Important: The information on this page is for current (2017) plan members enrolled in the Consumer-Directed Health Plan (CDHP) for Active Members. To view information on 2018 plans including rates and what’s new for Active Members, please click the Learn More button.
The Consumer-Directed Health Plan is a high deductible health plan that is accompanied by a Health Reimbursement Account (HRA), which is set up by the State Health Plan. This plan includes the ability to lower your monthly premium by completing wellness activities.
Affordable Care Act (ACA) Preventive Services performed by an in-network provider are covered at 100% in this plan, which means there is no charge to you.
PLEASE NOTE: The Consumer-Directed Health Plan (CDHP) will not be a plan option for 2018. As such,
the Health Reimbursement Account (HRA) will not roll over for use in 2018. HRA funds provide first dollar payments
for covered services and benefits to members and are not actual funds that can be reimbursed or paid to members.
The HRA funds will only be available for claims incurred in 2017 and submitted for processing before March 31, 2018.
Please plan accordingly for the remainder of the year regarding any unused HRA funds.
2017 CDHP Preventive Medications List
2017 Affordable Care Act (ACA) Preventive Medications List
2017 Uniform Summary of Coverage - CDHP
2017 CDHP Benefits Booklet
2017 Plan Comparison Chart
2017 Consumer-Directed Health Plan (CDHP) Preventive Services Summary
Consumer-Directed Health Plan (85/15) for Active and Non-Medicare Subscribers
Consumer-Directed Health Plan (85/15) for 50% Contributory Non-Medicare Subscribers
Consumer-Directed Health Plan (85/15) for 100% Contributory Non-Medicare COBRA Subscribers and Other 100% Contributory Subscribers
Consumer-Directed Health Plan (85/15) for Active Subscribers Who Are Medicare Primary Due to Upcoming Retirement or RIF
Consumer-Directed Health Plan (85/15) for Active Subscribers and Dependents Who Are Medicare Primary Due to ESRD
Although your Benefits Booklet provides a good overview of what services and products are available to you under the PPO plans, the medical policies provide detailed information around the circumstances under which certain services and products are and are not covered. Medical policies can be found here on the
Blue Cross and Blue Shield website*.
* If any of the State Health Plan medical policies conflict with the Blue Cross and Blue Shield of North Carolina medical policies, the State Health Plan medical policies will prevail.
Certain services require prior review and certification before they can be covered by your health insurance plan.
Click here for more information.
If you disagree with the way a claim has been handled, you can request an appeal or grievance review. For the complete appeals process, please