State Health Plan
The State Health Plan of North Carolina offers two Preferred Provider Organization (PPO) plans to permanent full-time and three-quarter time employees who work a minimum of 30 hours per week. Both plans offer coverage for both in-network and out-of-network providers, however, visiting an in-network provider lowers deductibles, copays and decreases coinsurance liability. In addition, The State Health Plan’s Clear Pricing Project (CPP) helps employees control health care costs. The university contributes toward the monthly cost of coverage for regular full-time employees. Remaining employee premiums and/or employee dependent premiums are withheld from the employee’s paycheck on a pre-tax basis. The amount you pay depends on your selected plan level, who you cover and if you have completed a tobacco attestation. Learn how you can save money by visiting a CPP provider.
The 70/30 PPO Plan offers lower premiums, higher co-pays, higher deductibles and an increased co-insurance and out-of-pocket maximum compared to the 80/20 PPO Plan.
Appalachian State University also offers a High Deductible Health Plan (HDHP) which is through The State Health Plan of North Carolina. Temporary (non-permanent) employees working an average of 30 or more hours per week are eligible for coverage. Benefits include Affordable Care Act (ACA) preventive care services and medications covered at 100% with in-network providers. Both Appalachian and the employee share the monthly cost of the coverage. The employee will receive a monthly bill for his/her portion of the monthly cost. If you choose to enroll in this plan, you will be billed monthly for your premiums by the State Health Plan. This is a pre-paid plan; therefore, you will be billed a month in advance. You will be responsible for paying your bill in a timely manner and failure to do so will lead to termination of coverage. Once you are eligible for this plan, you will have 30 days to elect coverage. Coverage will start the first day of the month following enrollment. Coverage ends the last day of the month in which eligibility change or employment end occurs.
When Does Coverage Begin?
If you are a new hire or become eligible for coverage due to a qualifying life event and enroll in the plan, benefits will begin on the first day of the month following your hire/event date. You have 30 calendar days starting from your hire/event date to enroll. Employees who do not complete enrollment or process a qualifying life event within the 30 day window, will be required to wait until annual enrollment to enroll in a plan or make any appropriate changes.
When does Coverage End?
If an employee terminates between the 1st – 15th of the month, their medical coverage will terminate on the last day of the month in which their employment ends.
Example: Employee termination date is 4/5/2022, medical coverage will terminate on 4/30/2022.
- If an employee terminates between the 16th through the last day of the month, coverage will terminate on the last day of the month following the month their employment ends.
Example: Employee termination date is 4/20/2022, medical coverage will terminate on 5/31/2022
How to Enroll or Make Changes
Health Plan enrollment and changes are made through EBenefits. You will use your university username and password to login to the system.
Please visit The North Carolina State Health Plan website for more comprehensive information regarding plan benefits and coverage.