2025 Employee Benefits | NC State Health Plan

Explore Your 2025 Plan Benefits!

You are a valued State Health Plan member! The Plan offers health benefits to teachers, state employees, retirees and their dependents. Take a look at your 2025 benefits now!

Base PPO Plan (70/30)

The Base PPO Plan (70/30) is a Preferred Provider Organization (PPO) plan administered by Aetna. A PPO plan offers freedom of choice among in-network providers and lower out-of-pocket costs (copay only for most in-network office visits). Preventive services and medications are covered at 100% with this plan.

Enhanced PPO Plan (80/20)

The Enhanced PPO Plan (80/20) is a Preferred Provider Organization (PPO) plan administered by Aetna. A PPO plan offers freedom of choice among in-network providers and lower out-of-pocket costs (copay only for most in-network office visits). Preventive services and medications are covered at 100% with this plan.

High Deductible Health Plan (HDHP)

The High Deductible Health Plan is administered by Aetna. Affordable Care Act (ACA) Preventive Services performed by an in-network provider are covered at 100%. Check with your Human Resources department to confirm your eligibility for this plan.

Subrogation/Recovery

The State Health Plan has the right of subrogation upon its injured members' right to recover from liable third parties. The Plan's objective is to recover medical expenditures incurred by the Plan where a third party is liable for the care.

Important Forms

Click here to find several forms you may need regarding your State Health Plan benefits.

Joint Replacement Program

The State Health Plan is working with select high-quality orthopedic specialists to offer a joint replacement program for eligible employees in need of knee, hip or shoulder replacement surgery.