North Carolina State Health Plan for Teachers and State Employees

New Charter Schools

January 28, 2013

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Topics

• Legislation

• Group Set-up

• Electronic Enrollment

• Eligibility

• Rates

• Plans

• Effective Dates

• Benefits

• Group Premiums

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Legislation

• § NCGS 135-48.54• Charter School Board of Directors must make election

in writing • Election must be made no later than 30 days after

charter signed• Sent to the SHP Executive Administrator and the State

Board of Education• Election is irrevocable• Shall notify each employee of the election in writing• Each employee shall acknowledge receipt

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New Group Set Up

• Complete group set-up form and submit to SHP

• Address

• Contact information including e-mail

• Order new employee kits – requisition form

• State Health Plan website www.shpnc.org

• Electronic enrollment setup – free (required)

• Benefitfocus – electronic enrollment vendor

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Electronic Enrollment

• The State Health Plan is paperless and enrollment is only available electronically.• No paper applications are accepted

• Following receipt of Group Set-up form, a Benefitfocus Representative will be assigned to implement the new group onto the eBenefitsNow system.

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Eligibility

• Full-time employees – covered at 100% of premium on the 70/30 basic plan• 30 or more hours per week

• Part-time employees – covered at 50% of premium• 20 – 30 hours per week

• Dependents – employees pay 100% of premium• Legal spouse• Natural, stepchild, adopted, foster and legal guardian up

to age 26

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Rates

• Current Employee-Only Rate - $432.66 (Employing Unit currently pays 100% for 70/30 plan; employees pay $22.76 for the 80/20 plan)

• 4-Tiers (emp-only, emp-spouse, emp-child(ren), emp-family)

• Rates for dependent coverage are based on tier and plan

• Current rate sheet attached

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Plans

• Two PPO Plans offered – benefits are the same, cost sharing varies• 80/20 Standard Plan

• 20% coinsurance• $30 office visit copay - primary• $700 deductible• Higher dependent premiums• Employee pays $22.76 per month

• 70/30 Basic Plan• 30% coinsurance• $35 office visit copay – primary• $933 deductible• Lower dependent premiums• Employee pays $0 per month

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Effective Dates

• Effective date is the first of the month or first of the second month following date of hire

• Dependents must be added at time of hire or or due to a qualifying event

• Dependents must be enrolled within 30 days of the qualifying event or added at annual enrollment

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Group Premiums

• Prepaid Plan• Billed monthly for the next month

• i.e., June bill is for July

• Bills are generated in the middle of the month• Premium is due by the 5th of the next month and must be

paid as billed• If premium is not paid by the due date, claims are held• Premiums not received by the fifteenth day of the month

following the due date shall be charged 1 ½% interest of the amount due the Plan, per month beginning with the sixteenth day of the month following the due date. (NCGS 135-48.55)

www.shpnc.org

www.nctreasurer.com

Thank You!