NC S159

Increases Board of Trustees contract approval threshold from $500,000 to $3,000,000 for the State Health Plan for Teachers and State Employees.

Clarifies that disabled dependent children may receive coverage beyond age 26 if disability occurred before age 19 (or before age 26 in certain cases) and the child was covered under the Plan on their 26th birthday, with verification required within 60 days.

Modifies administrative review procedures by designating the Executive Administrator (rather than Executive Administrator and Board of Trustees) to determine whether internal appeals qualify for external review under state insurance law.

Exempts the State Health Plan from contested case provisions under Chapter 150B for determinations related to internal appeals and utilization review decisions regarding medical necessity and benefit denials.

Grants Legislative Services Commission employees access to all Plan records and the right to attend Board of Trustees meetings, including executive sessions, upon designation by the Legislative Services Officer.