Decision Guide, Summary, Rates and Information
State Health Benefit Plan Virtual Visits
State Health Benefits:
Providers currently offering Virtual Visits (including mental health)
Enrollment for Medical through ADP
Due to expected heavy call volume and online traffic, SHBP strongly encourages all members to:
- Confirm your access to the enrollment portal in advance of the Open Enrollment (OE) election start date, and
- Make your election early
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.
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).
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.
- 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
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
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.
- High Deductible Health Plan (HDHP)
- Health Maintenance Organization (HMO)
- Medicare Advantage (standard and premium)
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)
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
- Health Maintenance Organization (HMO) for SHBP members who live or work in the 27 county metro Atlanta service area.
- Included is the Prescription Plan.
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
Appointment Scheduling or Prescription Help: Monday thru Friday, 7:00 a.m. to 7:00 p.m. ET
Wellness Program Customer Service: Monday thru Friday (except holidays), 8:00 a.m. to 10:00 p.m. ET
Kaiser Permanente Rollover Account (KPRA) Customer Service: Monday thru Friday (except holidays), 11:00 a.m. to 8:00 p.m. ET
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 include 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
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