Projecting big deficits in coming years, the Georgia agency that runs the state employee and teacher health plan is hunting for savings through an array of strategies.
Clyde Reese, commissioner of the Department of Community Health, told GHN last week in an interview that the agency is conducting an audit to ensure that all dependents covered by SHBP are indeed eligible for those benefits.
A similar audit took place in 2005, and resulted in the suspension or termination of benefits for 30,378 dependents. The estimated savings were at least $30 million, Community Health said Monday.
The State Health Benefit Plan covers more than 650,000 state employees, teachers, other school personnel, dependents and retirees. The total budget for the plan is $3.3 billion.
SHBP has been a center of controversy in the past couple of years.
Two years ago, a wave of complaints from members on benefit changes led to a quick fix for that year’s plan and more revisions the following year.
In 2015, Gov. Nathan Deal’s budget plan proposed eliminating health coverage for 11,500 “non-certificated’’ school personnel working fewer than 30 hours a week, including school bus drivers and cafeteria workers. The state Legislature, though, restored that money and kept the coverage.
Still, the state budget has charged school districts more to insure the non-certificated workers.
The projected deficit in SHBP for fiscal 2018 is about $55 million.
Reese told GHN that Community Health is also auditing the pharmacy benefit manager Express Scripts, which oversees prescription drug program for the State Health Benefit Plan.
Community Health is planning to open two worksite health clinics for employees – one possibly at the 2 Peachtree Street building in Atlanta that houses several state agencies, and one located at a school system. “This is something we’ve not done before,’’ Reese said. “We want to see if it will save money and increase productivity.”
Community Health also wants to offer another Medicare Advantage plan for its retirees, Reese said. Currently, these people have a single choice – UnitedHealthcare.