North Carolina State Health Plan for Teachers and State Employees New Charter Schools January 28, 2013

Topics Legislation Group Set-up Electronic Enrollment Eligibility Rates Plans Effective Dates Benefits Group Premiums 2

Legislation § NCGS Charter School Board of Directors must make election in writing Election must be made no later than 30 days after charter signed Sent to the SHP Executive Administrator and the State Board of Education Election is irrevocable Shall notify each employee of the election in writing Each employee shall acknowledge receipt 3

New Group Set Up Complete group set-up form and submit to SHP Address Contact information including Order new employee kits – requisition form State Health Plan website Electronic enrollment setup – free (required) Benefitfocus – electronic enrollment vendor 4

Electronic Enrollment The State Health Plan is paperless and enrollment is only available electronically. No paper applications are accepted Following receipt of Group Set-up form, a Benefitfocus Representative will be assigned to implement the new group onto the eBenefitsNow system. 5

Eligibility Full-time employees – covered at 100% of premium on the 70/30 basic plan 30 or more hours per week Part-time employees – covered at 50% of premium 20 – 30 hours per week Dependents – employees pay 100% of premium Legal spouse Natural, stepchild, adopted, foster and legal guardian up to age 26 6

Rates Current Employee-Only Rate - $ (Employing Unit currently pays 100% for 70/30 plan; employees pay $22.76 for the 80/20 plan) 4-Tiers (emp-only, emp-spouse, emp- child(ren), emp-family) Rates for dependent coverage are based on tier and plan Current rate sheet attached 7

Plans Two PPO Plans offered – benefits are the same, cost sharing varies 80/20 Standard Plan 20% coinsurance $30 office visit copay - primary $700 deductible Higher dependent premiums Employee pays $22.76 per month 70/30 Basic Plan 30% coinsurance $35 office visit copay – primary $933 deductible Lower dependent premiums Employee pays $0 per month 8

Effective Dates Effective date is the first of the month or first of the second month following date of hire Dependents must be added at time of hire or or due to a qualifying event Dependents must be enrolled within 30 days of the qualifying event or added at annual enrollment 9

Group Premiums Prepaid Plan Billed monthly for the next month i.e., June bill is for July Bills are generated in the middle of the month Premium is due by the 5 th of the next month and must be paid as billed If premium is not paid by the due date, claims are held Premiums not received by the fifteenth day of the month following the due date shall be charged 1 ½% interest of the amount due the Plan, per month beginning with the sixteenth day of the month following the due date. (NCGS ) 10

Thank You!