State employees and teachers will face an average premium increase of about 3.7 percent for coverage next year in the State Health Benefit Plan.
The SHBP deductibles, co-pays, co-insurance, and health plan options will remain the same as this year, the Georgia Department of Community Health said Thursday at an agency board meeting.
The rate hikes for non-Medicare plans will depend on the insurance plan options that a member selects, DCH officials said. Premium increases approved in 2016 for the current year’s coverage averaged 2.5 percent.
Medicare Advantage premiums will also depend on member choice, officials said
The $3.1 billion SHBP covers about 650,000 state employees, teachers, other school personnel, retirees and dependents.
Changes in the giant health plan have sparked political controversy in recent years. In 2014, an avalanche of complaints from members of the plan erupted after employees were limited to one insurer, among other changes. That led state officials to implement a quick fix for that year’s plan and to make more revisions in the 2015 plan.
Debra Charnote, a state employee who’s a member of an SHBP advisory council, said Thursday that the 12-member group was pleased by the rates and benefits designs for next year.
“Overall, the plan that was presented was encouraging, with more choices and little to no increases to our premiums,’’ she told the Community Health board.
The 3.7 percent premium hike is modest compared to the large double-digit percentage increases that insurers are proposing for individual coverage in the insurance exchanges next year. And large employers in a recent survey said the costs of their health plans will grow 5 percent next year.
Sid Chapman, president of the Georgia Association of Educators, said that “when you hear about the constant uncertainty in the health care market and the proposed double-digit increases across the country, 3.7 percent sounds rational. However, due to local school district waivers, we have many teachers who have yet to receive the raises put forth by Gov. [Nathan] Deal and passed by the Legislature. For them, any health care increase amounts to a reduction in their take-home pay. We just expect that leaders at the SHBP will continue to do everything in their power to keep any increases as sensible as possible.”
A group that has acted as a watchdog on SHBP moves in the past said it’s thankful that members continue to have choices of health plans. A spokesman for the Facebook group Teachers Rally to Advocate for Georgia Insurance Choices (TRAGIC) also said Community Health “has tried to keep premium costs down as best they can, working within the budget prescribed by the Legislature.”
But the TRAGIC spokesman, John Palmer, also noted that Georgia used SHBP reserve funds in the past to help balance the state budget.
“SHBP helped the state through the Great Recession with over $600 million in reserve funds; teachers and state employees rebuilt those reserves over the past decade by paying higher premiums and taking on a greater share of health care costs,’’ Palmer said.
“While Georgia has built up over $2 billion in surpluses, state workers have seen higher health care ‘cost-sharing’ affect their personal finances every year,’’ he said. “These increases add up over time and, combined with stagnant wages, hurt the state’s ability to attract and retain quality candidates for state agencies and local school positions.”
Overall SHBP costs are increasing at a 4.7 percent rate, Jeff Rickman, division chief of the SHBP. He did not provide further details on that cost growth Thursday.
Open enrollment for SHBP members will run from Oct. 16 to Nov. 3.
Members will again have a choice of HMOs; a Health Reimbursement Arrangement (HRA) with Gold, Silver and Bronze options; a High-Deductible Health Plan; and Medicare Advantage.
The health insurers offering coverage are Blue Cross and Blue Shield of Georgia; UnitedHealthcare; and Kaiser Permanente. The HMO run by Blue Cross has the highest number of enrollees this year, at 27 percent.
The Professional Association of Georgia Educators said Thursday that keeping SHBP out-of-pocket costs and plan options the same was good for members. But Craig Harper of PAGE added that “it’s disappointing that the average premium increase is higher than the increase was last year, and increased rates cut into the bottom line of overall teacher compensation.”
The SHBP will have a new pharmacy benefit manager, CVSHealth, beginning in January. The wellness program provider, Healthways, was acquired by Sharecare, which officials say can help raise member engagement.
Sharecare uses a smartphone app and website to provide a more member-driven approach to personal wellness, Community Health said.