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Wednesday, June 12, 2024

State Health Plan to see no increase in premiums in 2024

Treasurer Dale R. Folwell and the State Health Plan Board of Trustees approved Monday flat health insurance premiums for State Health Plan active members for 2024.

It’s the sixth straight year that premiums have remained stable. The State Health Plan covers 740,000 state employees and dependents and paid out $3.8 billion in total net claims last fiscal year.

However, Folwell says he still has not hit his goal of lowering family premiums.

“The credit goes to the state employees who have worked to negotiate these contracts,” says Folwell. “We are not satisfied with freezing these premiums.

Dale Folwell

“Data shows that there are thousands of uninsured children of state employees,” says Folwell. “I’m trying to create a product that people can afford. I need those young, healthy people on the plan to afford people my age.”

The largest health insurer in the state, Blue Cross and Blue Shield of North Carolina received a 7.2% average rate increase for individual customers who enrolled in Affordable Care Act (ACA) plans for 2023. For next year, Blue Cross and Blue Shield has filed for a 3.99% decrease for individuals and a 1.99% increase for small group coverage, according to the Department of Insurance.

Medicare-eligible members of the State Health Plan on the Humana Group Medicare Advantage coverage will also see no changes in their premiums. The Medicare Advantage Plans offer spousal coverage to eligible members for only $4, compared to $425 on the Base PPO Plan.

Folwell says that the Humana contract has resulted in $1 billion in savings in the health plan, and that a pharmacy management benefit contract negotiation saves nearly $800 million. He also noted that the State Health Plan has cut more than $100 million in expenses.

“We have done this without tinkering with co-pays and deductibles,” said Folwell. “And in the case if insulin, we removed the cost. The reason I sound so passionate about this is that any government agency should be proud of cutting costs. But the credit goes to the state health plan employees who negotiated these contracts.”

Active and non-Medicare members will be automatically enrolled into the Base PPO Plan (70/30) for the 2024 benefit year. Members that want to reduce their premium in either plan option or want to enroll in the Enhanced PPO Plan (80/20) will need to take action during Open Enrollment, which will take place Oct. 9-27, 2023.

Earlier this year, Treasurer Folwell announced that the plan saved $47 million by enrolling 9,975 additional members into the Humana Medicare Advantage Plans. Currently, 87% of retirees over 65 have taken advantage of these plans.

The State Health Plan, a division of the Department of State Treasurer, provides health care coverage teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents.

Chris Roush
Chris Roush
Chris Roush is executive editor of Business North Carolina. He can be reached at croush@businessnc.com.

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