January 2016


News and Information for SHBP Employee Benefit Coordinators
Welcome to our e-newsletter for SHBP Benefit Coordinators in payroll locations throughout Georgia. Each month, we'll provide benefit news and information to help you assist SHBP Members in your organization. We welcome your feedback and feel free to send any comments or questions to [email protected].
ADMINISTRATIVE SOLUTIONS TEAM (AST)

The AST promotes employer self-sufficiency by means of easily accessible, understandable and consolidated communications. The dedicated team of knowledgeable ambassadors assist employer locations managers with their daily entries on the rules-based enrollment portal. Each employer has been assigned a work team to assist with online data, reports and timely collection of accurate payment of health plan premiums to sustain a fiscally sound and efficient health plan. AST may be contacted at 1-800-610-1863; when prompted, select "employer services," Monday through Friday, 8:30 a.m. to 5:00 p.m., ET.
SHBP APPEAL PROCESS

Members can file an appeal if they or their dependent/s have been denied SHBP coverage due to eligibility or if a typographical error (for example: incorrect spelling of member/dependent name, social security number, etc.) was entered into the SHBP Call Center web portal during Open Enrollment (OE) and the error would affect the member/ dependent's eligibility. There are two tiers in the appeal process. Additional information can also be found on the website http://dch.georgia.gov/shbp-publications-forms and in the Summary Plan Description for your specific Plan Option. The Appeal Tiers are noted below:

Note: Any issue regarding the Plan's eligibility or participation should first be addressed with Member Services at 1-800-610-1863.

Tier 1 Telephone Administrative Review
Tier 2  Written Formal Appeal

Tier I - TELEPHONE REVIEW
Call Member Services and ask for a review within 31 days of the eligibility denial. If you disagree with the results of the review, you may file a written request for a Formal Appeal Review within 30 days of when the Plan advises you that your request cannot be approved.

If you request a Tier 1 appeal to correct a typographical error made in the SHBP Call Center web portal during OE or the Retiree Option Change Period (ROCP), the SHBP Benefit Administration Vendor has the authority to approve your Tier 1 appeal request immediately and correct all necessary errors.

Tier II - FORMAL APPEAL
If your request is denied at the first level, you may file a Formal Appeal, which must be postmarked within 30 days following the date of the Tier 1 Telephone Review decision. To file a Formal Appeal, you must complete the Formal Appeal Form http://dch.georgia.gov/shbp-publications-forms  and attach a copy of the decision of the Telephone Review.
Submit the Formal Appeal and applicable documents to:

State Health Benefit Plan
P.O. Box 1990
Atlanta, GA 30301-1990
BLUE CROSS AND BLUE SHIELD OF GEORGIA (BCBSGa) MEMBERS

LiveHealth Online Registration
With LiveHealth Online, you can see a medical doctor 24 hours a day/7 days a week or a licensed therapist or psychologist from 7 a.m. to 11 p.m.1 (coast to coast) on your computer or mobile device with a webcam. You don't have to schedule an appointment2 or even leave your home or office. LiveHealth Online covered providers can answer questions, make a diagnosis and may even be able to prescribe3 basic medications when needed. Best of all, LiveHealth Online visits are covered by your State Health Benefit Plan (SHBP) Blue Cross and Blue Shield of Georgia (BCBSGa) health plan, subject to applicable co-pay (HMO plan) and co-insurance (HRA plans).

Registering with LiveHealth Online is quick and easy
Visit livehealthonline.com to get started. Then follow these steps:
  1. Enter your first and last name
  2. Provide and confirm your email address
  3. Create a secure password for your account
  4. Read the "Terms of Use" and check the box to agree
  5. Choose your location in the dropdown box of states
  6. Enter your birthdate
  7. Choose your gender
  8. For the question "Do you have insurance?" select Yes. Be sure to have your SHBP BCBSGa member ID card on hand to complete your insurance information
  9. For Health Plan, in the drop-down box, select Blue Cross and Blue Shield of Georgia
  10. For Subscriber ID, enter your identification number, which is found on your SHBP BCBSGa member ID card
  11. Select Yes if you are the primary subscriber or No if you are not the primary subscriber.
  12. Click the green Finish button
_____________________________
1Behavioral health providers are available from 7 a.m. to 11 p.m, coast to coast, seven days a week.
2Most psychologists, licensed therapists or behavioral health providers who use LiveHealth Online will require an appointment to be scheduled in advance. Members can schedule an appointment from 7 a.m. to 11 p.m., coast to coast, seven days a week.There will be some access to visits without an appointment when a provider is available; however, most behavioral providers require an appointment.
3Some state laws require a face-to-face visit before allowing prescriptions. To check availability in your state, go to livehealthonline.com. Prescription availability is defined by physician judgment and state regulations. Psychologists and licensed therapists using LiveHealth Online cannot prescribe medications. LiveHealth Online is available in most states and is expected to expand to more in the near future. Visit the home page of livehealthonline.com to view the service map by state.
UNITEDHEALTHCARE MEMBERS

Sleep for Health
What to Know About Sleep Apnea

Poor sleep and groggy days could be due to sleep apnea. Learn about symptoms and why it's important to diagnose and treat sleep apnea.

Many of the two to four percent of adults with sleep apnea don't know they have it. They go for years feeling poorly rested, often until a bed partner complains. The symptoms of sleep apnea - loud snoring, snorting and gasping for air - are more likely to trouble one's bed partner. But the dangers are real. Don't ignore sleep apnea. Untreated, sleep apnea can lead to high blood pressure, heart disease and stroke. Daytime drowsiness can also affect your quality of life, your work performance and it can cause traffic accidents.

What is sleep apnea?
Sleep apnea is a sleep disorder in which there are repeated pauses in breathing or shallow breathing during sleep. There are two types:
* Obstructive sleep apnea.
* Central sleep apnea.

To read the full article about the two types of sleep apnea and how it can affect you, click here.

If you have questions about your health, please call your UHC Customer Care Advocate 1-888-364-6352. 
KAISER PERMANENTE (KP) MEMBERS

Announcing the 2016 Wellness Program
KP Members can earn up to $480!
The 2016 Wellness Program is underway. Kaiser Permanente members (subscribers and covered spouses, age 18 and over) can each earn a gift card valued at $240 (up to $480 per household) for completing the following four health activities.
  • Complete the Total Health Assessment
  • Complete a Biometric Screening either at a Kaiser Permanente Medical Office, or by a Kaiser Permanente clinician at a SHBP-sponsored screening event.
  • Complete an age and gender appropriate preventive screening for breast, cervical or colorectal cancer.
  • Complete one online Healthy Lifestyle Program (HLP).
Members will be encouraged to register (required for reward) and participate in the Wellness Program throughout the year, and we thank you in advance for your support. For more information, please visit the 2015 Wellness Program site.

KP Onsite Biometric Screening | SHBP-sponsored Wellness Events
Beginning in January, members will receive a series of emails and a direct mailer promoting SHBP-sponsored health screening events and sharing information on what a Biometric Screening is all about, where they can get one and why they should want one.

Bringing body and mind into balance
KP is committed to caring for "the whole" you. How you think, feel and act affects your total health and well-being. A positive outlook on life can bring your mind and body into balance and make a big difference to your overall well-being. Take a look at http://www.gahealthfocus.com/60245819_OE_NHT_Mind-Body_ (Dec) _Email_r1_ATC_jn-DG_HR_Link.pdf to see three simple steps to make your day a bit brighter. 

KP Wellness Coaches
We all want to feel healthy, be well and have more energy. But sometimes making changes can be harder than it seems. How about some help? A wellness coach is specially trained to help you make a healthy change. Whether you want to eat better, quit smoking, manage your weight, reduce stress or exercise more, our telephone coaches can help you understand your readiness to change and the obstacles you face. Phone a coach today... You'll be glad you did! Go to https://thrive.kaiserpermanente.org/thrive-together/live-well/call-health-wellness-coaching . 
HEALTHWAYS - BE WELL SHBP MEMBERS

The 2016 Well-Being Program year has begun.
January 1, 2016 kicked off a new program year for Be Well SHBP. Here are the highlights of what is going on in January:

2016 Kickoff Mailer and Trip Promotion
All Be Well SHBP members will receive a welcome mailer the week of January 4, 2016, to announce the new 2016 well-being program year and....an exciting promotion to win a $500 trip voucher! All members and covered spouses who complete their Healthways Well-Being AssessmentTM by March 30, 2016, will be entered to win a $500 trip voucher. Healthways will announce one winner a month, January through March. Here are the links to support/reference materials:
SHBP-Sponsored Onsite Biometric Screenings
  • Members and covered spouses covered under Blue Cross and Blue Shield or UnitedHealthcare (non-Medicare Advantage) can book their 2016 SHBP-Sponsored onsite biometric screening appointment starting on Wednesday, January 20, 2016. The link to the scheduling tool is located at
    https://www.hhtinc.com/selfscheduler/Default.aspx?aspxerrorpath=/SelfScheduler/State_Health_Benefit_Plan.aspx. A list of the event locations and dates is also available on this page.
  • Onsite biometrics screenings begin in February and continue through September.
  • Did you schedule? Last minute requests for 2016 SHBP-Sponsored screening events are still being accommodated.  To request an event at your location you need to do so now. Click here to complete the Healthways online registration. For questions, email [email protected].
Stress Less Quest
Starting January 25, 2016, members will have the opportunity to join the Stress Less Quest. In this 14-day stress reduction challenge, members will try a new technique provided through daily emails and then journal their experience. To encourage members and their covered spouses to join, five lucky participants will be randomly selected to win one of five $100 Spafinder gift certificates. How's that for promoting stress reduction?
DEPARTMENT OF COMMUNITY HEALTH ON SOCIAL MEDIA
 
Did you know you can access the latest SHBP news and updates via Facebook and Twitter?

The Department of Community Health (DCH) frequently posts Department news and updates, including news on SHBP and the Be Well SHBP wellness incentives program, on its social media feeds. Be sure to join the conversation!

Follow DCH on Facebook at https://www.facebook.com/gadept.communityhealth and Twitter at https://twitter.com/GADCH for the latest SHBP news and updates today.
RESOURCES/CONTACT INFORMATION
 

VENDOR

MEMBER SERVICES

WEBSITE

Medical - Blue Cross Blue Shield of Georgia ( BCBSGa) 

  

Member Services

  

Hours: 8 a.m. - 8 p.m. ET; Monday - Friday 

  

  

855-641-4862

  

  

  

 www.bcbsga.com/shbp  

Medical -- UnitedHealthcare 
Member Services: Monday through Friday, 8 a.m. to 8 p.m. ET

888-364-6352  
 
Medical - Kaiser Permanente 
Member Services 24 hours a day/7 days a week 
(Appointment Scheduling, Prescriptions and Nurse Advice)
KP Wellness Program Hours: Monday through Friday, 7 a.m. to 7 p.m. ET   
    855-512-5997 
 

Wellness - Healthways

  

Member Services

Hours: 8 a.m. - 8 p.m. ET; Monday - Friday

888-616-6411

 

Medicare Advantage (MA) plan members are ineligible for participation in Be Well SHBP.

  

  

www.BeWellSHBP.com  

Pharmacy - ExpressScripts

  

Member Services

Hours: 24 hours a day / 7 days a week

877-841-5227

 

The pharmacy benefit for Medicare Advantage (MA) plan members is provided through UnitedHealthcare, not ExpressScripts. Contact UnitedHealthcare at 877-246-4190.

  

  

  

 www.express-scripts.com/GeorgiaSHBP 

SHBP Call Center

  

Hours: 8 a.m. - 5 p.m. ET; Monday - Friday

 

800-610-1863

 

(listen to the prompts, and choose employer services)  

  

  www.mySHBPga.adp.com 

ADDITIONAL INFORMATION

MEMBER SERVICES

WEBSITE

Centers for Medicare & Medicaid (CMS)

  

24 hours a day / 7 days a week

800-633-4227

  

  

 www.medicare.gov  

TRICARE Supplement

866-637-9911

www.asicorporation.com/ga_shbp 

PeachCare for Kids

877-427-3224

www.peachcare.org