2011 Annual Enrollment
Annual Enrollment for the 2011/2012 benefit year is from May 9 - June 8, 2011
IMPORTANT
ALL members with the State Health Plan as their primary health coverage will be moved to the 70/30 Basic plan, effective July 1. If members choose to remain on the Basic plan, no action is required unless members need to add or remove dependents.
The tobacco cessation component of the Comprehensive Wellness Initiative went into effect July 1, 2010, and the weight management component will go into effect July 1, 2011. Session Law 2009-16 requires that all members start in the 70/30 Basic plan and must qualify for the 80/20 Standard plan. If members wish to enroll in the 80/20 Standard plan, members will need to complete an Attestation Form on line declaring that they and if applicable, their covered dependents:
- do not use tobacco and have a Body Mass Index (BMI) less than 40 kg/m2, or
- qualify for exemption due to participation in a tobacco cessation program and/or weight management program, or
- have a medical condition that prevents the member from obtaining a healthy weight
Please note this does not apply to Medicare primary subscribers and their dependents.
The Attestation Form is a legally binding document that all employees must complete to enroll in the 80/20 Standard plan.
If a member does not take action during Annual Enrollment, they will remain in the 70/30 Basic plan for the 2011/2012 benefit year.
Members claiming an exemption due to participation in a tobacco cessation program, or weight management program, or due to a medical condition that prevents the member from obtaining a healthy weight must complete a Physician Certification Form. The completed form must include a dated physician; nurse practitioner or physician assistant’s signature or be obtained through QuitlineNC.
Members should keep the original, completed certification form for their records, as the Plan may request it at any time. The start date of the program on the Physician Certification Form must be by or on July 1, 2011.
The Annual Enrollment elections must be processed electronically. There will be no paper enrollment forms accepted.
How to enroll or make changes online?
- Go to https://dpsnc.hrintouch.com and click on Login
- Enter the following information:
- Login ID: Your first name, the first initial of your last name and the last 4 digits of your social security number
- Enter your password: your social security number without spaces or dashes.
- To retrieve your log on ID or reset your password select the “Can’t access your account” link on the website.
Trouble accessing a computer?
- A computer is available in the lobby of Human Resource Services Department/Fuller Building
- Ask your principal or supervisor for computer locations
- Visit the computer lab at your school or site
- Visit the local county library
If you have questions or are unable to enroll or make changes online, please contact the Durham Public Schools Human Resource Services/Benefits office at 560-3643.
COMPREHENSIVE WELLNESS INITIATIVE SUPPORTS
NC HealthSmart, a State Health Plan initiative, offers a variety of resources to address concerns about tobacco use and weight management.
QuitlineNC offers tobacco cessation coaching and free over-the-counter generic nicotine replacement therapy patches to members, subject to specific limitations. 1-800-QUIT-NOW (1-800-784-8669). QuitlineNC is available 8:00 a.m. to 3:00 a.m., 7 days a week, in English and Spanish. In addition, a completed Physician Certification Form can be obtained from QuitlineNC free of charge.
Prescription medications for tobacco cessation, including patches, are covered. One-on-one counseling for tobacco use is also covered.
For weight management concerns, the Plan covers four visits per year for an in-network dietitian for a primary care copay. Members with diabetes receive six free visits per year. In addition, FDA-approved weight management medications and certain medical procedures, including bariatric surgery, are covered. Restrictions do apply.
Annual Enrollment kits will be posted on the SHP website at www.shpnc.org, enrollment instructions, enrollment forms, 2010 rates, attestation form, physician certification form, link to determine Body Mass Index (BMI) and FAQs.
CHANGES
- Dependents Age 19 – 26
In compliance with the Federal Affordable Care Act, the State Health Plan will cover dependent children up to age 26 regardless of:
• Student status
• Marital status
• Residential status
Note: The covered dependent child cannot be eligible for other employer-sponsored health coverage - Pre-existing Conditions for members under the age of 19
In compliance with the Patient Protection and Affordable Care Act, (the Affordable Care Act) effective July 1, 2011, there will no longer be any pre-existing condition waiting periods for subscribers and/or dependents under the age of 19 enrolling in the State Health Plan for the 2011-2012 benefit year. - Hearing Aides for members 22 years of age and younger
On July 1, 2011 the State Health Plan will begin covering hearing aids and fittings for members 22 years of age and younger. A member can receive one hearing aid per hearing impaired ear up to $2,500 once every three years. This benefit is subject to your deductible and coinsurance.
QUESTIONS
For detailed information on the Annual Enrollment, Comprehensive Wellness Initiative and additional resources and supports available to members, please visit the State Health Plan website at www.shpnc.org/comp-wellness.html or call Customer Services at 1-888-234-2416.
