Contact Us
View contact information for various State Health Plan vendors to address specific questions or concerns.
| State Health Plan Resource | Description | Customer Service | Mailing Address | Audience |
|---|---|---|---|---|
| Eligibility & Enrollment Support Center | For questions regarding enrollment, eligibility or for assistance regarding the enrollment system. | 855-859-0966 M-F 8AM to 5PM |
3200 Atlantic Avenue Raleigh, NC 27604 |
All Members |
| Third-Party Administrator (Blue Cross & Blue Shield of NC) |
For questions regarding benefits or any claim inquiries. | 888-234-2416 TTY: 800-442-7028 M-F 8AM to 6PM |
State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702 |
Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Appeals & Grievances (Blue Cross & Blue Shield of NC) | To appeal a claim decision or to file a grievance. | 888-234-2416 Fax: 919-765-2322 M-F 8AM to 6PM |
State Health Plan c/o BCBSNC Appeals Department PO Box 30055 Durham, NC 27702 |
Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Smart NC is a program provided by the NC Department of Insurance. | For information on requesting an external review of claims decisions (after all internal grievance procedures have been exhausted). | 855-408-1212 M-F 8AM to 5PM |
325 N. Salisbury St. Raleigh, NC 27603 |
All Members |
| CVS Caremark (Pharmacy Benefit Manager) |
To file a claim for prescription drugs, locate pharmacies within the network, or learn more about your Pharmacy Benefits. | 888-321-3124 7 days a week, 7AM to 11PM |
CVS Caremark P.O. Box 52136 Phoenix, Arizona 85072 |
Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Prescription Drugs Prior Authorization | To initiate a prior authorization request of your prescription drugs. | 800-294-5979 7 days a week, 7AM to 11PM |
CVS Caremark P.O. Box 52136 Phoenix, Arizona 85072 |
Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Behavioral Health and Chemical Dependency/ Substance Use Services | For questions regarding precertification for behavioral health services and chemical dependency. | 800-367-6143 M-F 8AM to 6PM |
Blue Cross Blue Shield NC PO Box 30055 Durham, NC 27702-3055 | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Hospital Pre-admission Certification/ Prior Approval (Blue Cross & Blue Shield of NC) | To request prior authorization (certification) for certain out-of-network or out-of-state services. | 800-672-7897 M-F 8AM to 6PM |
State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702 |
Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Humana (Medicare Advantage Carrier) | For questions regarding Humana Medicare Advantage Plans. | 888-700-2263 M-F 8AM to 9PM |
P.O. Box 14162 Lexington, KY 46512-4162 | Humana Medicare Advantage Members |
| NC Retirement Systems | For questions regarding retirement, pension information and supplemental retirement plans. | 919-814-4590 NCRetirement@nctreasurer.com M-F 8:30AM to 4:30PM |
3200 Atlantic Avenue Raleigh, NC 27604 |
All Members |
| Seniors Health Insurance Information Program (SHIIP). SHIIP is a division of the N.C. Department of Insurance. |
For information about Medicare, Medicare Advantage plans, Medicare claims, Medicare supplement insurance, Medicare Prescription Drug Plans, fraud and abuse prevention as well as long-term care insurance. | 855-408-1212 or 919-807-6900 M-F 8AM to 5PM |
325 N. Salisbury St. Raleigh, NC 27603 |
Retirees |
| Social Security Administration | For specific questions about Medicare premiums and claims. | 800-772-1213 TTY : 800-325-0778 M-F 7AM to 7PM |
7500 Security Blvd. Baltimore, MD 21244 |
Retirees |
| iTEDIUM (Direct Bill & COBRA Adminstrator) |
For questions regarding your bill for premiums. | 877-679-6272 M-F 8AM to 5PM |
State Health Plan c/o iTedium P.O. Box 505211 (Direct Bill) P.O. Box 505200 (COBRA) St. Louis, MO 63150 |
Retirees/Surviving Spouses/COBRA Participants |
| The Rawlings Company (Third Party Liability Recovery Services) | For questions regarding subrogation | 877-229-0872 NCStatemanualreferrals@rawlingscompany.com M-F 8AM-8PM |
PO Box 2000 La Grange, Kentucky 40031-2000 | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Report Fraud and Abuse | To report suspected fraud and abuse. | 800-324-4963 M-F 8AM to 6PM |
State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702 |
Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| State Health Plan Board of Trustees | To share concerns or feedback to the Board of Trustees. | SHPBoard@nctreasurer.com | 3200 Atlantic Avenue Raleigh, NC 27604 |
All Members |
| State Health Plan Member Inquiries | To share comments, concerns or general feedback on specific medical or pharmacy issues. | 919-814-4400 ppo.inquiries@nctreasurer.com M-F 8AM to 5PM |
3200 Atlantic Avenue Raleigh, NC 27604 |
All Members |
| Health Benefit Representative (HBR) Inquiries | For general questions for the Plan from HBRs | hbrinquiries@nctreasurer.com | 3200 Atlantic Avenue Raleigh, NC 27604 |
HBRs |
| Media Inquiries | For public records or other media inquiries. | 919-814-3820 press@nctreasurer.com M-F 8AM to 5PM |
3200 Atlantic Avenue Raleigh, NC 27604 |
Media |
| BEACON (BEST Shared Services) | For questions on how to navigate BEACON or other BEACON system assistance. | 919-707-0707 (Raleigh area) 866-622-3784 (statewide) M-F 8AM to 5PM |
3512 Bush St. Raleigh, NC 27609 |
Active Members |