Aetna set to run North Carolina worker health care as Blue Cross will not appeal judge's ruling

Aetna is poised to manage health coverage plan benefits for North Carolina state workers and teachers starting early next year because Blue Cross and Blue Shield of North Carolina said Monday it won't appeal a judge's decision that upheld Aetna as the next contract winner.

An administrative law judge last week determined evidence showed that the State Health Plan conducted properly the procurement process for a third-party administrator, which has been Blue Cross for over 40 years. The plan's trustee board in late 2022 chose Aetna over Blue Cross and a unit of United Healthcare, which also competed. The initial three-year contract with Aetna is to begin in January 2025.

In announcing its decision not to appeal to Superior Court, Blue Cross said that it “will continue to provide the highest level of service throughout the current agreement” it still holds with the State Health Plan.

The administrator handles health care expenses for several hundred thousand state employees, teachers, their family members and retirees, ensuring claims are paid and building out a provider network. Contract costs — with health care claims included — exceed $3 billion annually.

State Treaurer Dale Folwell, the trustee board chairman and head of the agency under which the State Health Plan is housed, was pleased with the Blue Cross decision not to appeal. “The members of the State Health Plan and taxpayers like them deserve to have this uncertainty ended,” Folwell said.