Decision Guide, Summary, Rates and Information
State Health Benefit Plan Virtual Visits
State Health Benefits:
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
- 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
- 855-641-4862
(TTY 711) - www.anthem.com/shbp
NurseLine: 24 hours a day/7 days per week
- 866-787-6361
Fraud Hotline:
- 800-831-8998
United Healthcare
- 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)
- 888-364-6352
(TTY 711) - www.welcometouhc.com/shbp
Kaiser
- 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.
Member Services
Kaiser Permanente Member Services: Monday thru Friday, 7:00 a.m. to 7:00 p.m. ET
- 855-512-5997
(TTY 711) - https://my.kp.org/shbp/
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
- 877-761-3399
- www.kp.org/healthpayment
Fraud Hotline:
- 855-512-5997
- www.kp.org/healthpayment
Prescription Provider: Caremark
2024 Drug Lists
- 2024 Georgia State Health Benefit Plan Preferred Drug List
- 2024 State Health Benefit Plan Co-payment/Co-Insurance Waiver Medication List
- Retail 90 Pharmacies in Georgia by Alphabet
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.
Wellness Provider: Sharecare
How to Enroll, Earn and Use Points
State Health Wellness Incentives
Reminder that employees and covered spouses can receive an additional $480 each ($960 for employee & spouse) in HRA credits with State Health for completing certain wellness actions. Visit www.BeWellSHBP.com for details or see https://bewellshbp.com/faqs/.
Peachcare for Kids
Employees should not drop children from the State Health Benefit Plan until they receive notice of coverage from PeachCare.
Tricare Supplement
- 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