For members enrolled in the Base PPO Plan (70/30) and Enhanced PPO Plan (80/20):
- Virtual State Health Plan ID cards are available and can be accessed by logging into Blue Connect via eBenefits, the Plan’s enrollment system. This is also available via the Blue Connect app. For assistance with medical benefits, members can call Blue Cross NC Customer Service at 888-234-2416.
- CVS Caremark, the Plan’s Pharmacy Benefit Manager is also available to help members in need of assistance with their medications, members can call CVS Caremark at 888-321-3124.
For Plan members enrolled in one of the Humana Medicare Advantage Plans:
- Humana is available to assist members with their benefit needs. Members can call Humana if they need assistance with their benefits at 888-700-2263.
Aetna, the Plan’s TPA as of Jan. 1, 2025, has offered State Health Plan members the use of Teladoc services for free during this time. Please click below for information on how to access this service.
Aetna Teladoc Informational Flyer →
Open Enrollment
Open Enrollment is currently underway and ends Oct. 25, 2024. As a reminder, all members can call the Eligibility and Enrollment Support Center at 855-859-0966 to complete their enrollment by phone.
For the members located in the North Carolina counties listed below, the Plan will be extending Open Enrollment by one week. This means impacted members will have until Nov. 1, 2024, to complete their enrollment. To ensure all members receive new ID cards in a timely manner, the Plan is unable to extend Open Enrollment past this date.
The Plan will, however, continue to assist members impacted by Helene via the enrollment exceptions process. Here are a few detailed notes of how this will work.
- Tobacco Credit: For the members in the counties listed below that do not take action during Open Enrollment, the Plan will be placing them in the Base PPO Plan (70/30) for the 2025 benefit year with the tobacco credit applied. Therefore, members will not be charged the tobacco surcharge.
- Enrollment Changes: After November 1, 2024, members that would like to change plans, add or remove dependents or cancel their enrollment for 2025, can make that request through their Human Resources department who can submit an exception. This is the only way to process updates after the enrollment window is closed. This includes retirees in the designated counties that didn’t complete their enrollment will also be able to receive an enrollment exception by calling the State Health Plan at 919-814-4400.
- 2025 ID Cards: 2025 ID cards will be mailed at the end of November-early December. We realize that some members have been displaced and/or currently do not have access to receive mail. These members will also have access to a virtual ID card through Aetna. They can access their ID card via the Aetna member portal or through Aetna’s app. For assistance, members can call Aetna at 833-690-1037. For retirees enrolled in one of the Humana Medicare Advantage Plans, they should call Humana at 888-700-2263.
North Carolina Counties included in the Helene Exception
Based on FEMA Disaster Designation and subscriber residential address.
Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Cabarrus, Caldwell, Catawba, Cherokee, Clay, Cleveland, Forsyth, Gaston, Graham, Haywood, Henderson, Iredell, Jackson, Lincoln, Macon, Madison, McDowell, Mecklenburg, Mitchell, Polk, Rowan, Rutherford, Stanly, Surry, Swain, Transylvania, Union, Yadkin, Yancey, Watauga, and Wilkes.
There are areas outside of North Carolina that are also included in the Helene exception. These areas are designated by the FEMA Disaster Designation and subscriber residential address as well.