Open enrollment for new health option
scheduled to begin May 22

Open enrollment for the state’s new Preferred Provider Organization (PPO) health insurance plan will take place from May 22 to June 30.

In order to help educate employees on the new options, Human Resources is hosting a series of campus workshops. Topics for the workshops include:
• How the PPO works and compares with the current Comprehensive Major Medical plan (indemnity plan)
• Coverage level options to meet individual and family needs
• Cost, including premiums, co-pays, deductibles, etc.
• Choosing the best plan to meet your needs

The workshops will be held around campus from noon to 1 p.m. on the following dates:
• May 8 – Faculty Senate Chambers, D.H. Hill Library
• May 16 – Room 101, Administration III
• May 19 – Room B112, Main Building, College of Veterinary Medicine
• May 25 – Walnut Room, Talley Student Center
• June 6 – Convocation Room, College of Textiles, Centennial Campus
• June 7 – Walnut Room, Talley Student Center
• June 12 – Room 101, Administration III
• June 22 – Faculty Senate Chambers, D.H. Hill Library

The PPO plan’s start date is Oct. 1. Features of the PPO include:
• Network availability in all 100 North Carolina counties
• No deductibles or co-insurance for in-network physician visits
• Reduced premiums for dependent coverage
• A new employee-spouse tier, in addition to existing tiers

PPO plans contract with various physicians, hospitals and other providers to form medical care networks. PPO members will receive services at reduced premiums and out-of-pocket costs when they use in-network providers. Physician referrals are not required. Members decide when to visit a specialist and whether to select a provider from in-network or out-of-network.

The PPO will offer four tiers of coverage: employee only; employee and children; employee and spouse; and employee and family. The PPO will have three options: the standard SmartChoice; the less-expensive SmartChoice Basic; and the richer SmartChoice Plus.

Both SmartChoice and SmartChoice Basic provide individual coverage at no cost to the employee, as well as dependent coverage at lower rates than the traditional indemnity plan.

For dependent coverage, the SmartChoice Basic option offers relatively low monthly premiums but somewhat higher deductibles and co-pays. The SmartChoice Plus option has a modest monthly premium for employees as well as higher dependent premium costs, but it offers smaller deductibles and richer co-insurance levels.

The pharmacy benefit for the PPO will be the same as for the current indemnity plan.

Summaries of the PPO plan options, costs and enrollment kits are available online.

Current State Health Plan participants will receive enrollment packets at their home addresses. The NC State Benefits Office will distribute packets to individuals who are eligible who but don’t currently participate in the State Health Plan.

Posted April 28, 2006

Return to the Bulletin homepage