Treasurer Folwell Updates State Health Plan Open Enrollment for 2021 No Premium Increases for 3rd Year in a Row and Medicare Advantage Members Enjoy Lower Dependent Premiums

Raleigh

(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, announced today that Open Enrollment for the 2021 benefit year for State Health Plan (SHP) members is under way! Open Enrollment started Oct. 15 and will end Oct. 31, 2020. The SHP saw a 300% increase in members “taking action” on the first day of Open Enrollment and they experienced no technical issues with the enrollment system.

“The staff at the State Health Plan, and our vendors, have done amazing work to get ready for this year’s Open Enrollment,” said Treasurer Folwell. “With the challenges present due to COVID-19, I’m pleased with how things are progressing so far. I ask that members don’t wait until the last minute and take action as soon as they can!”

Treasurer Folwell noted that there will be no premium increases for individuals or families for the 3rd year in a row. Also, both non-Medicare and Medicare members on the 70/30 Plan, will see significant cost reductions for those who visit a Clear Pricing Project provider. Specifically:

  • Members who select a Clear Pricing Project Provider as their Primary Care Provider will enjoy a $0 copay!
  • Reduced copays for members who visit a Clear Pricing Project Specialist!
  • Preferred and non-preferred insulin will have a $0 copay, which means it is free for members!
  • Preventive Services remain free – no copay or deductible – on the 80/20 and 70/30 plans!

“A daughter of a retiree called me last week and said she estimates these savings will pay for her mom’s property tax and utilities for 2021. I’m thrilled that the State Health Plan can offer significant health cost savings to the people who educate our children, protect our communities, and otherwise serve the people of this state,” said Treasurer Folwell. “These enhancements will help lower the cost of health care and keep the State Health Plan financially strong as we work together to bend down the economic curve caused by COVID-19.”

With this year’s Open Enrollment, the SHP unveiled new programs and a major new Medicare Advantage (MA) contract. Because the state’s contract with UnitedHealthcare was expiring, the SHP was required to complete a competitive bid process, which resulted in the Medicare Advantage Fully Insured Plan and Related Services contract being awarded to Humana with services beginning Jan. 1, 2021.

The potential annual cost savings under the new contract will be approximately $197 million, which totals approximately $600 million over the course of the three-year contract or $1 billion if extended for five years. Eligible Medicare subscribers will continue to enjoy premium-free coverage for the Medicare Advantage Base Plan with no benefit changes.

In addition, savings generated from this new contract allows the SHP to offer significant reductions to dependent premiums for those on the Medicare Advantage Plans. These changes come with no cost to state taxpayers. As an added benefit, the renegotiated MA contract reduced the state’s long-term health care liability by $3.3 billion leaving more money for schools, public safety and roads.

Treasurer Folwell also provided an update on a new program to lower costs by waiving the deductible for eligible members enrolled in the 70/30 and 80/20 Plans in need of certain orthopedic procedures. The SHP is working with select high-quality orthopedic specialists to offer the new program for eligible members in need of knee, hip or shoulder partial and full replacement surgery.

The program simplifies the entire process – from pre-surgery consults and testing to post-surgery follow-up and physical therapy – with one simple payment. Participating providers include EmergeOrtho, OrthoCarolina, Delta/Surgical Center of Greensboro, PSC/Surgery Center of Pinehurst. Members interested in learning more should visit the SHP’s website.

“We decided to start with carpentry – knees, hips, shoulders,” said Treasurer Folwell. “Then we’ll move to plumbing and electrical. I’m very excited about the cost savings to our members and the State Health Plan while, at the same time, providing quality, accessible and transparent health care.”

The SHP, 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.

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