I am a Member Group (Employer)

The NCACC is focused on designing and delivering risk management programs that meet the unique needs and exposures of the counties. The Pools, which are not-for-profit, are governed by a Board of Trustees which is comprised of county elected officials and county government staff.

On this page, you can find the various forms you need to manage your plan.

• Healthy Babies information: Poster | Resource list
• Model Creditable Coverage Notice (As of Jan. 1, 2009 - PDF)
• 2009 Creditable Coverage Guidance for Medicare Part D (As of July 1, 2009 - PDF)
• Enrollment form for NCACC Group Benefits Medical/Dental (PDF)
• Caremark primary/preferred drug list(As of July 1, 2011 - PDF)
• Subscriber Termination Form (PDF) - Remove an employee from medical and dental coverage when the employee leaves employment or has a reduction in hours.
• Member Transfer to Retiree Form (PDF) - Transfer an active employee to retiree status upon the employee's retirement.
• CAPE provider nomination form: Excel spreadsheet | PDF
• 2010-11 Summary Plan Descriptions (PDF): HMO | PPO | Dental
• Find a pharmacy: Log into your account at www.caremark.com, go to My Coverage, and then click on Find a Local Pharmacy.

Don't let the Holidays stress you out!

The holiday season is a wonderful time of year, but it also can be a very stressful time. This month's VitaMin newsletter contains some healthy tips to avoid getting the holiday blues!

• Click here for the December 2010 edition of VitaMin newsletter (PDF)
• Click here for a payroll stuffer for employees.

Appeals

The County Health Plan strives to be responsive to our Member Groups. We encourage our covered Counties to discuss with us their benefits coverage and to present any disputes concerning the coverage we offer to your employees. It is our policy to provide the Member Group a forum to address the decision or action taken by the County Health Plan or its administrators Caremark or CIGNA. Appeals should only be completed by the Member Group, not an individual covered employee, and should be submitted to the NCACC after first and second level grievances at CIGNA have been exhausted. The appeals process in its entirety is outlined in the County Health Plan’s Summary Plan Descriptions provided to our Member Groups on CD in August 2006.

• Appeals form

Can't find what you need? Click on the mailbox icon to e-mail customer service with your specific request.