your state health plan decision guide n decision gu€¦ · total wellness premium credits $50 per...

YOUR STATE HEALTH PLAN DECISION GUIDE

OCTOBER 1 – 31, 2013

N DECISION GU

OPEN ENROLLMENT 2014

Open Enrollment is coming soon. You will have three health care options and new money-saving incentives for 2014. These important changes offer you more choices for coverage and encourage you to take steps to improve your health in partnership with the Plan.

Open Enrollment will be held Oct. 1-31, 2013. The choices you make will remain in effect from Jan. 1, 2014, through Dec. 31, 2014. You may not switch coverage type (for example, employee only) unless you experience a qualifying life event, such as marriage, birth, death or retirement. You can fi nd a complete list of qualifying life events in your Benefi ts Booklet, which will be available in December online at www.shpnc.org.

Read Your Materials CarefullyHealth care is complicated. There are concepts and terms that are unfamiliar to many people. Some of these terms are defi ned in the Glossary and appear throughout this booklet in italics. You do not have to be a health care expert to choose an option, but you do need to take the time to understand how the plans work. Here are the actions you need to take:

Step 1: Read this Decision Guide

Step 2: Understand your options

Step 3: Make your choice

This Decision Guide will navigate you through your new options and assist you with taking these steps.

What You Will Find Inside

Your Plan Options

The Enhanced 80/20 Plan .......... Page 1

The Consumer-Directed Health Plan ............................... Page 3

The Traditional 70/30 Plan ......... Page 6

How to Enroll ................................. Page 6

Additional Resources ........................ Page 6

Glossary ........................................ Page 8

Comparing Your Plan Options ............ Page 9

If you take no action during Open Enrollment, you and your currently enrolled family members will be automatically enrolled in the Traditional 70/30 Plan effective Jan. 1, 2014.

This Decision Guide is a brief summary of plan benefi ts. Refer to the applicable plan benefi ts booklet for a full description of benefi ts, which will be available on the Plan’s website in December 2013. In the event of a discrepancy between the information in this Decision Guide and the plan benefi ts booklet, the information provided in the benefi ts booklet will govern.

1

THE ENHANCED 80/20 PLAN

The Enhanced 80/20 Plan is the current Standard 80/20 Plan with improved benefi ts and the opportunity to earn wellness premium credits (see below). It is a Preferred Provider Organization (PPO) plan administered by Blue Cross and Blue Shield of North Carolina (BCBSNC). A PPO plan offers freedom of choice among in-network providers, lower out-of-pocket costs (copay only for most in-network offi ce visits) and a strong emphasis on preventive health.

With the Enhanced 80/20 Plan, you can seek care from providers in the BCBSNC Blue Options network or go out-of-network. However, if you stay in-network, your deductibles, copays and coinsurance will be lower. Services identifi ed as preventive care by the Affordable Care Act (ACA) and performed by an in-network provider are covered at 100%, which means there is no charge to you, as long as medical management requirements are met. Prescription drug coverage remains the same as the current Standard 80/20 Plan with copays for each 30-day supply. Also, some preventive medications are offered at no charge. Please refer to the ACA Preventive Medications list located on the Plan’s website at www.shpnc.org. Additionally, you will have the ability to lower your monthly premium by completing wellness activities.

Monthly PremiumsYour monthly premiums for the Enhanced 80/20 Plan effective Jan. 1, 2014, are included in the table below. The rates shown apply to active employees and non-Medicare Primary retirees and their non-Medicare Primary dependents.

Coverage Type

Employee/ Retiree Monthly

Premium

Dependent Monthly Premium

Total Monthly Premium

Monthly Wellness

Premium CreditTotal Monthly

Premium

Employee/Retiree $63.56 N/A $63.56 $50.00* $13.56*

Employee/Retiree + Child(ren)

$63.56 $272.80 $336.36 $50.00* $286.36*

Employee/Retiree + Spouse

$63.56 $628.54 $692.10 $50.00* $642.10*

Employee/Retiree + Family

$63.56 $666.38 $729.94 $50.00* $679.94*

* Assumes completion of all three wellness activities.

Wellness Premium CreditsYou can lower your monthly premium for the Enhanced 80/20 Plan by completing the wellness activities listed in the table at the top of the next page. Wellness premium credits apply only to the employee/retiree premium.

In order to receive the wellness premium credits, you must complete your wellness activities by Oct. 31, 2013. The smoker attestation can be completed only during Open Enrollment through eEnroll, but you may select your Primary Care Provider (PCP) any time prior to enrollment by logging into eEnroll. You can complete your Health Assessment now by logging into your Personal Health Portal, which is available via the State Health Plan website at www.shpnc.org or by telephone by calling 800-817-7044.

2

Enhanced 80/20 Plan Wellness Activities Wellness Premium Credits

Attest that you and your covered spouse (if applicable) are non-smokers or commit to a smoking-cessation program by Jan. 1, 2014

$20 per month

Complete a confi dential Health Assessment* $15 per month

Select a Primary Care Provider (PCP) for yourself and each covered dependent (if applicable)

$15 per month

Total wellness premium credits $50 per month

* Important Note: If you have completed a Health Assessment since Nov. 1, 2012, through your Personal Health Portal or by phone, it will count toward your premium credit. If you are not sure when you completed your Health Assessment, call 800-817-7044. The information you provide on the Health Assessment is confi dential. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, except as allowed by law.

A Primary Care Provider (PCP) is a medical professional (a doctor who practices general medicine, internal medicine, pediatrics or obstetrics and gynecology or a licensed family nurse practitioner or physician’s assistant) whom you select to oversee all of your health care. Your PCP is listed on your ID card, but choosing a PCP does not limit you to that provider in any way.

To view premium rates for Medicare Primary retirees and dependents, visit www.shpnc.org. To see how your premium would be reduced for completing one, two or three wellness activities, visit www.shpnc.org and click on the 2014 Premium Calculator.

WHAT IS A BLUE OPTIONS DESIGNATED PROVIDER?

Blue Options Designated providers have been designated because they provide the best quality and are the most cost effective. To fi nd a Blue Options Designated provider, visit the Plan’s website at www.shpnc.org and click on Member Services, then select “Find a Doctor or Facility,” or call BCBSNC at 888-234-2416. You can also access these providers through your enrollment system by clicking the BCBSNC link, which will take you directly to Member Services, BCBSNC’s secure member portal.

Wellness IncentivesIf you enroll in the Enhanced 80/20 Plan, you can take advantage of additional wellness incentives that lower your out-of-pocket costs for various health care services you receive throughout the year. These additional incentives include reduced copays for using your PCP and Blue Options Designated providers.

Things you can do to reduce your costs Wellness Incentives

Visit the PCP listed on your ID card or another provider in the same practice

Your copay is reduced by $15

Visit a Blue Options Designated specialist**

Your copay is reduced by $10

Get inpatient care in a Blue Options Designated hospital**

Your $233 inpatient copay is not applied

** Blue Options Designated specialists and hospitals are designated as such in the “Find a Doctor or Facility” online tool.

3

THE CONSUMER-DIRECTED HEALTH PLAN (CDHP)

The new Consumer-Directed Health Plan (CDHP) takes a different approach to health insurance. It is made up of two components: a high deductible health plan and a Health Reimbursement Account, or HRA. The CDHP also gives you the opportunity to earn wellness premium credits (see page 4).

The High Deductible Health PlanThe high deductible health plan covers the same medical services as the Enhanced 80/20 and Traditional 70/30 Plans. However, the CDHP deductible is higher. In addition, when you enroll in the CDHP, the State Health Plan sets up an HRA in your name. This account starts with a balance provided by the Plan, which is used to help you meet the deductible.

As with the other Plans, you can seek care from providers in the BCBSNC Blue Options network or go out-of-network. If you stay in-network, the Plan pays a greater portion of the cost. Also, like the Enhanced 80/20 Plan, ACA preventive care services performed by an in-network provider are covered at 100%, which means there is no charge to you, as long as medical management requirements are met. In addition, ACA preventive medications are covered at 100%, while CDHP preventive medications are subject to coinsurance only. Please refer to the ACA and CDHP Preventive Medications lists located on the Plan’s website at www.shpnc.org. Additionally, you will have the ability to lower your monthly premium by completing wellness activities.

The Health Reimbursement Account (HRA)For the account the Plan sets up for you, the beginning balance as of Jan. 1, 2014, will be:

• $500 if you have employee/retiree only coverage

• $1,000 if you have employee/retiree + 1 dependent coverage

• $1,500 if you have employee/retiree + 2 or more dependent coverage

The HRA funds are applied to the deductible, which means that you do not pay anything towards the fi rst $500 (for employee only) of services received. Once your account is depleted, you pay all of your remaining expenses in full until your deductible is met. After you meet the deductible, you pay 15% coinsurance for in-network services (35% for out-of-network services) until your payments reach the out-of-pocket maximum (medical and pharmacy). Then the Plan pays 100% of your covered expenses for the rest of the calendar year.

You can accumulate HRA value over time. Any amount remaining in your HRA at the end of the year can be used the next year for covered services. However, you cannot take the remaining funds with you when you leave employment or your coverage ends.

If you work for an employer that offers Flexible Spending Accounts (FSAs), you can contribute to an FSA and enroll in the CDHP. However, any expense covered under the CDHP will be automatically reimbursed from your HRA if funds are available—even if you pay the expense with your FSA debit card. To avoid using funds from your FSA and HRA for the same expense, be careful to use your FSA only after your HRA is depleted or for items that are not covered by the CDHP (such as eyeglasses). Once funds are reimbursed from your HRA, they cannot be redeposited.

4

Monthly PremiumsYour monthly premiums for the CDHP effective Jan. 1, 2014, are included in the table below. The rates shown apply to active employees and non-Medicare Primary retirees and their non-Medicare Primary dependents.

Coverage Type

Employee/ Retiree Monthly

Premium

Dependent Monthly Premium

Total Monthly Premium

Monthly Wellness

Premium CreditTotal Monthly

Premium

Employee/Retiree $40.00 N/A $40.00 $40.00* $0.00*


$40.00 $184.60 $224.60 $40.00* $184.60*

Employee/Retiree + Spouse

$40.00 $475.68 $515.68 $40.00* $475.68*

Employee/Retiree + Family

$40.00 $506.64 $546.64 $40.00* $506.64*

* Assumes completion of all three wellness activities.

Wellness Premium CreditsYou can lower or eliminate your monthly premium for the CDHP by completing the wellness activities listed in the table below. Wellness premium credits apply only to the employee/retiree premium.

In order to receive the wellness premium credits, you must complete your wellness activities by Oct. 31, 2013. The smoker attestation can be completed only during Open Enrollment through eEnroll, but you may select your Primary Care Provider (PCP) any time prior to enrollment by logging into eEnroll. You can complete your Health Assessment now by logging into your Personal Health Portal, which is available via the State Health Plan website at www.shpnc.org or by telephone by calling 800-817-7044.

CDHP Wellness Activities Wellness Premium Credits

Attest that you and your covered spouse (if applicable) are non-smokers or commit to a smoking-cessation program by Jan.1, 2014

$20 per month

Complete a confi dential Health Assessment* $10 per month

Select a Primary Care Provider (PCP) for yourself and each covered dependent (if applicable)

$10 per month

Total wellness premium credits $40 per month

* Important Note: If you have completed a Health Assessment since Nov. 1, 2012, through your Personal Health Portal or by phone, it will count toward your premium credit. If you are not sure when you completed your Health Assessment, call 800-817-7044. The information you provide on the Health Assessment is confi dential. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, except as allowed by law.

5

To view premium rates for Medicare Primary retirees and dependents, visit www.shpnc.org. To see how your premium would be reduced for completing one, two or three wellness activities, visit www.shpnc.org and click on 2014 Premium Calculator.

Wellness IncentivesIf you enroll in the CDHP, you can take advantage of additional wellness incentives that will add value to your HRA for various health care services you receive throughout the year. For example, you will receive additional value in your HRA when you use your PCP and Blue Options Designated providers. Page 2 provides more information about Blue Options Designated providers.

Things you can do to reduce your costs Wellness Incentives

Visit the PCP listed on your ID card or another provider in the same practice

$15 is added to your HRA

Visit a Blue Options Designated specialist**


Get inpatient care in a Blue Options Designated hospital**


** Blue Options Designated specialists and hospitals are designated as such in the “Find a Doctor or Facility“ online tool.

Prescription Drug Coverage under the CDHP

Most prescription drugs will be subject to the deductible and coinsurance. For preventive medications on the CDHP Preventive Medications list, you will be responsible only for the coinsurance instead of having to meet the deductible fi rst. This makes it easier for you to purchase the medications you and your family may need to stay healthy. In addition, medications on the ACA Preventive Medications list will be covered at no charge.

For all other medications, you will be responsible for the full cost of your prescriptions at the time of purchase until your deductible is met. Your pharmacy claims will be sent automatically to your HRA for claims consideration. If there are HRA funds available, you will then be reimbursed by check within a few weeks.

6

THE TRADITIONAL 70/30 PLAN

The Traditional 70/30 Plan is identical to the current Basic 70/30 Plan. It is a Preferred Provider Organization (PPO) plan administered by Blue Cross and Blue Shield of North Carolina (BCBSNC). With the Traditional 70/30 Plan, you can seek care from providers in the BCBSNC Blue Options network or go out-of-network. However, if you stay in-network, the Plan pays a greater portion of the cost. Prescription drug coverage remains the same as under the current Basic 70/30 Plan with copays for each 30-day supply. The Traditional 70/30 Plan does not provide 100% coverage for ACA preventive care services or drugs on the ACA Preventive Medications list.

Monthly PremiumsYour monthly premiums for the Traditional 70/30 Plan effective Jan. 1, 2014, are included in the table below. These rates apply to active employees and non-Medicare Primary retirees and their non-Medicare Primary dependents. Wellness premium credits and incentives are not available with this Plan.

Coverage TypeEmployee/Retiree Monthly Premium

Dependent Monthly Premium Total Monthly Premium

Employee/Retiree $0.00 N/A $0.00


$0.00 $205.12 $205.12

Employee/Retiree + Spouse $0.00 $528.52 $528.52

Employee/Retiree + Family $0.00 $562.94 $562.94

HOW TO ENROLLIf you are actively employed, to begin the enrollment process, you will need to log into eEnroll at https://shp-login.hrintouch.com. Enter your login ID and password. If you’re unable to log in, select the “Can’t Access Your Account” link to reset your password or retrieve your login ID. If you are a retiree, the online system, ORBIT, is available at www.MyNCRetirement.com. After you log in, select “Get Started” and then “Start Section.” Follow the instructions on each screen. If you need help logging into eEnroll or have questions about site navigation, call Customer Service at 855-859-0966.

If you are a retiree, the online system, ORBIT, is available at www.MyNCRetirement.com. Once you are logged into ORBIT, click eEnroll. If you need help enrolling online, call 855-859-0966.

ADDITIONAL RESOURCESSeveral resources are available to help you make informed health plan decisions for 2014, and you are encouraged to take advantage of them.

Online VideosGo to the State Health Plan website at www.shpnc.org to view informational and interactive videos about your health plan options.

Online Premium Calculator To fi nd all rates for all plans that apply to you, go to www.shpnc.org and click on 2014 Premium Calculator.

7

Enrollment Tour InformationThe State Health Plan will be conducting an Enrollment Tour during the month of October to offer members the opportunity to learn more about these new options and receive assistance with the enrollment process. Visit the State Health Plan website at www.shpnc.org for more information.

County Date Time Location

Wake 10/1/13 10 a.m.-2 p.m. OSP – Flex Benefi t Fair, Halifax Mall, Raleigh

Wake 10/2/13 10 a.m.-2 p.m. Downtown Bus Tour, Halifax Mall, Raleigh

Wayne 10/3/13 1-6 p.m. Wayne Community College, 3000 Wayne Memorial Dr., Goldsboro

Pasquotank 10/7/13 2-6 p.m. College of the Albemarle, Elizabeth City Campus, 1208 N. Road St., Elizabeth City

Beaufort 10/8/13 12-4 p.m. Beaufort County Community College, 5337 Highway 264 East, Washington

Columbus 10/11/13 2-6 p.m. Southeastern Community College, 4564 Chadbourn Highway, Whiteville

Pitt 10/14/13 2-6 p.m. Pitt Community College, 1986 Pitt Tech Rd., Winterville

Cumberland 10/15/13 12-5 p.m. Fayetteville Tech Community College, 2201 Hull Rd., Fayetteville

Wake 10/16/13 9 a.m.-12 p.m. Wake Tech Community College, Main Campus, 9101 Fayetteville Rd., Raleigh

Wake 10/16/13 2-6 p.m. Wake County Public Schools, Crossroads II, 110 Corning Rd., Cary

Durham 10/17/13 2-6 p.m. Durham Tech Community College, 1637 Lawson St., Durham

Forsyth 10/23/13 2-6 p.m. Forsyth Tech Community College, 2100 Silas Creek Parkway, Winston-Salem

Moore 10/24/13 2-6 p.m. Sandhills Community College, 3395 Airport Rd., Pinehurst

Mecklenburg 10/25/13 2-6 p.m. Central Piedmont Community College, 1206 Elizabeth Ave., Charlotte

Buncombe 10/28/13 2-6 p.m. A-B Tech Community College, 340 Victoria Rd., Asheville

Burke 10/29/13 2-6 p.m. Western Piedmont Community College, 1001 Burkemont Ave., Morganton

LEGAL NOTICESNotice Regarding Wellness IncentivesYour health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. A reasonable alternative to smoking status (participation in a smoking cessation program) has been provided to you. If your physician recommends a different alternative because he or she believes the program we make available is not medically appropriate, that recommendation may be accommodated to enable you to achieve the reward. Contact us at 855-859-0966 to make an accommodation request.

Notice of Grandfather StatusThe State Health Plan believes the Traditional 70/30 and the Enhanced 80/20 Plans are “grandfathered health plans” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act,

a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefi ts. Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to Customer Service at 888-234-2416. You may also contact the U.S. Department of Health and Human Services at www.healthcare.gov. As a plan “grandfathered” under the Affordable Care Act, cost sharing for preventive benefi ts will continue as it does currently and will be based on the location where the service is provided.

8

GLOSSARY

ACA Preventive Medications: A list of preventive medications required by the Affordable Care Act (ACA) to be covered at 100% with no member cost share. The list of medications is based on recommendations from the US Preventive Services Task Force (USPSTF). The government guidelines are updated periodically and are subject to change.

Allowed amount: The charge that BCBSNC determines is reasonable for a covered service. This amount may be determined by agreement between the provider and BCBSNC. BCBSNC does not pay benefi ts on amounts that exceed the allowed amount. If you use an out-of-network provider who charges more than the allowed amount, you are responsible for coinsurance plus 100% of the charge that exceeds the allowed amount.

CDHP Preventive Medications: A list of preventive medications used to help prevent and manage certain health conditions. The prescription medications on this list will be covered as if the deductible is already met and will be subject only to coinsurance. This list is subject to change.

Coinsurance: The percentage of the cost you pay for certain services once you meet your deductible. For example, under the Traditional 70/30 Plan, a member pays 30% coinsurance for an MRI performed through a network provider. If the bill comes in at $100, the member pays $30 (30% of $100). Under the Enhanced 80/20 Plan, a member pays 20% coinsurance for that same service. If the bill comes in at $100, the member pays $20 (20% of $100).

Coinsurance maximum: Under the Traditional 70/30 and Enhanced 80/20 Plans, this is the most you pay for coinsurance in a calendar year. It excludes premiums, deductibles and copays. For the limit under the CDHP, see out-of-pocket maximum to the right.

Copay: A fl at dollar amount you pay usually at the time of service for certain services and products.

Deductible: The amount you pay each year before a plan pays benefi ts for services that require coinsurance. Under the Traditional 70/30 and Enhanced 80/20 Plans, the deductible does not apply to services with a copay except for inpatient

hospital. All plans have in-network and out-of-network deductibles. Payments for out-of-network services count toward the in-network deductible, but payments for in-network services do not count toward the out-of-network deductible. All plans also have an individual and family deductible. If the family deductible is satisfi ed, all individual deductibles are also satisfi ed.

Health Assessment: A confi dential questionnaire about your health and lifestyle that helps identify potential health risks.

Health Reimbursement Account (HRA): Under the CDHP, an account established for you by the Plan to help you meet your annual deductible.

Out-of-pocket maximum: Under the CDHP, this is the most you pay for covered expenses (medical and pharmacy) in a calendar year. It includes deductibles and coinsurance but excludes premiums. For the limit under the Traditional 70/30 and Enhanced 80/20 Plans, see coinsurance maximum to the left.

Premium: The amount you pay from your paycheck for health coverage, whether or not you receive health care services during the year. Use the online premium calculator at www.shpnc.org to see your monthly premiums for 2014.

Primary Care Provider (PCP): A medical professional (a doctor who practices general medicine, internal medicine, pediatrics or obstetrics and gynecology or a licensed family nurse practitioner or physician’s assistant) whom you select to oversee all of your health care. Your PCP is listed on your member ID card, but choosing a PCP does not limit you to that provider in any way.

Wellness incentives: Financial rewards available under the Enhanced 80/20 Plan and CDHP for using your PCP and Blue Options Designated providers.

Wellness premium credits: Reductions in your premium available under the Enhanced 80/20 Plan and CDHP for attesting that you do not smoke (or signing up for a smoking-cessation program by Jan. 1, 2014), completing a Health Assessment and selecting a PCP.

9

COMPARING YOUR PLAN OPTIONS

Plan Design FeaturesEnhanced 80/20 Plan Consumer-Directed Health Plan Traditional 70/30 Plan

In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network

HRA Starting Balance N/A $500 Employee/retiree

$1,000 Employee/retiree +1

$1,500 Employee/retiree + 2 or more

N/A

Annual Deductible $700 Individual

$2,100 Family

$1,400 Individual

$4,200 Family

$1,500 Individual

$4,500 Family

$3,000 Individual

$9,000 Family

$933 Individual

$2,799 Family

$1,866 Individual

$5,598 Family

Coinsurance 20% of eligible expenses after deductible

40% of eligible expenses after deductible and the difference between the allowed amount and the charge

15% of eligible expenses after deductible


30% of eligible expenses after deductible


Coinsurance Maximum (excludes deductible)

$3,210 Individual

$9,630 Family

$6,420 Individual

$19,260 Family

N/A N/A $3,793 Individual

$11,379 Family

$7,586 Individual

$22,758 Family

Out-of-Pocket Maximum (includes deductible)

N/A N/A $3,000 Individual

$9,000 Family

$6,000 Individual

$18,000 Family

N/A N/A

Pharmacy Out-of-Pocket Maximum

$2,500 Included in total out-of-pocket maximum

Included in total out-of-pocket maximum

$2,500

Preventive Care $0 (covered at 100%)

N/A $0 (covered at 100%)

N/A $35 for primary doctor

$81 for specialist

Only certain services are covered

Offi ce Visits $30 for primary doctor; $15 if you use PCP on ID card

$70 for specialist; $60 if you use Blue Options Designated specialist

40% after deductible

15% after deductible; $15 added to HRA if you use PCP on ID; $10 added to HRA if you use Blue Options Designated specialist


$35 for primary doctor

$81 for specialist


Inpatient Hospital $233 copay, then 20% after deductible; copay not applied if you use Blue Options Designated hospital

$233 copay, then 40% after deductible

15% after deductible; $50 added to HRA if you use Blue Options Designated hospital




Prescription Drugs

• Tier 1 $12 copay per 30-day supply

Applicable copay and the difference between the allowed amount and the charge



$12 copay per 30-day supply

Applicable copay and the difference between allowed amount and the charge





• Tier 4 25% up to $100 per 30-day supply

25% up to $100 per 30-day supply

• Tier 5 25% up to $150 per 30-day supply

25% up to $150 per 30-day supply

• ACA Preventive Medications

$0 (covered at 100%)




N/A N/A

• CDHP Preventive Medications

N/A N/A 15%, no deductible 15%, no deductible N/A N/A

For more information, visit the Plan’s website at www.shpnc.org.

YOUR STATE HEALTH PLAN DECISION GUIDE

OCTOBER 1 – 31, 2013

CONTACT USeEnroll Questions:855-859-0966

Blue Cross And Blue Shield of NC(Benefi ts And Claims):888-234-2416

Express Scripts (Pharmacy Questions):800-336-5933

NC HealthSmart:800-817-7044

www.shpnc.org

100 Benefi tfocus WayCharleston, SC 29492

SHP335-eEnroll

PRSRT STD U.S. POSTAGE

PAIDStrasburg, VAPermit #275

your state health plan decision guide n decision gu€¦ · total wellness premium credits $50 per...

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