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Open EnrollmentState Health 2015

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Welcome to open enrollment 2015!

• Website Open & Close Dates–Website opens at 12 a.m. October 27, 2014–Website closes at 5:00 p.m. November 14, 2014

• Online Election - Members make their health election at

www.myshbpga.adp.com

Open Enrollment2015

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State Health Open EnrollmentMonday, October 27th – Friday, November 14th

Open Enrollment2015

• Your password expires 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

• If the system does not recognize you: Please click on REGISTER HERE from the login page.

Where do I go to enroll?

- Go to www.mycalhounbenefits.com by clicking on the RED button or - Go to www.myshbpga.adp.com

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2015 Plan Options

Blue Cross Blue Shield – HRA & HMO

United Healthcare – HMO & HDHP

Kaiser Permanente– HMO (Only if you live or work in one of the 27 counties. Barrow, Bartow, Butts, Carroll,

Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsythe, Fulton, Gwinnett, Haralson, Heard, Henry, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spaulding, Walton.)

Open Enrollment2015

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2015 Plan Options… What’s new?

Applied Behavior Analysis (ABA) for Autism • Effective January 1, 2015, SHBP will provide limited coverage for medically necessary ABA treatment of Autism

Spectrum Disorder • Maximum benefit of $35,000 per year per approved member (through age 10) • Co-payments, deductibles and/or co-insurance may apply Bariatric Pilot • The Georgia Legislature has established a pilot program to provide benefit coverage for certain bariatric surgical

procedures for the treatment and management of obesity and related conditions • Effective January 1, 2015, the pilot program is limited to 75 non-Medicare Advantage members for the 2015 Plan

Year • Qualified applicants will be randomly selected by the vendors for which you are enrolled. Please contact your vendors

for more information Hearing Aids • Benefit allowance for hearing aids has increased for children up to age 19 from $1,500 to $3,000 every five years Incentive Accounts • Includes well-being incentive credits that accompany the HMO and HDHP Plan Options. Credits can be earned by

completing certain health actions

Open Enrollment2015

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2015 Plan Design – HRA

  BCBSGA / Gold Plan BCBSGA / Silver Plan BCBSGA / Bronze PlanMedical Benefits Network

ProviderOut-of-

Network RateNetwork Provider

Out-of-Network Rate

Network Provider

Out-of-Network Rate

Deductible            

You $1,500  $3,000  $166.08 $2,000  $4,000  $108.64 $2,500  $5,000  $66.28

You + Child(ren)  $2,250  $4,500  $300.38 $3,000  $6,000  $202.74 $3,750  $7,500  $130.74You + Spouse $2,250  $4,500  $405.52 $3,000  $6,000  $284.90 $3,750  $7,500  $195.96You + Family $3,000  $6,000  $539.84 $4,000  $8,000  $379.00 $5,000  $10,000  $260.40

Plan Pays after deductible 85% 60% 80% 60% 75% 60%

ACA Preventive Care 100% Not covered 100% Not covered 100% Not  covered

Out-of-Pocket Maximum            

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  15%, Min $20, Max $50 15%, Min $20, Max $50

Tier 2 25%, Min $50, Max $80 25%, Min $50, Max $80 25%, Min $50, Max $80

Tier 3 25%, Min $80, Max $125 25%, Min $80, Max $125 25%, Min $80, Max $125    Add $80 surcharge        for tobacco use

Open Enrollment2015

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2015 Plan Design – HMO / HDHP

 

BCBSGA / UHCHMO

UHCHDHP

KPHMO

Covered Services In –Network only Monthly Rate

In-Network Provider

Out-of-Network Monthly Rate

In-Network Only Monthly Rate

Deductible   BCBSGA / UHC      

You $1,300  $130.74  /  $181.32 $3,500  $7,000  $53.02 None $145.78

You + Child(ren) $1,950  $240.88  /  $326.86 $7,000  $14,000  $108.74 None $266.44You + Spouse $1,950  $333.06  /  $439.26 $7,000  $14,000  $169.84 None $364.64You + Family $2,600  $443.18  /  $584.80 $7,000  $14,000  $225.56 None $480.53

Plan Pays after deductible 80% 70% 50% 100%

ACA Preventive Care 100% 100% Not covered 100%

Out-of-Pocket Maximum        

You $4,000  $6,450  $12,900  $6,350 

You + Child(ren) or Spouse $6,500  $12,900  $25,800  $12,700 

You + Family $9,000  $12,900  $25,800  $12,700 

Pharmacy Benefits        

Tier 1  $2070%  coverage;

 subject to deductible 

 $20

Tier 2  $50  $50

Tier 3  $90  $80

   Add $80 surcharge for tobacco use

Open Enrollment2015

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2015 Wellness Incentives(Well-Being requirements must be met between January 15 to December 15, 2015)

What to DO What you EARN

1. Assess Your Health Complete  your  2015 Healthways Well-Being Assessment®  (WBA),  a confidential, online questionnaire that will take about 20 minutes.

Complete BOTH and earn

240Well-being incentive 

credits.

(WBA must be completed before any

incentive can be earned.)

Know Your NumbersComplete a 2015 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 and your results submitted appropriately on the 2015 Physician Screening Form.

2. TAKE Action It’s your choice! Complete the coaching pathway,  online pathway or a combination of both.

Coaching Pathway•     Complete your WBA and,•     Actively engage in telephonic coaching.Online Pathway

Complete your WBA and, Record FIVE online activities using the same tracker within four consecutive weeks and earn 40  well-being incentive credits. HRA funds.  You can earn these rewards up to six times. Sample activities: track exercise five times, record daily steps five times               within four consecutive weeks. 

Earn up to240

Well-being incentive credits.

(WBA must be completed before any

incentive can be earned.)

Open Enrollment

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Questions or Additional Information?

Resource Contact # Website

Blue Cross 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

United Healthcare Member Services: Monday thru Friday, 8:00 a.m. to 8:00 p.m. ET 888-364-6352 www.welcometouhc.com/shbp

Kaiser Permanente (KP) Member Services: 24 hours a day/7 days per week (Appointment Scheduling, Prescriptions and Nurse Advice) 855-512-5997 www.my.kp.org/shbp

Healthways Member Services: Monday thru Friday, 8:00 a.m. to 8:00 p.m. ET 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

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State Health Benefit Plan

Thank YouOpen Enrollment

2015

State Health Benefit Plan / Active Employee Rates January 1, 2015 – December 31, 2015

You You + Children

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

BCBS HMO $130.74 $240.88 $333.06 $443.18

UHC HMO $181.32 $326.86 $439.26 $584.80

UHC HDHP $ 53.02 $108.74 $169.84 $225.56

Kaiser HMO $145.78 $266.44 $364.64 $485.30