Contact Us
View contact information for various State Health Plan vendors to address specific questions or concerns.
| State Health Plan Resource | Description | Customer Service | Mailing Address | Audience |
|---|---|---|---|---|
| Eligibility & Enrollment Support Center | For questions regarding enrollment, eligibility or for assistance regarding the enrollment system. | 855-859-0966 M-F 8AM to 5PM | 3200 Atlantic Avenue Raleigh, NC 27604 | All Members |
| Third-Party Administrator (Blue Cross & Blue Shield of NC) until 12.31.24 | For questions regarding benefits or any claim inquiries. | 888-234-2416 TTY: 800-442-7028 M-F 8AM to 6PM | State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702 | Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Third Party Administrator Aetna Health Concierge (Customer Service) as of 1.1.25 | For questions regarding benefits or provider inquiries for the 2025 benefit year. | 833-690-1037 TTY: 711 (#833-690-1037) M-F 8AM to 5PM Fax inquiries: 859-455-8650 | State Health Plan c/o Aetna PO Box 14079 Lexington, KY 40512-4079 | Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Appeals & Grievances (Blue Cross & Blue Shield of NC) | To appeal a claim decision or to file a grievance. | 888-234-2416 x: 919-765-2322 M-F 8AM to 6PM | State Health Plan c/o BCBSNC Appeals Department PO Box 30055 Durham, NC 27702 | Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Smart NC is a program provided by the NC Department of Insurance. | For information on requesting an external review of claims decisions (after all internal grievance procedures have been exhausted). | 855-408-1212 M-F 8AM to 5PM | 325 N. Salisbury St. Raleigh, NC 27603 | All Members |
| CVS Caremark (Pharmacy Benefit Manager) | To file a claim for prescription drugs, locate pharmacies within the network, or learn more about your Pharmacy Benefits. | 888-321-3124 7 days a week, 7AM to 11PM | CVS Caremark P.O. Box 52136 Phoenix, Arizona 85072 | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Prescription Drugs Prior Authorization | To initiate a prior authorization request of your prescription drugs. | 800-294-5979 7 days a week, 7AM to 11PM | CVS Caremark P.O. Box 52136 Phoenix, Arizona 85072 | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Behavioral Health and Chemical Dependency/ Substance Use Services | For questions regarding precertification for behavioral health services and chemical dependency. | 800-367-6143 M-F 8AM to 6PM | Blue Cross Blue Shield NC PO Box 30055 Durham, NC 27702-3055 | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Hospital Pre-admission Certification/ Prior Approval (Blue Cross & Blue Shield of NC) | To request prior authorization (certification) for certain out-of-network or out-of-state services. | 800-672-7897 M-F 8AM to 6PM | State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702 | Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| Humana (Medicare Advantage Carrier) | For questions regarding Humana Medicare Advantage Plans. | 888-700-2263 M-F 8AM to 9PM | P.O. Box 14162 Lexington, KY 46512-4162 | Humana Medicare Advantage Members |
| NC Retirement Systems | For questions regarding retirement, pension information and supplemental retirement plans. | 919-814-4590 NCRetirement@nctreasurer.com M-F 8:30AM to 4:30PM | 3200 Atlantic Avenue Raleigh, NC 27604 | All Members |
| Seniors Health Insurance Information Program (SHIIP). SHIIP is a division of the N.C. Department of Insurance. | For information about Medicare, Medicare Advantage plans, Medicare claims, Medicare supplement insurance, Medicare Prescription Drug Plans, fraud and abuse prevention as well as long-term care insurance. | 855-408-1212 or 919-807-6900 M-F 8AM to 5PM | 325 N. Salisbury St. Raleigh, NC 27603 | Retirees |
| Social Security Administration | For specific questions about Medicare premiums and claims. | 800-772-1213 TTY : 800-325-0778 M-F 7AM to 7PM | 7500 Security Blvd. Baltimore, MD 21244 | Retirees |
| Group Premium Billing | For questions regarding your Group Premium bill | For October 2024 premium invoices and after contact iTEDIUM: For premiums invoices for September 2024 and prior contact Blue Cross of NC:
| N/A | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| iTEDIUM (Direct Bill & COBRA Adminstrator) | For questions regarding your bill for premiums. | 877-679-6272 M-F 8AM to 5PM | State Health Plan c/o iTedium P.O. Box 505211 (Direct Bill) P.O. Box 505200 (COBRA) St. Louis, MO 63150 | Retirees/Surviving Spouses/COBRA Participants |
| The Rawlings Company (Third Party Liability Recovery Services) | For questions regarding subrogation | 877-229-0872 NCStatemanualreferrals@rawlingscompany.com M-F 8AM-8PM | PO Box 2000 La Grange, Kentucky 40031-2000 | Base PPO Plan (70/30), Enhanced PPO Plan (80/20) & HDHP Members |
| Report Fraud and Abuse | To report suspected fraud and abuse. | 800-324-4963 M-F 8AM to 6PM | State Health Plan c/o BCBSNC PO Box 30085 Durham, NC 27702 | Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members |
| State Health Plan Board of Trustees | To share concerns or feedback to the Board of Trustees. | SHPBoard@nctreasurer.com | 3200 Atlantic Avenue Raleigh, NC 27604 | All Members |
| State Health Plan Member Inquiries | To share comments, concerns or general feedback on specific medical or pharmacy issues. | 919-814-4400 shpmemberinquiries@nctreasurer.com M-F 8AM to 5PM | 3200 Atlantic Avenue Raleigh, NC 27604 | All Members |
| Health Benefit Representative (HBR) Inquiries | For general questions for the Plan from HBRs | hbrinquiries@nctreasurer.com | 3200 Atlantic Avenue Raleigh, NC 27604 | HBRs |
| Media Inquiries | For public records or other media inquiries. | 919-814-3820 press@nctreasurer.com M-F 8AM to 5PM | 3200 Atlantic Avenue Raleigh, NC 27604 | Media |
| FIORI (BEST Shared Services) | For questions on how to navigate FIORI or other system assistance. | 919-707-0707 (Raleigh area) 866-622-3784 (statewide) M-F 8AM to 5PM | 3512 Bush St. Raleigh, NC 27609 | Active Members |