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70/30 Plan for Non-Medicare Retirees

70/30 Plan Overview

The 70/30 Plan is a Preferred Provider Organization (PPO) plan administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). A PPO plan offers freedom of choice among in-network providers and lower out-of-pocket costs (copay only for most in-network office visits).

Affordable Care Act preventive services and medications will require the applicable copay under this plan.

70/30 Important Documents

70/30 Plan Rate Sheets

Members indicated as 50% or 100% contributory notes the percentage of the premium for which they are responsible.

Medical Policies

Although your Benefits Booklet provides a good overview of what services and products are available to you under the PPO plans, the medical policies provide detailed information around the circumstances under which certain services and products are and are not covered. Medical policies can be found here on the Blue Cross and Blue Shield website*. 

* If any of the State Health Plan medical policies conflict with the Blue Cross and Blue Shield of North Carolina medical policies, the State Health Plan medical policies will prevail.

Prior Authorization

Certain services require prior review and certification before they can be covered by your health insurance plan. Click here for more information. 

Appeals

If you disagree with the way a claim has been handled, you can request an appeal or grievance review. For the complete appeals process, please click here.