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State Health Plan Changes for 2014

August 12, 2013 | In Benefits & Work/Life

The State Health Plan is making major changes to employee and dependent health insurance for 2014. Please review the information below with your HR representatives.

More information on our communications plan for campus is also included below. Much of this information will be included in the August issue of HR Headlines, but feel free to begin communicating with your employees now if you like. However, remember that with changes of this magnitude, wording is important. We encourage you to use the text below as the basis for your internal communications. Also, please let us know about questions you hear from your HR representatives and your employees. We are working on an FAQ document that will be available closer to enrollment. Annual enrollment will be Oct. 1-31, and plan selections and changes will be effective Jan. 1, 2014.

 As a reminder, please let me know if you have any meeting space available for employee informational sessions in September (for 50-75 people).  As I mentioned at HR Council, the Benefits Office will schedule several informational sessions in September.  The purpose is to present information about the State Health Plan changes to employees and answer questions.

Plan Changes

The State Health Plan will introduce a new health plan option – a consumer directed health plan with a state-funded health reimbursement account – and make significant changes to the current PPO 80/20 Standard plan. The Basic 70/30 plan will change only its name (to the Traditional 70/30 plan); no plan features or benefits will change.

For the 80/20 plan – which will now be called the Enhanced 80/20 plan — changes include new and enhanced plan options, as well as surcharges on monthly premiums. The surcharges can be offset by wellness credits — surcharges will be added to employee-only monthly premiums, and any wellness credits you earn can be used to reduce your monthly premium.  Surcharges will not be added and credits cannot be earned for dependent coverage.

There are three ways to earn wellness credits towards your premium:

  • attest to not smoking or participating in a cessation program
  • designate a Primary Care Physician in the enrollment portal
  • complete a Health Assessment prior to Oct. 31

The State Health Plan will credit the employee-only monthly premium for each of the above items.  For example, if an employee completes the Health Assessment – but does not designate a Primary Care Physician and continues to smoke – they will still receive a partial wellness credit.  To receive the full credit – a $50 reduction in your monthly premiums – you must complete all three wellness credit opportunities.

The Consumer Directed Health Plan (CDHP) is a high-deductible medical plan that includes a health reimbursement account (HRA) to help offset the deductible. After the deductible is met, the plan will pay 85 percent of in-network costs. The surcharges and wellness credits noted above will also apply to employee-only CDHP premiums.

What Can Employees Do Now?

Have you taken your Health Assessment? Employees can take the health assessment now and it will apply to their enrollment in October. The assessment can be completed online (at www.myactivehealth.com/nchealthsmart) or by phone at 800-817-7044 (press option 2).  

To take the assessment, you will need your current State Health Plan Subscriber ID. The assessment is a five-minute questionnaire about your medical history, lifestyle and preventive health. As part of the questionnaire, you will be asked your waist measurement, so you may want to have a tape measure handy.

By completing the assessment, you will learn about your risk for developing a chronic health condition, and receive personalized action items to improve overall health and well-being. As an added benefit, if you complete the assessment early, you increase their chances of winning a free iPad®. Now through October 2013, monthly drawings for an iPad® will be held for all eligible State Health Plan members who have completed their health assessment.

Employees can also designate a primary care physician for each covered member before enrollment begins. To do this, log in to https://unc.hrintouch.com and click on the Benefits icon, then click the View/Edit Information link under Section 1 Medical.  The primary care provider edit link is listed under the Medical icon.  Click the edit link and follow the prompts from there.  You can change your primary care provider at any time.  A primary care physician can also be set by calling BenefitFocus at 855-859-0966. In addition to the wellness credits, the State Health Plan will be introducing incentives to reduce copays and other costs for healthy choices…..more details to come.    

Employee Communications

The State Health Plan will send information directly to employees’ homes about the coming enrollment. This is expected to arrive in mid-September. In addition, both the August and September issues of HR Headlines will contain additional employee-focused information about the coming State Health Plan enrollment. We also plan to publish a special HR Headlines issue at the beginning of the enrollment period, which should help you get the word out to employees. We will, as always, send Formal Notice emails as well.

In early September, we will launch a special page on the OHR website with additional information, and we hope to make videos available on specific topics. Lastly, as noted above, Benefits will be holding informational sessions on campus. Dates and locations for those will be announced soon.