north carolina health exchangeHealth Insurance Options Limited in North Carolina for First Year

Just three insurance companies will be offering individual health plans through the North Carolina health exchange in 2014. Only one company will be offering coverage through the Small Business Options Program (SHOP) for employees of small businesses.

North Carolina health insurance marketplace will be run by federal government, learn more about state health exchanges here. More information on North Carolina health care reform is available at North Carolina department of insurance website.

Three Companies Offering Over 20 Plans

Although Blue Cross Blue Shield, FirstCarolinaCare Insurance Co. and Coventry are the only companies to apply to sell on the North Carolina health exchange, there will be more than 20 plan options for consumers to compare and purchase. This will provide North Carolina residents with a variety of deductibles, copays and premiums to suit individual budgets and needs, even though only Blue Cross operates in all 100 counties in North Carolina.

These plans will appeal to the approximately 800,000 uninsured residents in North Carolina who are expected to purchase health insurance with federal subsidies on the North Carolina health insurance marketplace. Also, an additional 200,000 North Carolinians that already have individual health insurance coverage are expected to drop their current insurance in favor of the cheaper plans through the exchange.

Major Companies Decline to Participate

Three of the largest health insurance companies in the country are taking a wait-and-see approach in North Carolina, at least for 2014. UnitedHealthcare, Cigna and Aetna are worried about competition from the state’s biggest insurer, Blue Cross Blue Shield, which currently covers 85 percent of insured residents. They are also concerned about how the Affordable Care Act (ACA) is going to impact their business model.

Before the law was passed, health insurance companies could refuse to cover people with pre-existing conditions; however, they are no longer allowed to do so under the ACA. The mandated coverage of the sick and elderly could lead to higher medical costs that must be absorbed by insurance companies, leading to higher premiums.

Other States Have More Options

Even though more than 1 million people in North Carolina will be eligible for coverage under the ACA, they will be one of the states to offer the fewest insurance options through the North Carolina health exchange. Other states, such as California, have more than a dozen insurers signed up to offer coverage to residents. However, the number of insurers participating on the North Carolina health exchange is expected to increase in 2015 and beyond.

North Carolina Health Exchange Rates Still Unknown

Until the state insurance department approves the deductibles, copays and premiums submitted by the three insurance companies, rates will not be made public. For this reason, it is not yet known what the lack of competition on the North Carolina health exchange will mean in terms of premium prices.

What is known is that North Carolina rejected a $27.2 million federal grant to set up its own state-run exchange. Instead, they have been given $6.65 million to implement the federally-operated exchange in the state. As a result, there will not be a concerted effort to assist residents in the enrollment process or in promoting the federal tax credits available through the exchange. All outreach will come from federally sponsored outreach efforts.

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