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Health Insurance

2 insurers picked for university health plan

The contract for state employees and teachers has dominated the discussion of Georgia health benefits this year, because of widespread complaints that erupted over choice of plans and out-of-pocket costs.

indexBut almost drowned out by that uproar is another state health contract with a big impact for employees and the insurance industry.

The Board of Regents this week approved two insurers to deliver medical services in 2015 to University System of Georgia employees.

The two winners currently hold University System contracts. Blue Cross and Blue Shield of Georgia has been selected as a statewide health plan, and Kaiser Permanente will offer an HMO alternative in metro Atlanta and in Athens.

CVS Caremark was chosen as the pharmacy benefits manager for the self-insured plans. full story

Georgia exchange applications hit 220,000

Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday.

Ralph Hudgens

Ralph Hudgens

Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people.

“Many Georgians completed the application process by the deadline, but have yet to pay for the coverage,” Hudgens said in a statement Wednesday.

March 31 was the official deadline for individuals to get insurance coverage or face a financial penalty under the ACA. Yet because of the deluge of last-minute shoppers, federal officials relaxed the rules for those who reported having trouble with the exchange, and gave them into this week to sign up.

Given that extra time, there have presumably been more Georgians both signing up and paying for their premiums in April. They would not be included in the figures released Wednesday. full story

State seeking more choice in 2015 health plan

State officials said Tuesday that they plan to increase the number of insurers and health plan options for state employees and teachers next year.

The State Health Benefit Plan (SHBP) has been a target of fierce criticism since Jan. 1. That’s when changes to its benefit design, plus the use of just one insurer, sparked widespread complaints about a lack of choice of insurance plans and higher health care costs.

Sarah Lesley and her daughters joined a Capitol rally in February against the change in the state health plan.

Sarah Lesley and her daughters joined a Capitol rally in February over the state health plan.

Now, though, the Department of Community Health is asking for proposals for a second statewide insurer to offer a high-deductible health plan, a Medicare Advantage plan for retirees, and a statewide HMO.

The current single insurer for SHBP, Blue Cross and Blue Shield of Georgia, would retain its health reimbursement arrangement plans and Medicare Advantage plans, plus add a statewide HMO option for the 2015 plan year. A third insurer would offer a fully insured in-network-only option for metro Atlanta, under the Community Health plan.

“SHBP is looking to enhance member choice in the 2015 plan year,” said DCH Commissioner Clyde Reese in a statement

The State Health Benefit Plan covers 650,000 state employees, teachers, other school personnel, retirees and dependents. With those numbers, the plan’s members can be a political force in an election year such as this one. When many of them began to complain about this year’s plan, and some began to organize, the state moved swiftly to amend it. full story

Deadline day for exchange busy but rocky

Like many other last-minute shoppers, radio talk show host Sidney Wood sought to sign up for insurance coverage Monday just before a midnight deadline.

Wood, of WAOK in Atlanta, originally signed up for an Affordable Care Act health plan in December, but he didn’t pay the premiums and wound up without a policy.

Sidney Wood meets with navigator Amanda Ptashkin

Sidney Wood meets with navigator Amanda Ptashkin

At a Monday event sponsored by World Changers Church International in College Park, Wood got help enrolling from Amanda Ptashkin. She’s a health insurance navigator, a specially trained guide for people using the health care exchange.

“I’m a cancer survivor,’’ said Wood, 48, adding that he has been uninsured for a couple of years.

Unfortunately, he didn’t find everything running smoothly on deadline day. Even with the expert help of Ptashkin, Wood was among legions of people across America who had difficulty making headway on healthcare.gov. full story

Athens’ medical discount plan in limbo

John Boyle, a 63-year-old Athens guitarist, has never bought health insurance. He credits good genes and good luck with keeping him healthy enough not to need it.

But now, a couple of years before he becomes eligible for Medicare, he is looking for a little extra health security.

“As I get older, I hope I can stay healthy,” he said. “It is a concern.”

YouTube Preview ImageLast year, a program designed with people like Boyle in mind was in the works in the Athens area. But now the organizers have put the plan on hold because they’re worried that it could actually discourage people from obtaining insurance under the Affordable Care Act.

(The ACA enrollment deadline for 2014 is Monday. That remains in effect, though the government said last week that people who have attempted the enrollment process and not been able to complete it will be allowed extra time, till about mid-April.)

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