Annual Enrollment, May 20-31, 2013
The State Health Plan will conduct Annual Enrollment May 20-31, 2013. Members do not need to do anything during Annual Enrollment if they are satisfied with their current plan. If they take no action, they and any dependents will remain on their current plan. There are no changes to member or dependent premiums.
During Annual Enrollment members can:
- Enroll in the State Health Plan
- Switch between plans
- Add or remove dependents without a qualifying event
- And a new feature – add your Primary Care Physician
When adding dependents to their benefit plan, members may be asked to provide documentation of a dependent's State Health Plan eligibility.
Any plan changes made during this time will become effective July 1, 2013. Once members make any changes, they may not elect to switch plans until the next enrollment period unless they experience a qualifying life event. This includes adding or removing a dependent. For a list of qualifying life events, members should refer to the Benefits Booklet, which is available on the State Health Plan website at www.shpnc.org.
Beginning July 1, 2013, the mental health/substance abuse office copay has been reduced to align with the primary care visit copay. For the 70/30 Basic Plan, that copay is $35. For the 80/20 Standard Plan, the copay is $30.
The State Health Plan will be offering training webinars regarding Annual Enrollment for Benefitfocus agencies and for BEACON agencies. For a list of webinar dates and times, as well as registration information, please see the April 3, 2013, HBR Alert on Annual Enrollment training.
Important note: The current benefit year runs from July 1-June 30 of the following year. However, the State Health Plan Board of Trustees recently approved moving the benefit year to a calendar year. To facilitate the transition to a calendar year benefit period, the upcoming benefit period will only be six months: July 1, 2013 — Dec. 31, 2013. This means your deductibles and out-of-pocket maximums will be reduced by half.
The Plan encourages employees to have a Primary Care Physician (PCP) to provide proactive, preventive and chronic care management throughout all stages of their lives. Members will be able to select a PCP for themselves and any covered dependents during enrollment. The selection will appear on member ID cards. With the addition of the PCP information, each family member will receive an individual ID card.
Annual Enrollment Mailers:
