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Retired Employees

Retirees exercising

Below you will find Decision Guides, rates and more for retirees (including annuitants and other former employees continuing coverage).

Members will experience a number of positive enhancements as a result of the new SHBP plan options.  The 2014 plan options (listed below) are designed to provide members with affordable premiums and their choice of plan options that best meets their needs.

Medicare Advantage (MA) Plan Options

  • UnitedHealthcare Medicare Advantage (MA) PPO – Standard
  • UnitedHealthcare Medicare Advantage (MA) PPO – Premium

Claims administration for MA plan options is provided by UnitedHealthcare for medical and pharmacy benefits.

Members may use any Medicare-eligible provider.

MA plan options are the only subsidized options for retirees age 65 and older

OR

Non-Medicare Advantage (MA) Plan Options 

Blue Cross Blue Shield of Georgia (BCBSGa)

  • Health Reimbursement Arrangement (HRA) without co-payments
    • Gold HRA
    • Silver HRA
    • Bronze HRA
  • Health Maintenance Organization (HMO), Statewide

UnitedHealthcare

  • High Deductible Health Plan (HDHP)
  • Health Maintenance Organization (HMO), Statewide

Express Scripts administers the prescription drug benefit for members enrolled in BCBSGa and UnitedHealthcare.  Express Scripts provides benefits for retail prescription drug products, mail order, home delivery and specialty pharmacy services.

Healthways provides members enrolled in BCBSGa and UnitedHealthcare with comprehensive well-being resources and incentive programs.  Healthways also administers the 2015 action-based health incentives that allow those SHBP members and covered spouses to additional well-being incentive credits.

Kaiser Permanente of Georgia (KP)

  • Health Maintenance Organization (HMO), Regional
  • The Medical, Pharmacy and Wellness benefits are administered by KP for their members only.

​​Note: You must live or work in one of the below 27 counties within the Metro Atlanta Service Area to be eligible to enroll in KP:

Barrow Cherokee Dawson Forsyth Heard Newton Rockdale
Barton Clayton DeKalb Fulton Henry Paulding Spalding
Butts Cobb Douglas Gwinnett Lamar Pickens Walton
Carroll Coweta Fayette Haralson Meriwether Pike  

Other Plan Options (not administered by SHBP)

  • The TRICARE Supplement is available to those members enrolled in TRICARE.
  • PeachCare for Kids® continues to be available to the children of eligible SHBP members.

Additional Information

Member rates are established by the Board of Community Health.  For the Board rate resolutions, which describe subsidized rates, unsubsidized rates and subsidy policies, see Plan Documents.

Your Summary Plan Description(SPD) contains several sections specifically designed for individuals who are continuing SHBP coverage after termination of employment with an employer that offered SHBP coverage, or who are enrolled as a surviving spouse or child of an annuitant.  Although commonly referred to as “retirees,” there are important distinctions between those who continued coverage with an immediate annuity, those enrolled as survivors of annuitants, and those who continue coverage through extended coverage rules. 

In addition, there are many active employees enrolled in the SHBP who do not have a right to continue coverage after employment except for temporary COBRA continuation.  Please see Plan Documents for SPDs, rate resolutions, and annuitant subsidy policies.  More generalized information can be found under Health Plans and Programs and in the Retiree Decision Guide included below.