2027 State Health Benefit Plan (SHBP)

The Georgia legislature established the State Health Benefit Plan (SHBP) for school districts and other governmental employers. The Georgia Department of Community Health (DCH) administers SHBP. SHBP and DCH determine the plan design, the monthly premiums, and the network providers. Baldwin County Schools provides payroll deduction for your premium along with other administrative support. Download the Decision Guide for more information, and find monthly premiums at baldwincountyschoolsbenefits.com/rates.

You can choose between Anthem and UnitedHealthcare for your health plan. Anthem offers four plan options: three HRA plans and one HMO plan. The HMO plan option provides in-network coverage only and requires copays for many services. Visit the Anthem website at www.anthem.com/shbp for more information. UnitedHealthcare offers an HMO similar to the Anthem plan, along with a High Deductible Health Plan (HDHP). The HDHP has the highest deductible and out-of-pocket costs, but the lowest premiums. Visit the UnitedHealthcare website at www.whyuhc.com/shbp for more information.

Premium Information: baldwincountyschoolsbenefits.com/rates

Important Documents: baldwincountyschoolsbenefits.com/resources

Medical Plan Options

Anthem Health Reimbursement Account (HRA): Gold, Silver, Bronze Options

Anthem and UnitedHealthcare HMO Options

UnitedHealthcare High Deductible Health Plan (HDHP) Option

Approved preventive care services obtained from in-network providers are covered at 100% for all plan options.

District Contribution

No matter which plan you choose, the district funds $1,935 per month ($23,220 per year) toward medical coverage for all eligible employees. This generous employer contribution helps you and your family access a high-quality health plan while keeping your employee costs competitive.

Transfers from Other Georgia Systems

If you transfer from another Georgia system, you must retain your current medical coverage for the remainder of the calendar year.

No changes are allowed to your SHBP coverage until the next Open Enrollment period, unless you have a Qualifying Life Event (QLE).

Medicare

For active employees with spouses who are enrolled in Medicare and not disabled, SHBP is primary. The spouse is not required to elect Part B (medically necessary services such as outpatient care and preventive care) until the active employee retires. However, the spouse will automatically receive Part A (hospital insurance).

In-Network Benefits Summary

Pharmacy Benefits

Express Scripts Pharmacy Benefit Services, part of Evernorth Health Services, administers the SHBP pharmacy benefits.
Retail (up to 31 day supply), mail order (32-62 and 63+ day supply), and specialty pharmacy services are included. Eligible mail order medications have reduced out-of-pocket costs.
Express Scripts has an extensive pharmacy network. Access the pharmacy locator at express-scripts.com/shbp.

Disease Management Program

Certain drug costs are waived if SHBP is primary and you enroll and actively participate in one of the Disease Management (DM) Programs for diabetes, asthma, coronary artery disease, or medication for addiction treatment.
Call Anthem at (866) 901-0746 or UHC at (888) 364-6352 for program information.

9amHealth Weight Management Program

This optional program is available for SHBP members aged 18 or older to improve your health and help you achieve your weight loss goals.
The program includes access to weight health experts through virtual appointments, prescription medications, lab tests, at-home devices, and nutrition and fitness coaching.
9amHealth providers include obesity medicine specialists, endocrinologists, pharmacists, dietitians, bariatric specialists, and more.
To sign up, go to https://join9am.com/shbp or call/text: (888) 870-9542.

Telemedicine

The medical plans include a telemedicine benefit, which allows you to speak to a participating doctor from home or work through your smartphone, tablet or computer 24 hours a day / 7 days a week.

You must use in-network providers to receive coverage. HMO members pay a copay, and HRA members pay coinsurance for telemedicine. High Deductible Health Plan members can access this benefit subject to the health plan deductible.

Download the LiveHealth Online (Anthem) or Virtual Visits (UHC) mobile app for convenient access when you need it, and consider using telemedicine for non-complex medical conditions.

More information is available under the Resources page at baldwincountyschoolsbenefits.com/resources.

Dependent Verification

If you are electing new coverage for a dependent spouse and/or child(ren), ADP will provide instructions for submitting the required documentation.
Be sure to provide documentation in the format requested by the deadline provided by ADP.
If you do not receive the documentation request, contact SHBP by phone at (800) 610-1863.
Your dependents will not be covered unless documentation is received and approved by the deadline.
Additional information can be found on the SHBP website at shbp.georgia.gov/dependent-verification-audit-faqs.

Other Medical Plan Options

TRICARE Supplement Plan

The TRICARE Supplement Plan is available for retired military employees and is a supplement to your current TRICARE benefits. The plan reimburses copays and other medical expenses associated with your current TRICARE plan. Additional information can be found on the TRICARE website at https://shbp.georgia.gov/plan-options-programs/tricare.

PeachCare for Kids

Georgia offers an affordable health insurance program called PeachCare for Kids. This plan provides healthcare, dental, and vision benefits for children, up to age 19. To learn if you are eligible and to obtain benefits, cost, and application information, visit the PeachCare for Kids website at https://dch.georgia.gov/peachcare-kids.

Additional Resources

Visit these two plan websites to find participating providers, health and wellness tools, plan details, and print ID cards.

Anthem

www.anthem.com/shbp

Select "Find Care" from the Main Menu and then follow instructions to find a doctor.

UnitedHealthcare

www.whyuhc.com/shbp

Select "Search for a Provider" under the Benefits drop-down. Select "Choice HMO" or "HDHP with HSA" and follow the search instructions.

Completing Your Enrollment

How to complete your State Health Benefit Plan (SHBP) Enrollment through the ADP Portal.

Visit the SHBP ADP Portal at https://myshbpga.adp.com/shbp to review your health coverage elections. Your registration code is "SHBP-GA."

Once registered, you should:

Verify your address
Verify your coverage tier (you only, you & spouse, you & child(ren) or you & family)
Verify your dependents
Answer the Tobacco Surcharge question
Make sure you print your confirmation, write down the confirmation number, or save an electronic copy