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August 13, 2012

FOR IMMEDIATE RELEASE

State Health Plan Board Awards Contracts for Third Party Medical Claims, Related Services

New Plan Options to be Rolled Out Next Year

RALEIGH – The North Carolina Department of State Treasurer announced today that the State Health Plan Board of Trustees approved the award of multiple contracts for health care claims and related services.

  • The Third Party Administration Services contract was awarded to Blue Cross Blue Shield of North Carolina with services beginning July 1, 2013. Blue Cross Blue Shield of North Carolina will provide a network of health care providers, process claims and provide premium billing services.
  • The Eligibility and Enrollment Services contract was awarded to Benefitfocus with services beginning July 1, 2013. Benefitfocus will provide eligibility and enrollment services for active and retired state employees. The Plan and the N.C. Office of State Personnel (OSP) partnered for this portion of the request for proposals (RFP) to streamline the enrollment process for all Plan members and OSP NCFlex participants.
  • The COBRA Administration and Individual Billing Services contract was awarded to COBRAGuard with services beginning July 1, 2013. COBRAGuard will provide a full range of COBRA administration and direct billing services for Reduction-In-Force (RIF) members, former legislators and their surviving spouses.
  • The Medicare Advantage Fully Insured Plan and Related Services contracts were awarded to Humana and United Healthcare and will be an optional service beginning January 2014. In addition to claims processing and customer service, Medicare Advantage offers services to help Medicare Primary members effectively manage their health. By awarding two contracts for this product, the Plan and its Medicare-eligible members will have greater flexibility and choice.

A listing of bidders by component is outlined in the table below.

​​Third Party Administration Services  - St​andard Products Eligibility and Enrollment Services COBRA Administration and Individual Billing Services Medicare Advantage Fully Insured Plan and Related Services
Blue Cross Blue Shield of NC
United Healthcare
Aon Hewitt
Benefitfocus
Blue Cross Blue Shield of NC
United Healthcare
COBRAGuard
Aetna
Blue Cross Blue Shield of NC
Humana
United Healthcare
 

The Board made its decision based on a desire to offer quality health benefits, provide an excellent member experience, and ensure services are provided at a competitive cost. The potential annual administrative cost savings under the new contracts will be approximately $22.4 million annually, which is a reduction of approximately 19 percent.

There was a high level of commitment by the new Board to a competitive and transparent bid process. The RFP was issued in February, and technical proposals for all components were received on May 2. The RFP was designed to offer the Board of Trustees the flexibility to consider different health care plans that will be in the best interest of members. The intent of the RFP was to solicit partners who are industry leaders equipped to provide customer service, technology, staff and a collaborative approach needed to support the Plan’s employers and members. All contracts have a three and half year term except for Medicare Advantage, which has a three year term.

The State Health Plan provides health care coverage to more than 663,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, state hospital staff and their dependents. The Plan became a division of the Department of State Treasurer effective Jan. 1, 2012.

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