North Carolina State Health Plan

The meeting commenced with the call to order and the pledge of allegiance. A conflict of interest statement was read, followed by the introduction of the newest board member, Joe Slater, whose Statement of Economic Interest was noted. A resolution honoring former board member Dr. Carrie Willis was presented. The board unanimously approved the consent agenda, which included the minutes and the resolution for Dr. Willis. A separate vote approved the Wayne Prep School participation application. The board also delegated powers concerning charter school review applications. During the public comment section, representatives from the State Employees Association of North Carolina, the North Carolina Association of Educators, and the North County Retired School Personnel spoke in opposition to proposed premium increases, arguing they represent a pay cut for employees and retirees and are politically motivated due to chronic underfunding and corporate healthcare influence. The Treasurer provided an update, noting that the premium finalization was necessary to address a half-a-billion-dollar deficit entering 2026, attributing the fiscal challenges to previous years of frozen premiums and a flawed Clear Pricing Project strategy. The Treasurer stressed the commitment to making the plan viable for the future.

The primary focus of the meeting was the discussion and approval of three primary care clinically integrated network contracts. The plan aims to support independent practices, ensure statewide access to high-quality local primary care, and better align incentives between members, providers, and the plan. Benefits discussed include lower co-pays and elimination of prior authorization requirements for members utilizing preferred primary care providers, improved reimbursement for providers, and reduced utilization of high-cost services for the plan. The board also discussed future steps, including phase two contracts involving shared savings, and potential future specialty clinically integrated networks for specialties like maternity and dermatology. The board ultimately approved the three primary care network contracts.

The agenda for this special meeting, convened by the Chair, included roll call for attendance and a conflict of interest statement. The primary substantive item for consideration and approval involved contract review for Preferred Primary Care Provider Network Contracts with three entities: Aledade, Community Care Physician Network, and UNC Health Alliance. The meeting concluded with adjournment.

The meeting agenda focused primarily on the State Health Plan's strategy following the conclusion of the Clear Pricing Project on December 31, 2025. The core discussion revolved around implementing strategies to ensure statewide access to high-quality, local primary care by supporting independent practices. This involved presenting a program designed to align incentives between the practices, the member, and the Plan, which is the central part of Phase One of the Preferred Provider Strategy aimed at improving health, reducing costs, and sustaining partner providers. Key incentives discussed for providers included lower copays, removal of medical prior authorization, better reimbursement, and reduced administrative burden. The Board was asked to vote on approving provider network contracts for Aledade, Community Care Physician Network, and UNC Health Alliance, as these contracts exceeded the three million dollar threshold requiring Board approval under N.C.G.S. 135-48.33(a). Future phases will focus on Specialty Clinically Integrated Networks, Maternity, Dermatology, and Independent Pharmacy.

The State Health Plan Board of Trustees held a meeting to discuss several key topics. The agenda included a year in review, a local government discussion, a population risk report, financial reports, a retiree health benefit OPEB report, and the 2027 benefit strategy. The year in review covered financial sustainability efforts, a refocused provider strategy, health improvements, and population health returns. The local government discussion focused on employer contributions, employee contributions, and the retiree health benefit fund. The population risk report included key findings from the 2025 report, medical and prescription drug summary trends, and emerging cost trend drivers.