September 2019 • Vol. 37, Issue 6
THE
REPORTER
State Employees Association of North Carolina
State Health Plan to operate two networks in 2020 Clear Pricing Project and BCBSNC’s Blue Options
With most of the state’s hospitals continuing their boycott of the Clear Pricing Project, State Treasurer Dale Folwell announced on Aug. 8 that the State Health Plan would operate in the coming year with a hybrid system. This system features two networks that will ensure all state employees and retirees have in-network coverage at facilities close to home. The new North Carolina State Health Plan Network will consist of the more than 28,000 providers that signed on to the Clear Pricing Project in addition to Blue Cross Blue Shield of North Carolina’s Blue Options Network, the network the plan currently uses. The announcement came just days after a report by WalletHub found that North Carolina ranks 50th in the nation in health care, mostly because of outrageous costs and lack of access. SEANC was the only employee organization willing to stand with Folwell in this fight to bring lower costs and transparency to the State Health Plan.
If implemented fully, the Clear Pricing Project would have saved plan members more than $60 million in out-of-pocket expenses and saved taxpayers more than $250 million. Affordable Healthcare for North Carolina, an advocacy group created by SEANC members, launched an advertising and social media campaign aimed at compelling the boards of the state’s hospitals to do the right thing and sign on to the plan. In the end, the hospitals would not budge from their boycott and cartel-like tactics. “This process has exposed the amount of outsized influence and control the big hospital cartel has on our health care system,” said SEANC Executive Director Robert Broome. “We knew this would be a long-term struggle. We applaud State Treasurer Dale Folwell for having the courage to stand up to the hospitals, and SEANC will not diminish its efforts to bring transparency and lower costs to the State Health Plan.”
Folwell said the decision for the hybrid system was made to comply with access to care requirements for hospital coverage.
HERE'S WHAT YOU NEED TO KNOW »» For 2020, members will have access to the SAME broad, statewide network that they do today, which is the Blue Options network administered by Blue Cross NC. »» Members enrolled in the 70/30, 80/20 and High Deductible Health Plans will also have access to the new network created by the Clear Pricing Project. »» Because of the success of the Clear Pricing Project, this network will include even more providers who are supportive of transparent and lower pricing. »» Open Enrollment for the 2020 benefit year will be held later in the fall at a date that will be announced soon. »» SEANC will continue to fight for transparency and lower costs in the State Health Plan.
Budget stalemate jeopardizes raises, bonuses There is little to report in the ongoing state budget standoff since the July edition of The Reporter. The legislature passed a budget in June that provides most state employees with the largest two-year pay increase in a decade (5%) and includes a 1% bonus for retirees. Gov. Roy Cooper vetoed the bill because it didn’t contain Medicaid expansion. He issued a counterproposal that includes Medicaid expansion and a huge 8.5% pay increase for teachers. As of press time, there are no indications that there are enough votes
to override the governor’s veto. The governor’s counterproposal does not have majority support either. SEANC does not have a position on Medicaid expansion, and your raises and bonuses should not be used as a bargaining chip. This stalemate may result in the legislature leaving Raleigh without a budget in place—meaning no raises, no bonuses, no much-needed correctional officer supplements, no community college and UNC System employee raises or any of the other parts of the budget that benefit state
employees and retirees. In response, SEANC is working with legislators on an amendment to the technical corrections bill that would spend another $50 million to extend the 5% raise to all university staff. We will alert members as soon as an agreement has been reached.
WAYS YOU CAN HELP
»» Visit seanc.org/engage to tell your legislators to override the governor’s veto and pass the budget to end the standoff. »» Follow SEANC on Facebook and Twitter for the latest information.