North Carolina can switch to Aetna for state worker health insurance contract, judge rules

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North Carolina News

North Carolina State Government,General News,NC State Wire

A North Carolina judge has upheld the state employee health plan’s decision in 2022 to chose Aetna to administer the plan starting next January. Longtime third-party administrator Blue Cross and Blue Shield of North Carolina had challenged the bid process and what it called other errors or failures.

RALEIGH, N.C. — In a legal fight involving two health insurance companies seeking to manage North Carolina’s public employee benefits plan, a judge ruled Monday that the plan’s board acted properly when it switched to Aetna and dropped longtime administrator Blue Cross and Blue Shield of North Carolina.Blue Cross has administered the State Health Plan for over 40 years.

Blue Cross challenged the decision, arguing that the State Health Plan erred in how it decided which company would get the contract and calling the bid process oversimplified and arbitrary. But Administrative Law Judge Melissa Owens Lassiter, who heard the contested case in February, wrote Monday that Blue Cross had not met the burden of proof necessary to show that plan leaders had acted erroneously or failed to follow proper procedures.Already not seeking another term, North Carolina Sen.

Blue Cross said it was disappointed in the ruling but “gratified that the court reviewed the serious questions we raised” about the State Health Plan’s proposal request process. “Blue Cross NC is honored to serve our teachers, public safety officers and state employees and will continue to provide the highest level of service throughout the current contract,” the company said in a written statement.

State Treasurer Dale Folwell, the trustee board chairman, praised the ruling, saying it had been clear that the State Health Plan “performed a well-reasoned, high-integrity, and correct procurement process for third-party administrative services.” Aetna North Carolina market president Jim Bostian said several hundred of its employees so far have worked on implementing the contract on time “while demonstrating in court that the transition to Aetna is in the best interests of the State Health Plan and its members.”

 

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