State Health Plan for TSERS . Heres what you need to know. However, if your 65th birthday is on the first day of a month, you become Medicare eligible the first day of the prior month (e.g., 65th birthday is 5/1, you become Medicare eligible 4/1). For only $17.24 per month, you receive access to experienced Network Attorneys, industry-unique online tools and trusted resources with full-time legal protection that offers 100% paid-in-full coverage for most legal matters. Folwell said the start date for the switch from Blue Cross NC to Aetna begins on Jan. 1, 2025. Medicare Retirees Base PPO Plan (70/30) Man Group Medicare Advantage Base Plan (90/10) . Today, members pay $112 per month for spousal coverage and $224 for family coverage. Seniors' Health Insurance Information Program (SHIIP). State Health Plan Medicare retirees have several options for health plan coverage. You can lower your monthly premiums in the Enhanced 80/20 Plan, and the Traditional 70/30 Plan by completing the tobacco attestation. The administrative contract awarded to Aetna by the State Health Plans trustees board lasts for three years, until Dec. 31, 2027. Automatically enrolled in the Base PPO Plan (70/30). About Us. Certain services require prior review and certification before they can be covered by your health insurance plan. A formulary exclusion exception process is available for Plan members who, per their provider, have a medical necessity to remain on an excluded, or non-covered, medication. Benefits are paid directly to you unless you specify otherwise.
, New Contract Generates $590 Million in Savings, Board to Vote on Premium-Free Coverage for Dependents. The letter asks that you confirm your eligibility for Medicare benefits. More than 700,000 teachers, state employees, dependents and retirees are on the NC State Health Plan. This insurance provides a lump-sum payment when a covered person experiences a covered condition, such as cancer, bone marrow transplant, heart attack, stroke, coronary artery bypass graft, heart transplant, major organ transplant, or kidney failure. NC State Health Plan Formulary List of covered drugs 42 PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN. After outbursts, court bans father and son from harassing Chapel Hill superintendent, Autopsy finds severely disabled North Carolina woman did drown in townhouse bathtub, House Republican appalled by NC Senates attempt to force a vote on medical marijuana, Has Buc-ees found a site for its 1st NC store? In observance of Independence Day, the North Carolina Retirement Systems will be closed Tuesday, July 4. A lock icon or https:// means youve safely connected to the official website. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits). It is recommended to talk with your HBR or Human Resources Department ahead of your retirement to plan your steps and submit your retirement paperwork at least 120 days prior to your planned retirement date. Blue Cross ramps up drive to win back State Health Plan contract, New documents show how Aetna won NCs State Health Plan contract, State Health Plan emails show lost confidence in Blue Cross NC before big switch, Under the Dome podcast: The latest developments with the State Health Plan, NC employee health plan switch is sure to sink Dale Folwells aspirations to be governor | Opinion, What NC teachers, state employees, retirees need to know about health insurance change. An official visit of to Your of Ne Carolina An official website of NC How they know . Members should be aware of the Medicare primary change and the need to elect Medicare Part B to be effective as of the date of their retirement. What comes next? 2023 Retiree Benefits | NC State Health Plan - Humana Group Medicare For questions regarding the Medicare Advantage Base and Enhanced plans. For yourself, you may choose $20,000, $30,000, $40,000, up to $500,000 of coverage (at intervals of $10,000). Parents for child involvement in the schools; Any employee for volunteer activity in the schools or, Any employee for volunteer activity in a not-for-profit Community Service Organization, or. (Raleigh, N.C.) State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) Board of Trustees today announced benefit changes for Humana Medicare Advantage members offering a substantial decrease in the cost of critical dialysis and lab services costs, saving impacted members more than $1.5 million for the 2023 benefit year. Secure websites use HTTPS certificates. Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations and terms under which the coverage may be continued in force or discontinued. A maximum of 240 hours can be carried over to the following calendar year. Pays in addition to any other insurance coverage the employee may have. In-network and out-of-network benefits are the same. Please see the table below. However, if you want to make a change, you will need to notify us no later than 30 days before your Medicare coverage is to become effective. Any employee for tutoring and mentoring in public or private schools, or, any employee to volunteer in a literacy program in any public school. Benefits begin the first day, if you are hospitalized, regardless of the elimination period you select. Remember: It is essential for the State Health Plan to have your most up-to-date contact information (i.e., both physical and mailing addresses, phone numbers, email address) to ensure you receive important benefit details and other information. North Carolina State Health Plan.
Not for about two years. Full-time permanent, probationary, time-limited or trainee appointment employees accumulate eight hours of sick leave each month, and 96 total hours annually. Members will receive information on this transition prior to this falls Open Enrollment. Q&A: What does the Blue Cross NC ouster mean for State Health Plan members? North Carolina state agencies have contracted with an Employee Assistance Program (EAP), McLaughlin Young Group, to serve as a resource for helping you in times of need. For enrollment information, please contact your Division/Facility Health Benefits Representative. The vacuum of information has been filled with questions from state employees and few clear answers from those in charge of the health plan. DHHS promotes employee health and wellness including hosting a variety of programs to promote healthy living. To qualify for PPL you must meet all of the following eligibility criteria: Learn more about Paid Parental Leave (login required). If you are already retired and about to turn 65, you will become eligible for Medicare and your options under the State Health Plan will change. Please note that for active members who will be Medicare eligible at the time of retirement, Medicare becomes primary the last month that a retiring active member is covered by his or her agency and the Medicare reduced rate applies. It was one of her best friends, sharing a link to a news article. The State Health Plan offers several health plan options for Medicare eligible retirees. To learn more, view our full privacy policy. DHHS offers a Disability Plan through Colonial Life with the following plan features: This plan offers universal life insurance which gives you permanent life insurance protection and access to cash values that grow, tax-deferred, at competitive interest rates. Coverage is portable. Using Your Sick Leave. Supplemental insurances are not part of the Medicare Advantage plans. You may also add coverage for your spouse or dependents based on different coverage amounts. The DHHS Supplemental Benefits are selected by the DHHS Employee Insurance Committee. Questions? To enroll in Medicare, contact the Social Security Administration at 800-772-1213or by visiting their website at www.socialsecurity.gov. If you are actively working for the state after 65, the Plan will continue to be your primary coverage and Medicare will be secondary. The IRS sets the maximum contribution each year. For qualified retirees, the plan is premium-free for retiree-only coverage. You can keep your coverage with NO INCREASE in premiums if you change jobs or retire. Once you're logged into eEnroll, you will see a Blue Connect Quick Link on the left side of your screen. One of these options is the Humana Group Medicare Advantage PPO Base Plan (90/10)*, which includes Medicare prescription drug coverage. You may also participate in the State Health Plan by paying the full cost for coverage, employee premium and employer share, if you work in a permanent part-time position working 20-29 hours. The contract will provide Medicare Advantage products to the Plan’s Medicare-eligible members with services starting January 1, 2021. If you have purchased an association plan, an association fee may also apply. You can choose a maximum benefit amount of $15,000 or $25,000. You will receive written notification of this auto-enrollment from the State Health Plan approximately 80 to 90 days before your Medicare becomes effective and be given an opportunity to make a change. These options include the following plans: In order for a retiree to be eligible for the Humana Group Medicare Advantage (PPO) Plans, the retiree must be enrolled in Medicare Parts A and B. If a member is approved for the excluded drug, that drug will be placed into Tier 3 or Tier 6. Read about the latest plans here, Duke basketball coach Jon Scheyer makes a staff change, with others looming, Affirmative action for white people? Convenient payroll deduction of premiums while employed with DHHS. To learn more, view our full privacy policy. There are NO benefit changes for 2021 on the Medicare Base Plan. You can contribute to the DDCFSA to pay for dependent daycare and eldercare expenses on a pre-tax basis if both you and your spouse work, your spouse goes to school full-time or your spouse isnt able to care for himself or herself. An employee is fully vested after five years ofmembershipservice. Health Benefit Coverage. Instead, they are placed in the various trust funds for the payment of specific benefits. Our state agencies have invested in this contractual agreement to offer you a wide range of support services and work/life options. If you have questions about your Humana contract, please contact your local contracting representative. Frequently Asked Questions About Retiree Health Care Changes, BCBSNC 70/30 Secondary insurance to Medicare. For questions regarding the Base PPO Plan (70/30). But the details are still shrouded in secrecy. These benefits include the State Health Plan, DHHS Supplemental Benefits, NCFlex Benefits, Retirement, 401K/457 Prudential Savings Plans, Leave Benefits, EAP, Service Awards, and many other important Benefits options. You will still be able to receive the same benefits as you do now through United Healthcare plus some additional benefits. pre-filled, please login. Medicare Primary members have several options for health plan coverage. 3200 Atlantic Ave Raleigh, NC 27604 Map It ppo.inquiries@nctreasurer.com 855-859-0966. State Government websites score user customer. Secure websites use HTTPS certificates. If both eligible parents work in DHHS or another PPL-participating agency, PPL can be taken separately or simultaneously, Pays at 100 percentof regular pay (excluding overtime pay, shift premium, on call, callback), and. PDF Important Changes to Retiree Health Insurance Eligibility Changes to plan elections for the following plan year can then be made during the next Open Enrollment period. Susanna Gibson remembers where she was and what she was doing on June 24, 2022, the way some remember 9/11 or the Challenger explosion. To report any changes, contact the Eligibility and Enrollment Support Center at 855-859-0966. North Carolina State Retirees Move to Humana PPO Plan - Humana Also, in a temporary cash crunch, you can pay less than the scheduled premium and let the policy's accumulated cash value pay the remainder of the monthly charges. See the following for benefits features and cost information. Under this term life insurance, your premium is based on the amount of coverage you choose. The Humana Dental is one of the nation's largest dental benefits companies offering group dental insurance to employees. In the meantime, 600 Aetna employees will begin working with the State Health Plan on the transition. A lock icon or https:// means youve safely connected to the official website. . Below are answers to some Frequently Asked Questions to help retirees navigate this change. (8:30 a.m. - 4:30 p.m.) (919-814-4590) By Email NC.Retirement@nctreasurer.com. Blue Cross fights back: Its appealing NCs pick of Aetna for health plan. In addition, with this new contract, it will be recommended to the Board that all eligible dependents on the Medicare Advantage Base Plan be premium free as well. The North Carolina Retirement Systems is a division of the Department of State Treasurer, and we administer the pension benefits for state and local government employees. Medicare Retirees | NC State Health Plan - shpnc.org Secure websites use HTTPS certificates. For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. In recognition of the States interests in supporting its employees who wish to volunteer in schools, communities, institutions of higher education, State agencies, and not-for- profit organizations, and recognizing the commitment of State employees to engage in volunteer service, Community Service Leave, within the parameters outlined below, may be granted to: In addition, there are special provisions for granting Community Service Leave to: Twenty-four hours (24) of paid leave is credited to each full time permanent, probationary, trainee, or time-limited employee on January 1 of each year, unless the employee chooses one of the special provision options for volunteering in a literacy program or tutoring/mentoring. Medicare Retirees Base PPO Plan (70/30) Humana Group Medicare Advantage Base Plan (90/10) Humana Group Medicare Advantage Enhanced Plan (90/10) Understanding Disability; . Your coverage will remain mostly unchanged with Humana. A lock icon or https:// means youve safely connected to the official website. 3200 Atlantic AveRaleigh, NC 27604 Map Itppo.inquiries@nctreasurer.com855-859-0966, State Health Plan Policies and Procedures, An official website of the State of North Carolina. Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits). State Government websites value user privacy. Enhanced:A plan that provides an annual comprehensive eye exam and your choice of contact lens,or glasseswith increased frequency,and ahigherframeand contact lens allowance. Annual cost savings under the contract will total almost $600 million over the course of the three-year contract. Although your Benefits Booklet provides a good overview of what services and products are available to you under the PPO plans, the medical policies provide detailed information around the circumstances under which certain services and products are and are not covered. Blue Cross NC was one of the three insurance companies that went through the request for proposals process, along with Aetna and UMR, Inc. People insured by the State Health Plan will get more information during their 2024 benefits enrollment process. The Supreme Court just issued its biggest rulings of the year. The website is maintained outside of New York state and the insurer is not authorized to transact the business of insurance in New York. State Government websites value user privacy. The Enhanced PPO Plan (80/20) is a Preferred Provider Organization (PPO) plan administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). By Mail North Carolina Department of State Treasurer Retirement Systems Division 3200 Atlantic Avenue Raleigh, NC 27604. Eligible members will continue to enjoy premium-free . A lock icon or https:// means youve safely connected to the official website. To calculate benefits with your information NCFlex offers an excellent Vision Care Plan. Member identification card: Please see below for examples of the 2021 member identification card for North Carolina State Health Plan retirees. You can use the benefit payment as you see fit. Please make sure that you do not inadvertently discard mailings from the North Carolina State Health Plan. To learn more, view our full privacy policy. For qualified retirees, this plan is also premium-free for retiree-only coverage. NC teachers, state employees health insurance change | Raleigh News If so, you will need to register to create your account. Online resources are available in ORBIT and on our website - myNCRetirement.com. After 10 years of total state service, an employee is eligible for longevity payments. Click here to learn more about Humana. So why arent they running? The DDCFSA offers you a tax-free way to pay yourself back for eligible dependent care expenses throughout the year. Eligibility Criteria Click here to log into eBenefits, where you can complete your enrollment, make changes to your State Health Plan benefits and access Blue Connect, where you can find your EOBs, request new Plan ID cards and other benefit details. Medical policies can be found here on the Blue Cross and Blue Shield website. Members indicated as 50% or 100% contributory notes the percentage of the premium for which they are responsible. The Humana Medicare Advantage Enhanced Plan is a Group Medicare Advantage Plan that includes prescription drug coverage. (Raleigh, N.C.) - State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) Board of Trustees today announced benefit changes for Humana Medicare Advantage members offering a substantial decrease in the cost of critical dialysis and lab services costs, saving impacted members more than $1.5 million for the 2023 benefit year. Raleigh, NC 27699-2000. Member could be left without Medicare coverage being effective as of their retirement date thus increasing their out-of-pocket cost for medical services in addition to limiting members plan selection to the Base PPO Plan (70/30) administered by Blue Cross, NC for the remainder of the plan year. However, it will be important to remember to enroll in Medicare Part B to become effective as of your retirement date. Retirees will have up until the day before the health plan effective date to elect a Medicare Advantage option. Understanding Your Medical Plan Options When You Become Medicare-Eligible is designed primarily for retired members who are turning 65 in the next 2 years, and for members who are over 65 and still actively working. Contracted healthcare providers with the Humana Medicare Advantage PPO plan will receive the contracted rate for services rendered. Life will look different: NC student loan borrowers grapple with Supreme Court ruling. This means you can choose to enroll in Medicare Part A but you can delay enrollment into Medicare Part B until you actually retire from state employment. Treasurer Folwell Announces $1.5 Million in Savings for State Health The plan helps offset medical deductibles, copays, and coinsurance. Normal pregnancy is covered the same as any other covered sickness if you become pregnant after the effective date of your policy. . Employees with a hire date on or after 1/1/2021 are not eligible for retiree health benefits at retirement. Were always looking at ways to improve this benefit by making it more affordable for those that utilize it, said Treasurer Folwell. Level benefits for on-the-job and off-the-job disabilities. If you are nearing retirement, click here to learn more . Eligible subscribers will continue to enjoy premium-free coverage for the Medicare Advantage Base Plan. The U.S. Social Security Administration administers Social Security, a social insurance program consisting of retirement, disability and survivors' benefits. Its too soon to say (see below.) NC Department of Health and Human Services Taking effect on July 1: NC laws on abortion, guns and sharks. 2023 Retiree Benefits | NC State Health Plan This formulary was updated on 12/01/2022. The State Health Plan mails you a Medicare eligibility letter prior to your 65th birthday. This plan helps pay 100 percentof members TRICARE outpatient deductibles, cost shares, copayments plus 100 percentof covered excess charges. * If any of the State Health Plan medical policies conflict with the Blue Cross and Blue Shield of North Carolina medical policies, the State Health Plan medical policies will prevail. However, Blue Cross NC will appeal the decision, The News & Observer reported Wednesday. Eligible members will continue to enjoy premium-free coverage for the Medicare Advantage Base Plan. The value of the award increases in proportion to tenure. These benefits are selected by the DHHS Employee Insurance Committee. Administered by Humana Insurance Company. NC Treasurer Folwell backs a risky switch in who runs the State Health Plan | Opinion, Vote to fire Blue Cross as health plan administrator was unanimous, NC treasurer says. The plan's insurance carrier is set to change. View plan provisions or check with your sales representative. A lock icon or https:// means youve safely connected to the official website. State Treasurer Dale Folwell and the State Health Plan Board of Trustees announced in mid-June a new contract with Humana for Medicare Advantage plans that will save retiree families up to $220 a month! Medicareeligible retirees of North Carolina State Health Plan will move to the Humana Medicare (Group) Preferred Provider Organization (PPO) plan for their healthcare coverage, effective Jan. 1, 2021. Treasurer Dale Folwell announced that the plan will switch contractors from BlueCross BlueShield of North Carolina, also known as Blue Cross NC, to Aetna insurance. If you currently have TRICARE Select, Prime, or TRS benefits offered to the military community, you may be eligible and interested in the TRICARE Supplement Plan. DHHS also offers a number of other supplemental insurance plans as follows: legal, dental, disability, term life, and universal life. The employee contribution is 6 percentof gross salary. Retirees that cancel their coverage for any reason will not be allowed to enroll unless they experience a qualifying life event or enroll during the next scheduled Open Enrollment. Note: If no action is taken, retirees will remain in the Humana Group Medicare Advantage (PPO) Base Plan or Base PPO Plan (70/30) for the remaining portion of the plan year.