The North Carolina State Health Plan will not extend its contract with Aetna into 2028, and instead is seeking bids for its coverage of state workers and retirees, the state treasurer’s office confirmed to Becker’s March 12.
“This administration has different priorities and would prefer a contract that is more in line with those priorities,” the office said. “The plan is seeking partners who support the alignment of incentives between members, providers and the plan. Future partners will assist us with improving health, delivering an excellent member and provider experience while fostering financial sustainability.”
Along with the potential transition away from Aetna, the state also solicited bids this year for its pharmacy benefit manager, a role that has been occupied by CVS Caremark since 2017. In 2025, the health plan and PBM reached an “impasse” over an alleged failure to offer rebates. However, the groups eventually rectified the issue.
Aetna took over the state health plan contract in 2025 after BCBS North Carolina’s 40-plus-year run, securing a three-year agreement through 2027. In 2023, Aetna shared how it had been bolstering its network in the state. Prior to Aetna’s tenure, the plan faced possible insolvency in 2024.
“In close partnership with State Health Plan staff, we successfully executed the first third-party administrator transition in decades, and we remain committed to improving the overall health and well-being of State Health Plan members,” an Aetna statement shared with Becker’s said. The company said it does not comment on future bids, especially leading up to requests for proposal, but added that RFPs are “routine.”
The North Carolina State Health plan encompasses more than 742,000 members.
