ATLANTA — 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.
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.”
In January, the Community Health board responded to the employee uproar over the health plan by voting to replace the HRA co-insurance system with one based on co-pays.
Clyde Reese, commissioner of the Department of Community Health, said Thursday that the state is projecting an increase in overall spending in the $3 billion health plan as a result of the new options.
“We’ve listened to our members…and to the provider community,’’ said Reese. He called the remodeling of the health benefits “a positive and important step to have a plan we can be proud of.’’
David Stacks, whose wife is a retired teacher in Augusta, added Thursday, “Generally speaking, it sounds like the SHBP and Commissioner Reese got the message that the SHBP needs to offer more choices.’’
Blue Cross and Blue Shield of Georgia, currently the only insurer providing medical plans this year, next year will give SHBP members three HRA choices and a statewide Medicare Advantage to retirees, along with a statewide HMO option.
UnitedHealthcare will offer members the options of a statewide HMO, a high-deductible health plan and a statewide Medicare Advantage plan.
A second new insurer, Kaiser Permanente, will offer an HMO plan in metro Atlanta, Community Health said.
The SHBP chief, Jeff Rickman, told the Community Health board that if employees stay with the HRA plan they have now, they will have no monthly premium increase.
If they move from the HRA to United’s HMO, they will get a premium hike, but if they move to United’s high-deductible health plan, their premium will decrease.
If the current HRA member shifts to Blue Cross’ HMO or Kaiser’s HMO, those with the Gold Plan option will see their premiums drop, while those in a Silver or Bronze plan will have their rates increased.
Deductibles and co-pays will vary with the member’s plan choices, Reese said.
After the board meeting, Jarrett and other TRAGIC members expressed concern about what they see as high deductibles.
Kevin Edwards, a Gwinnett school bus driver, said the current deductibles made it difficult for many lower-paid school employees to afford to go to a doctor. Because of the increased costs of care, Edwards said, “last year we lost a lot of bus drivers — they quit.”
Ashley Cline, the founder of TRAGIC, praised the new offerings in the health plan, but added, “Premiums, deductibles and out-of-pocket maximums are still high in relation to the salaries of state employees who utilize these plans, so we will continue to advocate for affordable coverage for our families in 2015 and beyond.”
The SHBP this year was expected to offer a health plan alternative – a metro Atlanta HMO offered by Kaiser Permanente – but the Community Health board voted against the proposal, noting it would not be offered statewide. That disparity is addressed in the 2015 plan design.
Morgan Kendrick, president of Blue Cross, said Thursday that he had anticipated having competition this year from Kaiser.
Kendrick said of the increased competition from health insurers in 2015: “It’s our job to continue to provide value…and spectacular customer service to our members.’’
The SHBP has been buffeted by controversy for more than a year.
The state’s original contract award to Blue Cross was appealed by UnitedHealthcare, which called the contracting process “state-sponsored bid-rigging.’’ The Department of Community Health strongly denied that characterization and dismissed the appeal.
Another controversy erupted when medical groups said they were upset about having to collect money from state employees and teachers – payments that were linked to the benefits shift earlier this year.
Open enrollment for the SHBP will be held Oct. 27 to Nov. 14 for the Jan. 1, 2015, start date of the new plan year.
Andy Miller is editor and co-founder of Georgia Health News, Inc.