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All information posted on this site is for Plan Year 2026. For current plan year, please see the Carroll County Schools 2025 Benefit Guide
Health Insurance Plans
Each plan offers unique coverage and benefits to suit different needs.
State Health Benefit Plan
The State Health Benefit Plan (SHBP) is established for the benefit of school districts and other governmental employers by the Georgia legislature. SHBP operates through the Georgia Department of Community Health (DCH). SHBP and DCH determine the plan design, the monthly premiums, and the network providers. Carroll County Schools provides payroll deduction for your premium along with other administrative support. A Decision Guide is available for plan details and monthly premiums.
There are three health plan carriers available to you, and multiple plan options under those carriers.
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.
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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.
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Kaiser Permanente offers an HMO option that is in-network coverage only. This plan has no deductible or coinsurance and is a copay only plan.
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Carroll County Schools pays a significant portion of your health insurance premiums. This financial contribution reduces your premium for a quality health plan at a competitive cost.
Anthem Plan Options
The Anthem plans include Gold, Silver, and Bronze HRA plan options, and an HMO plan option. On the HRA plan options, most services are subject to a deductible and there are no copays. After you meet your in-network deductible, you pay coinsurance up to the out-of-pocket maximum. For prescription drugs, you pay a percentage of the retail cost. The HRA plans include a plan-funded Health Reimbursement Account to reduce / offset your deductible and pharmacy expenses (unused balances carry forward into new plan years). Preventive care is covered at 100% in-network before the deductible.
The HMO plan option has the lowest deductible out of all plans, but provides in-network coverage only. Some services (office visits, ER visits, and prescription drugs) are covered at 100% after a copay. For most other services, you are responsible for a deductible and coinsurance until you meet your out-of-pocket maximum. Please be aware that copays do not count towards your deductible. Preventive care is always covered at 100% before the deductible.
UnitedHealthcare Plan Options
The UnitedHealthcare plans include an HMO option and a High Deductible Health Plan (HDHP) option. This HMO plan has the same benefits as the Anthem HMO, but utilizes the UHC network. Visit https://www.whyuhc.com/shbp for more information.
The HDHP plan has the lowest premiums, highest deductible, and highest maximum out-of-pocket costs. All services, including pharmacy, are subject to the deductible and coinsurance, and there are no copays with this plan. Once you meet your deductible, you pay coinsurance until you satisfy the out-of-pocket maximum. As with the other State Health plan options, wellness incentive points can be earned by High Deductible Health Plan members. You are eligible to open an HSA if you enroll in the State Health Benefit Plan (SHBP) High Deductible Health Plan (HDHP) and do not have other coverage through 1) your spouse’s employer’s plan, 2) Medicare, or 3) Medicaid. The HSA is not set up through the district and must be established separately.
Kaiser Permanente Plan Options
Kaiser Permanente offers a single HMO plan. The KP Regional HMO option requires you to choose your own Primary Care Physician (PCP) from a network of carefully selected Kaiser Permanente providers in 25 medical facilities within the Metro Atlanta Service Area. You won’t need a referral for dermatology, behavioral health, OB/GYN, optometry or ophthalmology. For other specialties, your PCP can coordinate any specialty care you might need. This is a copay only plan option. There are no medical deductibles or coinsurance and the medical and pharmacy out-of-pocket maximums are combined
Pharmacy Benefits
CVS Caremark is the pharmacy vendor for all medical options.
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For the HRA, you pay a percentage of the cost subject to a minimum and maximum per prescription.
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For the HMO plans, prescription drugs are covered at 100% after a copay at participating pharmacies.
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For the High Deductible Health Plan, prescription drugs are subject to deductible and then coinsurance, similar to other medical services.
The pharmacy costs are included in your out-of-pocket maximums, and a mail order benefit for a 90 day supply is also available. Additional information is found in the State Health Decision Guide.
Disease Management Program
Managing chronic health conditions can be challenging, but the State Health Benefit Plan (SHBP) offers support to help ease the burden. Through SHBP's Disease Management Programs, you have access to valuable resources designed to help you better manage conditions like diabetes, asthma, coronary artery disease, and addiction. These programs provide personalized care and guidance, ensuring you stay on track with your treatment while also lowering your healthcare costs.
Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma, coronary artery disease, and/or medications for additction treatment.
To enroll in SHBP’s Disease Management Programs, you can access your SHBP enrollment portal online at mySHBPga.adp.com or contact SHBP Member Services at (800) 610-1863 for assistance.
Transfer From Other Georgia Systems
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If you are transferring from another Georgia school system or state agency with SHBP, you must keep your current medical coverage for the remainder of the plan year.
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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 that 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).
Title Copy | Anthem HRA Gold Plan | Anthem HRA Silver Plan | Anthem HRA Bronze Plan | Anthem or UHC HMO Plan | UHC HDHP Plan | Kaiser Permanente HMO Plan |
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Deductible | ||||||
You | $1,500 | $3,000 | $2,000 | $4,000 | $2,500 | $5,000 | $1,300 | $3,500 | $7,000 | $0 |
You + Child(ren) / Spouse | $2,250 | $4,500 | $3,000 | $6,000 | $3,750 | $7,500 | $1,950 | $7,000 | $14,000 | $0 |
You + Family | $3,000 | $6,000 | $4,000 | $8,000 | $5,000 | $10,000 | $2,600 | $7,000 | $14,000 | $0 |
Medical Out-of-Pocket Max | ||||||
You | $4,000 | $8,000 | $5,000 | $10,000 | $6,000 | $12,000 | $4,000 | $6,450 | $12,900 | $6,350 |
You + Child(ren) / Spouse | $6,000 | $12,000 | $7,500 | $15,000 | $9,000 | $18,000 | $6,500 | $12,900 | $25,800 | $12,700 |
You + Family | $8,000 | $16,000 | $10,000 | $20,000 | $12,000 | $24,000 | $9,000 | $12,900 | $25,800 | $12,700 |
Coinsurance (Plan Pays) | 80% | 60% | 85% | 60% | 75% | 60% | 80% | 70% | 50% | 100% |
HRA Credits | ||||||
You | $400 | $200 | $100 | N/A | N/A | N/A |
You + Child(ren) / Spouse | $600 | $300 | $150 | N/A | N/A | N/A |
You + Family | $800 | $400 | $200 | N/A | N/A | N/A |
Medical | ||||||
ER | Coins after Ded | Coins after Ded | Coins after Ded | $45 Copay | Coins after Ded | $45 Copay |
Urgent Care | Coins after Ded | Coins after Ded | Coins after Ded | $45 Copay | Coins after Ded | $45 Copay |
PCP Visit | Coins after Ded | Coins after Ded | Coins after Ded | $45 Copay | Coins after Ded | $45 Copay |
Specialist Visit | Coins after Ded | Coins after Ded | Coins after Ded | $45 Copay | Coins after Ded | $45 Copay |
Preventative Care | 100% | None | 100% | None | 100% | None | 100% | 100% | None | 100% | None |
Medical
HRA Credits
Medical Out-of-Pocket Max
Deductible
Medical Monthly Premium
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Anthem Gold
$213.71
$531.82
$390.68
$708.79
Anthem Silver
$146.11
$389.86
$275.76
$519.51
Anthem Bronze
$92.12
$276.48
$183.97
$368.33
Anthem HMO
$177.21
$455.17
$328.63
$606.59
UHC HMO
$217.19
$539.13
$396.59
$718.53
UHC HDHP
$81.11
$253.36
$165.26
$337.51
$455.17
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.
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You must use in-network providers for coverage to apply. 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 the Virtual Visits (UHC) mobile app for convenient access when you need it, and remember to consider using telemedicine for non-complex medical conditions.
Choosing the Right Plan
Dive into your State Health Plan: State Health Benefit Plan's OE gives you the opportunity to review your plan options and make changes to your coverage based on your needs. Be sure to follow the steps below to choose an option that best meets you and your covered dependent's healthcare needs.
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Think about your health needs and those of your family.
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Review how much you'll have to pay out-of-pocket, like deductibles and copays.
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Check that your preferred doctors are in the plan's network to save money.
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Think about any extras the plan offers like telemedicine or wellness programs.
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Compare a few plans to find one that fits your needs and budget.
View the document below for more information on your State Health Benefit Plan Decision.
Enrollment - ADP Portal
How to complete your State Health Benefit Plan (SHBP) Enrollment through the ADP Portal.
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Access https://myshbpga.adp.com/shbp to review your health coverage elections. Your registration code is "SHBP-GA."
Dependent Verification
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If you wish to add dependent(s) (spouse and / or children) to your health plan, ADP will contact you (by mail and email) to request appropriate verification documents. If you do not receive the request, contact SHBP directly to have the request sent to you. They can be reached at (800) 610-1863.
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The communication from ADP will include a personalized fax cover sheet with a bar code that must be used when submitting documentation.
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Appropriate documentation must be attached to the fax cover page and provided by the deadline set by ADP.
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Non-verified dependents cannot be added until the next open enrollment period and would require appropriate documentation.
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Additional information can be found on the SHBP website.
Additional Resources
Go Online for More Resources
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Access the two following plan websites to locate the participating providers and to find health and wellness tools, plan details, and to print ID cards.
Anthem
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Select "Find Care' from the Main Menu and then follow instructions to find a doctor.
UnitedHealthcare
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Select "Search for a Provider" under the Benefits drop down. Select "Choice HMO" or "HDHP with HSA" and follow the search instructions.
Kaiser Permanente​
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https://choose.kaiserpermanente.org/shbp/plans
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Select "Find Doctors & Locations" at the bottom of the page then follow prompts to find a provider.
Other Medical Plan Options
TriCare Supplement Plan
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The TriCare Supplement Plan is available for retired military employees, and is a supplement to your current TriCare benefits. The plan provides reimbursement of copays and other medical expenses associated with your current TriCare plan. Additional information can be found here.
PeachCare for Kids
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The state of 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, click here.
