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A FRESH, NEW LOOK FOR THE STATE HEALTH PLAN
We are excited to introduce a fresh look for the State Health Plan, as we continue our journey toward maintaining a healthy, active lifestyle and feeling great about it. The Plan remains committed to improving healthy outcomes as well as the long-term stability of the Plan for all members. The new brand represents our combined efforts to be the healthiest we can be.
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TASTY & LIGHT RECIPE OF THE MONTH
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HEALTHY ACTIVITY
Get in Step
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Do you have employees interested in being tobacco-free? Click here to learn about the NC HealthSmart resources available to help them quit.
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ANNUAL ENROLLMENT IS UNDER WAY
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Annual Enrollment is under way through May 31, 2013. Members do not need to do anything during Annual Enrollment if they are satisfied with their current plan. If they take no action, they and any dependents will remain on their current plan. There are no changes to member or dependent premiums.
During Annual Enrollment members can:
- Enroll in the State Health Plan
- Switch between plans
- Add or remove dependents without a qualifying event. (When adding dependents to their benefit plan, members may be asked to provide documentation of a dependent's State Health Plan eligibility.)
- In addition, and new this year, they may choose a Primary Care Provider to list on their ID card
To learn more about Annual Enrollment 2013, click here. |
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NC HealthSmart Corner
BE SURE EMPLOYEES KNOW ABOUT FREE AND LOW COST NUTRITION VISITS
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Diet plays an important role in overall health. Creating a diet rich in fruits, vegetables, and whole grains is one of the best things you can do to protect against developing a chronic condition, such as heart disease, type 2 diabetes or high blood pressure.
Incorporating healthy foods in one's daily diet, and avoiding unhealthy foods, is not always easy. However, to meet that challenge, the State Health Plan offers members access to discounted nutrition visits. Members and their covered dependents can receive four in-network nutrition visits each year at the cost of a primary care copay ($30 for 80/20 Plan members, $35 for 70/30 Plan members).
To learn more about free and low cost nutrition visits, click here. | |
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MENTAL ILLNESS AND THE WORKPLACE: LIFTING THE STIGMA
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One in five people will suffer from depression at some point in their lifetime. Unlike most other diseases, mental health is one that many sufferers choose to live with, untreated, even when treatment is available. For them, the promise of some relief competes with the fear of being stigmatized for their condition.
Employees with a mental illness may be perceived - unfairly - as people who cannot handle stress, do second-rate work, or are incurable.
To continue reading about mental illness and the workplace, click here. |
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HEALTH CARE REFORM REMINDER
The State Health Plan has provided several updates regarding health care reform resulting from the Patient Protection and Affordable Care Act (PPACA). Health Benefit Representatives are invited to visit the Plan website's health care reform page to view all the information the Plan has made available to HBRs. | |
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DETERMINING WHEN MEDICARE IS PRIMARY
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The State Health Plan wants to assist Health Benefit Representatives faced with determining when Medicare is primary for certain employees. The Plan has confirmed the following rule with the Centers for Medicare and Medicaid Services (CMS). Please review it carefully.
If an employee retains employment status and is:
- Medicare disabled, or
- Over 65 and disabled, or
- On workers' compensation and over 65,
and the employer continues to reflect the member as enrolled in the active group, then Medicare is secondary to the State Health Plan.
The State Health Plan should be primary even if the covered member has not worked for years. The member must be terminated or in the last month of coverage prior to retirement in order for the Medicare to be primary and the member to receive the Medicare reduced rate.
To learn more about determining when Medicare is primary, click here. | |
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EMPLOYING UNITS RESPONSIBLE FOR PREMIUMS
As a reminder, the State Health Plan will not approve a retroactive termination when a member is not terminated correctly or in a timely manner by the HBR. This includes requests from employing units who have continued to provide health coverage for a member under their group even though the employee is no longer employed, but is in the process of applying for long term disability through the Retirement Systems.
Employing units will be responsible for premiums incurred for members for the period of time the employing unit continued to cover the member after the member was no longer eligible. This includes the employee portion of the premiums. | |
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DO YOU HAVE AN EMPLOYEE WHO IS LEAVING AND ELIGIBLE FOR COBRA?
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Remember, federal regulations require employers to notify their plan administrator within 30 days of an employee's termination. Once notice is received, COBRA notices are sent to members within 14 days. So the faster you notify the State Health Plan, the sooner employees will receive information regarding their COBRA options.
If employees have questions about COBRA before they receive their COBRA notices, please point them to the State Health Plan website at www.shpnc.org. Typically, the most often asked question is regarding rates. Members can just click on "My Medical Benefits" and then scroll down to "Rate Comparison" to access the COBRA rate sheets. Coverage under COBRA represents a significant increase in cost and knowing the rate information as soon as possible will help your employees make important decisions about their continuing coverage. | |
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WE'RE COMING TO A TOWN NEAR YOU
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As you may have heard, there are several benefit changes coming to the State Health Plan for the 2014 plan year that will provide more options for members. You, our Health Benefit Representatives statewide, are the critical main avenue through which members receive benefit information.
The Plan wants to make sure you are equipped with the all the information you will need to assist members with their new options during the October enrollment for 2014 benefits. For that reason, staff from the Plan will be touring the entire state in July to meet personally with you and other HBRs to explain these changes.
For more information on these meetings, click here. | |
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FOLLOW US ON FACEBOOK
 The State Health Plan is on Facebook! Our new page is all about you and your health as a Plan member. For the latest on State Health Plan updates, changes and healthy initiatives, members can access the Plan in a whole new way. So check us out at https://www.facebook.com/SHPNC and join the conversation.
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NEW IPAD® WINNER ANNOUNCED
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NC HealthSmart works for Clarissa Jacobs, who was the winner of a new iPad® in the State Health Plan's latest monthly drawing.
Ms. Jacobs, who works for the N.C. Department of Public Safety in Goldsboro, said she gets frequent and informative updates from NC HealthSmart, the Plan's health and wellness initiative, to help her with her healthy living goals.
"I initially registered to win an iPad through NC HealthSmart, as I was doing my Health Assessment. I was shocked and pleased to receive the call that I had won an iPad!" she said.
Click here for more information on winning an iPad®. |
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