State Health Plan Approves Strategic Plan and Medicare Advantage Benefits

The State Health Plan (Plan) Board of Trustees approved its 2026-2032 Strategic Plan today, advancing initiatives designed to improve member health outcomes while strengthening the Plan's long-term financial sustainability. The unanimous approval establishes a roadmap focused on three priorities: protecting affordable premiums and stable benefits, helping members achieve better health and ensuring members have access to care.

In addition, the Board approved the 2027 Medicare Advantage Benefits for the Plan. The changes for the Humana Medicare Advantage plans, which currently serve nearly 177,000 Medicare retirees, are projected to save the Plan approximately $31.5 million while continuing to provide comprehensive coverage options for retirees.

Together, the actions support the Plan's ongoing efforts to improve health outcomes, preserve affordability for members and taxpayers and address long-term financial challenges facing the affordability of health care.

The Plan has already implemented multiple initiatives aimed at keeping members more healthy.

One program is preparing to move to the next phase. Lantern, a surgery and specialty care navigation program that connects members with high-quality providers and offers eligible procedures at no cost, is making meaningful impact with members. As Lantern and the Plan now look to Phase II, there will be increased efforts and availability in general surgery, gynecology, gastroenterology and ear, nose and throat no cost options.

Since launching late last year, more than 1,000 Plan members have received a zero-dollar procedure through Lantern, generating approximately $12 million in savings for the Plan while improving access to high-quality care. The network of participating North Carolina providers has grown from 60 providers in November 2025 to 194 providers in May 2026.

The Board also received an update on the Eat Well Pilot Program, which launched June 1. The initiative is currently limited to 1,000 eligible members if they have a diagnosis of at least one cardiometabolic condition - Type 2 diabetes, coronary artery disease, or chronic kidney disease - and a household income at or below $50,000. Eat Well will provide a $80 monthly grocery benefit to purchase nutrient-dense foods such as fruits, vegetables and beans. The 12-month pilot run through Reinvestment Partners reflects the Plan's commitment to preventive care and addressing chronic disease through innovative population health programs.

"Food is medicine," Treasurer Brad Briner said. " The people who teach our kids and keep our state running deserve access to interventions that work - and that's exactly what this partnership provides. The Eat Well program can improve health outcomes and potentially reduce the need for more costly medical interventions in the future."

"When people are asked what their biggest barrier to eating fruits and vegetables is, the answer is cost. This partnership removes that barrier for state employees managing serious chronic conditions - and the research shows that when you do that, their health improves," Reinvestment Partners CEO Peter Skillern said.

The Board also reviewed proposed benefit changes for 2027 for active and Non-Medicare members which include the multi-tier network structure that the Board approved in March. The final vote on those proposed changes will take place at the July 10 meeting, which will include several major votes including 2027 premium rates. In addition, that meeting will announce the 2028 third-party administrator and pharmacy benefit manager.

Treasurer speaks at the SHP June 2026 Meeting on Preferred Provider Strategy.

State Health Plan Board of Trustees meeting materials are available at https://www.shpnc.gov.

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The State Health Plan, a division of the Department of State Treasurer, provides health care coverage to more than 750,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents.

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