As of January 1, 2020, NC state employees are required to enroll in a new health insurance plan, which is administered by Aetna. This change affects all state employees, including those who were previously enrolled in the State Health Plan.
The new Aetna plan offers a range of benefits, including medical, dental, and vision coverage. It also includes a wellness program that provides incentives for employees to maintain a healthy lifestyle.
One of the key changes with the new Aetna plan is the introduction of a new network of healthcare providers. This network includes over 90,000 doctors and hospitals across the state, providing employees with more options for care.
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Insurance Changes for NC Employees
North Carolina state employees could see lower premium costs for their health insurance on the North Carolina State Health Plan, Treasurer Dale Folwell said.
The state's decision to switch from Blue Cross and Blue Shield to Aetna could lead to cost savings, with Aetna beating out Blue Cross and Blue Shield of North Carolina to manage the state health plan starting in 2025.
Aetna will manage health insurance for more than 740,000 North Carolina state employees, winning a contract BCBS North Carolina has held for over 40 years. The new contract could save the state up to $140 million in administrative costs.
State Treasurer Dale Folwell hopes to cut costs for state employees, with a goal of reducing family health premiums.
Despite the change, benefit coverage, including medical services covered by the plan, will remain the same. The out-of-pocket limit, co-pays, and deductibles will also stay the same.
However, the contract between Duke Health and Aetna is causing some concerns, as it could lead to higher insurance costs for state employees or upend existing care if they can't come to an agreement by October 20.
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Duke and Aetna Dispute
A contract battle between Duke Health and Aetna is causing concern for state employees in North Carolina.
The contract between Duke Health and Aetna is set to expire on October 20, leaving hundreds of thousands of state employees potentially stuck with higher health insurance costs if a deal is not reached.
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State Treasurer is worried about the outcome of the contract battle, which could increase costs for state employees and retirees.
Aetna-Duke Health talks could take doctors out of the state health plan, making it difficult for state employees to find new doctors if their current ones are no longer covered.
Duke Health could drop Aetna over the contract dispute, affecting thousands of state workers who might need to find new doctors.
State officials have voted to approve a resolution to identify new potential doctors for people at risk of losing their doctor due to the contract dispute.
The deadline for Duke Health and Aetna to come to an agreement is October 20, and if they fail to reach a deal, those with Aetna would no longer be covered at Duke Health facilities.
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Potential Consequences for Employees
Aetna insurance is taking over the state health plan in 2025, beating out Blue Cross and Blue Shield of North Carolina.
State employees can expect to see changes in their health insurance management, but not necessarily in their benefits or premiums. The State Health Plan Board of Trustees makes decisions related to premiums and benefits, and they've said that those should stay the same for now.
The out-of-pocket limit, co-pays, and deductibles will also remain unchanged. This is good news for state employees, who have been dealing with rising costs in the State Health Plan.
However, some retired state employees and their dependents under the State Health Plan's Medicare Advantage plans offered by Humana did see premium increases in June.
Duke Health is currently in a contract dispute with Aetna, which could potentially affect state employees who are also patients at Duke.
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Insurance Providers and Network
The network of providers for Aetna insurance is changing, and some providers will likely fall out of the network while others will become in-network.
You can expect about 99% of State Health Plan claims to be paid to in-network providers, according to an analysis conducted by Aetna in 2022.
Aetna has added an additional 5,200 providers to its network since being awarded the contract, and this number is expected to continue growing.
To check if your providers are in-network, you can visit the plan's website starting August 1, which will have a link to Aetna's "Find a Provider" Tool.
This tool will help you determine if your providers are still in-network, making it easier to plan your healthcare needs.
State Employee Insurance
North Carolina state employees could see lower premium costs for their health insurance on the North Carolina State Health Plan, Treasurer Dale Folwell said Tuesday.
The state's decision to switch the contract from Blue Cross and Blue Shield to Aetna could save the state up to $140 million in administrative costs.
Aetna will manage health insurance for more than 740,000 North Carolina state employees, winning a contract BCBS North Carolina has held for over 40 years.
The new contract includes healthcare spending of more than $17.5 billion over five years.
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Over 600 Aetna employees will be assigned to facilitate the transition.
State Treasurer Dale Folwell hopes to cut costs for state employees, including family health premiums.
Aetna beat out Blue Cross and Blue Shield of North Carolina to manage the state health plan starting in 2025.
Blue Cross says it will appeal the state's decision.
Meetings and Transitions
Aetna is taking over a multi-billion-dollar contract to run the NC State Health Plan for employees in 2025.
Meetings are being held with state employees as the transition continues.
Aetna is slated to take over the contract in 2025, so it's no surprise that meetings are being held to discuss the details.
Frequently Asked Questions
Is Aetna considered good insurance?
Aetna is considered a good health insurance provider overall, known for its extensive network, competitive rates, and comprehensive benefits. It offers a range of advantages, including 24/7 virtual care and mental health coverage.
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