Last week, when upcoming changes in the state employee and teacher health plan were announced, they drew a generally positive response. Members learned that...

Last week, when upcoming changes in the state employee and teacher health plan were announced, they drew a generally positive response.

Healthcare CostMembers learned that the 2015 plan would include an increased choice of insurers, which was welcome, and officials presented information showing that many members would see no premium increase.

But after studying the proposed rates in greater detail, a group representing teachers, employees and retirees is voicing concern. It says many of the new options will be unaffordable for members looking to switch from their current plans.

Most State Health Benefit Plan members will see a significant increase in premiums if they choose to move from the current Health Reimbursement Arrangement (HRA) to one of the new HMOs, especially the one run by UnitedHealthcare, said Ashley Cline of the group Teachers Rally to Advocate for Georgia Insurance Choices (TRAGIC).

“They’ve brought back options –- that’s a huge win,’’ Cline, founder of TRAGIC, told GHN on Monday. “But if you have choices that are unaffordable, there’s no benefit.”

Cline added, “The deductibles and out-of-pocket maximum are still way out of line with the salaries of SHBP members, and out of line with comparable plans offered under the University System of Georgia.”

The SHBP covers 650,000 state employees, teachers, other school personnel, retirees and dependents. With so many Georgians affected, dissatisfaction with the plan can become a political issue.

The 2014 plan was the target of complaints from the time it took effect Jan. 1, largely because of its change to a single health insurer and plan type. Cline founded TRAGIC as a Facebook group in response, and it grew to thousands of members and staged public protests.

That uproar caused the Georgia Department of Community Health, which runs the SHBP, to act swiftly, adding a co-pay system to the 2014 plan. It also promised more choices for 2015.

Community Health issued a statement Monday that said, “The department listened to the concerns presented by our SHBP members last year and is offering more options that provide members with a choice of vendor, plan design and associated costs for 2015. We will strive to clearly communicate and educate members about these options.

“We encourage members to review all benefit information from SHBP regarding the 2015 plan designs, as it becomes available prior to Open Enrollment, and choose an option that meets their individual and family needs.”

Last week, the Department of Community Health said that not only would those staying in the Blue Cross and Blue Shield HRA not see any increase in premiums for next year’s plan, but that members who had Gold plans and were looking to switch would see reduced premiums.

But Cline said Monday that she is most concerned about the difference in cost between the Blue Cross HMO and the one run by United – more than $140 a month. Many members are unhappy with their current Blue Cross plan, she said.

Blue Cross and Blue Shield of Georgia is currently the only insurer providing medical plans, but that will change in 2015.

SHBP_CoverImage

Next year, Blue Cross will give SHBP members three HRA choices and a statewide Medicare Advantage to retirees, along with a statewide HMO option. UnitedHealthcare will offer members the options of a statewide HMO, a high-deductible health plan and a statewide Medicare Advantage plan. A second new insurer, Kaiser Permanente, will offer an HMO plan in metro Atlanta, Community Health said.

A TRAGIC member, John Palmer, said in a statement Monday, “Continuing to cut the take-home pay of teachers and state employees through higher insurance costs will drive good teachers and state employees away, and make it harder to recruit and retain highly qualified candidates to state agencies.’’

Palmer also raised questions about increased premiums for state retirees in the Medicare Advantage plans.

Community Health, though, said the Medicare Advantage premiums depend heavily on the rates proposed by the insurer.


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

  • Grand Old Party

    August 20, 2014 #4 Author

    Shocker, so now TRAGIC and so many other State Employees understand that the pricing received in the the first bid was the best they could have hoped for. Common sense tells you that if you give all the business to one Insurance company you get the best price. With 650,000 plan members the cost to subsidize the bid from United alone on just the HMO would be $91,000,000 per month! Costing taxpayers close to $1 Billion per year for one option. TRAGIC has thrown cost to the wind with their demands. Each dollar the state pays for all plan members costs $650,000. Good luck Governor Deal, you invited this.

    Reply

  • Eliza

    November 3, 2014 #8 Author

    Dear GOP,
    Common since also says that if you allow more than one provider you have a better chance of getting better service. In this way, a company has to work for its members. With only one Insurance company and all people in the state being mandated to have them, you do not get quality customer service.
    We have a right to pick our provider. It is unfair that the HMO offered by United is 50 dollars more a month than the one offered by Blue Cross for the same coverage. This does not seem right or faif

    Reply

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