North Carolina General Statutes
Article 3B - State Health Plan for Teachers and State Employees.
§ 135-48.47 - Participation in State Health Plan by local government employees and dependents.

135-48.47. Participation in State Health Plan by local government employees and dependents.
(a) Eligibility. - The employees and dependents of employees of local government units are eligible to participate in the State Health Plan, as provided in this section. This section does not apply to employees of a charter school operated by a municipality.
Employees and dependents participating under this section are not guaranteed participation in the Plan, and participation is contingent on their respective local government units (i) electing to participate in the Plan and (ii) complying with the provisions of this section and this Article, as well as any policies adopted by the Plan.
(b) Participation Requirements. - A local government unit may elect to participate in the State Health Plan. Participation shall be governed by the following:
(1) In order to participate, a local government unit must do the following:
a. Pass a valid resolution expressing the local government's desire to participate in the Plan.
b. Enter into a memorandum of understanding with the Plan that acknowledges the conditions of this section and this Article.
c. Provide at least 90 days' notice to the Plan prior to entry and complete the requirements of this subdivision at least 60 days prior to entry.
(2) In order to participate, a local government unit and its employees must meet the federal requirements to participate in a governmental plan. The Plan may refuse participation to persons who would jeopardize the Plan's qualification as a governmental plan under federal law.
(2a) The Plan shall admit any local government unit that meets the administrative and legal requirements of this section, regardless of the claims experience of the local government unit group or the financial impact on the Plan.
(3) A local government unit shall determine the eligibility of its employees and employees' dependents.
(3a) The premiums employees pay to the local government unit for their own coverage shall conform to the premiums in the structure set by the Plan. The premiums employees pay to the local government unit for coverage of their dependents may be determined by the local government unit but may not exceed the premiums set by the Plan.
(4) Premiums for coverage and Plan options shall be the same as those offered to State employees and dependents on a fully contributory basis.
(5) The local government unit shall pay all premiums for all covered individuals directly to the Plan or the Plan's designee.
(c) Enrollment Limitation. - Local governments may elect to participate until the number of employees and dependents of employees of local governments enrolled in the Plan reaches 16,000, after which time no additional local governments may join the Plan. Any local government electing to participate must have less than 1,000 employees and dependents enrolled in health coverage at the time the local government provides notice to the Plan of its desire to participate.
(d) Local governments participating in the Plan as of April 1, 2016, may elect to withdraw from participating in the Plan effective January 1, 2017. Notice of withdrawal must be given by the local government to the Plan no later than September 15, 2016.
(e) Except as permitted under subsection (d) of this section, a local government unit's election to participate in the Plan is irrevocable. (2014-75, s. 3; 2014-105, s. 1; 2015-112, s. 2; 2016-104, ss. 4, 5(a), 6; 2018-145, s. 20(d); 2020-48, s. 1.17.)

Structure North Carolina General Statutes

North Carolina General Statutes

Chapter 135 - Retirement System for Teachers and State Employees; Social Security; State Health Plan for Teachers and State Employees

Article 3B - State Health Plan for Teachers and State Employees.

§ 135-48.1 - General definitions.

§ 135-48.2 - Undertaking.

§ 135-48.3 - Right to amend.

§ 135-48.4 - Conflict with federal law.

§ 135-48.5 - Health benefit trust funds created.

§ 135-48.8 - Statements of public interest.

§ 135-48.10 - Confidentiality of information and medical records; provider contracts.

§ 135-48.12 - Committee on Actuarial Valuation of Retired Employees' Health Benefits.

§ 135-48.15 - Whistle-blower protections related to the State Health Plan.

§ 135-48.16 - Fraud detection and audit programs.

§ 135-48.20 - Board of Trustees established.

§ 135-48.21 - Board officers, quorum, meetings.

§ 135-48.22 - Board powers and duties.

§ 135-48.23 - Executive Administrator.

§ 135-48.24 - Administrative review.

§ 135-48.25 - Rules.

§ 135-48.27 - Reports to the General Assembly; General Assembly access to information.

§ 135-48.28 - Auditing of the Plan.

§ 135-48.30 - Powers and duties of the State Treasurer.

§ 135-48.32 - Contracts to provide benefits.

§ 135-48.33 - Contracting provisions; large contract review by Board of Trustees and Attorney General, auditing, no cost plus contracts.

§ 135-48.34 - Contracts not subject to Article 3 of Chapter 143 of the General Statutes.

§ 135-48.35 - Contract disputes not contested case under the Administrative Procedure Act, Chapter 150B of the General Statutes.

§ 135-48.37 - Liability of third person; right of subrogation; right of first recovery.

§ 135-48.37A - Employing unit cooperation in collection of amounts owed to Plan.

§ 135-48.38 - Persons eligible for Medicare; optional participation in other Medicare products.

§ 135-48.39 - Operations during state of disaster or emergency.

§ 135-48.40 - Categories of eligibility.

§ 135-48.41 - Additional eligibility provisions.

§ 135-48.42 - Enrollment.

§ 135-48.43 - Effective dates of coverage.

§ 135-48.44 - Cessation of coverage.

§ 135-48.45 - Conversion.

§ 135-48.46 - Settlement agreements by employing units.

§ 135-48.47 - Participation in State Health Plan by local government employees and dependents.

§ 135-48.49 - IRC Sections 6055 and 6056 regulatory reporting.

§ 135-48.50 - Coverage mandates.

§ 135-48.51 - Coverage and operational mandates related to Chapter 58 of the General Statutes.

§ 135-48.52 - General limitations and exclusions.

§ 135-48.54 - Optional participation for charter schools operated by private nonprofit corporations or municipalities.

§ 135-48.56 - Education of covered active and retired employees.

§ 135-48.57 - Payments for county or city ambulance service.

§ 135-48.58 - Premiums for firefighters, rescue squad workers, and members of National Guard.