{"id":4745,"date":"2026-07-16T11:33:23","date_gmt":"2026-07-16T11:33:23","guid":{"rendered":"https:\/\/durhammovinghub.com\/?p=4745"},"modified":"2026-07-16T11:33:23","modified_gmt":"2026-07-16T11:33:23","slug":"nc-state-workers-have-questions-after-state-health-plan-switches-network-insurer","status":"publish","type":"post","link":"https:\/\/durhammovinghub.com\/?p=4745","title":{"rendered":"NC state workers have questions after State Health Plan switches network & insurer"},"content":{"rendered":"

AI-generated summary reviewed by our newsroom.<\/p>\n

Read our AI Policy.<\/a><\/p>\n

How much will my premiums go up?<\/p>\n

If my provider wasn\u2019t picked as one of the providers preferred by the State Health Plan, how long will that last?<\/p>\n

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If I\u2019m retired, will these changes affect me?<\/p>\n

Those are just some of the many questions that have flooded into the State Employees Association of North Carolina\u2019s social media sites, said Ardis Watkins, the organization\u2019s executive director.<\/p>\n

\u201cIt\u2019s a lot of change at one time. So my first thought is, this is really hard for the members to digest,\u201d she said.<\/p>\n

\u201cWe\u2019re getting that from our social media. We\u2019re inundated with questions.\u201d<\/p>\n

Most recently, the health plan\u2019s Board of Trustees voted Friday to:<\/p>\n

Watkins said the changes will take time for members to understand, but she believes the state\u2019s approach to increasing competition by naming some hospital providers as preferred, leading to lower costs to members who use them, should be given an opportunity to work.<\/p>\n

\u201cThe method the treasurer\u2019s office is trying to employ right now to increase the competition is something that, while it\u2019s complex and hard to understand, we do need to give it time,\u201d Watkins said. \u201cIf it works, then we might see premiums even come down in the future.\u201d<\/p>\n

As for the switch from Aetna, which has administered the plan since last year, to Blue Cross?<\/p>\n

\u201cThere was a huge outcry from folks about Aetna,\u201d Watkins said. \u201cBut before that, when Blue Cross had it, there was a huge outcry about Blue Cross. I think what folks have experienced is they\u2019ve had it with the system. Period.\u201d<\/p>\n

Since Republican Treasurer Brad Briner took control of the State Health Plan upon taking office last year, he has overhauled many aspects of how the program previously operated, with state employees and retirees facing significant adjustments as changes are made to the insurance program that serves roughly 750,000 beneficiaries.<\/p>\n

Under the previous treasurer, Dale Folwell, also a Republican, premiums were frozen for years, but the plan\u2019s deficits steadily climbed. Folwell also frequently criticized what he called the health care \u201ccartel,\u201d a term he used to describe powerful players in the health care industry \u2014 including hospitals, health systems and health care associations \u2014 that he argued contributed to high costs and a lack of transparency in medical pricing.<\/p>\n

Folwell implemented the Clear Pricing Project, a reimbursement model that tied medical payments to a set percentage above Medicare rates. The program was later rolled back by Briner\u2019s office, which has said it led to costs and not savings, as only providers who were paid less than that rate joined, leading the state to pay more.<\/p>\n

Watkins said the model could have worked with more political support behind it. \u201cThere has to be the political courage for it to work. And there was bipartisan resistance to what he wanted to do,\u201d she said.<\/p>\n

\u201cFaced with the political reality that there simply wasn\u2019t the courage to stand up to hospital systems, something else has to happen,\u201d Watkins said. \u201cAnd I think that\u2019s what Treasurer Briner is working with right now \u2014 trying to find a creative approach that kind of uses the market itself and competition to force people to the table with a more reasonable price.\u201d<\/p>\n

Briner has taken on changes he\u2019s said are aimed at tackling those rising costs, as well as increasing the benefit members see from their plan.<\/p>\n

It is a lot to track.<\/p>\n

State employees may find themselves weighing whether to switch providers to take advantage of potential savings, while also preparing for another major transition.<\/p>\n

And it\u2019s pretty important.<\/p>\n

If state employees use non-preferred providers and don\u2019t switch, it could mean paying thousands of dollars more for care.<\/p>\n

Tom Friedman, the State Health Plan\u2019s executive director, said during the July meeting that affordability would be a central focus as the plan moves forward with major changes.<\/p>\n

\u201cAffordability is going to be the theme of the conversation we\u2019re having,\u201d Friedman said. \u201cWhile we can\u2019t make everything\u2019s price go down, I think we have a great example of a lot of costs going down.\u201d<\/p>\n

The plan ran a survey this year to get member feedback. Friedman said the plan would continue seeking feedback from members as changes are implemented.<\/p>\n

\u201cThis (survey) is something that I would commit to doing every year, particularly with such significant changes within the plan coming,\u201d he said. \u201cWe need to hear from members what is working and what\u2019s not.\u201d<\/p>\n

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Communicating all these complex changes to a large membership will be a challenge, he said.<\/p>\n

\u201cWe all have our own styles of how we receive communication, and that\u2019s going to be the challenge of everything we\u2019re doing today and describing today,\u201d Friedman said. \u201cWe have to do all those things \u2014 lots of times, very clearly and simply. And I\u2019m going to screw up how we say stuff a lot of times, and we\u2019re going to have to refine the message over and over.\u201d<\/p>\n

John Baley, the director of psychology at the Black Mountain Neuro-Medical Treatment Center, a state facility, said he has learned about many of the upcoming State Health Plan changes through news reports and communications from SEANC.<\/p>\n

The changes, he said, appear as though \u201cthey are trying to move the system in two different directions at once.\u201d<\/p>\n

Baley said that some groups of state employees, including workers at UNC Health and ECU Health,<\/a> have been able to choose health coverage outside of the plan.<\/p>\n

He said those departures could affect the plan\u2019s risk pool, particularly if higher-paid employees with lower health care costs leave, leaving a smaller pool of members to cover claims.<\/p>\n

He said some of the new changes, including premium increases without significant pay raises, \u201cwill accelerate that process and overall weaken the State Health Plan.\u201d<\/p>\n

Lawmakers passed, and Democratic Gov. Josh Stein signed, a budget drafted by Republicans that provides a 3% raise to most state employees, with some receiving higher raises.<\/a><\/p>\n

Baley also said the State Health Plan\u2019s income-based premium structure, which charges lower premiums to lower-income employees and higher premiums to higher-income employees, may not go far enough in accounting for the differences among state workers.<\/p>\n

He said premium increases have a larger impact on lower-paid members of his team, including nurses, certified nursing assistants and behavioral technicians, than they do on him personally.<\/p>\n

These higher costs could make it harder for the state to recruit and retain employees at a time when many agencies are already facing hiring challenges and staffing shortages, Baley said.<\/p>\n

Beyond his concerns about the plan\u2019s financial changes, Baley said he has heard confusion among employees about what the new preferred provider network will mean for them.<\/p>\n

\u201cThey\u2019re busy working, and they don\u2019t have time to sort through the preferred provider distinctions,\u201d he said.<\/p>\n

As for the survey conducted by the State Health Plan, that was done from April 22 to May 27 to gather feedback on several issues, including upcoming changes to the plan.<\/p>\n

About 20,000 active and non-Medicare members responded, along with about 15,000 Medicare members, according to data presented during the July meeting by Beth Horner, the plans\u2019 director of communications.<\/p>\n

The largest share of responses came from public school employees (38%), followed by state agency employees (29%) and university employees (11%).<\/p>\n

On the preferred provider program, 91% of respondents said they were familiar with it.<\/p>\n

Members were also asked whether they would rather have lower monthly premiums or lower out-of-pocket costs when they receive care. Responses were divided:<\/p>\n

Read more Grim discovery made after driver is accused of following woman, NC sheriff says<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

North Carolina\u2019s State Health Plan will shift networks, raise premiums and return to Blue Cross in 2028, prompting questions from state employees and retirees.<\/p>\n","protected":false},"author":1,"featured_media":4744,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-4745","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-read-todays-edition"],"yoast_head":"\nNC state workers have questions after State Health Plan switches network & insurer - Durham Moving Hub<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/durhammovinghub.com\/?p=4745\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"NC state workers have questions after State Health Plan switches network & insurer - Durham Moving Hub\" \/>\n<meta property=\"og:description\" content=\"North Carolina\u2019s State Health Plan will shift networks, raise premiums and return to Blue Cross in 2028, prompting questions from state employees and retirees.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/durhammovinghub.com\/?p=4745\" \/>\n<meta property=\"og:site_name\" content=\"Durham Moving Hub\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-16T11:33:23+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/#\\\/schema\\\/person\\\/bf1f081e7f06a3ab66052e5f6015fd85\"},\"headline\":\"NC state workers have questions after State Health Plan switches network & insurer\",\"datePublished\":\"2026-07-16T11:33:23+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745\"},\"wordCount\":1327,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/durhammovinghub.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/d2d4a611b22b1edad24fa4b8e98a9a23.jpg\",\"articleSection\":[\"Read today's Edition\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745\",\"url\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745\",\"name\":\"NC state workers have questions after State Health Plan switches network & insurer - Durham Moving Hub\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/durhammovinghub.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/d2d4a611b22b1edad24fa4b8e98a9a23.jpg\",\"datePublished\":\"2026-07-16T11:33:23+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/#\\\/schema\\\/person\\\/bf1f081e7f06a3ab66052e5f6015fd85\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/durhammovinghub.com\\\/?p=4745#primaryimage\",\"url\":\"https:\\\/\\\/durhammovinghub.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/d2d4a611b22b1edad24fa4b8e98a9a23.jpg\",\"contentUrl\":\"https:\\\/\\\/durhammovinghub.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/d2d4a611b22b1edad24fa4b8e98a9a23.jpg\",\"width\":1200,\"height\":675,\"caption\":\"North Carolina State Treasurer Brad Briner, left, and Thomas Friedman, executive administrator of the State Health Plan, answer questions during a news conference following a Board of Trustees meeting Friday, July 10, 2026, at the Department of State Treasurer in Raleigh. 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