NC health plan proposal penalizes smoking

Published on NewsOK Modified: February 4, 2013 at 10:38 pm •  Published: February 4, 2013
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RALEIGH, N.C. (AP) — Some North Carolina state employees, teachers and retirees could see even higher premiums if they smoke or fail to make other health choices starting next year under a proposal approved Monday by State Health Plan board members.

The trustee board backed new premium rates that would go up on average by 4.7 percent annually in 2014 and 2015.

Enrollees in more generous plans would have to pay a $20-per-month surcharge for smoking and another $20 per month if they fail to choose a primary care doctor and take a health assessment. They could receive up to $50 per month in premium credits if a worker and his or her spouse don't smoke and decide to choose a doctor and other wellness initiatives. The more generous plans also would provide free preventive services.

State workers would continue to keep zero premiums for a less generous insurance plan, but they are likely to be subject to similar surcharges in 2016, according to plan officials. Leaders at the health plan, which provides insurance for 668,000 employees, retirees and their dependents, hope the changes will encourage healthier lifestyles and contain increasing health care costs.

"It's fairly well-documented that smokers cost (plans) more money," said Mona Moon, the State Health Plan's chief financial officer.

The changes also are designed in part to reduce projected double-digit premium increases in 2016 and 2017. Under the changes, the potential average annual increases would fall from 15 percent to just more than 10 percent.

Representatives of several worker or retiree organizations generally supported the proposal except for the State Employees Association of North Carolina, a union representing about 55,000 current and active workers.

Ardis Watkins, a lobbyist for SEANC, told the board her group likes wellness efforts but calls the extra monthly cost "a huge stick you're trying to disguise as a carrot." The plan should lobby legislative leaders to spend more on insuring members, not less.

"We're already not doing right by our employees and this will be doing worst," Watkins said. "You can call it a premium, you can call it a surcharge. It's money out of folks' pockets that they have to jump through hoops to get back. That's flat out wrong."