North Carolina State Health Plan Announces Significant Enrollment
in New PPO Plans, Effective October 1
State Health Plan Confirms Cost Savings for Taxpayers and Members
September 8, 2006
Raleigh, N.C. – The North Carolina State Health Plan announced today that approximately 330,000 State Health Plan members selected the new Preferred Provider Organization (PPO) plan offerings during the recent open enrollment period. This number reflects the state employees, teachers, retirees and dependents who chose the NC SmartChoice Blue OptionsSM PPO plans, effective October 1, 2006.
"The PPO will save North Carolina taxpayers more than $25 million dollars from October 1, 2006 through October 1, 2007. Most State Health Plan PPO members and their families will also realize notable health care savings," said Executive Administrator George C. Stokes. "As requested by members, the PPO enables the State Health Plan to deliver on its promise of improved affordability and choice." The total State Health Plan budget for the current fiscal year is approximately $2 billion.
Director of Network Operations Chris Evans emphasized that "based on the enthusiastic response to expanded choice and increased affordability during this initial enrollment, it’s very likely that we will see a larger percentage of our members in the PPO after the next annual enrollment."
PPO plans contract with various physicians, hospitals and other providers to form medical care networks. For the State Health Plan, NC SmartChoice Blue OptionsSM PPO members will receive services at lower premiums and reduced out-of-pocket costs when they use in-network providers. Members decide when to visit a specialist and whether to select a provider from in-network or out-of-network. They may also use out-of-network providers at a reduced benefit. Physician referrals are not required.
Other features of the State Health Plan’s new PPO include:
The PPO was offered for the first time, along with the current indemnity plan, during the 2006 open enrollment. A full breakdown of PPO membership will be available once members are officially switched to the PPO from the indemnity plan on October 1, 2006. Additional details will be released by the North Carolina State Health Plan after October 1, 2006.
Raleigh, N.C. – The North Carolina State Health Plan announced today that approximately 330,000 State Health Plan members selected the new Preferred Provider Organization (PPO) plan offerings during the recent open enrollment period. This number reflects the state employees, teachers, retirees and dependents who chose the NC SmartChoice Blue OptionsSM PPO plans, effective October 1, 2006.
"The PPO will save North Carolina taxpayers more than $25 million dollars from October 1, 2006 through October 1, 2007. Most State Health Plan PPO members and their families will also realize notable health care savings," said Executive Administrator George C. Stokes. "As requested by members, the PPO enables the State Health Plan to deliver on its promise of improved affordability and choice." The total State Health Plan budget for the current fiscal year is approximately $2 billion.
Director of Network Operations Chris Evans emphasized that "based on the enthusiastic response to expanded choice and increased affordability during this initial enrollment, it’s very likely that we will see a larger percentage of our members in the PPO after the next annual enrollment."
PPO plans contract with various physicians, hospitals and other providers to form medical care networks. For the State Health Plan, NC SmartChoice Blue OptionsSM PPO members will receive services at lower premiums and reduced out-of-pocket costs when they use in-network providers. Members decide when to visit a specialist and whether to select a provider from in-network or out-of-network. They may also use out-of-network providers at a reduced benefit. Physician referrals are not required.
Other features of the State Health Plan’s new PPO include:
- A new Employee-Spouse tier, in addition to existing tiers
- Reduced premiums for dependent coverage
- Network availability in all 100 North Carolina counties
- No deductibles or coinsurance for non-hospital based physician’s office visits -- only co-pays (in-network)
The PPO was offered for the first time, along with the current indemnity plan, during the 2006 open enrollment. A full breakdown of PPO membership will be available once members are officially switched to the PPO from the indemnity plan on October 1, 2006. Additional details will be released by the North Carolina State Health Plan after October 1, 2006.
