Benefits: Medical

2016 State Health Plan Decision Guide

2016 NCFlex Benefits Guide

Stork Reward Program

Health Plan Options

The State Health Plan offers a range of health benefits to all eligible state employees, teachers, retirees and other individuals identified in the North Carolina General Statutes. The Plan's mission is to improve the health and health care of North Carolina teachers, state employees, retirees, and their dependents, in a financially sustainable manner, thereby serving as a model to the people of North Carolina for improving their health and well-being.

The State Health Plan offers three preferred provided organization (PPO) plans.  PPO plans offer the freedom of choice among in-network providers, lower out-of-pocket costs and a strong emphasis on preventive health.   Two of the plans, the Consumer-Directed Health Plan (CDHP) and the Enhanced 80/20 plan, offer financial incentives for taking steps to improve your health.

Click on the link below to learn detailed information on specific plans.

Overview of PPO Plans

Once you've identified the plan that is right for you, enroll online.

The Plan’s website is
Customer Service 1-888-234-2416.

Eligibility: Permanent employees working three quarter time or more are eligible to participate in the State Health Plan.

Enrollment: Eligible employees must enroll within 30 days of date of hire or be subject to a 12-month waiting period for pre-existing conditions.

Employees can choose from the following coverage options:

Dependent children up to age 26 may be covered.

Plan Year: January 1 through December 31

Lifetime Maximum: Unlimited

Cost of Coverage

The university covers the cost of employee only coverage for permanent employees with a minimum ¾ time appointment for the 70/30 plan. Eligible employees pay the full cost for dependent coverage. Premiums are paid on a pre-tax basis. Please click here for premiums.

Prescription Drug Plan

The State Health Plan includes a prescription drug benefit managed by Medco. Co-payments are:

$12.00 – Generic
$40.00 – Preferred Brand Name with no generic available
$64.00 – Non-preferred Brand Name

Preferred brand name drugs are on the formulary/preferred drug list available here.

Changing Coverage

You may add or drop dependents within 30 days of a change in family status or other qualifying event (usually without being subject to a waiting period for pre-existing conditions or during the annual enrollment period (may be subject to a waiting period for pre-existing conditions). You must make the change online at within 30 days of the family status change or qualifying event or wait until the next annual enrollment period to make changes. Annual enrollment is during the month of October with the change in coverage effective January 1.

For additional information contact your HR Benefits counselor at 910-962-3006 or 910-962-3345 or visit

North Carolina Health Choice (NCHC)

When working families cannot afford health care for their children, the consequences can be dire. Families who make too much money to qualify for Medicaid, but too little to afford rising health insurance premiums may be eligible for free or reduced price comprehensive health care for their children. The plan, "NC Health Choice for Children" is the same as coverage provided for the children of state employees and teachers, plus vision, hearing and dental benefits. To see if you are eligible click on or apply at your county social services department by mail.

Cancer Insurance

Cancer Insurance is provided through Allstate Workplace Division (AWD). Details on this insurance can be found here.

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