Monday, June 15, 2020

Treasurer Folwell Announces Reduced Medicare Advantage Premium Rates; Savings Will Approach $600 Million the Next Three Years Medicare-Eligible Members Will See Premium-Free Coverage; Eligible Dependents to Have Monthly Premium of Only $4 With no Additional Cost to Taxpayers

Raleigh
Jun 15, 2020

(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) Board of Trustees today announced premium rates for Medicare Advantage members offering a substantial decrease in cost to dependents of Medicare-eligible members for the 2021 benefit year.

Medicare-eligible members will continue to enjoy premium-free coverage under this plan. Beginning Jan. 1, 2021, eligible dependents will have monthly premiums of only $4 for the Medicare Advantage Base Plan. Today, members in the Medicare Advantage Base Plan pay monthly premiums of $112 for spousal coverage and $224 for family coverage. For the Enhanced Plan, members currently pay a monthly premium of $256 for spousal coverage and $438 for family coverage. These changes come with virtually identical benefits as the previous plan.

In March, the Plan awarded the Medicare Advantage Fully Insured Plan and Related Services contract to Humana. The contract award to Humana was the result of a Request for Proposal, a required, competitive bid process that is a standard practice in state government when a contract has ended and there is continued need for services. The potential annual cost savings under the new contract will be approximately $197 million or almost $600 million over the course of the three-year contract.

“I’m thrilled that our Medicare-eligible members who teach, protect and otherwise serve can now reap the benefits of this new Humana contract with the ability to add their dependents for only $4 a month,” said Treasurer Folwell. “Our Medicare Advantage plans are a great benefit that an entire family can now enjoy for very little cost to members and taxpayers like them, and the same great benefits.”

“Our Plan staff is working hard to ensure that this transition to Humana is a smooth one,” said Dee Jones, State Health Plan executive director. “I also want members to understand that Humana offers a national, passive network that allows members to continue seeing their current providers regardless of being in or out of Humana’s network, which is how our Medicare Advantage plans work today.”

All members currently covered under UnitedHealthcare will be moved to Humana for the 2021 benefit year, which begins Jan. 1, 2021. Members will continue to have the choice of the Base or Enhanced plan under Humana as well as the option of the 70/30 Plan, which is administered by Blue Cross NC. Open Enrollment for 2021 will take place Oct. 15-31, 2020.

The State Health Plan, a division of the Department of State Treasurer, provides health care coverage to more than 727,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents. It also provides Medicare-Advantage plans to 155,000 Medicare-eligible members.