THE STATE HEALTH PLAN IS GEARING UP FOR A BUSY 2024!

Spring 2024 Living Power Magazine

The State Health Plan (Plan) is transitioning from Blue Cross NC to Aetna beginning Jan. 1, 2025. As a reminder, a TPA, or third-party administrator, provides a comprehensive network of healthcare providers—including doctors, specialists, and hospitals—and processes claims for the Plan. The Plan has always had a TPA. Taxpayers like you pay the claims, not the TPA.

The Plan Board of Trustees sets Plan benefits and premiums, not the TPA. The TPA simply administers the Plan. This transition affects members enrolled in the Base PPO Plan (70/30), Enhanced PPO Plan (80/20), and High Deductible Health Plan, including those Medicare members on the Base PPO Plan (70/30). This will not impact Humana Medicare Advantage Plan members.

You may be wondering if you can keep your doctor. The good news is that Aetna has an extensive national and in-state provider network. Aetna reviewed millions of Plan claims processed over an entire year, and about 99% of those claims came from providers already in the Aetna network. Even so, providers don’t have to wait to make sure they continue to serve Plan members. Talk to your provider!

It’s important to stay connected this year to ensure you receive announcements and messages
regarding the State Health Plan!

• Make sure you have your correct mailing address, email address, and phone number in eBenefits, the Plan’s enrollment system, which you can access on the Plan’s website at SHPNC.org.
• Make sure your employer has the correct addresses, as well. If you are a retiree, your personal information needs to be current in ORBIT and eBenefits, as the two systems do not coordinate.
• Sign up for the Plan’s monthly e-newsletter, Member Focus, on the Plan’s website at SHPNC.org.
• Follow the State Health Plan on Facebook! Visit Facebook.com/SHPNC.

CHART YOUR COURSE FOR A SMOOTH TRANSITION TO MEDICARE WEBINAR SERIES

As you become eligible for Medicare, you have some important decisions to make about your health coverage. The Plan is here to help you navigate your options. When considering your options, remember that timing is everything.

Don’t overlook your best option or miss an opportunity because you waited too long to take action. Attend a free, convenient online webinar so you can make informed and timely decisions regarding Medicare and how it impacts your health plan coverage. These webinars are designed specifically for the following individuals and typically last about two hours:

• Turn 65 in the next two years
• Work beyond age 65 and are planning for retirement
• Turn 65 in the next two years and are already retired. Select the webinar date below that works best for you, then register by visiting the Plan website at SHPNC.org and clicking on the blue box titled “Outreach Events and Webinars.”