Insurance company Aetna will take over third-party management of the North Carolina State Health Plan in 2025 if a ruling made Monday by an administrative law judge stands.

About 740,000 current and retired state government workers and family members receive health insurance through the state plan. For decades it has been run by Blue Cross Blue Shield of North Carolina.

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The board in charge of the plan voted last year to award the $3 billion third-party management contract to Aetna starting in 2025. Blue Cross sued, claiming the decision was made due to errors and an unfair scoring process used by the state.

Administrative Law Judge Melissa Owens Lassiter wrote in a ruling Monday that Blue Cross failed to prove its claims.

"The evidence showed that the plan conducted the procurement carefully and thoughtfully, fairly and in good faith, and that its decisions were properly within its discretion," she wrote.

Aetna is scheduled to take over management of the plan on Jan. 1. The start date could be pushed back, however, if Blue Cross appeals Monday's decision. The company has 30 days to file an appeal in Superior Court.

"We will carefully review the ruling and consider any appropriate next steps," Laura Eberhard, a Blue Cross Blue Shield of North Carolina spokeswoman, said in an email.

Many of the legal arguments revolved around the process the health plan used to score insurance companies on their ability to guarantee some technical issues with administering the plan, as well as how low they agreed to keep costs.

Blue Cross contended that the state put its thumb on the scale by incorrectly scoring the cost side of the equation and also putting too much weight on the technical side. If the scoring had been done fairly, Blue Cross argued, its bid would have been tied or outperformed Aetna’s. Blue Cross also said that it should have been credited for offering more providers in suburban and rural areas of the state, suggesting that if it lost the contract, people in those areas could lose their doctors.

Aetna said its plan offered more providers in urban areas — where state employees tend to be clustered. The company denied that it received the contract because of errors or bias. Even if there were errors, Aetna argued, they weren't significant enough to force the state to give the multibillion-dollar contract back to Blue Cross. Aetna also contended that even though its bid will be slightly more expensive for the state, it offered to pay higher penalties for missing financial goals than Blue Cross.

"While we are disappointed in the court’s ruling, we are gratified that the court reviewed the serious questions we raised about the State Health Plan’s 2022 [request for proposals] process," said Eberhard, the Blue Cross spokeswoman. "State Health Plan members and the public deserved an independent review of the plan’s RFP process, which failed to select the bid that offered the lowest cost and the broadest network."

She added: “Blue Cross NC is honored to serve our teachers, public safety officers and state employees and will continue to provide the highest level of service throughout the current contract.”

North Carolina Treasurer Dale Folwell, the chairman of the health plan’s board, said in a statement that the plan performed “a well-reasoned, high-integrity and correct procurement process for third-party administrative services.”

“This process clearly revealed that Aetna’s bid was superior to Blue Cross NC’s, and the plan’s board of trustees properly approved the contract’s award to Aetna,” he said.

Aetna celebrated the ruling Monday.

"We have been working on the impending, seamless transition at full speed all while demonstrating in court that the transition to Aetna is in the best interests of the State Health Plan and its members," Jim Bostian, Aetna's North Carolina market president, said in a statement. ... We are on schedule to begin serving the State Health Plan on Jan. 1, 2025, with our robust statewide network of providers in all 100 counties."

WRAL State Government Reporter Will Doran contributed to this report.