2024 Benefit Information: Active Members

For 2024, the State Health Plan will continue to offer two Preferred Provider Organization (PPO) plans administered through Blue Cross and Blue Shield of North Carolina (Blue Cross NC). They are the Base PPO Plan (70/30) and the Enhanced PPO Plan (80/20).

All members were automatically enrolled in the Base PPO Plan (70/30), with an $85 employee-only premium. Members could change plans and reduce this premium by $60 to a $25 employee-only premium by completing the tobacco attestation during Open Enrollment, which was held October 9-27, 2023.

2024 Rate Sheets

2024 OE Resources

No premium increases for the 6th year in a row with no increase in copays or deductibles!
The formulary (drug list), which determines what medications are covered and what tier they fall under, changes on a quarterly basis, so there is a possibility that you will have changes in your prescription coverage in 2024. Please refer to your Benefit Book for full coverage details.
Members who select a Clear Pricing Project Provider as their Primary Care Provider will continue to enjoy a $0 copay!
Members will continue to enjoy a reduced copay when visiting a Clear Pricing Project Specialist!
Joint replacement bundle pricing for eligible members!
Preferred and non-preferred insulin continues to have a $0 copay for a 30-day supply!
Preventive Services remain covered at 100% – no copay or deductible – on either plan!
You will not receive a new ID card unless you change your plans. You will continue to use your 2023 ID card in 2024.
To learn more about the Clear Pricing Project, click here.

At Time of Enrollment

Subscriber-Only Monthly Premium

Enhanced PPO Plan (80/20)

Base PPO Plan (70/30)

$110

$85

*Attest to being a non-tobacco user or agree to visit a provider (by Nov. 30, 2023) for at least one cessation counseling session to earn a monthly premium credit of $60.

-$60

Total Monthly Employee-Only Premium

(With Credit)

$50

$25

Tobacco users can attend a tobacco cessation counseling session at a provider's office for FREE to receive a lower premium for 2024! You have until November 30, 2023, to take action.
If you combine your tobacco cessation visit with another service, there may be a copay.
After you visit a provider for your tobacco cessation session, the provider will submit a claim on your behalf. To ensure you receive credit for your visit, you should upload your office visit summary to the “Document Center” located in eBenefits, the Plan’s enrollment system. Make sure to request a copy of your visit summary during your counseling session.

CVS Caremark is the State Health Plan’s Pharmacy Benefit Manager.

The State Health Plan utilizes a custom, closed formulary (drug list). The formulary indicates which drugs are excluded from the formulary and not covered by the Plan. All other drugs that are on the formulary are grouped into tiers. Your medication’s tier determines your portion of the drug cost.

These documents and tools include information based on the 2023 formulary and are subject to change prior to January 1, 2024.

For members that log in directly to eBenefits (not through an employer portal) you can reset your password yourself and DO NOT need to call the Eligibility and Enrollment Support Center to reset your password.

If you are having issues logging into eBenefits, do not continue to attempt to log in or you will lock your account. Instead you have the option to reset your password. Simply click “Reset your account” on the log-in page, and then click “I can’t remember my password." From there, you will be prompted to a screen that will ask you to enter your username, so a passcode can be sent to the email address you have in eBenefits.

Click here to log into eBenefits

2024 Benefit Information: Active Members