The State Health Plan has announced its 2026 Open Enrollment period, which will run from October 13–31, 2025. During this time, members will have the opportunity to review benefit options, make changes to their coverage, and ensure their health plan selections meet their needs for the coming year.
For 2026, the Plan will continue to offer two Preferred Provider Organization (PPO) options:
Standard PPO Plan (formerly Base PPO 70/30): All current members will automatically transition into this plan unless they take action to choose the Plus PPO option or make dependent coverage changes.
Plus PPO Plan (formerly Enhanced PPO 80/20): Members wishing to enroll in this plan must take action during Open Enrollment.
Key Reminders and Updates:
The tobacco attestation requirement has been eliminated.
Monthly premiums will continue to be based on the subscriber’s salary and will be displayed online during enrollment.
Deductibles and copays for both plans have increased for 2026.
Preventive services and medications remain covered at 100%, with no deductible or copay.
The Clear Pricing Project will transition to “Preferred Providers,” offering members lower copays when using participating providers.
A new surgical benefit is being introduced through Lantern. Members who use Lantern providers for pre-planned surgeries will have their procedures covered at no cost. All members will receive a Lantern ID card with additional details.
The State Health Plan has extended hours at its Eligibility and Enrollment Support Center (855-859-0966) during the Open Enrollment period. Representatives will be available Monday–Friday from 8 a.m. to 10 p.m., and Saturdays from 8 a.m. to 5 p.m.
For more information, a full schedule of Open Enrollment events, and detailed plan resources, visit shpnc.gov.