The Anthem plans include Gold, Silver, and Bronze HRA plan options, and an HMO plan option.  On the HRA plan options, most services are subject to a deductible and there are no copays.  After you meet your in-network deductible, you pay coinsurance up to the out-of-pocket maximum.  For prescription drugs, you pay a percentage of the retail cost.  The HRA plans include a plan-funded Health Reimbursement Account to reduce / offset your deductible and pharmacy expenses (unused balances carry forward into new plan years).  Preventive care is covered at 100% in-network before the deductible, and certain drug costs are waived if you participate in a Disease Management Program (diabetes, asthma and coronary artery disease).  To participate, contact Anthem.

The HMO plan option has the lowest deductible out of all plans, but provides in-network coverage only.  Some services (office visits, ER visits, and prescription drugs) are covered at 100% after a copay.  For most other services, you are responsible for a deductible and coinsurance until you meet your out-of-pocket maximum.  Please be aware that copays do not count towards your deductible.  Preventive care is always covered at 100% before the deductible, and certain drug costs are waived if you participate in a Disease Management Program (diabetes, asthma and coronary artery disease).  To participate, contact Anthem.

CVS Caremark is the pharmacy vendor for all medical options. 

• For the HRA, you pay a percentage of the cost subject to a minimum and maximum per prescription. 
• For the HMO plans, prescription drugs are covered at 100% after a copay at participating pharmacies.  
• For the High Deductible Health Plan, prescription drugs are subject to deductible and then coinsurance, similar to other medical services. 

The pharmacy costs are included in your out-of-pocket maximums, and a mail order benefit for a 90 day supply is also available. 

For active employees with spouses that are enrolled in Medicare and not disabled, SHBP is primary.  The spouse is not required to elect Part B (medically necessary services such as outpatient care and preventive care) until the active employee retires.  However, the spouse will automatically receive Part A (hospital insurance). 

The medical plans include a telemedicine benefit, which allows you to speak to a participating doctor from home or work through your smartphone, tablet or computer 24 hours a day / 7 days a week.

You must use in-network providers for coverage to apply.  HMO members pay a copay and HRA members pay coinsurance for telemedicine.  High Deductible Health Plan members can access this benefit subject to the health plan deductible.

Download the LiveHealth online (Anthem) or the Virtual Visits (UHC) mobile app for convenient access when you need it, and remember to consider using telemedicine for non-complex medical conditions. 

More information is available under Resources.

• If you wish to add dependent(s) (spouse and / or children) to your health plan, ADP will contact you (by mail and email) to request appropriate verification documents.  If you do not receive the request, contact SHBP directly to have the request sent to you.  They can be reached at (800) 610-1863.
• The communication from ADP will include a personalized fax cover sheet with a bar code that must be used when submitting documentation.
• Appropriate documentation must be attached to the fax cover page and provided by the deadline set by ADP.
• Non-verified dependents cannot be added until the next open enrollment period and would require appropriate documentation.
• Additional information can be found on the SHBP website.

TriCare Supplement Plan

The TriCare Supplement Plan is available for retired military employees, and is a supplement to your current TriCare benefits.  The plan provides reimbursement of copays and other medical expenses associated with your current TriCare plan.  Additional information can be found here.

PeachCare for Kids

The state of Georgia offers an affordable health insurance program called PeachCare for Kids.  This plan provides healthcare, dental, and vision benefits for children up to age 19.  To learn if you are eligible, and to obtain benefits, cost, and application information, click here.