North Carolina state employees, retirees and their families now have until Nov. 6, 2026 to choose 2027 coverage under the State Health Plan. The State Treasurer’s office extended open enrollment after Atrium Health announced a new member discount program less than a week before enrollment began. The Plan says the announcement created confusion among its 750,000 members, and it has asked a court to step in.

What the Treasurer’s office announced

In its Oct. 9 release, the office said open enrollment is extended through Nov. 6, 2026. It told members that Atrium Health’s program does not affect their coverage. The Plan also requested a temporary restraining order in Wake County Superior Court. That is a request, not a ruling, and the release does not say when a judge will take it up.

The Plan’s own website now lists the 2027 enrollment period as running from Oct. 12 to Nov. 6.

Who has to act

Members who use an Atrium doctor or hospital are the ones with a real stake in this fight. Members who see providers in the preferred systems are in a different spot, since nothing in either side’s statement changes their copays.

The Plan’s restraining order request in Wake County Superior Court is the next thing to move, and no ruling has been announced.

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What Atrium put on the table

Atrium, part of Advocate Health, unveiled its program on Oct. 6, according to Becker’s Hospital Review. Starting Jan. 1, State Health Plan members who use Atrium would pay Atrium copays that are lower than the Plan’s own copays for the less-preferred tier. Atrium’s examples for a member on the Standard Plan: an outpatient surgery at a nonpreferred facility would carry a $400 copay, against a $1,000 copay plus a deductible of up to $5,000 and 30 percent coinsurance. An inpatient stay at an Atrium urban hospital would be a $500 copay, against $1,500 plus the same deductible and coinsurance.

Atrium says it is absorbing the cost and that nearly 100,000 Plan members who use its hospitals would otherwise face substantially higher out-of-pocket costs. It also says it offered several proposals starting in July to match the preferred-tier discounts and that the Plan turned each one down.

The Plan’s side of it

The Treasurer’s office called Atrium’s program “a shell game” in an Oct. 6 statement, and said it puts further pressure on premiums beginning in 2028. State Treasurer Brad Briner says that if many members keep using Atrium, the program could cost the Plan more than $100 million next year. He said he believes the program is illegal and that his office is looking at legal options. Atrium rejects that, saying its member discounts are lawful and that its 2027 benefit design, not its prices, drives what members pay.

The dispute grows out of the Plan’s new tiered network for 2027. UNC Health and Novant Health are preferred providers, and Duke Health is an access partner. Atrium was not picked as a preferred system. A Sept. 14 agreement moved Atrium’s rural and children’s hospitals into a lower-cost middle tier, and those adjusted rural provider tiers take effect Jan. 1, 2027.

Which side is right on the numbers is for the court and the Legislature to sort out. The Plan has not said what it would do about its copays if the restraining order is granted.

What the extension means in practice

The extra time applies to everyone who is choosing or changing a Plan option for 2027. The Treasurer’s release does not list what changes at enrollment or what happens to someone who does nothing, so those details come from the Plan itself. Anyone who is not sure whether a doctor sits in a preferred, middle or nonpreferred tier should look that up before choosing, because the tier sets the copay.

The Plan’s website says members can make benefit changes through eBenefits, its member portal. The site gives no step-by-step instructions on the page that lists the enrollment dates, so questions about a specific option go to the Plan.

Finishing enrollment by Nov. 6

The free place to finish is the Plan’s website at shpnc.org, which now redirects to shpnc.gov. The enrollment dates, the eBenefits login and the Plan’s updates on Atrium are all there. The Treasurer’s office says Atrium’s program does not change coverage, so the choice between Plan options can be made on the Plan’s own terms.

Before logging in, it helps to list every doctor, clinic and hospital a household uses, and to note which health system each belongs to. Add the prescriptions each person takes. With that list in hand, a member can compare options against the tiers instead of guessing at them.

The court request and any new statement from the Plan or from Atrium will be the next news. Until then, the Treasurer’s two releases and the Plan’s website are the places the state is putting its position on the record.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.