In Case You Missed It: BCBSNC Gets State Health Plan Contract

Last month State Treasurer Dale R. Folwell, CPA, announced that the State Health Plan Board of Trustees had awarded the Third Party Administrator (TPA) medical claims contract for the State Health Plan to Blue Cross Blue Shield of North Carolina (BCBSNC).

The TPA contract provides the State Health Plan (Plan) with a provider network, health care claims processing and related services. The current TPA contract, also with BCBSNC, expires December 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, providing coverage to 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.

BCBSNC was one of four companies bidding for the contract. UnitedHealthcare (UHC), MedCost, and Aetna also submitted proposals.

The contract will extend for three years to 2021, at which time the Plan will review the performance of BCBSNC and make a decision on issuing another RFP or extending the contract in one-year increments for a total of up to five years.

Listen to a podcast of the State Treasurer’s announcement.


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