Frequently Asked Questions

Under the current model, employees in lower salary bands pay a higher share of their income for the same coverage as their colleagues who earn more. The new model rebalances the cost share and shields those in lower bands from disproportionate cost increases, so health insurance remains accessible for all of our team members. These premium adjustments also help Duke stay ahead of rising health care costs long term.

Salary tiers and premium changes were developed in partnership with actuarial experts and benefits consultants with the goal of creating stable, sustainable salary bands that provide long-term flexibility.

Duke’s premium increases in recent years have not kept pace with the increased cost we pay per employee as national health care costs have continued to rise, driven largely by increased prescription drug costs. Duke chose to introduce a sliding-scale approach based on salary band to rebalance the cost share and shield those in lower bands from disproportionate cost increases.

Yes, many of our peers have moved to a salary-based model to help address the continued cost increases and help ensure this important benefit remains accessible to all employees.

Placement in the salary tier is based on pay as of July 1 the previous plan year. There is no mid-year tier change if pay increases due to a raise, promotion or increase in work schedule after July 1.

Duke Basic was set to be phased out after 2026, but officials have decided to extend the plan through 2029 to extend the transition for current participants. However, the plan has incurred significant loses which require larger premium increases to ensure stabilization and prevent those losses from raising costs across other plans. The extension provides current participants more time to prepare for the transition to one of Duke’s other medical plans.

Because Duke Basic will be phased out in 2029, the plan will be frozen still to those currently covered by the plan. This will help reduce transition issues when the plan ends.

Duke Basic was set to be phased out after 2026, but officials have decided to extend the plan through 2029 to extend the transition for current participants. However, the plan requires a more significant subsidy by Duke and requires more larger premium increases and the elimination of Duke’s FSA contribution to ensure stabilization to mitigate cost increases that would affect other plans.

Yes, you can elect to make your own contributions to a Health Care FSA if you are enrolled in Duke Basic. You must enroll or re-enroll in the Health Care FSA during Open Enrollment in order to participate in this benefit in 2027.

The Cigna Care HMO plan was designed to provide coverage for employees working in North Carolina but outside the Triangle area covered by Duke Select and Duke Basic. Over the years, Duke’s employee population has spread beyond North Carolina and required a national network of providers. Three other plans now provide a national network of providers with different levels of coverage, eliminating the need for a state-network plan like Cigna Care.

Yes, any benefit-eligible employee can select the appropriate level of coverage to include their spouse, dependent children or family coverage. 

The new premium structure is based on Duke compensation because it is the only earnings information Duke can verify and administer consistently across all employee groups. We introduced this new sliding-scale approach to rebalance the cost share and shield those in lower bands from disproportionate cost increases.

If you are currently enrolled in Cigna Care, your plan will end after 2026. Participants who do not select a new plan during Open Enrollment will be automatically mapped to Duke Options (PPO), which offers similar coverage and a broader provider network. We encourage you to review all available plan options to determine what best meets your needs.

We’ve worked closely with Cigna to improve support services and the administration of claims, and we’re confident in the administration of the plans going into 2027. If you have a specific question about your coverage or a claim, please reach out to the HR benefits team at (919) 684-5600, opt. 1, or Ask about Open Enrollment online.

Employees can call (919) 684-5600, option 1, to speak with a customer service representative to enroll or make changes in their benefits. See times listed below:

• 8 a.m. – 6 p.m. Monday through Friday, October 12 – October 30

Last year, Duke shifted to paperless open enrollment materials to reflect our commitment to sustainability and focus on conservation. All information is now available digitally on the Open Enrollment website. If you prefer a pdf version of the information, please reach out to DukeOpenEnrollment@duke.edu, and we will provide an electronic copy of the 2027 Open Enrollment Guide.