On Friday, the North Carolina State Plan Board of Trustees (SHP) voted on what are being called monumental changes to the Plan over the next few years, including preferred provider hospital systems, benefit changes, and premiums for 2027, and the announcement of a Third Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) for 2028, in an effort to make improvements and reduce overall costs for the nearly 750,000 members covered by the Plan.
SHP will issue a new RFP in the coming weeks, with the goal to have the plan’s Board of Trustees approve the contract award later this summer.
On Tuesday, the North Carolina State Health Plan Board of Trustees voted unanimously at its meeting to approve the implementation of a three-tier provider network for 2027 that will strengthen the Preferred Provider Program (PPP), which will steer members toward providers at a cost savings for both the member and the State Health Plan (SHP), while delivering a volume of patients to preferred providers.
Blue Cross and Blue Shield of North Carolina will not appeal a judge’s decision upholding the shift of a State Health Plan administrator contract to Aetna. Blue Cross’ decision to drop its legal complaint means the shift will take place as scheduled on Jan. 1.
An administrative law judge has upheld the decision to replace Blue Cross and Blue Shield of North Carolina with Aetna as third-party administrator of the State Health Plan for government workers and retirees. Blue Cross had challenged the process used to grant the TPA contract to Aetna.
North Carolinians who are on the State Health Plan (SHP) for their medical insurance will not see an increase in their premiums for the 2024 benefit year. State Treasurer Dale Folwell
Jim Bostian, Aetna’s market president for North Carolina, addressed the State Health Plan
The North Carolina State Health Plan and State Treasurer Dale Folwell released documents from the Plan’s Request for Proposal process to change its third-party administrator from North Carolina Blue Cross Blue Shield to Aetna at a media event Tuesday.
Blue Cross and Blue Shield of North Carolina will no longer be the third-party administrator for the State Health Plan come Jan. 1, 2025. According to a press release by North Carolina State Treasurer Dale Folwell, Aetna has been awarded the Third-Party Administrative (TPA) Services Contract for the Health Plan.
State Treasurer Dale Folwell has awarded BlueCross BlueShield of North Carolina the Third Party Administrator contract for the State Health Plan. The TPA negotiates contracts with health-care providers and processes claims paid with taxpayer money. BlueCross BlueShield of North Carolina holds the current TPA contract, which expires Dec. 31, 2018. The new contract will...
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