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State Treasurer Dale R. Folwell, CPA, announced today that the State Health Plan Board of Trustees unanimously passed a resolution favoring a new provider reimbursement strategy for North Carolina providers that care for Plan members.

The provider reimbursement strategy, to go into effect January 1, 2020, will move the Plan away from a commercial-based payment model to a reference-based government pricing model based on a percentage of publicly available Medicare rates, according to the resolution passed today. This effort is aimed to keep rising health care costs under control

State Treasurer Dale R. Folwell, CPA announced today that the State Health Plan (Plan) will launch a new medical reimbursement strategy for North Carolina providers that care for Plan members. This effort is part of a longer term strategy to take advantage of the Plan’s “largeness” to keep rising health care costs under control while promoting quality care, transparency and affordability.

Your Explanation of Benefits, or EOB, is a detailed financial statement of how one or more of your medical claims has been processed. It outlines what the State Health Plan has paid and what is your responsibility. It’s not a bill, but it can help 70/30 Plan and 80/20 Plan members track their health care costs.

House Bill 1056 became law on June 25, 2018.  This legislation mandates employing unit cooperation in collecting through wage garnishment money that members owe the State Health Plan (Plan). Specifically, any payment of benefits or other amounts to, or premiums or claims paid on behalf of, any Plan member that is later determined to be an overpayment, an erroneous payment, or a benefit or amount for which the Plan member was ineligible, shall be repaid by the Plan member.

Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the State Health Plan’s Third Party Administrator, has launched a significant redesign and improvement of several online member transparency tools, making it even easier for your employees to find the care they need.



These transparency tools are part of our State Health Plan initiative to enhance the tools you use to get the most out of your health benefit at the lowest cost. We call that being a State Health Plan Watchdog!

A small number of State Health Plan members have reported receiving scam phone calls from people asking for personal information. These phone calls are not coming from the State Health Plan. If you receive such a call, you should not provide the caller with any personal information.

Have you recently been involved in a car crash that resulted in an injury? The Plan protects member funds by paying only those claims for which it is responsible.

As reported in the News & Observer, the Centers for Disease Control and Prevention said in a preliminary estimate that 2,505 people in North Carolina overdosed on opioids and other drugs last year.