What Happens to Your Georgia Health Insurance if You Return to Active Service

If you choose to return to active service with an employing entity under the Plan, whether immediately after you retire or at a later date, your retirement annuity may be suspended or continued. Health plan coverage, however, must be purchased as an active Employee and through payroll deduction by your Employer. You will need to complete enrollment paperwork with your Employer and the appropriate form to have the deduction stopped with the retirement system.

When you return to retired status, Retiree coverage may be reinstated after notifying the Plan within 31 days. You will be eligible for continuous coverage, based on the conditions that first made you eligible as a Retiree.

If you retired before the initial legislative funding for a particular Employee group, you will not be entitled to Retiree Plan coverage - unless the final service period qualifies you for a retirement benefit from a state-supported retirement system.

Impact of Medicare On Benefits/Premiums

Coordination of Benefits With Medicare
Medicare is the country's health insurance program for people age 65 or older who qualify based on Medicare eligibility rules. Medicare also covers certain people with disabilities who are under age 65 and people of any age who have permanent kidney failure.

To prevent duplicate benefit payment, the Plan coordinates benefits with Medicare and any other plan that may cover you and your Dependents. The first step in coordination is the determination of which plan is primary - or which plan pays benefits first - and which plan is secondary. Under Georgia law, the SHBP is required to subordinate health benefits to Medicare benefits.

The chart below provides important details relate to primary and secondary coverage based on your Medicare status.

If you are retired and...	The Plan will pay...
...age 65, Medicare-eligible and enrolled in Part A, Part B, and Part D; consider enrolling prior to the month in which you turn 65 to maximize coverage	Secondary benefits starting on the first day of the month in which you turn 65
...age 65, Medicare-eligible and do not enroll in Part A, Part B and Part D	Primary benefits; however, Plan premium will increase
...age 65 or older and not entitled to Medicare	Primary benefits; however, Plan premium will increase
NOTE: If you are enrolled in Medicare Part D, each time you go to the pharmacy, present both your Medicare Part D and BCBSGa ID cards. When you are in your coverage gap, you should still present both Identification Cards, but you will be required to pay your BCBSGa Copayment. If your pharmacy can't bill both your Medicare Part D and BCBSGa card at the point-of-sale, you will have to file a paper claim with BCBSGa or change drug stores.

State Health Benefit Plan (SHBP) Medicare Policy

• Georgia law requires that SHBP pay benefits for Covered Services after Medicare has paid.
• SHBP will calculate premiums and claims payments based upon Medicare enrollment for Retirees over 65 or those eligible for Medicare due to a disability.
• Premiums will be based on the Parts of Medicare (A, B and D) that you have. There will be no adjustments in premiums because you have other coverage such as TRICARE, VA or other group coverage since SHBP may have potential primary liability.
• SHBP will coordinate benefits for Participants who are enrolled in Medicare A, B or D.
• SHBP will pay primary benefits on Participants not eligible or not enrolled in Medicare, but you will pay a higher premium.
• If you enroll in Medicare (A, B or D), please send a copy of your Medicare cards to SHBP by the first month in which you are eligible for Medicare. 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 is available at:

• www.cms.hhs.gov/medicarereform
• www.medicare.gov
• www.ssa.gov
• 1-800-669-8387 (Georgia Cares)
• 1-800-633-4227 (Medicare)