Health care overhaul has fans

State workers, teachers switch to new managed care plans

RALEIGH -- More than half the patients in the health insurance program for state employees, teachers, retirees and their dependents have decided to switch to one of its three new managed-care options that begin Oct. 1.

About 330,000 of the 590,000 members of Teachers' and State Employees' Comprehensive Major Medical Plan decided to switch from a traditional indemnity plan during an open-enrollment period earlier this year, the plan announced Friday.

Two of the three managed-care programs, called NC SmartChoice Blue Options, will result in lower monthly premiums for patients and should save the health plan more than $25 million in its first year, said plan administrator George Stokes.

The change "enables the State Health Plan to deliver on its promise of improved affordability and choice," Stokes said in a statement.

The preferred-provider contract that the plan agreed to with Blue Cross and Blue Shield of North Carolina will allow patients who see doctors within a "network" of qualifying physicians and hospitals to pay less on premiums and for out-of-pocket costs. Patients who visit out-of-network physicians are still covered but have to pay more for services.

Patients will be able to use physicians and visit hospitals within the Blue Cross network, and they won't have to meet deductibles for doctor visits.

The health plan used to offer participation in private health maintenance organizations a decade ago, but they all pulled out when profits became harder to generate.