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The following is a list of concerns that have been raised regarding the new conditions of the State Health Plan.

1. Is there an attorney who represents state employees? If so, what is his/her affiliation?i.e. politically motivated? Will this battle be fought? What recourse do we have?

Probably the best way for employees to express their opinions or concerns about changes to the State Health Plan (SHP) is to either --

• (a) email the SHP itself, at cwi@shpnc.org or
• (b) contact their elected state representatives. You can search for state senators or house of representatives members online here http://www.ncga.state.nc.us/GIS/RandR07/Representation.html
  The State General Assembly mandated the changes to the SHP by changing the State Statutes that govern the SHP.

2. Has anyone thought to contact the ACLU to see what individual rights are being violated with this new policy?

• Questions have been raised about whether the SHP can provide differing levels of benefit coverage to employees based on health factors like body-mass index (BMI) or tobacco use.
• Group healthcare plans that are covered by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act of 1996) are prohibited from discriminating based on health status related factors.
  However, employer healthcare plans that “self-fund” their healthcare program (rather than buying insurance through a provider) can exempt their plan from HIPAA rules.
• The SHP is self-funded, so the State elected to exempt the SHP from HIPAA in order to implement its “comprehensive wellness” initiative. Since the SHP will be exempt from HIPAA, they won’t technically violate HIPAA.[ HIPAA rules prohibit discrimination against individual participants and their beneficiaries based on health status related factors, including health status, medical condition (physical and mental illnesses), claims experience, receipt of health care, insurability, and disability. The SHP exemption from these federal requirements will be in effect for state fiscal year 2011 beginning July 1, 2010 through June 30, 2011. The election may be renewed for subsequent plan years.]

3. What are the repercussions if employees take a stand against this issue, i.e.: job loss, demotion?

• As a state employee and citizen of North Carolina, you can certainly express your opinion through appropriate channels, such as those noted in Question 1, as well as through representative employee advisory bodies such as the NCSU staff and faculty senates and UNC staff and faculty assemblies
• Employees shouldn’t be subject to disciplinary actions just for expressing concerns or disagreement with issues like the State’s actions on the SHP. Of course, as in all work situations, employees should conduct themselves in ways that are professional and not disruptive.
  
  

4. Who represents the retirees?
There are groups that represent the interest of the retirees of North Carolina, such as the North Carolina Retired Governmental Employees’ Association, http://www.ncrgea.com/.

5. Random testing at the worksite is mentioned. How will this be administered to ensure the privacy of the employee? How random is the test? i.e.: will people with BMI’s of 12 be part of the random selection or is the random selection based upon employees who are within so many points of the threshold?
NC State hasn’t been given any specifics about how the SHP plans to perform any random testing. We’ve been told that this is still under discussion and consideration.

6. Saliva testing. In one case, it states that all state employees will be tested to identify the presence of a drug that is found in smokers. What policies and/or laws are in effect to ensure that the employee’s DNA is not used for other purposes, especially since employees are NOT covered under HIPAA?
Again, the SHP hasn’t shared details with NC State about specific types of testing being contemplated, or how the SHP would manage the information they collect. Such questions could be posed directly to the SHP at cwi@shpnc.org.

7. When additional paperwork is required from the employee’s physician, who will pay the co-pay?
A visit to a healthcare provider in order to get a health-related statement could be subject to the standard co-pay. But again, the SHP is still developing an implementation plan. As the NC State Benefits Office learns more about those plans, we will keep employees posted.

8. Must the current benefits be grandfathered-in for those currently on staff, and only new employees would be subjected to the new smoking and BMI requirements, or any future such reductions on our benefits?

• Healthcare coverage levels and types can, and do, change from year to year, and typically those changes apply to everyone covered by the plan.
• These statutory changes did not provide any “grandfather” provisions for current participants as part of the SHP’s new wellness initiatives. Everyone on the plan [active employees, retirees, COBRA recipients, and covered dependents] are subject to the new plan requirements, with the exception of participants and covered dependents whose primary coverage is Medicare (and it will apply to Medicare subscribers’ covered dependents whose primary health coverage is through the State Health Plan.)
  

9. Can the Staff Senate offer a “town-hall” type meeting for employees to gather and express their concerns?
The staff senate can, and has, hosted forums on a variety of topics.

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