Healthways well-being coach. • Complete your WBA and actively engage in telephonic coaching. Earn 60 well-being incentive credits for completing one (1) coaching call in a calendar month - up to four (4) times in a Plan Year, for a maximum of 240 wellbeing incentive credits. NOTE: Only one call in a calendar month qualifies for the 60 well-being incentive credits. Online Resources • Complete your WBA and record five online well-being activities using the same tracker within a calendar month and earn 40 well-being incentive credits. Sample activities: track exercise five (5) times, record daily steps five (5) times, track food five (5) times. You can earn these incentive credits up to six (6) times in a Plan Year for a maximum of 240 well-being incentive credits. Earn up to 240 well-being incentive credits

Questions or Additional Information Resource Member Services Website Blue Cross and Blue Shield of Georgia (BCBSGa) Member Services: Monday thru Friday, 8:00 a.m. to 8:00 p.m. ET 855-641-4862 www.bcbsga.com/shbp UnitedHealthcare 888-364-6352 www.welcometouhc.com/shbp Kaiser Permanente (KP) Member Services: Monday thru Friday, 7:00 a.m. to 7:00 p.m. ET 855-512-5997 www.my.kp.org/shbp Healthways 888-616-6411 www.BeWellSHBP.com Express Scripts Member Services: 24 hours a day/7 days per week 877-841-5227 www.express-scripts.com/georgiaSHBP SHBP Member Services: Monday thru Friday, 8:30 a.m. to 5:00 p.m. ET 800-610-1863 www.mySHBPga.adp.com PeachCare for Kids® 877-427-3224 www.peachcare.org TRICARE Supplement 866-637-9911 www.selmantricareresource.com/ga_shbp

Important Notice The information provided in this presentation is a summary of changes for the 2017 Plan Year. It is intended only to highlight principle benefits Please refer to the Active Decision Guide for more details Premium rates, Decision Guides and other information is available at www.dch.georgia.gov/shbp

RATE COMPARISON Rate Comparison for 2016 vs 2017 You You + Child(ren)   Rate Comparison for 2016 vs 2017 You You + Child(ren) You + Spouse You + Family 2016 2017 BCBS Gold $ 158.79 $ 164.36 $ 288.01 $ 298.72 $ 390.23 $ 405.84 $ 519.43 $ 540.20 BCBS Silver $ 105.33 $ 108.49 $ 197.12 $ 203.74 $ 277.96 $ 288.51 $ 369.74 $ 383.76 BCBS Bronze $ 66.28 $ 68.96 $ 130.74 $ 136.54 $ 195.96 $ 205.50 $ 260.40 $ 273.08 BCBS HMO $ 130.58 $ 130.96 $ 240.05 $ 241.94 $ 330.99 $ 335.69 $ 440.44 $ 446.67 United HC HMO $ 170.68 $ 166.23 $ 308.22 $ 301.91 $ 415.20 $ 409.78 $ 552.71 $ 545.45 United HC HiDed HP $ 57.46 $ 51.01 $ 115.75 $ 106.02 $ 177.45 $ 167.80 $ 235.72 $ 222.82

GA Breeze = Flexible Benefits MetLife One-Up program. Begin or increase life insurance with no Statement of Health Delta Dental is still the preferred dental insurance for our area. Cigna has expanded their coverage but not a lot in our area.

GA Breeze You may log in and change your flexible benefits as often as you like up until midnight on November 4. You will receive the SAME confirmation number regardless of how many times you log in & make changes. Be sure to print your confirmation page!