Welcome North Carolina

2011/2012 Plan Updates and Reminders

Please take a moment to review this summary of changes for the 2011/2012 plan year. Additional details are included in your enrollment guide.

Eligibility

  • Dependent coverage extended to age 26 — you and/or your spouse’s/same gender domestic partner’s children will be eligible for medical coverage until the end of the month in which they turn age 26. You may be asked periodically to show proof of dependent eligibility.

 

Medical

  • Unlimited preventive care benefits — there are no limits on preventive care services.
  • Eliminating the lifetime maximum on medical benefits — there will no longer be a lifetime maximum limit on benefits in the Open Access (Premier) Plan and Consumer Directed (Enhanced) Plan.
  • Therapy changes — inpatient and outpatient rehabilitation services, such as physical therapy, occupational therapy, speech therapy, cardiac rehabilitation, and pulmonary rehabilitation will no longer have a per benefit year limitation. Rehabilitation services are covered only if they are expected to result in significant improvement in the covered person’s condition.
  • Comprehensive hearing exams now covered — preventive hearing exams are still covered every three benefit years; a comprehensive hearing exam is covered at the same level as any other benefit.

 

Health Care Flexible Spending Account (FSA)

  • Over-the-counter medications (except insulin/diabetic supplies and a few other items) are no longer eligible for Health Care FSA reimbursement — unless you have a written prescription from your doctor.

Life and Disability Insurance

  • New vendor — The Hartford; your coverage and premium will remain the same, unless you make changes during the enrollment period or have had a birthday in the past year that moves you to the next Life Insurance premium category.

 

For more details about these changes, and to review all of your 2011/2012 benefits, click here to access your enrollment guide.