On Wednesday, the North Carolina State Health Plan (SHP) announced that it has canceled the current Request for Proposal (RFP) for Third Party Administrator (TPA) services, as none of the bids received met the RFP’s minimum requirements. The Plan issued the RFP on March 20.

Tom Friedman, executive administrator of the SHP, said at a board of trustees meeting last month that they would have recommendations for the plan’s pharmacy benefit manager (PBM) and third-party administrator (TPA) in July.

According to a press release, SHP will issue a new RFP in the coming weeks and remains in the silent period as staff work to issue another RFP. The goal remains to have the plan’s Board of Trustees approve the contract award later this summer.

“The Plan is committed to the RFP process, which will ultimately deliver the best value of services for our members,” Friedman said in the release. “This process is essential to securing a partner who can help us provide strong and sustainable benefits and an improved experience for those we serve.”

The SHP awarded Aetna as the third-party administrator two years ago.

The new contract would start on Jan. 1, 2028.

Aetna replaced Blue Cross and Blue Shield of North Carolina in January 2025 after it served as the TPA for more than 40 years.

The change occurred in 2023 under former State Treasurer Dale Folwell.

“This administration has different priorities and would prefer a contract that is more in line with those priorities,” said Loretta Boniti, director of communications and media relations for Briner, in an email. “The Plan is seeking partners who support the alignment of incentives between members, providers, and the Plan. Future partners will assist us with improving health, delivering an excellent member and provider experience, while fostering financial sustainability.” 

The State Health Plan issued the RFP for Pharmacy Benefit Services last month and is currently in the silent period for that as well. This contract would be effective Jan. 1, 2028. The CVS concerns have been resolved.

The Board of Trustees also voted unanimously at last month’s meeting to approve the implementation of a three-tier provider network for 2027 that aims to strengthen the Preferred Provider Program (PPP). The network will steer members toward providers, purportedly at a cost savings for both the member and the State Health Plan (SHP), while delivering a volume of patients to preferred providers.

The final dollar amounts (copays) associated with the tiers will be voted on at the June 5 meeting.