Benefits - Health Insurance - PPO (Preferred Provider Organization): Smart Choice
As you may have heard, or seen, the State Health Plan has created a PPO alternative for all state employees called Smart Choice. What is a PPO? A PPO is an arrangement where providers are under contract to provide medical services at lower than usual fees in return for prompt payment and a certain volume of patients. There is freedom of choice among in-network providers, including specialists. No referrals are required for specialist office visits. When in-network providers are used, out-of-pocket expenses are lower and no claims forms are required.
Premium Structure Comparison of Traditional State Health Plan and Smart Choice Plans:
| Coverage Types | | State Plan | | NCSC Basic | | NCSC | | NCSC Plus |
|---|---|---|---|---|
| EE | 0 | 0 | 0 | 39.54 |
| EE+Child(ren) | 200.18 | 135.48 | 180.18 | 242.60 |
| EE+Spouse | Family Rate | 349.08 | 415.14 | 507.38 |
| Family | 480.14 | 371.82 | 440.14 | 535.54 |
*EE = Employee
**NCSC = NC Smart Choice
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