The State Health Plan offers health benefits to all eligible teachers, state employees, retirees and other individuals identified in the North Carolina General Statutes. The Plan’s mission is to provide quality health care products and services for the health and well being of the members.
The State Health Plan offers two health plan designs for its members.
The two PPO options are the SmartChoice Basic Blue Options (70/30) and SmartChoice Standard Blue Options (80/20).
- 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 an employee/spouse coverage type.
- 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.
To learn detailed information on specific plans or if you are trying to decide which plan is best for you, visit the plan comparison page and plan rate page.
Who is eligible to enroll in the PPO State Health Plan options?
All permanent full-time state employees and permanent part-time eligible state employees (who work 20-30 hours per week) and their dependents are able to participate in the State Health Plan. 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.
Permanent 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.
How do I enroll in the State Health Plan?
You may enroll online using the Employee Self-Service (ESS) Portal in BEACON or submit the State Health Plan Enrollment Form if you wish to enroll in the 80/20 plan. If you have an NCID user ID, do not submit a paper enrollment form. For more information on how to enroll, please contact your Health Benefits Representative.
As a new employee, when can I enroll in the State Health Plan and when does it become effective?
As a new employee, you must enroll within 30 days of your start date.
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
Are my insurance premiums pre-tax or post-tax deducted?
Generally, your premiums are deducted on a pre-tax basis but you may elect for your premiums to be deducted on a post-tax basis instead.
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October 2, 2012