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New Charter Schools

New Charter Schools. December 16 , 2013. Topics. Legislation Group Setup Electronic Enrollment Eligibility Rates Plans Effective Dates Benefits Group Premiums. Legislation. § NCGS 135-48.54 Charter School Board of Directors must make election in writing

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New Charter Schools

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  1. New Charter Schools December 16 , 2013

  2. Topics • Legislation • Group Setup • Electronic Enrollment • Eligibility • Rates • Plans • Effective Dates • Benefits • Group Premiums

  3. Legislation • § NCGS 135-48.54 • Charter School Board of Directors must make election in writing • Election must be made no later than 30 days after charter signed • Send 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

  4. New Group Setup • Contact at State Health Plan (SHP) Rita Sandoval Rita.Sandoval@nctreasurer.com • Complete group setup form and submit to SHP • Order new employee kits • State Health Plan website www.shpnc.org • Electronic enrollment setup – free (required) • Benefitfocus – electronic enrollment vendor

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

  6. Eligibility • Full-time employees • 30 or more hours per week • Part-time employees – pay full premium • 20-29 hours • Dependents – employees pay 100% of premium • Legal spouse • Natural, stepchild, adopted, foster and legal guardian up to age 26

  7. Plans for 2014 Enhanced 80/20 Plan NEW: Consumer-Directed Health Plan (CDHP) with HRA Traditional 70/30 Plan • The current Standard 80/20 Plan with a new name to match the new features • $0 Affordable Care Act (ACA) Preventive Services • $0 ACA Preventive Medications • New Wellness Incentives • Reduced copays • A newhealth plan option • A high-deductible medical plan • A Health Reimbursement Account (HRA) to help offset the deductible • 85/15 Coinsurance • $0 Affordable Care Act (ACA) Preventive Services • $0 ACA Preventive Medications • CDHP Preventive Medication List ($0 deductible) • New wellness incentives • Additional HRA funds for visiting certain providers • The current Basic 70/30 Plan with a new name • No incentives available • No $0 Affordable Care Act (ACA) Preventive Services • No $0 ACA Preventive Medications Third Party Claims Administrator - Blue Cross Blue Shield of North Carolina

  8. Focus on Wellness Enhanced 80/20 Plan NEW: Consumer-Directed Health Plan (CDHP) with HRA Traditional 70/30 Plan • Wellness premium credits when: • Subscriber completes a Health Assessment • Subscriber attests for him/herself and spouse (if applicable) to not smoking...or to being in a smoking cessation program • Selecting a Primary Care Provider (PCP) for self and all dependents • Additional wellness incentives • $15 copay reduction for utilizing the PCP (or someone in that practice) listed on the ID card • $10 specialist copay reduction for utilizing a Blue Options Designated Specialist • $0 inpatient hospital copay for utilizing a Blue Options Designated Hospital • Wellness premium credits when: • Subscriber completes a Health Assessment • Subscriber attests for him/herself and spouse (if applicable) to not smoking...or to being in a smoking cessation program • Selecting a Primary Care Provider (PCP) for self and dependents • Additional wellness incentives • $15 added to the HRA when the PCP (or someone in that practice) listed on the ID card is seen • $10 added to the HRA when a Blue Options Designated Specialist is seen • $50 added to the HRA when a Blue Options Designated Hospital is utilized for inpatient services • No incentives available • No $0 ACA Preventive Services • No $0 ACA Preventive Medications

  9. Monthly Premium – Enhanced 80/20 Plan *Assumes completion of three wellness activities Employer Share $448.12

  10. Monthly Premium – CDHP *Assumes completion of three wellness activities Employer Share $448.12

  11. Monthly Premium – 70/30 Plan Reminder: Wellness premium credits are not offered under the Traditional Plan. Employer Share $448.12

  12. 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 due to a qualifying event • Dependents must be enrolled within 30 days of the qualifying event or added at annual enrollment

  13. 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 5th 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 135-48.55) • eBilling offers paperless invoices, electronic one-time and recurring payments, on-demand and scheduled reporting

  14. Thank You!

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