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Health Insurance

Another important change in state benefit plan

Blue Cross and Blue Shield of Georgia is dropping its Medicare Advantage plan for next year for retirees in the State Health Benefit Plan.

That means UnitedHealthcare will be the sole provider of the Advantage plans for 2015. (Blue Cross is the sole provider for 2014.)

The Georgia Department of Community Health is informing retiree health plan members about the Blue Cross move through email and letter this month, letting them know that the decision won’t affect the coverage in effect for the current year.

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Medicare Advantage is a health plan offered by a private company that contracts with the federally administered Medicare program to provide benefits. The majority of the 54 million people on Medicare are in the traditional Medicare program, with about 30 percent enrolled in an Advantage plan, according to the Kaiser Family Foundation.

More than 102,000 people are in Medicare Advantage plans under Georgia’s State Health Benefit Plan, according to Community Health, which runs the health plan.

Blue Cross said Monday that its decision to discontinue its Advantage plan was made jointly with the SHBP.

Still, in a comparison of next year’s rates, Blue Cross had premiums that were much higher than United’s. full story

2 nonprofits share $3.3 million in ‘navigator’ grants

Two nonprofit organizations will divide $3.3 million in federal money to provide “navigators” to help consumers enroll in the Georgia health insurance exchange this fall, the federal government announced Monday.

Sylvia Burwell

Sylvia Burwell

Navigators provide face-to-face, in-person help for consumers seeking information about the exchanges.

SEEDCO (Structured Employment Economic Development Corporation) will receive nearly $2.2 million, roughly the same as it received last year as a navigator grantee.

The second grantee will be an alliance led by Macon-based Community Health Works and consisting of cancer coalitions and other organizations. It will get $1.1 million.

Nationally, U.S. Health and Human Services Secretary Sylvia M. Burwell announced $60 million in navigator grant awards to 90 organizations in states with federally facilitated and state partnership exchanges. Also known as marketplaces, the exchanges were created under the Affordable Care Act, sometimes known as Obamacare. full story

Another insurance deadline only days away

More than 20,000 Georgians have until next Friday to provide missing information or they will lose their insurance exchange coverage Sept. 30.

Renard Murray

Renard Murray

The regional administrator of the federal Centers for Medicare and Medicaid Services told GHN on Friday that most of the data discrepancies involve immigration or citizenship issues.

Letters requesting further information were mailed earlier in August to 310,000 people in three dozen states that have their insurance exchange run by the federal government. The exchanges were created under the Affordable Care Act.

Georgia’s total of 20,900 people getting the notices was the third-highest total in the nation, after Florida’s 93,800 and Texas’ 52,700.

Renard Murray, the regional CMS administrator, said the federal agency has been working on getting this information for months, and that as many as seven letters requesting data have been sent to some people. full story

Key activist group sees flaws in state health plan

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. full story

State health plan choices for 2015 draw praise

Many state employees and teachers will see no increase in their health insurance premiums next year under rates approved by a state agency’s board Thursday.

The State Health Benefit Plan members will have choices among plans offered by three health insurers, rather than a single insurance company this year.

The SHBP covers 650,000 state employees, teachers, other school personnel, retirees and dependents. With those numbers, the members of the health plan have proved to be a potent political force in this election year.

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

Changes in the health plan that started Jan. 1 triggered fierce criticism from members, who complained about a lack of choice of insurance plans and higher health care costs. A Facebook group (Teachers Rally to Advocate for Georgia Insurance Choices, or TRAGIC) attracted thousands of members. Teachers and state employees rallied at the state Capitol, protesting the new health plan design.

TRAGIC members Thursday praised the wider health plan options.

“I’m glad to see we have a choice,” said a member of the group and a retired Marietta teacher, Julie Jarrett, after the Department of Community Health board vote Thursday. (Community Health oversees the state health plan.)

Many SHBP members had trouble understanding the 2014 Health Reimbursement Arrangement (HRA) and how it worked, Jarrett added.

“I’m happy they’re going to educate all the members what the HRA really is,’’ Jarrett said Thursday. “They didn’t do that last year.” full story

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