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SHBP Info and Stats
The Department of Community Health administers the State Health Benefit Plan (SHBP). The SHBP provides health coverage to nearly 700,000 state employees, teachers, retirees and dependents. Teachers and school personnel represent 72 percent and retirees comprise about 18 percent of the covered lives.
Six operating units within the SHBP process and manage the information necessary for member coverage and claim payments. The units and responsibilities are as follows:
- Plan Management determines benefit Plan design and negotiation of vendor contracts and compliance.
- Clinical Services oversees the vendors clinical and quality operations, as well as, assists members and providers with questions related to clinical coverage issues that include, but are not limited to, medical/surgical procedures, wellness, disease management, behavioral health, transplants, durable medical equipment and pharmacy management.
- Communications provides information to both payroll locations and members on the plan’s workings and changes.
- Employer Services assists employer and agencies research and solve any employee problems and to assist employers with SHBP Bills and training issues
- Member Services applies the eligibility regulations and assists members with their issues and problems and efficiently process member changes and payroll deductions.
- Vendor Program Management provides oversight and monitoring of vendor performance, member correspondence and eligibility appeals.
State Health Benefit Plan
Membership Enrollment as of January 2012
Covered Lives by Option
| Option | Current Month’s Totals |
| UHC Standard HMO | 111,903 |
| UHC Wellness HMO | 133,480 |
| UHC Standard HRA | 80,983 |
| UHC Wellness HRA | 174,833 |
| UHC Standard HDHP | 10,934 |
| UHC Wellness HDHP | 13,485 |
| UHC MA PPO Standard | 41,994 |
| UHC MA PPO Premium | 38,492 |
| CIGNA Standard HMO | 11,470 |
| CIGNA Wellness HMO | 16,126 |
| CIGNA Standard HRA | 10,321 |
| CIGNA Wellness HRA | 25,950 |
| CIGNA Standard HDHP | 1,536 |
| CIGNA Wellness HDHP | 2,302 |
| CIGNA MA PPO Standard | 2,095 |
| CIGNA MA PPO Premium | 2,156 |
| Tricare Supplement | 317 |
| Total | 678,377 |
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