Judge Allows NC to Choose Aetna for State Employee Health Coverage
TL/DR –
In a legal dispute between two major health insurance firms, a judge ruled that the board of North Carolina’s public employee benefits plan acted correctly when it replaced Blue Cross Blue Shield with Aetna. The plan, which has annual contract costs exceeding $3 billion, impacts several hundred thousand state employees, teachers, their families, and retirees. Despite Blue Cross Blue Shield’s objections to the bid process and accusations of oversimplification and arbitrariness, the judge stated that the company failed to prove that the plan’s leaders acted improperly or failed to follow due process.
Aetna Wins Public Employee Benefits Plan Contract in North Carolina: Judge Rules
A state judge has ruled that the board of North Carolina’s public employee benefits plan acted within its rights when it selected Aetna over Blue Cross and Blue Shield of North Carolina and a unit of United Healthcare. This decision is significant in the backdrop of a legal battle involving the two health insurers vying to administer this insurance plan.
Blue Cross has managed the State Health Plan for over four decades, handling medical expenses for hundreds of thousands of public servants, educators, their dependents, and retirees. With annual contract costs exceeding $3 billion, the switch to Aetna after a bidding process marks a significant change.
Blue Cross questioned the fairness of the bidding process, suggesting that it was oversimplified and arbitrary. However, the Judge, Melissa Owens Lassiter, in her decision, stated that Blue Cross failed to provide enough evidence to establish that there were errors in the process or a failure to follow correct procedures.
“The bulk of the evidence demonstrated that the plan conducted the procurement process diligently, equitably, and in good faith,” wrote Judge Lassiter in her ruling, affirming the board’s decision to award the contract to Aetna.
Blue Cross expressed disappointment at the decision but acknowledged that the court had taken their concerns seriously. They pledged to continue offering the highest level of service for the duration of their existing contract.
Drawing attention to the integrity of the procurement process, State Treasurer Dale Folwell, who is also the chairman of the trustee board, lauded the court ruling. Aetna North Carolina’s market president, Jim Bostian, also echoed these sentiments, emphasizing the dedication of his team in proving in court that the transition to Aetna is in the best interest of the State Health Plan members.
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