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 7.2% average rate increase for individual customers who enroll in Affordable Care Act (ACA) plans in 2023.

This average rate increase, which is below the nationwide inflation rate,[1] reflects Blue Cross NC’s commitment to creating a health care system that is affordable for all.

“While inflation and rising medical costs require us to increase rates for 2023, our rates for an ACA plan offered in 2023 are, on average, lower than they were in 2018,” said Dr. Tunde Sotunde, CEO and president of Blue Cross NC. “Our work over the last five years continues to demonstrate that deeper collaboration with health professionals helps to make health care more affordable for all North Carolinians.”

Despite the rising costs of health care in the U.S., Blue Cross NC is finding new ways to help hold down rate increases and make plans more affordable. These include:

  • Blue Cross NC’s industry-leading Blue Premier initiative, which reduces costs by paying health care providers for meeting quality and cost standards. So far, 12 health systems in North Carolina have signed onto Blue Premier, with 1.4 million members under the care of Blue Premier providers.
  • Negotiating lower costs with drug manufacturers and making sure Blue Cross NC plans cover the most effective drugs at the lowest cost. Recent efforts are having a big impact: After seeing a 13% increase in pharmacy costs for its individual under-65 market in 2021, the overall pharmacy trend for this customer segment in 2022 is currently flat (0.0%).[2]
  • In the Triad, Triangle and Charlotte regions, Blue Cross NC will continue to offer Blue LocalSM and Blue HomeSM plans. These plans’ average monthly rates are $100 to $220[3] lower than a similar broad network PPO plan.
  • Lowering deductible amounts – by up to $2,300 – on most of the plans offered in the individual ACA market in 2023.

“In order to keep North Carolinians healthy, we must connect our customers to affordable health care,” said Dr. Sotunde. “As we continue to address the underlying causes of high costs, more of our members will be able to access high-quality care, no matter where they live.”

Individual premiums will be available in October. Open enrollment for individual under-65 ACA plans begins on November 1, 2022 and ends on January 15, 2023.

Rates are largely determined by the cost of members' medical claims, and rates vary based on location, age and plan. For individual ACA customers, customers’ premium amounts depend on federal premium subsidy levels, which will be determined in October. About 85% of Blue Cross NC’s current customers with individual ACA plans qualify for subsidies for their 2023 plans. Subsidies vary by plan and household income.

The federal American Rescue Plan Act (ARPA) expanded these subsidies to more individuals, lowering premiums to no more than 8.5% of customers’ household incomes. These expanded subsidies were recently extended for three years, through the federal Inflation Reduction Act.

Blue Cross NC will continue offering renewal of transitional plans in 2023, for both individuals and small groups. These are plans purchased between March 2010, when the ACA was signed, and October 2013 when regulations went into effect. Transitional plans do not meet ACA requirements but are allowed by federal law. The plans cannot be sold to new customers.

[2] Blue Cross NC internal data, January 2021—July 2022.

[3] Based on rates for a 40 year-old non-tobacco user on the lowest cost Silver plan design