Who We Are
Welcome to the North Carolina State Health Plan for Teachers and State Employees!
The mission of the State Health Plan 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 Plan provides health care coverage to nearly 750,000 teachers, state employees, retirees and their dependents.
Our Membership Includes:
Active Employees and Dependents
More than 482,000 active employees and dependents on the Plan.
Medicare Eligible Retirees
More than 197,000 Medicare eligible retirees and their dependents.
Non-Medicare Eligible Retirees
More than 56,000 non-Medicare eligible retirees and their dependents.
COBRA Participants and Dependents
More than 2,000 COBRA participants and their dependents.
The Plan is self-insured and exempt from the Employee Retirement Income Security Act as a government-sponsored plan. The Plan offers two Preferred Provider Organization (PPO) plans; the Base PPO Plan (70/30) and Enhanced PPO Plan (80/20), for active and non-Medicare members. PPO plans offer freedom of choice among in-network providers, lower out-of-pocket costs and a strong emphasis on preventive health.
The Plan also offers a High Deductible Health Plan for those who are deemed eligible by their employing agency.
For our Medicare eligible retirees, the Plan offers three health plan options. These plans include two Group Medicare Advantage Plan options that feature benefits and services such as access to the SilverSneakers® Fitness Program, a nurse help line and disease and case management. Retirees may also choose the Base PPO Plan (70/30), which is the same plan available to active members.