(WGHP) — Blue Cross and Blue Shield of North Carolina submitted its formal protest of the North Carolina State Health Plan’s decision to award the 2025-2027 contract for third-party administrative services to Aetna on Thursday.
The appeal comes after an announcement earlier in January that Aetna had won the contract to replace Blue Cross as the third-party administrator, a position that Blue Cross had held for over 40 years.
Blue Cross says their protest “highlights the limited information and distorted scoring system used during the decision-making process.”
Blue Cross also says it submitted public record requests on Dec. 15 and Dec. 20 “to better understand the State Health Plan’s decision.”
“Blue Cross NC is proud of our long record of serving North Carolina’s teachers, state employees, first responders, county and city employees, and their families. State Health Plan members are more than customers, they are our neighbors, our friends and our family, and we have filed this protest to ensure the best outcome for them, for taxpayers, and for our state.”
Dr. Tunde Sotunde, president and CEO of Blue Cross NC.
There is no timeline for a response to the appeal at this time.
“Blue Cross NC’s focus will remain on providing the highest level of service to the State Health Plan members it is honored to serve,” said Sotunde.
Aetna provided FOX8 with the following response to Blue Cross’ appeal of the decision:
“We submitted an aggressive proposal affirming the State Health Plan’s commitment to high-quality and affordable health benefits. The people who teach, protect and serve North Carolina deserve a health benefits administrator that leads with customer service, quality care and affordability, and Aetna intends to deliver it to them. The hundreds of Aetna employees dedicated to this seamless transition will continue their work without distraction.”
Jim Bostian, North Carolina President, Aetna
