Has anyone had issues with State Health Benefits in Georgia after retirement? I have had multiple issues and would like to be in touch with others who have experienced the same. Issues include large so called penalty because I didn't notify them prior to 65th birthday ($2500.00), claims not paid in pror years (insurance claimed that I my insurance was not in effect (according to hospital and doctor) when in fact coverage had been continuous for more than 25 years. Latest issue is termination of insurance because they said I received a letter from wage works or ADP (which I didn't, could have been lost in mail, I have letter from US Postal Service attesting to my mail being mis-delivered on several ocassions) and didn't respond in the alloted time period. I appealed through tier 2 appeals and was denied reinstatement although they didn't respond within the 90 day period which their web site states will happen. I have contacted state representative but no luck so far. I would like to hear from other folks who have had a bad experience with Georgia State Health Benefits so maybe we can get on a legislative agenda to get things changed. Years ago when State Health handled everything in house most problems could be resolved easily but since ADP/Wageworks etc. have been eating at the pie everything is a mess!
Problems with Georgia State Health Benefits
- Thread starter baxwink
- Start date
Try using paragraphs if you want help.
Transitioning from SHBP to retiree health insurance is a challenge.
Your "active" carrier (BX or UHC) will try to seamlessly enroll you in their MA plan. If you miss the deadline to enroll or enroll in a plan in the open market you will not be allowed back in the SHBP.
Were you an active employee up to age 65 or early retiree?
Did your paystubs reflect premium deductions?
Your post rambles and is difficult to follow.
If you think you can change things you are tilting at windmills. Play by the rules. You will be dead before you are successful in getting things changed to suit you
Transitioning from SHBP to retiree health insurance is a challenge.
Your "active" carrier (BX or UHC) will try to seamlessly enroll you in their MA plan. If you miss the deadline to enroll or enroll in a plan in the open market you will not be allowed back in the SHBP.
Were you an active employee up to age 65 or early retiree?
Did your paystubs reflect premium deductions?
Your post rambles and is difficult to follow.
If you think you can change things you are tilting at windmills. Play by the rules. You will be dead before you are successful in getting things changed to suit you
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- Thread starter
- #3
Sorry about the rambling, but I was forced to retire (by the school superintendent because I couldn't get my doctors to give me a release) at 62 due to an on the job injury. This was after 23 years continuous service. And yes negotiating the transition has been a nightmare but I did transition and had State Health Benefit Plan coverage for about six years up until this past April when I was terminated from coverage. They say it was due to a one month non payment of premium and claim they sent me a notice but I never received a notice. The lapse in payment did occur due to a bank error and the bank vice president provided a letter on bank letterhead stating that there was an error on the part of the bank. I also sent a letter signed by the postmaster on US Postal service letterhead stating that I have had issues with my mail delivery (something a post office rarely admits). 102 days after I filed my tier 2 appeal I finally received a denial from State Health Benefits via email. This was 12 days beyond what they state on their webpage as the required amount of time to review appeals. My issue is 1) after providing the bank documentation and post office documentation they should have reinstated me. I also have issue that they violated their own stated policy of replying WITHIN 90 days. They want me to follow rules but they don't want to. All of this appears to be instigated by either ADP or Wageworks.
Probably better off enrolling in Medicare (if he hasn't already) and pursuing coverage in the open market. SHBP is very political and extremely messed up . . . staffed by folks who really don't know what they are doing.
Even if he did hire an attorney it could take months or years and still no resolution. In the interim he still could have medical needs.
Even if he did hire an attorney it could take months or years and still no resolution. In the interim he still could have medical needs.
