(a) The State Treasurer shall have the following powers and duties:
(1) Administer and operate the State Health Plan for Teachers and State Employees in accordance with G.S. 135-48.2 and the provisions of this Article.
(2) Set benefits, premium rates, co-pays, deductibles, and coinsurance percentages and maximums, subject to approval by the Board of Trustees. In setting premium rates, the State Treasurer may set a partially contributory rate of zero dollars, subject to approval by the Board of Trustees.
(3) Set the allowable charges for medical and prescription drug benefits, as necessary.
(4) Design and implement coordination of benefits policies.
(5) May offer wellness incentives.
(6) Set administrative and medical policies that are not in direct conflict with this Article.
(7) Adopt and implement, in consultation with the Board of Trustees, utilization review and internal grievance procedures that are substantially equivalent to those required under G.S. 58-50-61 and G.S. 58-50-62. External review of determinations shall be conducted in accordance with Part 4 of Article 50 of Chapter 58 of the General Statutes.
(8) Implement and administer pharmacy and medical utilization management programs and programs to detect and address utilization abuse of benefits.
(9) Establish and operate fraud detection and audit programs.
(10) Expend funds for any independent audit.
(11) Establish procedures to require prior medical approval and implement the procedures after consultation with the Board of Trustees.
(12) Prepare and submit to the Governor and the General Assembly cost estimates for the Plan, including those required by Article 15 of Chapter 120 of the General Statutes.
(13) Disclose to the Governor and the General Assembly changes or additions to the health benefits programs and health care cost containment programs offered under the Plan, together with statements of financial and actuarial effects as required by Article 15 of Chapter 120 of the General Statutes.
(14) Secure and maintain tax qualification of the Plan under any applicable provisions of the Internal Revenue Code.
(15), (16) Repealed by Session Laws 2012-173, s. 3(c), effective January 1, 2013.
(17) Optionally offer Medicare-related options under G.S. 135-48.38.
(b) The State Treasurer may delegate his or her powers and duties under this section to the Executive Administrator, the Board of Trustees, and employees of the Plan. In delegating powers or duties, however, the State Treasurer maintains the responsibility for the performance of those powers or duties. (2011-85, s. 2.10; 2012-173, s. 3(c), 4(b).)
Last modified: March 23, 2014