Annual North Carolina Health Insurance Market Update
The following contains information for our NAHP Alternative Health Plan Solutions and ACA/Obamacare plans for individuals and small businesses in the state of North Carolina.
North Carolina Alternative Health Plan Solutions Updates
IMPORTANT NOTE: All non-ACA/Obamacare alternative plans are available year-round. For both individuals and small groups. There is NO limited (open enrollment) period for these options.
Health Insurance Buffet - Individual Alternative Plans
North Carolina is one of our states that continues to have the MOST options available for alternative health plans going into 2022. For those who do not qualify for a tax credit subsidy to help pay for an ACA/Obamacare plan, we have a STRONG “health insurance buffet” of alternative plans.
Our Primary Plan lineup has expanded and improved:
With our Primary Fixed Benefit plans we now offer the following:
Manhattan Life – Their newest and best fixed benefit plan - Affordable Choice Enhanced Fixed Benefit Plan. NOTE: The Affordable Choice plans have the BEST inpatient hospital coverage of any fixed benefit plan available today. They have also significantly upgraded their overall coverage.
Philadelphia American – Their newest and best fixed benefit plan – Health Saver Plus Gold. NOTE: The HSP Gold plan offers the BEST overall coverage of any fixed benefit plan in the market.
Our other Primary plan option - Short Term Medical (STM) plans are now available for duration's of 30 days up to as long as 36 months! We now offer plans from four great companies:
National General – Includes their STM plans with multiple deductible/coinsurance options for up to 36 months. Plans use the Aetna nationwide PPO networks.
IHC Group - Includes their best, updated STM plans with multiple deductible/coinsurance options for up to 36 months.
United Healthcare – Also offers multiple STM plans for up to 36 months.
Pivot Health – Includes their Classic STM plans that have unique “No Network” plans for up to 24 months.
North American Health Plans STM – NAHP has partnered with US Fire Insurance CO to offer the new Aspen or Choice Advantage STM plans for up to 36 months.
IMPORTANT TIP: In North Carolina, whenever possible we recommend combining one of the Fixed Benefit plans together with a Short Term Medical plan above. The Fixed Benefit plan pays “first dollar” benefits for charges that are applied to your annual deductible on the Short Term Medical plan, which lowers or eliminates your out of pocket costs. This is a “best of both worlds” package with a much larger choice of providers that can still be LESS than a high deductible ACA/Obamacare plan!
Our Supplemental Plan lineup has also expanded and improved:
REMINDER NOTE: All these supplemental plans pay in addition to ANY other coverage you have. So, they are NOT just for our alternative “buffet” plans. They can reduce/eliminate out of pocket costs (plus provide additional cash for bills and other costs) of ANY primary health plan (group, individual, Medicare, etc.)
Accident Plans – In addition to accident supplemental plans from all our Primary plan companies (above), we offer separate LifeSecure Accident plans.
Critical Illness Plans – Again, along with plans from all our Primary plan companies, we offer separate LifeSecure Critical Illness plans.
Accident + Critical Illness Plans - We have a new plan from the IHC Group called Metal Gap 2. This is a guaranteed issue product that offers $2,500 to $10,000 of both Accident and Critical Illness coverage.
Cancer and Dread Disease Treatment – This is my favorite addition to our supplemental plans. Manhattan Life Cancer Care Plus Cancer and Dread Disease treatment plans. For those who choose one of Philadelphia American’s Fixed Benefit plans, their new Specified Disease plan is the preferred option for getting maximum coverage for Cancer and other Dread Diseases.
First Day Hospital Stay Protection – Along with plans from most of our Primary plan companies, Manhattan Life Out of Pocket Protection Plan is my favorite to include with whatever primary health plan YOU have. That includes employer group plans, Medicare, etc. We have a new plan from the IHC Group called Independence Hospital Insurance. This plan is a little more expensive than the Manhattan Life base plan, but includes outpatient surgery coverage in addition to inpatient hospital coverage.
Hospitalization Buy-Up - We have a new plan from Enrollment First. When paired with their SelectMed Pro or Max plans (see below), this plan provides an extra $50,000 or $100,000 of inpatient hospital coverage. This can be a great addition to a Fixed Benefit plan as your primary coverage to provide extra protection for hospitalization.
Preventive Care Plus Plans – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we offer the Enrollment First SelectMed plans.
Prescription Drug Plans For anyone who needs extra coverage for high cost prescriptions, we offer the SHA SCRIPTS program that includes their SHARx prescription drug plan. This plan works with our alternative plans and any employer plan with a high deductible for non-preferred brand and specialty prescriptions.
More information on all plans above can be found on each company’s page on our website and on our US Supplemental Coverage page.
NOTE: You can also combine one of the above Fixed Benefit plans OR STM plans together with Accident, Critical Illness, Cancer Treatment, Hospital Indemnity and Preventive Care (Plus) plans and create a comprehensive plan that will still be at least 15-20% LESS than a high deductible ACA/Obamacare plan!
Small Group Alternative Plans
In addition to the three companies we already have (National General, Allied National (26+) and Trustmark), we have added three new companies that offer as many as seven different plan administrators that provide cost-saving, level funded alternative group health plans. Level funded plans can be a BETTER option for many businesses than the “one size fits all” ACA/Obamacare small group health insurance plans.
If you own, or work for a business with 5 to 50 employees covered on a “traditional,” fully insured group health plan, and believe the covered group members to be reasonably healthy overall, then it might be time for your company to explore a level funded plan.
To get quotes on a level funded group health plan, please schedule a call with us to review your situation. We will also need you to fill out our Group Census spreadsheet and email it to: email@example.com.
North Carolina 2022 ACA/Obamacare Health Insurance Market Updates
The following are some of the biggest updates/changes in the ACA/Obamacare individual market in North Carolina.
As of 2021, there are six insurers that offer plans in North Carolina’s marketplace. But Aetna CVS Health will join them as of 2022, with plans available for purchase starting November 1, 2021. The Aetna CVS plans will be available in 70 counties, covering most of the state.
There are also filings in SERFF for two additional insurers that plan to join North Carolina’s marketplace in 2022: Friday Health Plans and AmeriHealth Caritas. Those filings are still under review as of August 2021, however, and it’s not certain that they’ll be approved to offer coverage in the state
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in North Carolina.
North Carolina 2022 ACA/Obamacare Rate review:
North Carolina 2022 Preliminary Rate review:
NOTE: Final approved rates are not readily available at the time of this writing. We will do our best to update this page with the approved rates as soon as we can.
North Carolina preliminary 2022 individual plan rate filing requests are as follows:
Ambetter - requested an average decrease of 5.1% varying by plan (not finalized yet)
Blue Cross Blue Shield of NC - requested an average increase of 9.43% varying by plan and network (not finalized yet)
Bright Health - requested an average increase of 8.23% varying by plan and network (not finalized yet)
Cigna - requested an average increase of 6.46% varying by plan (not finalized yet)
Oscar Health - requested an average decrease of 1.98% varying by plan (not finalized yet)
United Healthcare - requested an average decrease of 6.06% varying by plan (not finalized yet)
North Carolina small group market rate filing requests look like this
Aetna - requested an average increase of 4.84% varying by plan and network (not finalized yet)
Blue Cross Blue Shield of NC - requested an average increase of 6.46% varying by plan and network (not finalized yet)
FirstCarolinaCare – requested an average decrease of 15.14% varying by plan and network (not finalized yet)
United Healthcare - requested an average increase range of 13.82% to 14.47% varying by plan and network (not finalized yet)
North Carolina 2022 ACA/Obamacare Approved Rates:
North Carolina individual plan approved rate filings are as follows:
Ambetter - Received an average increase of % varying by plan
Blue Cross Blue Shield of NC - Received an average decrease of % varying by plan and network
Bright Health - Received an average increase of % varying by plan and network
Cigna - Received an average decrease of % varying by plan
North Carolina small group market approved rate filings look like this:
Aetna - Received an average decrease range of % to % varying by plan and network
All Savers Insurance (United Healthcare) - Received an average increase of % varying by plan and network
Blue Cross Blue Shield of NC - Received an average increase of % varying by plan and network
FirstCarolinaCare – Received an average increase of % varying by plan and network
United Healthcare - Received an average increase range of % to % varying by plan and network
US Healthcare Resources and Shopping Services
I invite you to go to my US Healthcare Resources page and spend some time going through all of the different tools, services and providers that are available to help you become a better health care consumer. I believe these resources can help you lower your overall health care costs no matter what primary health insurance you have.
U.S. Insurance Solutions is here to help
Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.
To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.