State Treasurer keeps Blue Cross Blue Shield as administrator of State Health Plan

Blue Cross Blue Shield of North Carolina headquarters in Durham. N.C.
Blue Cross Blue Shield of North Carolina headquarters in Durham. N.C.

RALEIGH — At a press conference last week, State Treasurer Dale Folwell announced that the State Health Plan Board of Trustees has again awarded the Third Party Administrator (TPA) medical claims contract to Blue Cross Blue Shield of North Carolina (BCBSNC).

The TPA contract provides the State Health Plan with a provider network, health care claims processing and related services. The current TPA contract, also with BCBSNC, expires Dec. 31, 2018. BCBSNC is also able to provide Population Health Management services which has been previously provided under a separate contract by another vendor. The plan currently spends $3.2 billion a year for member health care according to the N.C. Treasurer’s Office.

“As we move toward implementation, we will reset our relationship not just renew our vows,” said Folwell, a Republican. “As the largest direct purchaser of health care in North Carolina, we will work with Blue Cross Blue Shield of North Carolina and medical providers to reduce complexity and improve Plan affordability as well as increase access for our members and taxpayers.”

The plan is self-funded and provides health care coverage for more than 700,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents. The TPA negotiates contracts with health care providers as well as processes claims that are then paid using taxpayer funds. The BCBSNC proposal kept the potential administrative costs essentially flat.