N.C. Department of Health and Human Services
New Employee Orientation
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State Health Plan

The State Health Plan offers three Preferred Provider Organization (PPO) plans. PPO plans offer the freedom of choice among in-network providers, lower out-of-pocket costs and a strong emphasis on preventive health. Two of the plans, the Consumer-Directed Health Plan (CDHP) and the Enhanced 80/20 Plan, offer financial incentives for taking steps to improve your health.

Consumer-Directed Health Plan (CDHP)

This is a high deductible health plan that is accompanied by a Health Reimbursement Account (HRA), which is set up for you by the State Health Plan. This plan includes the ability to lower your monthly premium by completing wellness activities.

Enhanced 80/20 Plan

This plan has higher premiums in exchange for lower copays, coinsurance and deductibles. This plan includes the ability to lower your monthly premium by completing wellness activities.

Traditional 70/30 Plan

This plan has lower premiums in exchange for higher copays, coinsurance and deductibles. Affordable Care Act preventive services and medications will require the applicable copay under this plan.

By choosing one of these plans, you have access to Member Services, a protected online resource for help in maximizing your benefits, and to NC HealthSmart, a protected online resource for help in managing your health.

Once you've identified the plan that is right for you, click here to learn how to enroll in a plan.

Wellness Premium Credits

You can lower your monthly premium for the Consumer-Directed Health Plan and the Enhanced 80/20 Plan by completing the wellness activities listed below. Wellness premium credits apply only to the employee-only premium. In order to receive the wellness premium credits, you must complete your wellness activities within 30 days of your hire date. For more information contact your Health Benefits Representative or call Customer Service at 855-859-0966.

Additional Wellness Incentives

Additional wellness incentives are available in the Consumer-Directed Health Plan and the Enhanced 80/20 Plan that lower your out-of-pocket costs for various health care services you receive throughout the year.

Enhanced 80/20 Wellness Activities Wellness Premium Credits
Attest that you and your covered spouse (if applicable) are non-smokers or commit to a smoking cessation program $20 per month
Complete a confidential Health Assessment $15 per month
Select a Primary Care Provider for yourself and each covered dependent (if applicable) $15 per month
Total wellness premium credits $50 per month
Consumer-Directed Health Plan Wellness Activities Wellness Premium Credits
Attest that you and your covered spouse (if applicable) are non-smokers or commit to a smoking cessation program $20 per month
Complete a confidential Health Assessment $10 per month
Select a Primary Care Provider for yourself and each covered dependent (if applicable) $10 per month
Total wellness premium credits $40 per month

Rate Comparison

January 1, 2014 – December 31, 2014

Plan Comparison

January 1, 2014 – December 31, 2014


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 insuranceóthe 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. For more information on how to enroll through BEACON, visit the How to Enroll in Benefits Guide or 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 payroll.

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.


Return to the Forms List page.

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If you have completed all forms and read all of the policies, go on to the next section.

- AND -

Don't forget to complete the short online evaluation after you complete the orientation program.


Last updated: January 3, 2014


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