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Learn About New Health Plan Options

All NC State employees enrolled in the State Health Plan have some big decisions to make about coverage for themselves and for their families in 2014. In fact, employees who don’t take action by the end of October may end up with less coverage than they want.

Details of the new state plan, which now offers three coverage options, were recently mailed in a decision guidebook to all of the state’s 700,000 employees and retirees. Informational events will be held across the state in September and October to discuss each enrolled employee’s options for the coming year. A list of dates, times and locations will be available on the State Health Plan website in early September.

Enrollment will run Oct. 1-31, with coverage beginning on Jan. 1, 2014. Employees and their families who do not select a plan by Oct. 31 will be enrolled automatically in the lowest level of coverage, which has the least expensive monthly premium.

Wellness Pays

Among the biggest changes is a program of three wellness activities that can reduce monthly premiums by as much as $600 per year and a new high-deductible plan that includes a state-paid health reimbursement account that is no longer available in other plans.

Both the newly created Consumer-Directed Health Plan (CDHP) and the newly named Enhanced 80/20 Plan offer premium reductions for participating in any of the three wellness activities: $240 annually for quitting smoking for both plans; $180 in the Enhanced Plan and $120 in the CDHP for taking a health assessment; and $180 in the Enhanced Plan and $120 in the CDHP for choosing a primary care physician.

Participating in all three wellness activities would reduce the premiums for an Enhanced Plan participant up to $50 per month ($600 annually) and a CDHP participant up to $40 per month ($480 annually).

Different Plans for Different Needs

The plans are designed to offer enhanced coverage for employees with different health-care needs, said State Treasurer Janet Cowell in an informational video about the new coverage options.

“The Enhanced Plan might be more suitable if you regularly seek health-care services,” Cowell said. “The CDHP may be more suitable if you rarely seek health care services and if you are fully engaged in your health.”

The Traditional 70-30 Plan remains relatively unchanged, except that neither it nor the 80-20 Plan offers health reimbursement accounts funded by an individual because of new federal guidelines. However, the CDHP does include a reimbursement account, funded by the state plan, to pay for incidental medical expenses while fulfilling a high deductible requirement that ranges from $1,500 for an individual to $4,500 for a family.