Cost Control Strategies and 2027 Benefit Restructuring Strategies On the Table at State Health Plan Meeting

One year after the State Health Plan (Plan) urgently needed to correct massive deficits, it is now squarely focused on cost-control strategies. In a meeting today, the Board of Trustees was briefed on the financial outlook of the Plan and took a vote on 2027 benefit design changes. The vote aims to strengthen the Preferred Provider Program by utilizing a three-tier network structure meant to encourage members to choose high-value providers.

"We have to keep our eye on the ball this year," said State Treasurer Brad Briner. "We are all in this fight together to keep the Plan sustainable. Our focus in 2026 is ensuring members receive high-quality care at the best possible value. This is how we protect affordable premiums and stable benefits for the teachers, state employees and retirees."

The Preferred Provider Program allows members the opportunity to save money by choosing a preferred provider, while providers benefit from increased patient volume and shared savings. The math shows this is a win-win-win for everyone. Today's vote allows the Plan to move forward with a three-tier network structure for this program in 2027. This gives more flexibility in choice for members. The final dollar amounts (copays) associated with the tiers will be voted on at the June 5, 2026, meeting.

The meeting also included updates on the Lantern Surgical Benefit. Several major expansions to the benefit have been announced this month including Novant Health and EmergeOrtho. Lantern connects members with high-quality providers for certain procedures and reduces the out of-pocket costs to members to $0. At the same time, Lantern surgeries lower overall expenses for the Plan.

"Our goal at the outset was to get our members to the best of the best providers, while cutting their costs dramatically," said State Health Plan Executive Administrator Tom Friedman. "The recent addition of two highly regarded surgical partners with locations throughout the state bring this care close to home for our members, while generating savings for the Plan."

State Health Plan Board of Trustees materials are posted to the Plan's website.

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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