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State Health Plan Insurance Options

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The State of North Carolina provides health care benefits to teachers, employees, retirees, and their eligible dependents according tot he provisions and limitations of North Carolina General Statutes.  Health Insurance is offered to every permanent employee that works at least least (30) hours per week.

Plan Options

The following State Health Plan options are available:

1.    PPO - Basic Plan (70/30)
2.    PPO - Standard Plan (80/20)

Benefit Comparison Chart for PPO Plans for Benefit Years 2009-2010
Monthly Contribution Rates for Benefits Years 2009-2010 (Rates effective 07/01/09)

For more information regarding the PPO Plans, go to the State Health Plan website at   Benefit booklets and enrollment kits are available on the State Health Plan website.  For additional inquiries, please contact PPO Customer Service at 1-800-234-2416, or contact your Benefit Representative at your work location.

Enrollment Information

New Hires Employees have (30) days to enroll in health insurance coverage from the date of hire.  If the employee applies for health insurance after the (30) day period, there may be a 12-month waiting period for pre-existing health conditions.

Annual Enrollment During annual enrollment, employees will be given the opportunity to change plan information including changing personal information and/or coverage for eligible dependents, etc.   Election changes made during annual enrollment should be documented on the enrollment form and submitted to BEST Shared Services for processing.  (NOTE:  Employees at facilities that are part of the Beacon Employee Self Service (ESS) project, can make enrollment changes online via ESS through the Beacon website.)  If no changes are made, an annual enrollment form or online changes are not needed and the employee will remain on their current plan. 

How to Reduce Your Health Insurance Costs w/ NCFlex

NCFlex Pre-Tax Health Care Flexible Spending Account

NCFlex is a program that enables you to save money on your out-of-pocket health care costs by reducing your taxable income.  Under the NCFlex HCSA program you may choose to contribute an amount of money to your Flex account through monthly payroll deduction. This will reduce the amount of your taxable income.

Your annual contribution can not be less than $120 a year or greater than $4200 per year. When you have a medical, dental, vision, or hearing expense for yourself or your family that is not paid by your health or other insurance, but which is paid for out of your own pocket, attach your receipt or the insurance company explanation of benefits (EOB) to a NCFlex claim form and you will receive reimbursement from the account to which you previously contributed.

With this account, you are reimbursed with the pre-tax dollars you set aside to pay for medical, dental, or other health care expenses not covered by a health plan. You never pay taxes on the money you receive from your spending account which helps your health care dollars go farther.

Claim forms and account balance information will be mailed to your home address. Reimbursements are deposited directly into the same bank account that your paycheck is deposited.  You can either fax or mail reimbursement requests.

Participation in NCFlex is voluntary and you can choose to sign up for any or all of the benefits offered through NCFlex. Please refer to Your NCFlex Benefits Overview booklet for additional information and enrollment application.

If you have questions regarding Health Insurance or NCFlex's Health Care Flexible Spending Account, please contact the Benefits Representative at your work unit.

COBRA - Continuation of Insurance Coverage

When you or your enrolled dependents are no longer eligible for regular coverage under our health and dental insurance plans, you may be eligible for continued coverage if you pay the monthly premium for the coverage. This is guaranteed to you under the Consolidated Omnibus Budget Reconciliation Act (COBRA) if you were covered under the group plan at the time of a qualifying event (see below for a list of qualifying events); you are not eligible for Medicare; you are not eligible for coverage under another employer's group plan; and, you have not applied to convert your group coverage to an individual health insurance policy.

Qualifying Events

You have the right to choose continuation coverage (COBRA) if you lose your group health insurance because of a reduction of hours in employment or the termination of your employment (voluntary or involuntary) for reason other than gross misconduct.

A covered spouse or dependent child has the right to choose continuation coverage (COBRA) if coverage is lost for any of the following reasons:

- Your death;

- Termination (voluntary or involuntary) of your employment or reduction in hours of employment;

- Divorce or legal separation;

- The insurance companies no longer consider your child a "dependent child".

If you elect COBRA, you will receive identical coverage provided under the plan to similarly situated employees or family members. Your right to continue coverage under COBRA will continue for at least 18 months, and in some situations up to 36 months. You will be advised as to the maximum length you may continue.

COBRA Election Period

Once your health insurance company has been notified of a qualifying event by Beacon BEST Shared Services, your insurance company will mail you and your covered dependents information about COBRA Rights, premium payments, and a COBRA election form.



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