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.


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.

One Blue Cross standard Advantage plan had a $221.04 per month premium, while the comparable United plan cost for a retiree was listed at $25.38.

A spokesman for Blue Cross, Tony Felts, declined to comment on the pricing difference.

He issued a statement that said, in part, “After mutual agreement with the State Health Benefit Plan, BCBSGa [Blue Cross] has made a strategic, yet difficult decision to no longer offer Medicare Advantage products to SHBP members for 2015. We will provide assistance to current BCBSGa Medicare Advantage members as they transition to a new carrier for next year. BCBSGa will focus its efforts on providing outstanding value and service to the SHBP membership, and we look forward to offering Medicare Advantage plans to the SHBP in future years.”

Lisa Marie Shekell, spokeswoman for Community Health, said Monday that the Medicare Advantage pricing is a function of what the companies bid, and that the state applies subsidies the same to each plan.

She added that retirees whose email addresses were known to the agency were sent a message about the Blue Cross move last week. Others, she said, will get the information this month by postal mail.

Blue Cross will still offer non-Medicare options in the SHBP that include three health reimbursement arrangement choices, along with a statewide HMO option.

UnitedHealthcare will offer members the options of a statewide HMO and a high-deductible health plan, as well as Medicare Advantage.

UnitedHealthcare spokeswoman Tracey Lempner issued a statement about the Blue Cross move, “Our experience serving the health care coverage needs of more than 90 percent of Georgia State Health Benefit Plan retirees has prepared us well for 2015. We intend to continue working closely with the Department of Community Health throughout the fall and look forward to offering state retirees the affordable coverage and quality benefits they’ve come to expect from our Group Medicare Advantage PPO plan.”

Open enrollment for SHBP members begins Oct. 27 and ends Nov. 14.

Community Health is stepping up its communication with SHBP members this year after acknowledging inadequate outreach last year during the enrollment period.

State employees, teachers, and school personnel are getting a wider array of insurers and choices in their 2015 health plan.

Some employees and teachers were vocal in their criticism of their current plan options since Jan. 1, when the plan took effect. The benefit changes made for 2014, plus the use of just one insurer, sparked widespread complaints about a lack of choice of insurance providers and higher health care costs.

Overall, the State Health Benefit Plan covers more than 650,000 state employees, teachers, other school personnel, retirees and dependents.