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From the State Health
Plan Office – August 2008
(page 2)
The State Health Plan
would like to make you aware of a change
in the
Blue PointsSM
program which allows members to earn
prizes for physical activity.
As you know, the State
Health Plan had a serious budget
shortfall in fiscal year 2007-2008,
which is projected to continue in the
current 2008-2009 fiscal year. The State
Health Plan must address the challenges
presented by this financial picture and
we are doing so in a variety of ways.
The State Health Plan is
working to
preserve the attributes
of quality and cost-effectiveness for
our members. Through the process of
researching and implementing financial
improvements, the Blue PointsSM
program will be discontinued as of
August 31, 2008 due to low utilization.
Only 9,600 of our 648,000 members
participated in the Blue PointsSM
program.
Current members enrolled
in the Blue PointsSM program
will have until August 31, 2008 to
continue earning points and selecting
prizes. Points that are not used before
this date will be forfeited.
State Health Plan members
who have actively participated in the
Blue PointsSM program will be
sent notification of the change mainly
by e-mail. In addition, a message will
be posted on the My Member Services Web
site notifying members of the
discontinuation of the program. Attached
is the letter that will be sent to
members who currently participate in the
Blue Points SM program, along
with some FAQs that you can share with
your employees.
If employees have
additional questions, please refer them
to our Web site at
www.shpnc.org/incentives.html,
or have them call Customer Service at
1-888-234-2416.
Please Note:
The
Blue ExtrasSM program which
provides discounts for complementary
services and products such as Lasik eye
surgery, hearing aids and vitamins and
supplements is still available.
Legislative
Summary excerpt by
Pam Deardorff, NCRSP
Executive Director
H 2443 State Health
Plan:
Authorizes the Executive
Administrator and Health Plan Board
of Trustees to offer multiple type
benefit plans (Preferred Provider
Options PPO’s, etc.). Requires an
act of the General Assembly if the
Executive Administrator or Board or
Trustees wants to change the Plan’s
comprehensive benefit coverage, such
as co-pays, deductibles, out-of
–pocket expenditures, and lifetime
maximums. Also authorizes an
optional Medicare Advantage
Program to Medicare eligible members
instead of other coverage offered
under the Plan, with “carve outs”
for Medicare Part A and B, but
requires the Plan to continue to
offer the current prescription drug
coverage to all Medicare eligible
plan members.
NOTE: During the last weeks of the
legislative session, legislative
leaders learned there would not
be a surplus in the State Health
Plan program this year as projected
and in fact, a huge deficit was
imminent. This disturbing news led
to the firing of the State Health
Plan Exec. Admin., (and bringing
back former Admin. Jack Walker as
interim administrator) along with
some emergency attempts by
legislative leaders to help fix the
problem. The Senate proposed to
increase plan member co-pay amounts
by $5 or $10 and increase certain
prescription drugs by $5. The
House said “no” to increases for
members and introduced legislation
to take money from the Rainy Day
Fund. In the end, neither was done,
so the deficit looms unattended for
now. The Governor has the authority
to call a special session of the
General Assembly to address the
problem if SHP reserves are not
adequate to cover the plan until
January when the GA returns.
H 2443 State Health Plan:
Authorizes the Executive Administrator
and Health Plan Board of Trustees to
offer multiple type benefit plans
(Preferred Provider Options PPO’s,
etc.). Requires an act of the General
Assembly if the Executive Administrator
or Board or Trustees wants to change the
Plan’s comprehensive benefit coverage,
such as co-pays, deductibles, out-of
–pocket expenditures, and lifetime
maximums. Also authorizes an
optional Medicare Advantage Program
to Medicare eligible members instead of
other coverage offered under the Plan,
with “carve outs” for Medicare Part A
and B, but requires the Plan to continue
to offer the current prescription drug
coverage to all Medicare eligible plan
members.
NOTE: During the last weeks of the
legislative session, legislative leaders
learned there would not be a
surplus in the State Health Plan program
this year as projected and in fact, a
huge deficit was imminent. This
disturbing news led to the firing of the
State Health Plan Exec. Admin., (and
bringing back former Admin. Jack Walker
as interim administrator) along with
some emergency attempts by legislative
leaders to help fix the problem. The
Senate proposed to increase plan member
co-pay amounts by $5 or $10 and increase
certain prescription drugs by $5. The
House said “no” to increases for members
and introduced legislation to take money
from the Rainy Day Fund. In the end,
neither was done, so the deficit looms
unattended for now. The Governor has
the authority to call a special session
of the General Assembly to address the
problem if SHP reserves are not adequate
to cover the plan until January when the
GA returns. |
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