State Health Plan costs will go up for most Wake school employees. See how much.

CARY

Most Wake County school employees will see increases in their State Health Plan costs next year, with many either seeing a doubling in their deductibles or sharp increases in their monthly premiums.

The State Health Plan is switching to a salary-based plan with premium increases as part of what state officials say are needed steps to keep the plan solvent. Wake County school administrators said Tuesday that 84% of the district’s employees will have higher health insurance costs next year, with most in a category seeing across-the-board premium increases.

The higher health costs are occurring at the same time state lawmakers left Raleigh last week without adopting a comprehensive state budget that includes school employee pay raises.

“Considering the increase in premiums and out-of-pocket expenses associated with the plan design changes — and in the absence of pay increases for a large portion of this group — this will result in a net negative in take-home pay for next year for these individuals,” Chad Hively, Wake’s director of benefits, told the school board’s finance and budget committee.

84% of Wake employees to see higher premiums

The State Health Plan provides coverage to nearly 750,000 teachers, state employees, retirees and their dependents. Aetna administers the State Health Plan for the state, The News & Observer previously reported.

The Plus PPO and Standard PPO plans will replace the 80/20 Enhanced PPO and 70/30 Base PPO plans for active employees.

State Treasurer Brad Briner cited a projected $500 million deficit in the State Health Plan in 2026 for needing to make major changes.

Open enrollment began in October for the State Health Plan.

In the Wake County school system, 13,942 of the 16,678 participants in the State Health Plan would see higher costs next year.

Hively said roughly half of the Wake school employees whose costs will go up are non-teachers. This group includes some of Wake’s lowest paid employees.

Some employees will begin seeing higher premiums starting in their December paychecks, according to Trisha Posey, Wake’s chief finance officer.

“While these changes are necessary to sustain the State Health Plan, we recognize they create additional financial pressure for our employees, especially since at this time we have not seen across-the-board state raises,” Posey told school board members.

Across-the-board increases for most Wake employees

State Health Plan premiums will decrease for some people, such as some groups of employees who are covering their children.

But 69% of Wake’s employees in the plan have employee-only coverage. This category will see across-the-board premium increases that will double in some cases.

The annual deductible in the Standard Plan will double from $1,500 to $3,000 a year for employee-only coverage. The deductible in the Plus PPO plan for employee-only coverage will only increase by $250, but they have higher monthly premiums than the standard plan.

In addition to the premium and deductible increases, the State Health Plan will have higher out-of-pocket costs for things such as prescriptions, primary care visits and hospital visits.

A beginning Wake teacher making less than $50,000 a year with employee-only coverage would see their monthly premium go up $10 in the standard plan and $16 in the plus plan.

A Wake teacher making between $50,001 and $65,000 a year with employee-only coverage would see their monthly premium double to $50 a month in the standard plan. It would go up 88% to $94 a month in the plus plan.

School board chair Chris Heagarty said some employees questioned if the district had overestimated their new premiums. Heagarty said the state had mistakenly told school employees that State Health Plan premiums would be based only on their state base salary.

In reality, Heagarty said, the premiums for school employees also include the local salary supplements that they get from school districts.