Design changes over the past two years prevent more than $1 billion deficit
ATLANTA – The Georgia Department of Community Health (DCH) continued its work to secure solid financial footing for the State Health Benefit Plan (SHBP), the health insurance plan that covers 663,000 state employees, teachers, school personnel, retirees and dependents. Without the action taken by DCH over the past two years, the SHBP would be facing a deficit of more than $1 billion at the end of FY2014. By incorporating additional structural and plan changes, officials are forecasting a balanced budget for FY 2014.
“As health care costs continue to rise across the nation, we have worked diligently to eliminate SHBP’s projected deficits and still deliver value to our customers,” said David A. Cook, DCH commissioner. “At this time last year, the plan faced a projected deficit of $815 million. We successfully reduced that by $750 million through structural and plan changes and finished FY 2012 with a $16 million surplus. Structural and plan changes this year and next will address concerns going forward for the next two years. Although costs have gone up, SHBP management has strived to keep the program a solid value for employees.”
Premiums in Georgia are comparable or lower than other Southeastern states, while offering more options. For example, some other states do not even subsidize spousal or dependent coverage for employees. For other states, similar coverage can cost more than 50 percent more than Georgia’s.
DCH has continued to move toward the goal of achieving a 25 percent/75 percent employee/employer split in paying for the costs of insurance. Premiums have been adjusted each year as DCH moves toward the 25 percent/75 percent goal. Groups most affected include categories of employee plus family, for which the state has been subsidizing the spousal portion of the family premium for a number of years. During the transition premium increases for family coverage were capped at a maximum of $90.The state also dropped the $50 per month spousal surcharge.
“We are moving toward the premium for adults – employees and their spouses – being closer to 25 percent of the cost of insurance, as it is with most public and private insurance plans,” said Trudie Nacin, director of the SHBP. “We are striving for an equitable and fair way to address the financial issue while continuing to provide quality health care insurance for our members.”
Wellness and Consumer Choice
SHBP offers a variety of Standard and Wellness plan choices for members, including Health Reimbursement Accounts (HRA), Health Maintenance Organizations (HMO) and High Deductible Health Plans (HDHP). Georgia’s Wellness Plan, with more than 330,000 enrollees, is the largest in the nation. It was introduced in 2012 to incentivize members to become more engaged in their health care and well-being.
“Members who select a Wellness Plan experience lower premiums in return for becoming engaged in their health care,” Nacin said. “This year, members who enrolled in a Wellness Plan agreed to complete an online health assessment and have a biometric screening to measure their blood pressure, blood sugar, body mass index and cholesterol. More than half of our members in the Wellness Plans completed their Wellness Promise.”
DCH will be continuing the plan design and structural changes that were introduced in 2012. Those include the use of direct billing, increasing the employer contribution rates for non-certificated school employees and the voluntary wellness options.
About the Georgia Department of Community Health
Through effective planning, purchasing and oversight, the Department of Community Health (DCH) provides access to affordable, quality health care to millions of Georgians, including some of the state’s most vulnerable and underserved populations.
DCH is responsible for Medicaid and PeachCare for Kids,® the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.
David A. Cook serves as Commissioner for the Georgia Department of Community Health.
To learn more about DCH and its dedication to A Healthy Georgia, visit www.dch.georgia.gov.