Georgia SHBP Blues

If things go as expected, state and local employee’s enrolled in the Georgia SHBP might be singing the Blues. Cigna and United Health Care may lose their lucrative contract to provide coverage for the state health plan and Blue Cross muscles their way back in.                    Georgia SHBP

An issue that Reese and his staff (at Community Health) face is the new contract for the State Health Benefit Plan (Georgia SHBP), which covers more than 650,000 state employees, teachers, school personnel, retirees and dependents.

Currently, UnitedHealthcare and Cigna hold the contract, with United covering more than 90 percent of members. Community Health had been expected to announce the winner of the new contract early in July. The winner would begin serving members Jan. 1.

Speculation on the winning bidder has centered on a single vendor — Blue Cross and Blue Shield of Georgia, the state’s largest health insurer.

Georgia Health News

Blue Cross had the Georgia SHBP for years and lost it to United and Cigna about 5 years ago. At the time the transition was not without issues as United scrambled to complete their network in the rural areas of the state. Within a few months hospitals in almost every county were eventually signed up with United and the turmoil subsided.

But some industry officials say they fear that Blue Cross’ reimbursements for services will be lower than the current rates, and lead to a financial squeeze for some medical providers.

Now that it’s mid-July, contract concerns are swirling. Community Health said it anticipates making an announcement on the winning vendor soon. But beyond that, it said, it “cannot comment on open and ongoing procurements.’’

Blue has already thrown their hat in the ring and as of now will be the only carrier offering coverage on the Obamacare exchanges in all Georgia regions.

Individuals seeking a premium subsidy can only get taxpayer assistance if they buy through the exchange and in some areas your choice will be Blue Cross or Blue Cross.

So much for more competition under Obamacare . . .

Doctors and hospitals currently participating in the Georgia SHBP may opt out of the Blue Cross contract if they feel the reimbursements are too low compared to what they have been accustomed to with United and Cigna. This could be bad news for employees who have health insurance through the Georgia SHBP.

 

Dental Insurance Georgia

Dental insurance, affordable Georgia plans to fit every budget. No waiting period on many dental insurance plans. No restrictions on pre-existing conditions.

Georgia Insurance Shop has dental insurance plans from many leading carriers including BCBSGA, Cigna, Humana and more.

Most dental plans are not insurance. Understand the difference BEFORE you buy.Humana One

  • dental plans offer discounts, not insurance coverage
  • dental plans can only be used at a small number of dental practices
  • dental plans are cheap for a reason. You have NO coverage

Dental insurance will actually PAY for most procedures. Many dental insurance plans cover routine exams and cleanings at no charge to you. For basic and major dental work, your dental insurance plan will pay a portion of the bill and you will be responsible for the balance.

Some dental plans, such as those offered by Blue Cross (BCBSGA) only pay a flat amount leaving you to owe a bundle for your treatment.

If you want a Cigna dental insurance plan you must first buy their major medical insurance.

Other dental insurance plans, including the C550 from Humana, offer the following benefits and do not require you to purchase health insurance from them..

  • no waiting period
  • no deductibles
  • copay’s for most procedures
  • no annual or lifetime maximum cap on benefits

Dental discount plans are generally priced in the $6 – $11 monthly range. Dental insurance plans begin around $16 per month for single coverage and can range upwards of $40 or more. Dental insurance plans that deliver the most VALUE do not have to be expensive. Many, such as Humana C550 offer tremendous value.

Cigna Lowers Rates

Cigna lowers rates on major medical plans in Georgia. Bucking the trend, Cigna has dropped rates on new AND RENEWAL individual and family major medical plans by double digits.

Imagine my surprise when I opened a renewal letter for one of my Cigna clients and noticed their rates would be 14.39% LOWER on the plan anniversary. This is unheard of. Health insurance rates DROPPING at renewal?

Cigna is one of the largest health insurance carriers in the country. They introduced their major medical line of coverage for individuals and families to Georgia residents about 3 years ago.

Offering a mix of HSA and copay plans, there are many benefits to their policyholders.

  • All copay plans have UNLIMITED doctor visits
  • Wide range of major medical deductibles from $1,000 to $10,000
  • Some copay plans offer 100% coverage after the deductible is satisfied
  • Complications of MATERNITY covered at no additional charge
  • Optional DENTAL coverage for major medical policyholders
  • HSA qualified plans with deductibles of $2500 – $5000

Fast turn around time on electronic applications submitted direct to Cigna using this link.

Cigna Dental Insurance

Cigna dental insurance for Georgia individuals and families. Find Cigna dental plans and rates. Instant Cigna dental quotes.  

Cigna dental insurance

Dental insurance from Cigna allows you to use any dentist. Additional discounts and lower out of pocket apply when you use a Cigna participating dentist. Cigna dental plans offer the following:

  • Low annual per person deductible applies to Basic and Major services
  • Cigna dental preventive services covered at 100%, deductible does not apply
  • Fillings, non-routine X-rays, emergency services and simple extractions, Cigna dental pays 80% of allowed charges after deductible
  • Crowns, inlays, root canal, periodontics and anesthetic, your Cigna dental plan pays 80% of allowed charges after deductible.

Dental insurance from Cigna is not available as a stand alone policy, it must be purchased as an add-on to a Cigna major medical health insurance plan. 

If you are looking for a superior dental insurance plan without major medical, consider one of the Humana dental insurance plans. Humana Preventive Plus is an excellent value, and allows you to use any dentist.

Cigna dental insurance plans require a 6 month waiting period before you can access Basic services and a 12 month waiting period before Major services are available for use. Your Cigna dental plan has a $1000 annual maximum on covered services.

Coinsurance applies to Basic and Major services. The amount paid by Cigna dental plan is a percent of their internal fee schedule for participating dentists. This is NOT the same as paying 80% or 50% of actual billed charges. If you use a Cigna participating dentist your out of pocket will be less than using a non-par dentist. 

Cigna dental plans and dentists are available in Atlanta and Athens. Coming soon to other areas of the state.

As with most dental insurance plans, benefit restrictions and policy limitations apply. Ask for a Cigna dental insurance plan summary of benefits for full details.

Cigna Lowers Rates

Cigna of Georgia lowers rates for 2012 by as much as 25%. January, 2012 and later will reflect the new, lower rates.

Apply direct with Cigna. Cigna Health Insurance

Run rates. Compare plans. Appy direct.

Compare Cigna major medical and Cigna dental with other plans.

Georgia Insurance Shop has the lowest major medical rates in the state.

 

Obamacare Casualties

Five more health insurance companies become casualties in the Obamacare war on consumers. Aetna, Cigna, Guardian, American Community and Pekin will all leave the individual major medical market in the next few months. Together, these 5 insurance companies cover about 10% of those with individual health insurance in the state of Indiana.

Obamacare sinking

As reported by the IBJ . . .

Their major complaint is about the new health law’s requirement that at least 80 percent of premiums be spent on medical bills. That new rule, known formally as a medical loss ratio or MLR, takes effect this year for all individual policies the insurers hold, not just new policies.

The insurers argue that the marketing and administrative expenses on individual policies are so high that they cannot transition so quickly to the new standard.

Even if they could make the change, policyholder services are already suffering due to downsized customer service departments. This means longer hold times and a greater chance of getting voice mail in lieu of a real person.

Many carriers have already shifted their customer service overseas to places like India and Pakistan where wages are lower.

Imposing loss ratio's on company's operating in a competitive market is stupid to say the least. If a carrier spends too much on themselves and it leads to an increase in premium rates they will lose market share.

The idiot's in DC look at pockets where market saturation is dominated by one or more carriers and claim this is proof positive that more regulation is needed. According to the report, Anthem Blue Cross has a 65% market share which politicians use to defend their position.

I look at the same thing and say they must be doing something right, delivering good value, or else their market share would be significantly less.

Golden Rule health insurance is number 2 in Indiana with 10% of the market.

If Blue Cross has 6.5x the market share of Golden Rule one must conclude that Blue delivers a better value than Golden Rule. Their pricing has nothing to do with how much, or how little, either carrier spends internally on administration.

So far Georgia is pretty much immune to the wholesale withdrawal by health insurance companies but our time is coming. I would not be surprised to see Aetna or Cigna pull out of Georgia before the end of the year.

Their products have failed to deliver good value for some time and the same can be said for Golden Rule who have been uncompetitive for over 3 years now.

Bob Vineyard at Georgia Insurance Shop is willing to help GA citizens find affordable health insurance for individuals, families and business owners.

Out of State Health Insurance

The GA legislature approved the sale of non-compliant health insurance, an incredibly stupid idea. Carriers approved to sell health insurance in Georgia will be allowed to offer plans approved in other states that have fewer mandates. The belief is this will create more choice and lower prices.

They are wrong.

With this passing, a company such as Cigna could offer a policy they sell in Texas to be sold in Georgia. On the surface, the policy may seem identical to ones offered here but the devil is in the details.

Details you will not know about unless you read the policy limitations and exclusions section.

Something no one ever does.

These non-compliant plans will have to be filed with the Georgia Dept. of Insurance and approved before they can be sold here. That process can easily take a year or longer. United Healthcare spent 4 years applying to get new policies approved. Those plans were finally approved in October of 2010.

So where will consumers find these policies?

Only by calling the carriers direct and even that is questionable. Good chance the carrier won't have Georgia rates for a Texas plan and will not care to develop that rate structure.

Current quote engines are not programmed to illustrate policies from other states on a side by side basis. If a consumer wants to see the Texas plan and compare it to a Georgia plan they won't be able to do that.

They can run a quote for Georgia, then one for Texas (using a Texas zip code) but even then the Texas quote won't be accurate. That plan is priced based on the cost of health care in Texas, not Georgia, so consumers won't know if the plan is less expensive or not.

With Obamacrap unfolding in 2014, I doubt any carriers will be willing to invest money to reprice plans to be sold in other states. Even if they do, there is the expense of filing the new plan and rates and underwriting guideline with in different states.

In fact, many carriers are withdrawing from the individual major medical market and have no desire to expand since the rules, and rates, will all change in 2014.

Bottom line is this.

The legislators spent all this time and effort to approve a bill that will accomplish nothing.

This is what happens when elected officials, that have no understanding about the industry they are attempting to regulate, make laws.

Just another stupid government trick.

Obamacare and Single Payer

For some reason, many think they want a single payer health care system. What they don't know is, Obamacare has already created that in some situations.

I had a call today from a lady looking for health insurance with maternity coverage. I told her how her options were limited to one carrier. When she asked why, I said this was due to Obamacare.

She became annoyed and said this is why we need single payer so the carriers won't hold us hostage.

At this point I had no desire to give singing lessons, so I thanked her for calling and went back to the business at hand. But that got me thinking.

If you consider states like Maine that have intense regulation and mandates with regard to health insurance then it doesn't take long to figure out the only choice other than a government plan is Blue Cross.

If you don't like or don't qualify for the taxpayer funded plan you buy from Blue Cross . . . and you pay some of the highest health insurance premiums in the country.

Obamacrap has come to Georgia already in a sense. Last spring if you wanted maternity benefits you could pick from about a half dozen health insurance companies and different kinds of maternity benefits.

Thanks to Obamacrap, now you have one choice.

Blue Cross.

If you want maternity coverage in Georgia you buy from Blue Cross. The additional premium (in addition to the regular premium on this "Cadillac" plan) is about $200 per month. You must pay that premium for 12 months before you conceive and then you can start to access the benefits.

Over a two year period (your one year waiting period plus another 9+ months waiting on the baby) you will pay in over $2,000 in additional premiums. Once the baby arrives and the bill is totaled, your share of a normal delivery will be about $5,000 and Blue Cross will pay less than $1,000.

Once Obamacrap became law every carrier but Blue Cross pulled out of the maternity market making them, in effect, a single payer.

Many will remember the days of Ma Bell when you got your service from AT&T (or one of their subsidiaries) or you didn't have phone service. Your phone came in a basic black (although they later added different colors for the Princess line), but your choices were limited.

And everyone complained . . .

Now we have phone service in all sizes and packages, and people still complain, but at least you have a choice. If you don't like your current phone company you can go somewhere else.

But in Georgia, if you want maternity coverage you pick Blue Cross. If you don't like what they have to offer you do without because Obamacrap has made them a single payer when it comes to maternity coverage.

So for those who think they want single payer, how is this working for you?

Affordable Health Insurance in Atlanta, Georgia

If you want health insurance and especially if you don't want a maternity benefit, Georgia Insurance Shop has health insurance plans to fit almost every need and budget. We have rates from all the top health insurance companies, including Blue Cross, but also Humana, Cigna and others.

 

Wedding Postponed for Health Insurance

The Washington Post reports a bride to be in North Carolina has postponed her wedding until she can obtain health insurance. According to the Post:

Rachelle Friedman was paralyzed from the chest down after one of her bridesmaids shoved her into a pool just a month before her June wedding to her college sweetheart.

Things can get rowdy sometimes and this is definitely tragic, but so is going without health insurance. As Marlin Perkins might say, "Just as a mother bear protects her cubs, protecting your finances from loss is accomplished with a health insurance policy".

They told ABC News that their combined income as a married couple would be too high to qualify for Medicaid payments. Friedman needs the state and federally funded health coverage to pay for her constant care and rehabilitation.

We don't know how old this woman is, nor anything about her finances before the accident. Nor do we know if her parents could have provided health insurance for her either separately, or as a dependent on their plan. This moment of revelry has changed her life, probably forever and now they are expecting the taxpayers to pay for her care.

Affordable Health Insurance in Georgia

Health insurance does not have to be expensive, especially for young people. Georgia Insurance Shop has several clients under the age of 30 that are covered by excellent health insurance plans for less than $150 per month and some less than $100. For $3 to $5 per day you could have a major medical insurance plan from Blue Cross, Humana, Cigna, Aetna or other health insurance companies. Ask for a competitive rate quote today.