Why the rate hike?
Open enrollment for the state health plan is underway for over 750,000 employees, which includes public school educators. Many will see increased health insurance premiums this year because of an August vote from the Board of Trustees of the North Carolina State Health Plan.
According to Republican State Treasurer Brad Briner, it was “necessary to keep the Plan solvent,” as it faced a half-billion dollar deficit. He has since issued statements that he expects the plan to be headed to “a more financially stable path.” It’s more or less a progressive tax, with those employees who make more paying the higher premiums.
The enrollment period opened on October 13 and will close Friday, October 31. Reporting from the NC Newsroom, shows that those who make under $50,000 will pay the least in increased premiums and those who earn more than $90,000 will pay the most. There are also middle brackets around $65,000.
The state offers two plans, one which covers 70% of costs after patients meet a deductible limit, and a more expensive one that covers 80% after deductible. According to the NC Newsroom’s analysis, the 70/30 standard PPO Plan is going from $25 per month to anywhere from $35 to $80, depending on an employee’s income. For the 80/20 Plus PPO Plan, employee-only coverage premiums are going from $50 a month to anywhere from $66 and $160. However, the State Health Plan did decrease some of the costs for those who are adding dependents.
Related: NC State Health Plan votes to hike premiums for many members, part of financial overhaul
Who is paying more?
Bryan Proffitt, the vice president of the North Carolina Association of Educators, said his health insurance premium, which just covers himself with no dependents, went up $20 a month. He’s been in education for 20 years and commented on how he’s seen these plans evolve, shifting more of the copay burden onto employees.
“Just over the course of my [educator] lifetime, we watched this go from 90/10 for free to paying for 70/30 to now paying more for 70/30 all in a context where we haven't seen a meaningful raise in probably two decades,” he said.
This increase comes as educators are still waiting for a raise. The General Assembly decided to end the year without a state budget, so public educators won’t see a salary increase as of yet. New Hanover County Schools had budgeted for a 3% raise from the state.
A NHCS high school teacher, who wishes to remain anonymous for fear of retaliation, said that they have one dependent on their 80/20 standard plan and are in the $50,000-$65,000 salary band. Since they are in the lower brackets, they technically are paying only $1 less each month; however, they say some veteran educators are upset because they are bearing more of the increased premiums.
Another NHCS employee reached out to WHQR about the health plan, they also want to remain anonymous for fear of consequences when using their voice. Like the high school teacher, they picked 80/20 but said they would “gladly go back to the [former plan] if it meant that our veteran teachers aren’t gouged. It’s about being fair across the board. Period.”
The employee added that it’s about $5 less per month out of their paycheck, but now their co-pays are “ridiculously high.”
Angela Whitmore is a retired Cape Fear educator with two decades of experience. She said one of the reasons she signed on in 1999 was that she knew if she continued teaching in North Carolina, her health insurance would be included in her retirement. Whitmore hopes that educators were clearly communicated with on these increases that are set to go into effect soon.
Confusion over how to calculate premiums
However, it looks like there was some miscommunication happening among the hundred-plus of public school districts, at least in terms of how the increased premiums were calculated. Specifically, it was unclear if any local county contribution to employees’ salaries could push them into higher premium brackets.
Proffitt said his organization was getting calls from educators about “being moved into the higher bracket because of their local supplement; they were [told] earlier in the process, before they rolled it out, that it was going to be based on your base salary.”
As it turned out, premiums were calculated with those local supplements. County supplements in New Hanover range anywhere from an additional $7,000 to $12,000 annually.
Holly West-Pauley, a public information specialist for the North Carolina Department of Public Instruction, wrote “NCDPI has been notified by the State Treasurer’s office that there are some discrepancies across public school districts regarding the inclusion of local salary supplements when calculating employees’ 2026 State Health Plan premiums. Under the new plan, premiums are based on employees’ total monthly salary, including any local supplements,” adding, “NCDPI‘s Office of Financial and Business Services is currently assisting LEAs [districts] across the state to clear up any confusion and ensure the correct premiums will be charged.”
WHQR reached out to NHCS to discuss the changes to the state health plan. On October 17, Assistant Superintendent Jennifer Geller wrote, “We will be in touch to provide you with an accurate statement regarding our processes, notifications to employees, and updates from the state that has occurred most recently.”
To date, NHCS has not provided this information.
Declining financial incentives for public educators
Proffitt said these mounting costs for public educators is part of a trend that is adding “one more insult on top of one more injury.”
Whitmore said she feels for new educators coming into the profession, as they're not compensated for Master’s pay, like she was.
Past benefits, like better health insurance and retirement coverage and Master’s pay compensation, often got her through some of the tougher days in the classroom. Now, she said, teachers are going into education with only intrinsic rewards as motivators to stay.
Proffitt adds the additional pain points of the state getting rid of longevity pay and freezing the salaries of public educators who’ve worked 15-25 years. He said additional state revenues are not coming in due to decreasing taxes for corporations and the wealthy.
“We are making a choice to prioritize wealthy people keeping their money over the things that working-class people need,” he said.
Proffitt sees this as a continuation of the lack of funding for public education, a trend that has concerned him for a while – and like Whitmore, said it’s impacting who is coming into the classroom.
“It's actually one of the most heartbreaking things about being an educator, and someone who is an advocate for public school educators in 2025, is a high number of people who are in the profession right now who actively discourage their own children, their students from coming in;” however, he said, they continue to go into teaching because they love and “believe in the potential of young people,” Proffitt said.
Resources
Here is a detailed breakdown on the decision to increase premiums, issued by the Board of Trustees of the North Carolina State Health Plan.
