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.