 |
Starting Jan. 1, 2025, Aetna will be the State Health Plan‘s third-party administrator. During open enrollment from Sept. 30-Oct. 25, 2024, all educators will need to select your primary care provider.
Here is what you need to know.
What is the State Health Plan?
The State Health Plan is a division of the Department of State Treasurer.
The plan provides health care coverage to more than 740,000 teachers, charter school employees, community college employees, other state employees, retirees, and dependents, according to the website.
What do educators need to do?
Mark your calendars: open enrollment is from Sept. 30-Oct. 25, 2024.
During open enrollment, you will need to select your primary care provider — sometimes referred to as a PCP. You will do this through an online process in eBenefits on the State Health Plan’s website. When enrollment opens on Sept. 30, this is where you will click to get started.
For 2025, the State Health Plan will continue to offer two Preferred Provider Organization (PPO) plans, the Base PPO Plan (70/30) and the Enhanced PPO Plan (80/20). There are no benefits changes and copays and deductibles are staying the same.
Notice: JavaScript is required for this content.
All educators will be automatically enrolled in the Base PPO Plan (70/30), which will have an $85 subscriber-only premium. You can reduce this premium by $60 to a $25 subscriber-only premium by completing the tobacco attestation.
During open enrollment, in addition to selecting your provider, you may enroll in the Enhanced PPO Plan (80/20) or reduce your monthly premium in either the Base PPO Plan (70/30) or Enhanced PPO Plan (80/20) by completing a tobacco attestation.
Here is more information.
Between now and open enrollment, is there anything educators need to do?
🗹 Make sure you have your correct mailing address, email address, and phone number in eBenefits, the Plan’s enrollment system. Click here to access eBenefits.
🗹 Make sure your employer has your correct address as well.
🗹 Sign up for the Plan’s monthly e-newsletter, Member Focus.
🗹 Follow the State Health Plan on Facebook or Instagram.
What if I have questions?
If you have question, there is a bus and van tour that will be visiting 20+ locations across the state, along with webinars and telephone town halls. Here is the complete list.
You can call the support center at 855-859-0966, or for questions about providers or benefits, call Aetna at 833-690-1037.
What do educators need to know about Aetna?
Jim Bostian, the president for Aetna in North Carolina, highlights Aetna’s footprint of nearly 125 years of operations in North Carolina, about 600 state-based employees, and a comprehensive, expanding network of providers in the transition, in this press release.
Bostian has ties to North Carolina. “As graduate of UNC-Chapel Hill, he was born and raised in his parents’ lifelong hometown of Salisbury and his wife is from Asheville. His late father was a Duke graduate and football player who competed in the 1958 Orange Bowl and later served as an administrator in the state community college system,” according to the press release.
Bostin said in this article published by the News & Observer, “My sole mission — along with the hundreds of North Carolina-based Aetna employees dedicated to this invaluable relationship — is to make this transition seamless for members of the state health plan.”
More information for personnel administrators in school districts and community colleges
In case you missed it over summer break, here are resource guides, presentations, and recordings of webinars.
More information for N.C. DPI and the N.C. Community College System
The next meeting of the Board of Directors of the State Health Plan is on Oct. 24, 2024, at 1:30 p.m. Here is where you can find more information.
The Friday before those meetings, there is a roundtable for stakeholders, so the next one is on Friday, Oct. 18, 2024. Reach out to Beth Horner, director of customer experience and communications for the State Health Plan, to be added to the list.
