Aetna picked to operate North Carolina employee health plan
RALEIGH, N.C. (AP) — Insurance giant Aetna will administer North Carolina’s health coverage plan for state government employees, teachers, retirees and their family members starting in 2025, the State Treasurer’s Office announced Wednesday.
The company won the contract and will replace Blue Cross and Blue Shield of North Carolina, which the State Health Plan said has held the third-party administrator’s job for over 40 years. Aetna would begin with a three-year contract, with the option afterward for two agreements that would last one year each.
Blue Cross, the state’s largest health insurer, said in a written statement that it’s pursuing an appeal of the State Health Plan’s contract award on Dec. 14, and suggested North Carolina residents could lose their jobs in the transition. In the competitive bid process, UMR Inc. also submitted a contract proposal along with Blue Cross and Aetna.
“A change of this magnitude is a great opportunity for a fresh perspective, and we look forward to working closely with Aetna to create new ways to provide price transparency, increase access and quality while lowering the cost of health care for those who teach, protect and serve, and taxpayers like them,” said Folwell, a Republican elected to a second term as treasurer in 2020.
Blue Cross said it was “deeply disappointed” by the State Health Plan’s decision, saying it “threatens North Carolina jobs.” The company also said it would seek more information through a public records request.
Folwell said he’s spoken with top Blue Cross leaders, who “assure me that they will finish strong for the next two years.”
While the plan wields great weight in health care in North Carolina, Folwell and others have been frustrated at times with Blue Cross’ administration, accusing it of opaque decision-making.
Ardis Watkins, executive director of the State Employees Association of North Carolina, a union representing state workers, expressed caution about the changes but said the association is open to hearing Aetna’s plans.
“State employees are always wary of change,” Watkins said, but “it has been our experience that the plan’s leadership has the interests of state employees and retirees at heart.”
Watkins said even more cost savings are needed in the coming years to prevent expenses from falling increasingly on plan members. Folwell has been battling with the state’s hospitals on that front.