State Health Plan e-Newsletters

Opioid Epidemic pill graphic CDCAs reported in the News & Observer, the Centers for Disease Control and Prevention said in a preliminary estimate that 2,505 people in North Carolina overdosed on opioids and other drugs last year.

That's a 22.5 percent increase from the year before. So far, 2,323 death have been reported in North Carolina for 2017, but that number could increase as reports are tallied.

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Subrogation – Third Party Recovery

The State Health Plan has the right of subrogation upon its injured members' right to recover from liable third parties. The Plan's objective is to recover medical expenditures incurred by the Plan where a third party is liable for the care.

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A small number of State Health Plan members have reported receiving scam phone calls from people asking for personal information. These phone calls are not coming from the State Health Plan. If you receive such a call, you should not provide the caller with any personal information.

The Plan, as a precaution, is working with our vendors and local authorities to determine the sources of these calls and if any member information is at risk. If so, we will inform Plan members as more information becomes available.

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Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the State Health Plan’s Third Party Administrator, has launched a significant redesign and improvement of several online member transparency tools, making it even easier for your employees to find the care they need.

These transparency tools are part of our State Health Plan initiative to enhance the tools you use to get the most out of your health benefit at the lowest cost. We call that being a State Health Plan Watchdog!

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House Bill 1056 became law on June 25, 2018.  This legislation mandates employing unit cooperation in collecting through wage garnishment money that members owe the State Health Plan (Plan). Specifically, any payment of benefits or other amounts to, or premiums or claims paid on behalf of, any Plan member that is later determined to be an overpayment, an erroneous payment, or a benefit or amount for which the Plan member was ineligible, shall be repaid by the Plan member.

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Screenshot of the new Explanation of Benefits

Your Explanation of Benefits, or EOB, is a detailed financial statement of how one or more of your medical claims has been processed. It outlines what the State Health Plan has paid and what is your responsibility. It’s not a bill, but it can help 70/30 Plan and 80/20 Plan members track their health care costs.Image of a video image of the Explanation of Benefits versus new Explanation of Benefits

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The State Health Plan will conduct Open Enrollment September 29-October 31, 2018.

You will receive a Decision Guide in the mail in September which will include information to help you choose the best plan for yourself and your family. Therefore, it is important to keep your address current! It is critical for your address to be accurate in eBenefits, the Plan’s enrollment system. It’s also important to inform your employing unit or the State Retirement Systems.

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2019 Open Enrollment ends October 31, 2018.

You should have already recieved your decision guide in the mail. This guide includes information to help you choose the best plan for yourself and your family. It is important to keep your address current!

It is critical for your address to be accurate in eBenefits, the Plan’s enrollment system. To update your address, log into eBenefits, which you can find on the State Health Plan website. It’s also important to inform your employing unit or the State Retirement Systems.

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An image of a stethascope on top of a stack of money

State Treasurer Dale R. Folwell, CPA announced today that the State Health Plan (Plan) will launch a new medical reimbursement strategy for North Carolina providers that care for Plan members. This effort is part of a longer term strategy to take advantage of the Plan’s “largeness” to keep rising health care costs under control while promoting quality care, transparency and affordability.

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