7 state, federal health plan contract shakeups

State health plan contracts, which provide coverage to thousands of employees and their dependents, can be worth hundreds of millions a year.  

Here are seven state and federal contracts awarded to payers in 2024: 

  1. Blue Shield of California was awarded the California Public Employees' Retirement System PPO contract, which provides coverage to over 400,000 California employees. Blue Shield of California won the contract from Anthem Blue Cross, which held it for more than 20 years.

  2. California selected Elevance Health's Carelon Behavioral Health as the administrative services organization for the state's Child and Youth Behavioral Health Initiative. The contract is worth $400 million and will include credentialing behavioral health professionals, managing claims, and submitting claims to Medicaid and other payers.

  3. New Jersey awarded its state health plan contract, worth $136 million annually, to Aetna and Horizon Blue Cross Blue Shield. The contract covers more than 600,000 New Jersey state and public school employees and was previously held exclusively by Horizon BCBS.

  4. The U.S. Office of Personnel Management selected 32 health plans to administer health benefits for 1.9 million U.S. Postal Service employees and families.

  5. Idaho awarded its state health plan to Regence BlueShield of Idaho over Blue Cross of Idaho. The state health plan covers nearly 62,000 people. Blue Cross has held the contract since 2004 and sued the state over its decision — a final decision on the new contract is pending until the lawsuit is resolved.

  6. Maryland selected Elevance Health's Carelon to administer mental health and substance use disorder services under its public behavioral health system, a contract worth $340 million. The services are currently administered by UnitedHealth's Optum, which did not submit a bid to be considered for the new contract.

  7. North Carolina awarded its state health plan contract, which is worth $17.5 billion over five years, to Aetna. Blue Cross Blue Shield of North Carolina, which held the contract for more than 40 years, is challenging the decision. 

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