Jan. 1 rang in a major change for more than 650,000 members of the state employees’ health plan.
And on Jan. 2, the wife of a Cherokee County teacher started a Facebook page to voice complaints about the 2014 changes to the State Health Benefit Plan.
In just days, the Facebook page has exploded, with thousands joining the group. The governor’s office has been deluged with phone calls. Preparations are under way for a rally against the new plan.
State employees’ leading complaint is the lack of choice of health plan providers, said Ashley Cline, creator of the Facebook group, called TRAGIC, or “Teachers Rally Against Georgia Insurance Changes.’’
A single vendor, Blue Cross and Blue Shield of Georgia, is providing medical care for the plan, which covers public school teachers in the state.
Cline told GHN on Wednesday that the family’s cost for occupational therapy for her 4-year-old daughter has soared to $130 a week under the plan. The deductibles and premiums are high as well, she said.
“I get upset and angry about our situation,’’ Cline said. “People always had options in health care.’’
The controversy over the State Health Benefit Plan erupted after the agency chose Blue Cross to provide a statewide health plan for members of the SHBP, which covers
state employees, teachers, other school personnel, retirees and dependents.
The award was quickly appealed by UnitedHealthcare, which called the contracting process “state-sponsored bid-rigging.’’ The Department of Community Health, which runs the SHBP, strongly denied that characterization and dismissed the appeal. (United still has a complaint pending in Fulton County Superior Court.)
And in September, the Community Health board unexpectedly rejected a proposal to offer an HMO option to state employees in seven metro Atlanta counties. The vote by the board reflected opposition to offering a choice of health plans in metro Atlanta but not in other areas of the state.
Blue Cross, meanwhile, emphasized at an October hearing that its contract will save the state more than $1.5 billion overall. Community Health told the Marietta Daily Journal that the plan will save an estimated $200 million this year.
Yet medical providers expressed concern that they would get lower payments if there is a single statewide insurer for the SHBP, especially given the level of savings that the state expects.
SHBP members were given a choice of Bronze, Silver and Gold plans under a Health Reimbursement Arrangement.
Sue McDonald, a newly retired Forsyth County teacher, told GHN on Thursday that she can’t afford the new cost for physical therapy after her December hip surgery.
“There are so many stories out there,’’ McDonald told GHN. “It’s unfair we don’t have more choices.’’
And Jamie Wills of Canton, a schoolteacher, said Thursday that she is being forced to switch pediatricians because the one who has seen her daughters from birth doesn’t take the Blue Cross plan.
When Blue Cross confirmed that the pediatrician wasn’t in the network, Wills said, “I started crying. I broke down. I was just dumbfounded.’’
“For all state employees, their health care choices are being made for them,’’ she said.
Sasha Dlugolenski, spokeswoman for the governor’s office, told the Marietta Daily Journal that the office’s phone lines were inundated with calls Monday, Tuesday and Wednesday.
“The governor’s office always keeps a detailed list of people who call in, and the appropriate people are informed regarding the volume and nature of the calls,” Dlugolenski said Wednesday. “In total, we have received around 600 calls.”
Community Health also said Thursday it has heard from SHBP members. “We’ve heard a wide range of opinions from people who have questions and concerns,’’ said a Community Health spokeswoman, Pam Keene, in an email to GHN.
“Fiscal and regulatory challenges continue to contribute to the increased costs experienced by both the plan and the members,’’ Keene said in the email. “The SHBP strives to be member-focused and fiscally sound by continuing to offer health benefits coverage that is high-quality, efficient and affordable health insurance options to its members.”
The 2013 plan offered state employees a choice of two different third-party administrators, United and Cigna, that offered the same set of plan options, which included a High Deductible Health Plan, a Health Maintenance Organization option and a Health Reimbursement Arrangement, the Daily Journal reported.
Bert Kelly, a spokesman for Blue Cross, said Thursday that more employer groups are using a single insurer to save on health costs.
“We’re working with DCH to make health care as affordable as we can,’’ Kelly said. The HRA helps “put patients in control’’ of their health spending, he added.
Kelly said Blue Cross is aware of the Facebook page. “We understand folks have some concerns,’’ he said. “We’re trying our best to educate our membership.’’ The company has created a website for SHBP members.
The TRAGIC group is planning a rally at the state Capitol on Feb. 18.
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