State Health Plan Moves Forward on Annual Enrollment with Current Benefit Structure
May 4, 2011 -- Health benefits for teachers and state employees are determined by the North Carolina General Assembly. State leaders are reviewing possible changes to the benefit structure. As of today, no legislative action has been taken to alter health benefits for the upcoming benefit year, which begins July 1, 2011. Therefore, benefits will remain the same as laid out in Session Law 2009-16 (Senate Bill 287), passed in April 2009.
The State Health Plan is moving forward with the current benefit structure to allow members to participate in the annual enrollment process in time for the beginning of the new benefit year.
What does this mean for members?
- Until otherwise notified, existing premiums will remain in effect with no changes to copays, deductibles, or coinsurance.
- The Comprehensive Wellness Initiative remains in effect and will include both the tobacco and weight management components.
What does this mean for annual enrollment?
- Annual enrollment will be held May 9-June 8. ALL members with the State Health Plan as their primary health coverage will be moved to the 70/30 Basic plan, effective July 1. If members choose to remain on the Basic plan, no action is required unless members need to add or remove dependents.
- To enroll in the 80/20 Standard plan, MEMBERS MUST TAKE ACTION during annual enrollment. They can elect the 80/20 Standard plan if:
- Primary coverage is through Medicare;
- Members and covered dependents do not use tobacco products and have a Body Mass Index (BMI) less than 40 kg/m2. Click here for the BMI calculator.
- Members and/or covered dependents are participating in a tobacco cessation or weight management program, or members and/or covered dependents have a medical condition that prevents the attainment of the required weight range.
Will there be any other changes in benefits this year?
- Yes, the General Assembly is still working on legislation that could impact premiums, copays, deductibles and coinsurance for members of the State Health Plan.
- If a bill is passed and signed by the Governor, another enrollment period may be conducted for members.
Plan members can click here for annual enrollment information and materials. Plan members with questions should call Customer Services at 888-234-2416.