State Health Plan Enrollment

Why do I need to enroll?

If you want to enroll in one of the health insurance options offered by the state, it is very important that you enroll online using the Employee Self-Service (ESS) Portal in BEACON or complete the following enrollment form within the first 30 days of your hire date. If you do not enroll in one of the choices described below within the first 30 days, you may have to wait up to 12 months if you have "pre-existing medical conditions."

If you work at least 30 hours per week, you and your dependents are eligible to enroll in a Health Insurance Plan.

The State of North Carolina currently offers a Preferred Provider Organization (PPO) insurance plan to its employees. *Beginning on July 1, 2008, the State no longer offers employees the CMM insurance plan. Blue Cross, Blue Shield of North Carolina (BCBSNC) is the administrator of the State Health Plan.

State Preferred Provider Organization (PPO) plan:

Highlights of the plan (see the State Health Plan PPO web site for additional information):

You may choose among three PPO options: SmartChoice Basic Blue Options, SmartChoice Standard Blue Options and SmartChoice Plus Blue Options.

• The PPO options are based on different levels of physician office visit “co-pays” different levels of “co-insurance” and different levels of the “deductible.” The amount of money that employees pay out-of-pocket for PPO premiums will differ based on the option that employees select.
• Employees pay no premiums for SmartChoice Basic Blue Options and SmartChoice Standard Blue Options employee-only coverage. There is a payroll deducted premium for SmartChoice Plus Blue Options employee-only coverage.
• There is an employee/spouse option.
• Employees who opt for the PPO health insurance will have “in-network” access to the BCBSNC “Blue Options” PPO network. Go to the provider search web page to verify that any medical care provider that you use is in the network.

Talk to your HR Representative in your local Human Resources office for more information.

Download the PPO enrollment form (.PDF)*

Who is eligible to enroll in the PPO State Health Plan options?

All full-time and part-time eligible state employees and their dependents are able to participate in either State Health Plan. Effective July 1, 2007, re-employed retirees, who work 30 or more hours per week and are "in a position that would require the employer to pay hospital-medical benefits if the individual had not been retired", are required to enroll in the State Health Plan.

Part-time state employees pay full cost for their insurance—the amount the employer contributes towards the cost of employees' health insurance premiums plus the employees' cost.

Who provides the pharmacy benefit?

Medco will be the pharmacy benefit manager for the PPO plan. Once enrolled you will receive a packet with a prescription benefit booklet, mail order form and the plan’s preferred drug list.

When does the State Health Plan become effective for the new employee?

The effective date of coverage is either the first day of the month following the date of hire or the first day of the second month. The employee selects the date that coverage begins. For example, a new employee hired on October 15 may begin coverage on either November 1 or December 1.

When are insurance premiums payroll deducted?

Insurance premiums are deducted one month in advance of the coverage effective date. For example, if coverage begins on November 1, payroll deduction will begin with the October payroll.

Last updated: August 5, 2008

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