TRAGIC: New State Benefit Plans "Are Not Affordable Options"

A Cherokee County-based advocacy organization that pushed for changes in the State Health Benefit Plan are denouncing new options approved by the Georgia Department of Community Health.

The 2015 plans for State Health Benefit Plan members, which were approved on Aug. 14, ”are not affordable healthcare options,” according to members of the Teachers Rally Against Georgia Insurance Changes.

The latest changes allows the board to “take another important step forward in providing the best possible array of vendors, plan options, and rates for our members,” said DCH Commissioner Clyde L. Reese III, Esq.

TRAGIC believes the latest plans contradict what SHBP Chief Jeff Rickman asserted: that rates would stay the same or possibly decrease for plan members. The majority of active member plan options will lead to price increases, which have been calculated as high as 180 percent, TRAGIC said in a press release.

With the exception of the High Deductible plan, most members will see a significant increase in premiums if they choose to select a new plan, the organization argues.

“The deductibles and out-of-pocket maximum are still way out of line with the salaries of SHBP members, and out of line with comparable plans offered under the University System of Georgia,” stated TRAGIC founder Ashley Cline of Canton, whose husband is a Creekview High School teacher. “The premiums are over 50 percent higher than the University System of Georgia out-of-pocket maximums and the out-of-pocket maximums plus premiums are 40 percent to 80 percent of the average starting teacher’s salary.”

The options, which were approved during the DCH’s board meeting, include:

• Blue Cross Blue Shield of Georgia: statewide Gold, Silver, Bronze Health Reimbursement Arrangement (HRA) (exclusively), statewide Health Maintenance Organization (HMO), Medicare Advantage (standard and premium)
• UnitedHealthcare: statewide High Deductible Health Plan (HDHP) (exclusively), statewide HMO, Medicare Advantage (standard and premium)
• Kaiser Permanente: fully-insured HMO for SHBP members who live or work in the 27-county metro Atlanta service area.

The board noted the current pharmacy benefit manager contract with Express Scripts Inc. and the current wellness contract with Healthways Inc. will be renewed for 2015, and will provide benefits to members who choose to enroll in either Blue Cross Blue Shield or United Healthcare.

The state in the next few months will work with the vendors to “finalize the benefit offerings of each plan option,“ DCH said in its news release. Open enrollment will be held from Oct. 27 to Nov. 14 for the January 1, 2015, start date of the new plan year.

The Georgia Department of Community Health administers the SHBP, which has around 650,000 members. Those members include teachers, school district employees, corrections officers and those working with state agencies.

TRAGIC spokesperson John Palmer also questioned the published rates for the 2015 Medicare Advantage plans.

“Retirees on the Blue Cross Blue Shield Medicare Advantage Plan are going to have to pay (between) 310 percent and 770 percent to keep their same coverage. How is this affordable? Why is the BCBS Medicare Advantage standard plan almost 800% higher than the comparable UnitedHealthcare plan?”

Palmer also said the healthcare costs are an additional burden on struggling state workers.

“Continuing to cut the take-home pay of teachers and state employees through higher insurance costs will drive good teachers and state employees away, and make it harder to recruit and retain highly qualified candidates to state agencies,” he stated. “ Why commit to a job where the Out-of-Pocket insurance costs may be higher than the yearly salary?”

Cline noted the Department of Community Health shouldn’t lose focus of its mission to provide affordable, quality health insurance to its members.

“The Department of Community Health needs to consider the financial constraints and hardships of the hard-working state employees, teachers and retirees of Georgia who rely on the State Health Benefits Plan to provide insurance for themselves and their families,” she added.