High Deductible Health Plan

HDHP Medical Benefits and Important Resources

The North Carolina General Assembly approved legislation to create a new health benefit to comply with the federal Affordable Care Act (ACA). The High Deductible Health Plan (HDHP) benefit option is available only to employees eligible for coverage under G.S. §135 48.40(e).

Please note that the HDHP utilizes the MedCost PPO Network — not Blue Cross and Blue Shield of North Carolina Network.

The High Deductible Health Plan is administered by MedCost. Affordable Care Act (ACA) preventive services performed by an in-network provider are covered at 100% in this plan, which means there is no charge to you.

Pharmacy and Find a Provider

The Pharmacy Benefit Manager for this plan is CVS Caremark. This does NOT mean members have to go to a CVS pharmacy location for their prescriptions. CVS Caremark has a broad pharmacy network, which can be found using the tools below.  For questions about the Pharmacy benefit, call CVS Customer Service at 888-321-3124.

Monthly Premiums

If you choose to enroll in this plan, you will be billed monthly for your premiums by the State Health Plan's direct billing administrator, iTEDIUM. This is a pre-paid plan; therefore, you will be billed a month in advance. For instance, you will receive a bill in December for January coverage. You will be responsible for paying your bill in a timely manner, and failure to do so will lead to termination of coverage.

View a sample of the bill you may receive.

How to Enroll

Icon representing a person enrolling in benefitsEnrollment for this plan will be available online only. You will need to register online at www.shphdhp.com. You will be prompted to create a user name and password. Once you have registered, you will be able to follow the necessary steps to complete your enrollment. During your enrollment period you are able to enroll yourself and any eligible dependents in the State Health Plan.

Instructions on how to enroll

An eligible dependent of a covered employee includes:

  • Legal spouse

  • Children up to age 26, including natural, legally adopted, foster children, children for which the employee has legal guardianship and stepchildren of the employee;

This includes coverage for such children (described above) who are covered by the Plan when they turn age 26 to the extent that they are physically or mentally incapacitated on the date that they turn age 26. A child is physically or mentally incapacitated if they are incapable of earning a living due to a mental or physical condition. Coverage continues for such children as long as the incapacity exists or the date coverage would otherwise end, whichever is earlier. 

Please remember that when adding dependents to your benefit plan, you may be asked to provide documentation of dependent eligibility under the State Health Plan. Outside of your enrollment period you may not add or remove dependents or disenroll from the State Health Plan unless you experience a qualifying life event, such as marriage, birth, death or retirement.  

Acceptable dependent eligibility documents

For questions about enrollment, call the HDHP Enrollment and Billing Support Center at 855-442-6272.