
The State Health Plan (SHP) NC BCBS is a vital resource for North Carolina's public employees, retirees, and their families. The plan is administered by Blue Cross and Blue Shield of North Carolina (BCBSNC).
As of 2022, the SHP NC BCBS has over 740,000 members, making it one of the largest health insurance plans in the state. This extensive network allows members to access a wide range of healthcare services.
The plan offers various health insurance options, including medical, dental, and vision coverage, as well as pharmacy and wellness programs. Members can choose from different network types, including the Blue Value network, which offers lower premiums in exchange for a larger deductible.
The SHP NC BCBS also provides a range of preventive services, including annual physicals, cancer screenings, and well-baby visits, with no out-of-pocket costs to members.
Blue Cross NC BCBS News
Blue Cross won't appeal the loss of the State Health Plan contract, instead shifting its focus to Aetna.
The State Health Plan officials voted to take the multi-billion-dollar contract away from Blue Cross after deciding Aetna scored better on questions about costs and technical capabilities.
Blue Cross sued but lost the legal fight.
A judge rejected Blue Cross's claim that the state unfairly picked Aetna to manage the health plan.
The board in charge of the plan voted to award the contract to Aetna starting in 2025.
Blue Cross claimed the decision was made due to errors and an unfair scoring process used by the state.
Premium Increases and Cost
The State Health Plan is considering a major overhaul of its pricing structure, which could lead to premium increases for most state employees by 2026.
This overhaul could result in premium increases of $20-$50 per month based on salary.
State Health Plan trustees voted to increase premiums for 26,000 NC members, affecting 4,200 retirees and 22,000 dependents covered by its Medicare Advantage plan.
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Raises Premiums for 26,000
The North Carolina State Health Plan recently voted to increase premiums for 26,000 members, specifically 4,200 retirees and 22,000 dependents covered by its Medicare Advantage plan.
This change affects a significant number of people, and it's essential to understand the impact on their healthcare costs.
Doctor Visits
With the increasing costs of healthcare, it's essential to explore ways to reduce medical expenses.
One option is to take advantage of telemedicine services, which can be accessed 24/7 with LiveHealth Online.
Weight Loss Drug Coverage
The state health plan in North Carolina has made some significant changes to its coverage of weight loss drugs. Specifically, the state health plan's governing board voted to phase out coverage of existing prescriptions for Wegovy and other GLP-1 drugs used for weight loss as of April 1, 2024.
State Treasurer Dale Folwell has been trying to negotiate a better financial deal with the companies that make these drugs, but so far, talks have gone nowhere.
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The high cost of these medications, including Ozempic and Wegovy, has been a major concern for the state health plan. A U.S. Senate committee is actually investigating the prices that Novo Nordisk charges for these blockbuster medications.
State officials, including the state health plan, have been trying to negotiate with the drugmaker, Novo Nordisk, to get a better price for the medications. However, officials for the state government and drugmakers have shot down each other's offers to negotiate.
Legal Issues and Fees
Recently, North Carolina State Treasurer Dale Folwell sent a letter to Dr. Tunde Sotunde, President of Blue Cross Blue Shield of North Carolina, demanding that it pay over $2 million in legal expenses.
The Treasurer's office incurred these expenses after successfully fighting a lawsuit by the health insurance giant. This move highlights the importance of holding insurance companies accountable for their actions.
Folwell's demand is a significant step in ensuring that the state's interests are protected and that the health plan is run fairly.
The exact amount demanded is over $2 million, a substantial sum that reflects the complexity and cost of the lawsuit.
For more insights, see: Bcbs Lawsuit
Company and Financial Status
The North Carolina State Health Plan is facing a significant financial challenge. It's expected to lose nearly a quarter of a billion dollars in 2025.
State Treasurer Dale Folwell is hoping for a bailout from state lawmakers to cover Covid-19 care and related expenses. This would help the plan recover from its projected financial loss.
The plan's financial struggles are a concern for many people in North Carolina. It's essential for lawmakers to consider the plan's needs and find a solution to prevent further losses.
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Frequently Asked Questions
What type of insurance is the North Carolina State Health Plan?
The North Carolina State Health Plan is a self-insured, government-sponsored plan exempt from ERISA regulations. It offers two PPO plans for active and non-Medicare members.
Is BCBS NC Medicaid?
Blue Cross NC offers a health plan called Healthy Blue for Medicaid members, serving millions of North Carolinians since 1933. This plan provides essential health coverage for those eligible.
Sources
- https://www.wral.com/state-health-plan/17553916/
- https://hr.ncsu.edu/benefits-and-wellness/benefits-plans/health-insurance-for-faculty-staff/
- https://www.carolinajournal.com/blue-cross-nc-takes-state-health-plan-decision-to-court/
- https://humanresources.ecu.edu/benefits/state-health-plan/
- https://www.healthybluenc.com/north-carolina/home.html
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