When is Open Enrollment for Health Insurance 2025 North Carolina

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Mark your calendars! The open enrollment period for health insurance in North Carolina starts on November 1, 2024, and ends on December 15, 2024.

Enroll or update your health insurance plan within this period to ensure coverage starting January 1, 2025.

Eligible employees can review and modify their health plans during this enrollment period. Make sure to note these key dates to secure the coverage you need.

Start Date: November 1, 2024

Open enrollment for 2025 health insurance in North Carolina begins on November 1, 2024. This period allows eligible employees to enroll or update their benefits.

The UNC System provides a downloadable summary of the 2025 Open Enrollment details to help employees review their options and make informed decisions.

End Date: December 15, 2024

The open enrollment period in North Carolina ends on December 15, 2024. Enroll by this date to ensure your health coverage starts on January 1, 2025, and avoid any gaps.

For 2025, the State Health Plan maintains its two preferred provider health insurance plans: the Base PPO Plan and the Enhanced PPO Plan. Both plans offer comprehensive health coverage but cater to different needs and preferences.

Detailed plan summaries and coverage documents are accessible through this website, allowing employees to review and compare their options.

Choosing the right plan is essential. Understanding the differences between these two options will help you make the best decision for your health and financial situation.

Base PPO Plan

The Base PPO Plan is the default option for State Health Plan members, providing essential health coverage at a lower monthly premium. For 2025, the premium for subscriber-only coverage is set at $85.

This plan ensures that preventive services remain covered, and members benefit from reduced copays at the provider’s office.

Enhanced PPO Plan

The Enhanced PPO Plan offers additional benefits compared to the Base PPO Plan, with a monthly premium of $110. This plan is ideal for those who seek more comprehensive coverage and are willing to pay a slightly higher premium.

Employees need to enroll in the Enhanced PPO Plan during the open enrollment period to take advantage of its benefits.

Tobacco Users and Premium Credits

Tobacco users can lower their monthly premiums by completing the tobacco attestation process, which is mandatory to avoid a premium surcharge. This process helps manage health insurance costs and encourages healthier lifestyle choices.

Here are the steps tobacco users can take to benefit from these premium credits.

By attending a tobacco cessation counseling session, tobacco users can reduce their monthly premium by $60. These sessions offer valuable strategies for quitting smoking and improving overall health.

To qualify for the premium reduction, tobacco users must attend a session by the end of November.

Non-tobacco users can also benefit from a monthly premium credit by completing an online attestation during open enrollment.

This process helps lower the Base PPO Plan premium from $85 to $25, incentivizing healthy choices and making health insurance more affordable.

Enrolling in your health insurance plan for 2025 is straightforward, thanks to the two enrollment platforms available. Members can use this website to manage their health coverage and make the necessary updates.

Previous elections made through the UNC System Benefits enrollment platform remain in effect until 2025 unless changes are made during Open Enrollment.

Here is a detailed look at the online enrollment process and available support.

Beneficiaries can enroll in health coverage and modify your elections through this website and by calling one of our licensed agents. During open enrollment, attest online to confirm your non-tobacco user status and receive the wellness premium credit.

Avoid repeated login attempts if issues arise, as this may lock your account.

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As we move into 2025, there are some significant changes to be aware of regarding the State Health Plan. The most notable change is the transition to Aetna as the third-party administrator, replacing Blue Cross NC.

This transition is expected to save North Carolina taxpayers around $140 million while maintaining the same health insurance plan terms.

New virtual care services are being introduced to enhance healthcare access for members, in addition to the administrative change.

Starting January 1, 2025, Aetna will take over as the third-party administrator for the State Health Plan. This change will not affect member premiums but will provide more efficient management of the health plans.

if you have any questions or concerns, call 1-877-517-5357.

The introduction of new virtual care services through Teladoc is a significant enhancement for 2025. These services will provide 24/7 access to healthcare, making it easier for members to receive care without needing to visit a provider’s office.

This addition aims to improve healthcare accessibility and convenience for all members.

Understanding your health insurance coverage is crucial for maximizing your benefits. In 2025, there will be no changes in benefits, copays, or deductibles. Preventive services, such as vaccinations and screenings, will continue to be fully covered without any copay or deductible.

Additionally, members will still have access to their current pharmacy benefits managed by CVS Caremark. Let’s break down these aspects further.

Preventive services, including essential health screenings and vaccinations, will continue to be offered at no cost to members.

This ensures that state health plan members have access to necessary health services without any out-of-pocket expenses, playing a crucial role in maintaining health and preventing illness.

Prescription coverage remains an essential aspect of the health insurance plans. While the formulary, which lists covered medications, is updated quarterly, the process ensures that members have access to necessary medications.

Stay informed about any changes to the formulary to manage your prescription needs effectively.

Having the right resources and contacts at your fingertips can make navigating open enrollment much easier. This website is the primary tool for managing your health coverage, and personalized assistance is available through the Aetna Health Concierge service.

Additionally, the N.C. A&T Division of Human Resources/Benefits Office and the UNC Charlotte Benefits Office offer information sessions and support during the enrollment period.

Here are specific resources available to you.

Accessing the Document Center during the open enrollment period is crucial. Here, you can find full coverage details, plan comparisons, and eligibility information.

These documents help you make informed decisions about your health insurance options and understand the benefits and coverage available to you.

As we conclude our journey through the 2025 open enrollment period for health insurance in North Carolina, it’s clear that staying informed and proactive is key.

From understanding the critical dates to exploring your plan options and utilizing available resources, each step ensures that you make the best decisions for your health and financial well-being.

This open enrollment period is your opportunity to secure comprehensive health coverage for the coming year. Take advantage of the available plans, attend necessary counseling sessions, and use the support services provided.

Being well-prepared will help you navigate the complexities of health insurance with confidence.

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