The mission of the State Health Plan is to improve the health and health care of North Carolina teachers, state employees, retirees, and their dependents, in a financially sustainable manner, thereby serving as a model to the people of North Carolina for improving their health and well-being.
The Plan provides health care coverage to over 714,000
teachers, state employees, retirees, current and former lawmakers, state
university and community college personnel, and
Our membership includes:
More than 492,000 active employees and dependents. Dependents include spouses and children up to age 26
More than 1,166 COBRA participants and their dependents.
More than 56,000 non-Medicare eligible retirees and their dependents.
More than 161,000 Medicare eligible retirees and their dependents.
Plan is self-insured and exempt from the Employee Retirement Income
Security Act as a government-sponsored plan. The Plan offers three
Preferred Provider Organization (PPO) plans. PPO plans offer the freedom
of choice among in-network providers, lower out-of-pocket costs and a
strong emphasis on preventive health. Two of the plans, the
Consumer-Directed Health Plan (CDHP) and the Enhanced 80/20 Plan, offer
financial incentives for taking steps to improve your health.
The Plan also offers a High Deductible Health Plan for those who are deemed eligible by their employing agency.
our retirees, the Plan offers three health plan options. These plans
include four Group Medicare Advantage Plan options that feature benefits
and services such as access to the SilverSneakers® Fitness Program, a
nurse help line and disease and case management. Retirees may also
choose the Traditional 70/30 Plan, which is the same plan available to
Through healthy living initiatives, such as NC HealthSmart,
the Plan seeks to empower members to make healthier lifestyle choices
and to become partners in addressing their health care needs.