Monday, February 24, 2014

TRAGIC Wins Shallow Victory in SHBP Battle

T.R.A.G.I.C, the teacher group we blogged about in January formed to protest #Obamacare changes to the Georgia SHBP (State Health Benefit Plan) won a shallow victory. State and local government groups and school systems that use SHBP as their health plan received an email today, announcing retroactive changes in the health plan.  

Readers may recall the uproar over the loss of copay plans and the announcement that BCBSGA was awarded the contract as the sole claims administrator for the health plan that covers 650,000 Georgia residents.

But Blue Cross was awarded the business in August of 2013 and there were no protests then.

During October SHBP particpants were given details on the new benefit packages. It was obvious there were no copay options. We had three choices, Bronze, Gold and Silver. All were high deductible HRA plans.

Where was TRAGIC then?

Crickets chirping

The state caved and agreed to overlay a doctor copay RETROACTIVELY to January 1, 2014. Yeah, that's going to be fun when Blue has to calculate refunds and then figure out if they restore dollars to an HRA or pay them to the policyholder.

So why is this a shallow victory?

The new copay's only apply to ER and doc visits.

Copay's do not count toward the major medical deductible.

SHBP participants still have the lousy Blue Cross POS limited provider network.

The Rx plan is still managed by Express Scripts. The amounts paid for Rx copay's still do not count toward the major medical deductible or OOP (out of pocket) limit.

Like I said. Shallow victory. The people behind TRAGIC fought to have doc copay's reinstated and completely missed the big picture.

Now that is tragic.

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