A snapshot of the State Health Benefit Plan for retirees [Jan. 2009]

An Option of the Division of State health Benefit Plan
A SNAPSHOT OF
State Health Benefit Plan for RetireeS

When You Retire

You may keep your health coverage if you are eligible and are receiving a monthly retirement benefit from a Georgia-sponsored retirement system

INCLUDED POPULATIONS

and are enrolled in SHBP coverage at the time you retire. You cannot

If you are actively working for

enroll in SHBP after you retire.

the state at age 65 or older,

Your eligible dependents must also be enrolled in SHBP coverage at the time you retire to continue their coverage. Dependents may not be added after retirement unless you experience a qualifying event. Qualifying events are
described below Your health insurance automatically rolls over into retirement
with the same option and dependents you currently have

State Health Benefit Plan (SHBP) will pay primary benefits on you and your spouse; you are not required to enroll for Medicare until you retire. Medicare does not impose penalties if you enroll in Medicare after you first become

covered if you are receiving your annuity from the Employees

eligible if the reason for delay

Retirement System, Teachers Retirement System or the Public School Employees Retirement System you do not have to complete any additional paperwork to continue your coverage At age 65, premiums will be based on the parts of Medicare coverage you and/or your spouse have even if your spouse is actively working and is covered by another group health plan. If you or your spouse are not enrolled in Medicare, your premiums will be higher than they are now. Once you are set

is that you were actively working and had group health insurance. However, you must apply within Medicare's time limits once you retire. For information regarding Medicare enrollment call 1800-MEDICARE (1-800-6334227) or visit the Web site at www.medicare.gov.

up as a retiree at a Georgia-sponsored retirement system, you

will receive a letter from SHBP that allows you to change your

option or discontinue your coverage within 31 days of the receipt of the letter. Note: If you

drop your coverage, you can never re-enroll.

Important Note: You cannot continue your health insurance if you take a lump sum distribution from a Georgia-sponsored retirement system and do not receive a monthly retirement benefit payment.

Changing Options

Annual Retiree Option Change Period (ROCP) is held each fall and corresponds with the annual open enrollment period. A ROCP packet will be mailed to your home prior to the start of the ROCP if SHBP has your correct address
Any changes made during the ROCP will be effective the following January 1 You can only change your option during the ROCP. You can not add dependents during the
ROCP unless you have experienced a qualifying event within the period outlined below

2 Peachtree Street, Atlanta, Ga 30303 www.dch.georgia.gov

January 2009

A Snapshot Of State Health Benefit Plan Retirees

Qualifying Events
Certain qualifying events such as marriage, divorce, birth, having a full-time student in your family or a spouse's loss of health coverage due to loss of eligibility allow you to make changes in your health insurance as listed below. You must submit the request to SHBP within 31 days prior to or after the qualifying event. The effective date of the change in coverage will be the first of the month following the request.
NOTE: Birth of Child or Adoption - If the qualifying event is for birth of a child or adoption, you can request to have the dependent covered as of the date of birth or date of adoption contract and placement. You must make the request on the Retirement Surviving Spouse Form which can be obtained on our Web site or by calling SHBP and must make the appropriate coverage premium payment(s) for coverage for the month of the birth or adoption contract and placement.
You have 31 days from the date of the qualifying event to notify SHBP of the qualifying event. If SHBP needs more information, you will be given a new date for submission of the dependent document. Your dependent's coverage will be inactive until the appropriate documentation has been received and verified by SHBP. Documentation must be received within the current plan year.

Qualifying Event
Eligibility for retiree coverage Annuity no longer covers premium amount Become eligible for Medicare Parts A and B

Action Allowed
Change to another option

Acquire dependent because of marriage, birth, adoption or Qualified Medical Child Support Order
Loss of dependent's health benefit coverage through spouse's or former spouse's Medicaid, Medicare, group coverage through active employment or COBRA coverage

Add dependent(s) proper documentation required

Spouse or enrolled dependent's employment status changes Add dependents

resulting in the loss of eligibility for coverage

Change coverage tier - proper documentation is required

Refer to your 2009 Retiree Decision Guide or you can access an electronic copy at www.dch.georgia.gov/ shbp_plans or you may call the SHBP Call Center at (800) 610-1863 or (404) 656-6322.
Changes without a Qualifying Event You can drop to single coverage at any time with proper written notice to SHBP If you and your spouse are retired, covered by SHBP and are both drawing a monthly retirement benefit from a Georgia sponsored retirement system you may change from family coverage to each having single coverage at any time. (The request for you and your spouse must be filed at the same time) You can drop coverage at any time but you won't be able to get the coverage back unless you return to work with the state of Georgia as an active employee in a benefits eligible position

A Snapshot Of State Health Benefit Plan Retirees
Surviving Spouses and Eligible Dependents
If your surviving spouse (living spouse of a deceased retiree) or eligible children receive(s) an annuity: Current coverage can continue Apply within 31 days of retiree's death Premium deducted from annuity if the annuity is large
enough to cover the premium. If not, payments must be made directly to the Plan New dependents or spouses cannot be added to survivor's coverage
If your surviving spouse does not receive an annuity: Coverage can continue if married at least one year Apply within 31 days of retiree's death Premium paid directly to Plan Coverage ends if spouse remarries Cannot add new dependents to coverage
If your surviving child does not receive an annuity and there is no surviving spouse, the child may continue the coverage for 36 months through COBRA provisions.
If you and your spouse are retired and under age 65 SHBP will remain your primary insurer until you or your spouse reach age 65 or become eligible for Medicare Read below for more information about when either of you reach 65
When you and/or your spouse reach age 65 You should consider enrolling in Medicare - Medicare is provided to persons at age 65 or those eligible by Medicare due to certain disabilities SHBP premiums are based upon each part of Medicare (A, B and D) in which you and your spouse have coverage A SHBP discount is given for each part of Medicare (A, B and D) that you and your spouse have SHBP health plans may coordinate with Medicare differently. Check with your health plan for specific details If you and or your spouse enroll in Medicare (A, B and D) send a copy of your and your spouse's Medicare cards to SHBP, P.O. Box 38342, Atlanta, GA 30334. Premiums cannot be reduced until copies of your Medicare cards are received and the change in premium is processed by the retirement system. Delay in submission of Medicare information does not qualify for a refund of the difference in premiums. Medicare information must be received by the first of the month in which you become eligible for Medicare (to receive the discount immediately)

A Snapshot Of State Health Benefit Plan Retirees
Medicare Enrollment
Eligibility is age 65 or earlier for certain disabilities Part A Inpatient hospitalization (usually free) Part B Covers physician visits, tests and outpatient hospital care (premiums mean-based but
usually $96.40) Part D Prescription drug coverage (monthly premium depends on the plan you select)
Policy Changes
July 1, 2009 Retirees 65 or older or those eligible for Medicare will need to have Medicare Part B to pay the lowest premium with SHBP SHBP will pay the penalties for retirees who enroll for Medicare Part B during the 2009 Medicare General enrollment period of January 1 March 31, 2009 Premiums will increase significantly for retirees not enrolled in Medicare Part B
January 1, 2010 Retirees 65 or older or those eligible for Medicare and their covered dependents are required to enroll in one of the Medicare Advantage (MA) options Retirees who do not enroll in MA will lose the 75 percent state subsidy and will pay the full premium for the SHBP option they select
How do I Select a Part D Plan?
Multiple plans are offered based on state and region A list of plans can be found in your 2008 Medicare and You Handbook, you can review the plans
on the Medicare Web site, www.medicare.gov, or by calling (800) 633-4227. The site compares plans based on your current prescription medications or you may call
Georgia Cares at (800) 669-8387 for assistance You should not enroll in Medicare Part D if you have enrolled in the Kaiser Medicare Option or
the Kaiser Senior Advantage Plan
Address Change
If your address changes, you must notify SHBP to continue to receive health plan information. SHBP will not be responsible for missed enrollment change opportunities or deadlines if you do not keep your contact information updated
Please send a letter with your name, social security number and new address to SHBP, P.O. Box 1990, Atlanta, GA 30301-1990
Disclaimer: This material is for informational purposes and is not a contract. It is intended only to highlight principal eligibility and benefits. Every effort has been made to be as accurate as possible; however, should there be a difference between this information and the Plan documents, the Plan documents govern. It is the responsibility of each member, active or retired, to read the Summary Plan Description and all Plan materials provided in order to fully understand the eligibility and option provisions.