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.
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
- Employees pay no premiums for SmartChoice Basic Blue
Options and SmartChoice Standard Blue Options employee-only
is a payroll deducted premium for SmartChoice Plus Blue
Options employee-only coverage.
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
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.
the PPO enrollment form (.PDF)*
Who is eligible to enroll in the PPO State Health
All full-time and part-time eligible state employees and
their dependents are able to participate in
Health Plan. Effective July 1, 2007,
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
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
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
June 18, 2009
* .PDF refers to Portable Document Format, which is a readable
format for many types of web documents. If you do not have
Adobe Acrobat Reader installed on your computer, you will
not be able to see the form. Acrobat Reader is free and available
at the Adobe website:
Adobe Acrobat Reader
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