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State Health Plan Enrollment and 2014 Changes

August 28, 2013 | In Benefits & Work/Life

The State Health Plan is making major changes to employee and dependent health insurance for 2014. Read below to review the changes and see what you can do now to prepare.

Annual enrollment will be Oct. 1-31, and plan selections and changes will be effective Jan. 1, 2014. For the first time, you will enroll at the same time for your State Health Plan elections and your NCFlex choices. Due to a legislative change earlier this year, the State Health Plan and NCFlex will both now run on a calendar year. More information on NCFlex plan changes will be available in mid- to late September.

The State Health Plan recently mailed all covered members an informational guide that detailed many of the upcoming plan changes.  Also included was information on the wellness initiatives mentioned below, and the message that you must take action in October.  This mailing is the first in a series that employees can expect to receive during the weeks leading up to annual enrollment.  You’re strongly encouraged to read through all of the materials to prepare for this year’s annual enrollment. 

State Health Plan Changes

The State Health Plan will introduce a new health plan option for 2014 – 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.

All current State Health Plan members will be automatically enrolled in the Traditional 70/30 plan. You must take action during enrollment in October if you want to change to the Enhanced 80/20 or Consumer Driven Health plans effective Jan. 1, 2014.

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 employee 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, an employee who completes the health assessment – but does not designate a Primary Care Physician and continues to smoke – will 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.

In addition, if you use physicians, specialists or hospitals in the Blue Options network as part of the Enhanced 80/20 plan, your copay will be reduced. The Blue Options network list is available at the Blue Cross Blue Shield website.

The new 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. Also, CDHP members who use a Blue Options provider as noted above will receive additional funds in their HRAs.

Find Out More

In addition to the information already mailed from the State Health Plan, the Office of Human Resources will provide a number of resources to help you consider your options and choose the plan that best suits your needs. In early September, we will launch a special page on the OHR website with additional information.

Want more information in person? The Benefits Office will hold several informational sessions on campus during September. See the OHR events calendar for dates and times.

The State Health Plan website has plan information and rates.

What You Can Do Now

You can take the health assessment now and it will apply to your enrollment in October. The assessment can be completed online 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. All information is completely confidential. The wellness credit is based on simply completing the assessment, not on the results.

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 the health assessment.

You can also designate a primary care physician for yourself and your dependents 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.