• Rate decrease means $120 million reduction in health care costs for 2019
  • First individual market rate decrease in Blue Cross NC history
  • Blue Cross NC Remains Only Insurer to Offer ACA Plans in All 100 Countie


Durham, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced today that the North Carolina Department of Insurance (NCDOI) has approved its 4.1 percent average rate reduction for 2019 Affordable Care Act (ACA) plans offered to individuals. The reduction marks the first rate decrease in the history of Blue Cross NC since entering the current individual market more than 25 years ago. The reduction was made possible in large part due to new provider arrangements that will reduce medical costs by $120 million in 2019.


“The biggest key to lowering rates is reducing health care costs. Our new provider arrangements do that by making both parties responsible for the quality and total cost of care,” said Dr. Patrick Conway, President and CEO of Blue Cross NC. “An average decrease is good news for many families, but we can’t lose sight of the fact that premiums are still too high – particularly for those who don’t get a subsidy. To keep driving premiums down, we need more market stability and more certainty from Washington.”


During the first three years of the ACA, Blue Cross NC lost more than $450 million dollars on the plans. Despite these losses, the insurer remained committed to offering coverage in all 100 of North Carolina’s counties. Those losses, however, necessitated rate increases. Now, for the first time since entering the ACA marketplace in 2014, Blue Cross NC is able to reduce rates by an average of 4.1 percent. Blue Cross NC is proud to serve over 475,000 ACA customers and expects to once again be the only ACA insurer in all 100 counties.


Federal tax credits known as premium subsidies are still available for customers with household incomes between 100 and 400 percent of the Federal Poverty Level. About 90 percent of Blue Cross NC current customers with ACA plans qualify this year. Subsidies vary by plan and household income. Open enrollment begins on November 1, 2018.


As always, rates vary based on location, age, subsidy amount, and plan. Individual premiums will be available in October. Blue Cross NC’s ACA rates for 2019 range from a 22 percent reduction to a 9.5 percent increase.


New Provider Arrangements Lower Costs


Through new arrangements with regional providers, Blue Cross NC will be reducing pre-subsidy premiums in Charlotte and Gastonia by 16.5 percent. The rate reductions were made possible through collaboration with Blue Cross NC’s provider partners.


Blue Local with Atrium Health and Blue Value with Novant Health and Caromont will continue to be offered.


The average Blue Value price reduction is $173 a month before subsidies. The average Blue Local with Atrium Health price reduction is $87 a month before subsidies. Benefits will remain similar. Blue Cross NC insures around 110,000 individual ACA customers in the Charlotte and Gastonia region.


Blue Cross NC is also reducing rates by more than 21 percent in the Triangle. The reduction is due to a new agreement with UNC Health Alliance which will allow Blue Cross NC to reduce rates for Triangle customers by a pre-subsidy average of $140 a month. Benefits will remain similar. Blue Cross NC insures around 90,000 individual ACA customers in the 10-county region where Blue Value with UNC Health Alliance will be offered.


Through our Blue Value Plan, UNC Health Alliance will be the in-network provider for Blue Cross NC ACA plans in the Triangle in 2019. Blue Cross NC will no longer offer its Blue Local product with Duke Health and WakeMed. Blue Cross NC has about 50,000 customers residing in 12 counties currently enrolled in the product. Blue Value with UNC Health Alliance customers will have access to an extensive network of high-quality providers in the Greater Triangle region. 


Duke and WakeMed are still in-network for other Blue Cross NC products, including the majority of group plans, Blue Advantage, Blue Select, Medicare Advantage, FEP and State Health Plan.


Blue Local with Duke Health and WakeMed will stay in place through the end of 2018. Blue Local customers can continue seeing their current doctor until the end of the year.


More information on this transition is available at www.BlueCrossNC.com/ReadyToRenew.


The Triangle, Charlotte and Gastonia regions account for roughly 40 percent of Blue Cross NC’s individual, under-65 ACA members.


2019 Regional Rates and Plans


Although some areas will see a rate increase, all requested county increases are less than 10 percent.


Products available in these regions may include broad network Blue Advantage and Blue Select plans.


Transitional Plans


The requested rate increase for transitional plans in 2019 is 9.8 percent. These plans were purchased between March 2010, when the ACA was signed, and October 2013 when regulations went into effect. Transitional plans cannot be sold to new customers because they do not meet ACA requirements. Currently, there are 41,500 members with these plans.