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February 15, 2011  

In This Issue
Dependent Eligibility
Retroactivity and Processing
NC HealthSmart Posters
Tasty & Light Recipe of the Month!

 cheese ball
Annual Enrollment Update

 

Benefits and rates are set by the North Carolina General Assembly, which recently began its Long Session.  Once the 2011-2012 benefits and rates have been determined, State Health Plan enrollment kits will be finalized and mailed.  As soon as we have more information, we will provide notice to all agencies, schools, colleges and universities.  Thank you in advance for your cooperation. 

 

Healthy Activity

Getting and Staying Active - Becoming More Active 

Quick Links...
 
Dependent Eligibility Verification Update

In the coming weeks, the State Health Plan will begin sending out recovery requests to subscribers with unverified dependents who incurred claims July 1, 2010, and later.  It is the Plan's fiduciary responsibility to collect any claims dollars paid for ineligible dependents.  Subscribers with a balance of more than $100 will have the option to set up a three-, six- or 10-month payment plan.  Members who receive these notices will be directed to contact Blue Cross and Blue Shield of North Carolina.

 
Retroactivity and Timeliness Issues


To ensure consistency and adherence to N. C. General Statute 135 Article 3 A, Section 125 of the Internal Revenue Code, and the Public Health Service Act, it is important that all transactions for enrolling newly eligible dependents and the processing of terminations are completed in a timely manner.

 

For detailed information on the requirements for enrolling newly eligible dependents, please review the "Adding and Removing a Dependent" section on page 50 in the Benefits Booklet that is available on the State Health Plan website at http://www.shpnc.org/sc-benefits-booklet.html.

 

Untimely termination notifications are costly, and can be very inconvenient to members, especially if claims have been paid beyond the eligibility date.  The Public Health Service Act that governs continuation of coverage under government-sponsored group health plans requires that employers notify the plan administrator within 30 days of a qualifying life event, such as a termination.  The plan administrator has 14 days to send the COBRA notice to the member.

 

Please note: The State Health Plan is closely monitoring all retroactivity.  The health benefits representative must state in writing the reason why the transaction wasn't processed within the appropriate timeframe when the request is submitted to Blue Cross Blue Shield of North Carolina.

 

 

 
Posters Highlight NC HealthSmart Programs 

On January 1, the State Health Plan's NC HealthSmart program introduced a Personal Health Portal with a fresh new look and some supportive new resources. Those resources include a health assessment questionnaire, the ability to connect to a health coach via e-mail, and a personal health record for members to store health information.

 

There is no additional cost for services through the NC HealthSmart program. The program includes health coaching, 24/7 nurse line services, case management and other resources. Members may register and take the online health assessment by clicking on the health portal icon at www.shpnc.org. They will receive a personalized action plan to discuss with their health provider.

 

To help HBRs spread awareness of this program to their colleagues and employees, the Plan has prepared color, 8.5-by-11 inch informational posters for HBRs to print out and post in their workplaces. The second set of these convenient and easy-to-print awareness posters can be found here. Posters describing specific programs will follow later in 2011.

 

Thanks for your support in spreading the word on this exciting and enhanced NC HealthSmart program!