(Raleigh, N.C.) - State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) Board of Trustees today announced benefit changes for Humana Medicare Advantage members offering a substantial decrease in the cost of critical dialysis and lab services costs, saving impacted members more than $1.5 million for the 2023 benefit year. Full-time permanent, probationary, time-limited or trainee appointment employees accumulate eight hours of sick leave each month, and 96 total hours annually. In states, and for products where applicable, the premium may include a $1 administrative fee. The contract, awarded by the State Health Plan Board of Trustees (Board), will provide Medicare Advantage products to the Plans Medicare-eligible members with services starting January 1, 2021. Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state. North Carolina state agencies have contracted with an Employee Assistance Program (EAP), McLaughlin Young Group, to serve as a resource for helping you in times of need. There are also employer contributions to TSERS which are determined each year by the North Carolina General Assembly. Retiring members who are Medicare-eligible AND. Eligibility Criteria Retirees will have up until the day before the health plan effective date to elect a Medicare Advantage option. The sections below contain important information categorized by age and by Medicare eligibility. These options include the following plans: In order for a retiree to be eligible for the Humana Group Medicare Advantage (PPO) Plans, the retiree must be enrolled in Medicare Parts A and B. The tobacco attestation premium credit applies only to the employee-only premium. This formulary was updated on 12/01/2022. . Under this term life insurance, your premium is based on the amount of coverage you choose. Not available with all Humana health plans. Secure websites use HTTPS certificates. Today, members pay $112 per month for spousal coverage and $224 for family coverage. Individual applications are subject to eligibility requirements. Although the Retirement System's primary purpose is to provide retirement income, it also provides death benefits. This insurance provides a lump-sum payment when a covered person experiences a covered condition, such as cancer, bone marrow transplant, heart attack, stroke, coronary artery bypass graft, heart transplant, major organ transplant, or kidney failure. In the event of a dispute, the policy as written in English is considered the controlling authority. Dawn Baumgartner Vaughan is the Capitol Bureau Chief for The News & Observer, leading coverage of the legislative and executive branches in North Carolina with a focus on the governor, General Assembly leadership and state budget. For more information regarding these benefits and what is covered, please call Customer Service at 888-234-2416. 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. A lock icon or https:// means youve safely connected to the official website. To learn more, view our full privacy policy. * The Humana Group Medicare Advantage Plans have a benefit value equivalent to a 90/10 plan. Base PPO Plan (70/30) The Base PPO Plan (70/30) is a Preferred Provider Organization (PPO) plan administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). North Carolina state retirees moving to Humana PPO, Humana legal entities that offer, underwrite, administer or insure insurance products and services. The 24 hours is prorated proportionately for part-time (half time or more) permanent, probationary, trainee, or time-limited employees. A lock icon or https:// means youve safely connected to the official website. Folwell said the start date for the switch from Blue Cross NC to Aetna begins on Jan. 1, 2025. You are encouraged to talk with your Health Benefits Representative (HBR) or Human Resources department ahead of time to plan the proper steps. Treasurer Dale Folwell announced that the plan will switch contractors from BlueCross BlueShield of North Carolina, also known as Blue Cross NC, to Aetna insurance. DHHS promotes employee health and wellness including hosting a variety of programs to promote healthy living. The State Health Plan offers several health plan options for Medicare eligible retirees. No. Statements in languages other than English contained in the advertisement do not necessarily reflect the exact contents of the policy written in English, because of possible linguistic differences. What comes next? The State Health Plan offers medical and prescription drug coverage. Remember: It is essential for the State Health Plan to have your most up-to-date contact information (i.e., both physical and mailing addresses, phone numbers, email address) to ensure you receive important benefit details and other information. For more recent information or other questions, please contact the NC State Health Plan Humana Customer Care Team with any questions at 1-888-700-2263 or for TTY Seniors' Health Insurance Information Program (SHIIP). Part-time employees who work half-time or more are granted prorated leave. Not for about two years. Members will also continue to have access to a passive network of providers, meaning you can go to your same medical provider and your coverage does not change. A lock icon or https:// means youve safely connected to the official website. Real-time updates and all local stories you want right in the palm of your hand. For complete details on these legal matters, visitARAGLegalCenter.comand enter Access Code 11246nc. State Government websites value user privacy. For enrollment information, please contact your Division/Facility Health Benefits Representative. These contributions are not credited to a members individual account. Go365 is not an insurance product. Please note that all new retirees who are eligible for State Health Plan coverage will be automatically enrolled into a plan at the time of retirement even if a member did not have Plan coverage as an active employee. If active member is planning to retire within a few months of turning 65, remember Medicare effective date will be delayed if member enrolls the month they turn 65 or during the three (3) months after their birthday month. For qualified retirees, this plan is also premium-free for retiree-only coverage. The premiums you pay go toward covering the cost of the insurance policy, and the remaining balance is invested and earns interest on a tax-deferred basis and may increase the cash and death benefit values. Raleigh, NC 27699-2000. To learn more, view our full privacy policy. Eligible subscribers will continue to enjoy premium-free coverage for the Medicare Advantage Base Plan. Womens interest in entering politics surged after Dobbs. You can contact McLaughlin Young Group at 704-717-5295 or 1-888-298-3907. The Supreme Court just issued its biggest rulings of the year. Member could be left without Medicare coverage being effective as of their retirement date thus increasing their out-of-pocket cost for medical services in addition to limiting members plan selection to the Base PPO Plan (70/30) administered by Blue Cross, NC for the remainder of the plan year. The potential cost savings under the new contract will be approximately $590 million over the course of the three-year contract. Please note that for active members who will be Medicare eligible at the time of retirement, Medicare becomes primary the last month that a retiring active member is covered by his or her agency and the Medicare reduced rate applies. You can keep your coverage with NO INCREASE in premiums if you change jobs or retire. In addition, with this new contract, it will be recommended to the Board that all eligible dependents on the Medicare Advantage Base Plan be premium free as well. For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. Non-Medicare Retirees Base PPO Plan (70/30) Non-Medicare Retirees Enhanced PPO Plan (80/20) Medicare Retirees Base PPO Plan (70/30) . However, Blue Cross NC will appeal the decision, The News & Observer reported Wednesday. The Humana Medicare Advantage Enhanced Plan is a Group Medicare Advantage Plan that includes prescription drug coverage. The new benefit changes represent the latest savings in the 2020 Medicare Advantage Fully Insured Plan and Related Services contract with Humana. If both eligible parents work in DHHS or another PPL-participating agency, PPL can be taken separately or simultaneously, Pays at 100 percentof regular pay (excluding overtime pay, shift premium, on call, callback), and. Participation in the Retirement System of North Carolina is mandatory for every permanent, probationary, time-limited or trainee appointment employee who works at least 30 hours each week. Coverage is portable. Humana will provide coverage under a Group Medicare PPO plan. Your coverage will remain mostly unchanged with Humana. No.
Discounts are available on vision materials if needed. If you currently have TRICARE Select, Prime, or TRS benefits offered to the military community, you may be eligible and interested in the TRICARE Supplement Plan. Important reminder: Your retiree health plan benefit effective date is the first of the month following your retirement effective date. State Health Plan Operations 101; Affordable Care Act About; Certain services require prior review and certification before they can be covered by your health insurance plan. These benefits include the State Health Plan, DHHS Supplemental Benefits, NCFlex Benefits, Retirement, 401K/457 Prudential Savings Plans, Leave Benefits, EAP, Service Awards, and many other important Benefits options. In recognition of the States interests in supporting its employees who wish to volunteer in schools, communities, institutions of higher education, State agencies, and not-for- profit organizations, and recognizing the commitment of State employees to engage in volunteer service, Community Service Leave, within the parameters outlined below, may be granted to: In addition, there are special provisions for granting Community Service Leave to: Twenty-four hours (24) of paid leave is credited to each full time permanent, probationary, trainee, or time-limited employee on January 1 of each year, unless the employee chooses one of the special provision options for volunteering in a literacy program or tutoring/mentoring. You will receive information in the mail explaining your choices in detail. The Medicare Advantage Enhanced Plan will still be offered for a small premium for subscribers as well as reduced premium for any added dependents. If under 65 (and not Medicare-eligible), you will be automatically enrolled in the health plan you were enrolled in as an active employee along with any covered dependents. It offersthreeschedules of benefits, andall threeprovide a comprehensive eye exam and benefits for vision materials. Click here to log into eBenefits, where you can complete your enrollment, make changes to your State Health Plan benefits and access Blue Connect, where you can find your EOBs, request new Plan ID cards and other benefit details. Sick leave hours add up throughout the employee's career. Secure websites use HTTPS certificates. About Us. Benefits under the BCBSNC plan will remain the same. The full amount you elect to contribute to your Healthcare FSA is available in your account on the first day of the plan year or the first day your benefits become effective. You can choose a maximum benefit amount of $15,000 or $25,000. State Health Plan Eligibility and Enrollment Support Center. If you are already retired and about to turn 65, you will become eligible for Medicare and your options under the State Health Plan will change. Our dental plans, vision plans, and life insurance plans may also have waiting periods. Beginning Jan. 1, 2021, Medicare-eligible members will continue to enjoy premium-free coverage through the new plans from Humana, while eligible dependents will have monthly premiums of only $4 for the Medicare Advantage Base Plan. Were always looking at ways to improve this benefit by making it more affordable for those that utilize it, said Treasurer Folwell. State Health Plan Medicare retirees have several options for health plan coverage. Secure websites use HTTPS certificates. The award of the contract was made to Humana after a required, competitive bidding process. After that, there is the option to renew the contract for two one-year terms, according to the treasurers office. EAP is offered at no cost to employees and family members and the service is confidential. for printing without logging in. A lock icon or https:// means youve safely connected to the official website. Waiver of premium included at no additional cost. These benefits are selected by the DHHS Employee Insurance Committee. By Fax For questions regarding enrollment or eligibility, to make address changes or for assistance with the eBenefits enrollment system. If a member is approved for the excluded drug, that drug will be placed into Tier 3 or Tier 6. Its too soon to say (see below.) Note: If no action is taken, retirees will remain in the Humana Group Medicare Advantage (PPO) Base Plan or Base PPO Plan (70/30) for the remaining portion of the plan year. More than 700,000 teachers, state employees, dependents and retirees are on the NC State Health Plan. Yes. He just updated his personal finances. Benefits are paid directly to you unless you specify otherwise. Secure websites use HTTPS certificates. . It was one of her best friends, sharing a link to a news article. Any employee for tutoring and mentoring in public or private schools, or, any employee to volunteer in a literacy program in any public school. Any employee for volunteering in a State of North Carolina Public University, Community College System or State agency provided that the service is outside of the employees normal scope of duties and responsibilities and that the employee is not receiving any form of compensation for the services rendered. State Health Plan for TSERS . If you disagree with the way a claim has been handled, you can request an appeal or grievance review. An annual comprehensive eye exam for a $20.00 co-pay. Convenient payroll deduction of premiums while employed with DHHS. The beneficiary(ies) receive a refund of the employee's retirement contributions plus interest. Member identification card: Please see below for examples of the 2021 member identification card for North Carolina State Health Plan retirees. A lock icon or https:// means youve safely connected to the official website. Susanna Gibson remembers where she was and what she was doing on June 24, 2022, the way some remember 9/11 or the Challenger explosion. The payment is a percentage of salary based on years of service. Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. You can lower your monthly premiums in the Enhanced 80/20 Plan, and the Traditional 70/30 Plan by completing the tobacco attestation. Eligible members will continue to enjoy premium-free . The plan options are the 70/30 PPO Plan or a Group Medicare Advantage Base Plan or a Group Medicare Advantage Enhanced Plan. If you are eligible for State Health Plan benefits under the State Retirement Systems, then you will be auto-enrolled into either the Humana Group Medicare Advantage (PPO) Base Plan or the Base PPO Plan (70/30). Weve got the rundown. Work in a permanent or time-limited position. To enroll in Medicare, contact the Social Security Administration at 800-772-1213or by visiting their website at www.socialsecurity.gov. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits). Thispageis designed to assistmembers as theyprepare for retirementand for members who are already retired, but becoming Medicare eligible. State Government websites score user customer. To learn more, view our full privacy policy. Who We Are. . Humana is the brand name for plans, products and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (Humana Entities). For more information, please see the Service Awards Policy. Sick leave can be accumulated and applied as time toward service retirement. Each employee selects and builds a plan that fits their individual financial needs. The plan will be dependent upon when your retirement paperwork is processed and approved by the State Retirement Systems. Customer Service Center:1-800-662-7030 The Enhanced PPO Plan (80/20) is a Preferred Provider Organization (PPO) plan administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). An employee is fully vested after five years ofmembershipservice. For qualified retirees, the plan is premium-free for retiree-only coverage. An employee is recognized at important milestones in their career upon granting of Career Status and every five years thereafter until retirement. North Carolina State Health Plan. See the following for benefits features and cost information. State Government websites value user privacy. Benefits do not reduce because of workers compensation, sick leave, vacation leave, or any other benefits. This story was originally published January 4, 2023, 1:26 PM. DHHS also offers a number of other supplemental insurance plans as follows: legal, dental, disability, term life, and universal life. Legacy college admissions come under renewed scrutiny. Your type of coverage depends on the health plan you choose. Learn how you can save money in 2023 by visiting a CPP provider! Click here for more information. You must enroll to receive this free benefit. The North Carolina Retirement Systems is a division of the Department of State Treasurer, and we administer the pension benefits for state and local government employees. North Carolina State Government thanks employees for their long-term service through the Service Awards Program. Medicare Retirees Base PPO Plan (70/30) Humana Group Medicare Advantage Base Plan (90/10) Humana Group Medicare Advantage Enhanced Plan (90/10) Understanding Disability; . Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits). Need to download forms without any pre-filled information? In observance of Independence Day, the North Carolina Retirement Systems will be closed Tuesday, July 4. If so, you will need to register to create your account. Members should be aware of the Medicare primary change and the need to elect Medicare Part B to be effective as of the date of their retirement. Benefits begin the first day, if you are hospitalized, regardless of the elimination period you select. Parents for child involvement in the schools; Any employee for volunteer activity in the schools or, Any employee for volunteer activity in a not-for-profit Community Service Organization, or. (This fee is non-refundable as allowed by state). These contributions are tax-sheltered. Automatically enrolled in the Base PPO Plan (70/30). Retirees will have three choices during open enrollment October 2020. Click here to download a helpful resource for when you are planning for retirement. Blue Cross ramps up drive to win back State Health Plan contract, New documents show how Aetna won NCs State Health Plan contract, State Health Plan emails show lost confidence in Blue Cross NC before big switch, Under the Dome podcast: The latest developments with the State Health Plan, NC employee health plan switch is sure to sink Dale Folwells aspirations to be governor | Opinion, What NC teachers, state employees, retirees need to know about health insurance change. Medicare Primary members have several options for health plan coverage. Humana individual dental and vision plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits).
You will still be able to receive the same benefits as you do now through United Healthcare plus some additional benefits. The nurse practitioner was sitting at her kitchen table in Henrico, Va., going over some patient charts, when her phone buzzed. You will receive written notification of this auto-enrollment from the State Health Plan approximately 80 to 90 days before your Medicare becomes effective and be given an opportunity to make a change. For your convenience, you can find a downloadable presentation and recorded webinar from our "Understanding Your Medical Plan Options When You Become Medicare-Eligible" series our our Presentation Archive page. Aetna NC CEO: You shouldnt worry about the change in the state health plan | Opinion. Core: available to employees at no cost. The State Health Plan, a division of the Department of State Treasurer, provides health care coverage to more than 750,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents. The state offers a systematic savings program that provides income to retirees and their families. State Government websites value user privacy. Visit theeBenefits page to access Blue Connect. The State Health Plans board of trustees voted in a closed-session meeting to award Aetna a contract that has been in the hands of Blue Cross NC for more than 40 years. Humana Group Medicare Advantage (PPO) Base Plan, HumanaGroup Medicare Advantage (PPO) Enhanced Plan. Secure websites use HTTPS certificates. State Government websites value user privacy. A lock icon or https:// means youve safely connected to the official website. Full-time permanent, probationary, time-limited or trainee appointment employees are granted at least 94 hours of vacation leave each year. Today, members pay $112 per month for spousal coverage and $224 for family coverage. One of these options is the Humana Group Medicare Advantage PPO Base Plan (90/10)*, which includes Medicare prescription drug coverage. For example: If your retirement date is January 1, your retiree health plan benefit effective date is February 1. Contracted healthcare providers with the Humana Medicare Advantage PPO plan will receive the contracted rate for services rendered. Be in pay status by working or using leave for at least 1040 hours during the preceding 12 months. You are eligible for coverage in the State Health Plan if you are employed in a permanent position working 30 hours or more each week. You can use the benefit payment as you see fit. An official website of the State of North Carolina Into functionary website the NC How you known . Health Benefit Coverage. The DHHS Supplemental Benefits are selected by the DHHS Employee Insurance Committee. State and Local Government Finance Division, Humana Medicare Advantage Plan Members to See Zero Cost Dialysis Care and Lab Services in Urgent Care Centers and Outpatient Facilities, An official website of the State of North Carolina, Treasurer Folwell Announces $1.5 Million in Savings for State Health Plan Members on Medicare Advantage Plans in 2023, Lab services at an urgent care facility (currently $40 copay Base; $10 copay Enhanced) will now have a $0 copay, Dialysis services at an outpatient facility (currently 20% coinsurance on both plans) will now have a $0 copay, Dialysis services at a dialysis center (currently 20% coinsurance on both plans) will now have a $0 copay. To learn more, view our full privacy policy. Visit RelayNCfor information about TTY services. The State Health Plan mails you a Medicare eligibility letter prior to your 65th birthday. The State Health Plan is self-insured and exempt from the Employee Retirement Income Security Act (ERISA) as a government-sponsored plan. Also, in a temporary cash crunch, you can pay less than the scheduled premium and let the policy's accumulated cash value pay the remainder of the monthly charges. The contract will provide Medicare Advantage products to the Plan’s Medicare-eligible members with services starting January 1, 2021.
Administered by Humana Insurance Company. The earliest you may enroll in Medicare is any time during the three months prior to your 65th birthday month. The benefit amount depends on the type of injury and care received. The Humana Dental is one of the nation's largest dental benefits companies offering group dental insurance to employees. You have the following options: The Accident Plan pays benefits for specific injuries and events resulting from a covered accident that occurs on or after your coverage effective date. 3200 Atlantic Ave Raleigh, NC 27604 Map It ppo.inquiries@nctreasurer.com 855-859-0966. Paid Parental Leave went into effect on September 1, 2019. A minimum one-year, initial contract period may be required for some dental and vision plans, excluding Dental Savings Plus. View plan provisions or check with your sales representative. Home Home Topics Related to Medicare Retirees IN-PERSON: Understanding Your Medical Plan Options When You Become Medicare-Eligible These in-person sessions are designed for active employees who will soon be 65, are already 65 or older, and retirees getting ready to turn 65. Fromthere, you will log into eBenefits,thePlan's enrollment system, through the appropriate portal. You have the option to elect Accident Plan coverage to meet the needs of you, your spouse, and/or children. How much did DeSantis make off his book deal? For only $17.24 per month, you receive access to experienced Network Attorneys, industry-unique online tools and trusted resources with full-time legal protection that offers 100% paid-in-full coverage for most legal matters. It is recommended to talk with your HBR or Human Resources Department ahead of your retirement to plan your steps and submit your retirement paperwork at least 120 days prior to your planned retirement date. Blue Cross fights back: Its appealing NCs pick of Aetna for health plan. Please make sure that you do not inadvertently discard mailings from the North Carolina State Health Plan. Members indicated as 50% or 100% contributory notes the percentage of the premium for which they are responsible. She has received the McClatchy Presidents Award, N.C. Open Government Coalition Sunshine Award and several North Carolina Press Association awards, including for politics and investigative reporting. Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc. Humana group life plans are offered by Humana Insurance Company or Humana Insurance Company of Kentucky. 3200 Atlantic AveRaleigh, NC 27604 Map Itppo.inquiries@nctreasurer.com855-859-0966, State Health Plan Policies and Procedures, An official website of the State of North Carolina, State Health Plan Awards Medicare Advantage Plan Contract to Humana, Non-Medicare Retirees Base PPO Plan (70/30), Non-Medicare Retirees Enhanced PPO Plan (80/20), Humana Group Medicare Advantage Base Plan (90/10), Humana Group Medicare Advantage Enhanced Plan (90/10), It will be recommended that beginning January 1, 2021, the Medicare Advantage Base Plan will offer. An official visit of to Your of Ne Carolina An official website of NC How they know . You may receive either eyeglasses or contact lenses in a benefit period but not both. Secure websites use HTTPS certificates. 3200 Atlantic AveRaleigh, NC 27604 Map Itppo.inquiries@nctreasurer.com855-859-0966, State Health Plan Policies and Procedures, An official website of the State of North Carolina, Non-Medicare Retirees Base PPO Plan (70/30), Non-Medicare Retirees Enhanced PPO Plan (80/20), Humana Group Medicare Advantage Base Plan (90/10), Humana Group Medicare Advantage Enhanced Plan (90/10). Retiring members who are eligible for coverage under 65 will be automatically enrolled in the health plan they were enrolled in as an active employee along with any covered dependents, regardless of contribution status. The United Healthcare contract will expire and no longer be a plan choice. The plan helps offset medical deductibles, copays, and coinsurance. The plan will be dependent upon when your retirement paperwork is processed and approved by the State Retirement Systems. Its designed to help you plan for, prevent and resolve a wide range of legal issues, and save you valuable time and potentially thousands of dollars in legal fees.