State Health Plan Exception Request

 ​Enter HBR Information

 Enter Member Information

 ​Enter Exception Information

To view the Privacy Practices of the NC State Health Plan please visit the link below:


Important Notes:

 1) Items with a * are required fields and will ensure the request can be processed in a timely manner.

 2) Please remember that exception requests can only be submitted by an HBR. Requests submitted by a member will be denied.

 3) If the member does not have a social security number or other ID yet, please enter N/A.

 4) In the reason field, please enter a detailed description for why this exception is needed.

 5) Any supporting documentation should be uploaded to the member's document center record in eBenefits.