Annual Enrollment

May 20-31, 2013
Frequently Asked Questions

• Do I have to do anything during Annual Enrollment if I am happy with the plan in which I am currently enrolled?
• Are there any benefit changes?
• Are there any changes in my premium?
• Why is the benefit period only 6 months long?
• How do I make changes to my coverage?
• Will I get a new ID card?
• Who can I call for benefit information?
• Do I have to choose a Primary Care Provider (PCP) during the Annual Enrollment?
• I heard we would have more benefit options. What are they?
• When will you hold the enrollment for these new options?
• I am retired and Medicare eligible. I opted out of the Express Scripts Prescription Drug Plan (PDP) which began in January 2013. Do I need to opt out again during Annual Enrollment?
• How can I get a new benefit booklet?

Do I have to do anything during Annual Enrollment if I am happy with the plan in which I am currently enrolled?

No, you do not have to do anything if you are satisfied with your current benefit plan and do not wish to add or remove any dependents.

Are there any benefit changes?

Beginning July 1, 2013, the office copay for mental health and substance abuse services has been reduced to align with the primary care copay for both the Basic and Standard plans. The copay for the Basic 70/30 plan will be $35 and for the Standard 80/20 plan the copay will be $30.

Are there any changes in my premium?

There are no changes to premiums for the upcoming benefit period.

Why is the benefit period only 6 months long?

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 — December 31, 2013.

As a result of the shortened benefit year, your deductibles and out-of-pocket maximums will be reduced by half. This includes the pharmacy out-of-pocket maximum. Medicare eligible members enrolled in the Express Scripts Medicare Prescription Drug Plan (PDP) will not receive the pharmacy out-of-pocket maximum, as the PDP is already on a calendar year.

How do I make changes to my coverage?

Paper applications are no longer accepted, so all members must make changes electronically. Your status as an active employee, place of employment or if you are a retiree determines where you enroll electronically.

• Employees of schools, community colleges or universities will make changes through eEnroll, formerly known as eBenefitsNow. You will need to log in to the system at the new universal log in page, https://shp-login.hrintouch.com to enroll. For assistance in navigating eEnroll, call Customer Service at 855-859-0966.
• Retirees will need to make any changes electronically through ORBIT, accessible at www.myncretirement.com or telephonically. If you need assistance with navigating through eEnroll, formerly known as eBenefitsNow, you may call 800-266-9119. Retirees who do not have access to a computer may call 800-266-9119 and a Customer Service representative can complete your election for you over the phone.
• If you are an active employee with a state agency you will need to enroll through BEACON's Employee Self Service (ESS), available on the BEACON website at http://mybeacon.nc.gov. Members without ESS access may contact BEST Shared Services at 919-707-0707 (in Raleigh) or 866-622-3784 (statewide) to complete enrollment by phone.
• If you are a COBRA or RIF member, or a former legislator, surviving spouse or dependent and wish to make changes in your health benefits, you will need to do so through eEnroll. You will need to log in to the system at https://shp-login.hrintouch.com to enroll. For assistance in navigating eEnroll call Customer Service at 855-859-0966.

Will I get a new ID card?

All members will receive a new ID card whether or not you make changes to your benefit plan. The cards will reflect the new Mental Health/Substance Abuse copays. Each covered member of your family will receive an individual ID card.

Who can I call for benefit information?

For benefit information, you can call Blue Cross and Blue Shield of North Carolina Customer Service at 888-234-2416.

Do I have to choose a Primary Care Provider (PCP) during the Annual Enrollment?

You will not be required to choose a PCP during this enrollment period. However, if you do select a PCP, the name will appear on your new ID card but does not limit you to that physician in any way.

The Plan encourages members to choose PCP. Having a PCP supports the concept of Patient Centered Medical Home (PCMH) — an ongoing, active partnership with your PCP who provides proactive, preventative and chronic care management throughout all stages of your life.

I heard we would have more benefit options. What are they?

New plan options will be available January 1, 2014. Active and Non-Medicare Retirees can choose to remain on the current premium-free 70/30 plan or select an Enhanced 80/20 plan option that comes with a premium or a Consumer Driven Health Plan (high deductible plan) with a Health Reimbursement Account (HRA).

Medicare-eligible retirees will also have new options. Medicare Advantage Plans will be offered for the 2014 benefit year. Contracts were awarded to Humana and United Healthcare. Medicare Advantage offers services to help Medicare-primary members effectively manage their health. The premium-free 70/30 plan will also remain as an option for Medicare-eligible retirees.

When will you hold the enrollment for these new options?

The enrollment period for the benefit year beginning on January 1, 2014, will be held during the entire month of October 2013. You should receive information regarding the October enrollment in late August.

I am retired and Medicare eligible. I opted out of the Express Scripts Prescription Drug Plan (PDP) which began in January 2013. Do I need to opt out again during Annual Enrollment?

No, if you opted out of the new Express Scripts Medicare PDP and remained in the Traditional Pharmacy benefit plan, you will not need to opt out again during Annual Enrollment.

How can I get a new benefit booklet?

You can download the current benefit booklet by clicking here.