135-48.51. Coverage and operational mandates related to Chapter 58 of the General Statutes.
The following provisions of Chapter 58 of the General Statutes apply to the State Health Plan:
(1) G.S. 58-3-191, Managed care reporting and disclosure requirements.
(2) G.S. 58-3-221, Access to nonformulary and restricted access prescription drugs.
(3) G.S. 58-3-223, Managed care access to specialist care.
(4) G.S. 58-3-225, Prompt claim payments under health benefit plans.
(5) G.S. 58-3-235, Selection of specialist as primary care provider.
(6) G.S. 58-3-240, Direct access to pediatrician for minors.
(7) G.S. 58-3-245, Provider directories.
(7a) G.S. 58-3-247, Insurance identification card.
(8) G.S. 58-3-250, Payment obligations for covered services.
(9) G.S. 58-3-265, Prohibition on managed care provider incentives.
(10) G.S. 58-3-280, Coverage for the diagnosis and treatment of lymphedema.
(11) G.S. 58-3-285, Coverage for hearing aids.
(12) G.S. 58-50-30, Right to choose services of certain providers.
(13) G.S. 58-67-88, Continuity of care. (2011-85, s. 2.10; 2012-129, s. 2; 2013-296, s. 3; 2013-324, s. 5; 2021-30, s. 1(b).)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 3B - State Health Plan for Teachers and State Employees.
§ 135-48.1 - General definitions.
§ 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.
§ 135-48.27 - 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.
§ 135-48.34 - Contracts not subject to Article 3 of Chapter 143 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.
§ 135-48.43 - Effective dates of coverage.
§ 135-48.44 - Cessation of coverage.
§ 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.
§ 135-48.56 - 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.