Decision Guide, Summary, Rates and Information

2024 Plan Year

Active Decision Guide

Medical Scenarios Employee Only

2025 Plan Year

Active Decision Guide

State Health Benefit Plan Virtual Visits

State Health Benefits:

https://shbp.georgia.gov/

Providers currently offering Virtual Visits (including mental health)

State Health Benefit Plan

https://shbp.georgia.gov/  – Decision Guides and Information.
Enrollment is through the ADP Website myshbpga.adp.com

Enrollment for Medical Through ADP

Due to expected heavy call volume and online traffic, SHBP strongly encourages all members to: 1) confirm your access to the enrollment portal in advance of the Open Enrollment (OE) election start date, and 2) make your election early.
mySHBPga.adp.com

You must bring your User ID and Password for the Benefits Counselor to assist you with SHBP enrollment

What if you do not take any action?

If SHBP does not receive an election from you through the website, or by contacting SHBP Member Services, you have made a decision to take the default coverage below:

Currently Enrolled in a SHBP Commercial Plan Option : If you are enrolled in a Commercial Option, you will remain in your current Plan Option and Tier with your current Medical Claims Administrator.

Currently Enrolled in TRICARE Supplement: If you are enrolled in the TRICARE Supplement, you will remain enrolled in the TRICARE Supplement.

NOTE: If you paid a Tobacco Surcharge, it will continue to apply. If you did not pay a Tobacco Surcharge, you will not pay one if you default coverage.

Eligibility Changes

Surviving Spouse/Adding New Born – members will have 31 days before or after a qualifying event to add a dependent (90 days for a newborn).

Anthem

Since 2014, Anthem Blue Cross and Blue Shield of Georgia (Anthem) has provided medical claims administration and medical management services for the State Health Benefit Plan (SHBP). Through Anthem, SHBP offers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA and Bronze HRA. Additionally, Anthem offers a statewide Health Maintenance Organization Plan Option for eligible members and pre-65 Retirees, as well as Medicare Advantage Premium and Standard Plan Options to Medicare-eligible members.www.anthem.com/shbp

  • Health Reimbursement Arrangement (HRA): Gold, Silver and Bronze
  • Health Maintenance Organization (HMO)

Need Help Choosing Between HMO – HRA Plans?

Click on the image below for a video on the difference between HMO/HRA

Member Services

Anthem Blue Cross and Blue Shield Member Services: Monday thru Friday, 8:00 a.m. to 8:00 p.m. ET

NurseLine: 24 hours a day/7 days per week

  • 866-787-6361

Fraud Hotline:

  • 800-831-8998

United Healthcare

Since 2015, UnitedHealthcare has provided medical claims administration and medical management services for the State Health Benefit Plan (SHBP). Through UnitedHealthcare, the SHBP offers eligible members, including pre-65 Retirees a choice of a statewide Health Maintenance Organization Plan Option and a High Deductible Health Plan Option. Additionally, UnitedHealthcare offers Medicare Advantage Premium and Standard Plan Options to Medicare-eligible members. www.welcometouhc.com/shbp

  • High Deductible Health Plan (HDHP)
  • Health Maintenance Organization (HMO)
  • Medicare Advantage (standard and premium)

Member Services

UnitedHealthcare Member services is open Monday through Friday from 8:00 a.m. to 8:00 p.m. ET. (24 hours a day/7 days per week for Nurseline support)

Kaiser

Since 2015, Kaiser Permanente has offered a regional in-network only Health Maintenance Organization Plan Option to State Health Benefit Plan eligible members who either live or work in one of the 27 counties within the Metro Atlanta Service Area:​

  • Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, Walton

https://my.kp.org/shbp

  • Health Maintenance Organization (HMO) for SHBP members who live or work in the 27 county metro Atlanta service area.
  • Included is the Prescription Plan.

Member Services

Kaiser Permanente Member Services: Monday thru Friday, 7:00 a.m. to 7:00 p.m. ET

Nurse Advice: 24 hours a day/7 days per week

  • 404-365-0966
  • 800-611-1811

Appointment Scheduling or Prescription Help: Monday thru Friday, 7:00 a.m. to 7:00 p.m. ET

  • 404-365-0966
  • 800-611-1811

Wellness Program Customer Service: Monday thru Friday (except holidays), 8:00 a.m. to 10:00 p.m. ET

  • 866-300-9867

Kaiser Permanente Rollover Account (KPRA) Customer Service: Monday thru Friday (except holidays), 11:00 a.m. to 8:00 p.m. ET

Fraud Hotline:

Prescription Provider: Caremark

2024 Drug Lists

Generic Drug Savings Information

Many brand name drugs are coming off of patent protection and generic drugs at significant savings are available.  The two links below provide information on the generic availability and potential savings.

For a list of $4.00 drugs from Walmart

Publix free medications

Wellness Provider: Sharecare

Wellness benefits for participants in BCBS or UHC plans.Members and their covered spouses enrolled in Anthem Blue Cross and Blue Shield (Anthem) and UnitedHealthcare Non-Medicare Advantage plan options have access to a variety of Sharecare tools and services such as the RealAge® Test, well-being incentives, well-being coaching including tobacco cessation coaching, biometric screenings, onsite activities, challenges and much more. To learn more, please visit BeWellSHBP.com.Wellness Incentive Credits earned between January 1 – November 30

How to Enroll, Earn and Use Points

State Health Wellness Incentives

Reminder that employees and covered spouses can receive an additional $480 each in HRA credits with State Health for completing certain wellness actions.  Visit www.BeWellSHBP.com for details or see the enclosed flyer.

Peachcare for Kids

1-877-GA-PEACH (427-3224)PeachCare includes dental, vision and health insurance at low premiums and low co-payments.Employees may complete an application on-line or may call and request a paper application be mailed to them by calling PeachCare.

Employees should not drop children from the State Health Benefit Plan until they receive notice of coverage from PeachCare.

Eligibility and Income Levels

Tricare Supplement

https://info.selmanco.com/ga_shbp

  • Available to SHBP eligible individuals who are also eligible for TRICARE, the military health benefit program
  • No Split Option – Everyone covered under the contract must be in Tricare
  • DEERS Number – Members must provide a Defense Enrollment Eligibility Reporting System (DEERS) number

Notices for Employees

Model Notice for Offer of Health Care Coverage 

Children’s Heath Insurance Premium (CHIP) Notice

See the State Health Decision Guide for additional required notices