Aetna to run North Carolina workers' health care as Blue Cross won't appeal ruling

Raleigh, North Carolina — RALEIGH, N.C. (AP) — Aetna is poised to administer health insurance plan benefits for North Carolina state employees and teachers starting early next year, after Blue Cross Blue Shield of North Carolina announced Monday that it would not appeal a judge's ruling in favor of Aetna as the next contractor.

An administrative law judge ruled last week that there was evidence the state health plan properly conducted its procurement process for a third-party administrator, Blue Cross, which has served in that role for more than 40 years. The plan's board of directors selected Aetna for later in 2022 over a subsidiary of UnitedHealthcare, which also competed with Blue Cross. The initial three-year contract with Aetna begins in January 2025.

In announcing its decision not to appeal to the higher court, Blue Cross said it would “continue to provide the highest level of service under our existing contracts with state health plans.”

Administrators manage health care costs for hundreds of thousands of state employees, teachers, their families and retirees, ensure claims are paid and set up provider networks. Contract costs exceed $3 billion annually, including medical claims.

Dale Folwell, the state treasurer and president of the agency that oversees the state's health insurance plans and chairman of its board of directors, welcomed Blue Cross's decision not to appeal. “State health insurance plan members and taxpayers like them deserve an end to this uncertainty,” Folwell said.