RALEIGH — UnitedHealthcare has apparently dropped its protest appeal over the change in third-party administration of the North Carolina State Health Plan.
With UnitedHealthcare (UMR, Inc.) dropping its appeal, Blue Cross Blue Shield of North Carolina (BCBSNC) remains the only party still engaged in litigation.
“We appreciate UnitedHealthcare’s efforts to win the TPA award for the Plan in 2025. We have a great relationship with them and hope that they will try to earn the business at some point in the future,” NC Treasurer Dale Folwell said in a press release.
In January of this year, Folwell announced that Aetna would assume the State Health Plan’s Third-Party Administrative (TPA) Services Contract starting in 2025. The announcement came after a December 2020 unanimous vote by the State Health Plan Board of Trustees to award the TPA to Aetna following a competitive bidding process.
One of the aspects under consideration in choosing a new TPA was reducing costs and increasing transparency. The full set of bidding contracts and other documents can be viewed on a portal hosted by the State Health Plan: https://www.shpnc.org/2025-transition-aetna-tpa.
In February, protests over the decision filed by BCBSNC and UMR, Inc. were rejected. That same month, BCBSNC notified the State Health Plan that it would pursue the matter in court and had filed a contested case hearing in the North Carolina Office of Administrative Hearings as well as a petition for judicial review in Durham County Superior Court. According to Folwell’s office, the administrative law judge has ordered the case to mediation.
“To sue until you are blue causes chaos and uncertainty; it is not what’s best for those that teach, protect and serve,” Folwell said of the legal actions.
A division of the treasurer’s office, the State Health Plan, provides health care coverage to around 740,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents.
