DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced on September 6 that the North Carolina Department of Insurance (NCDOI) has approved a 4% average rate decrease for individual customers and families who enroll in Affordable Care Act (ACA) plans in 2024.

This average rate decrease will lower total premiums by an estimated $130 million and reflects a Blue Cross NC commitment to creating sustainable health plans that are more affordable for all.

“Our rates for an individual ACA health plan are actually 5% lower than they were in 2018, despite the rising costs of health care and overall inflation in the US,” said Dr. Tunde Sotunde, CEO and president of Blue Cross NC. “As the only not-for-profit insurer in all 100 counties of the state, we are bringing savings directly to our members to make their health care more affordable.”

How Rates are Determined

Rates are largely determined by the cost of members’ collective medical and pharmacy claims. 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 by the Centers for Medicare and Medicaid Services in October. Factors with a significant impact on 2024 rates include:

• The Blue Cross NC industry-leading Blue Premier initiative reduces costs by paying hospitals and doctors based on improving patient care rather than only the number of procedures or tests performed. The program has lowered health care costs by approximately $650 million since it began in 2019. More than 1.4 million members are now under the care of Blue Premier providers.
• To address the skyrocketing cost of specialty drugs, Blue Cross NC has worked to negotiate lower costs with drug manufacturers and ensure Blue Cross NC plans cover the most effective drugs at the lowest cost. While pharmaceutical costs in the US grew 9.4% in 2022, Blue Cross NC successfully held down the overall pharmacy trend for its individual ACA market to 0.7% in 2022 and to 2.9%, so far in 2023.

Blue Cross NC is lowering ACA rates in every rating region of North Carolina: regional rate changes range from an average of -0.2% to -6.6%. Individual premiums will be available in October. Open enrollment for individual under-65 ACA plans begins on November 1, 2023, and ends on January 15, 2024.

For more details on this update read the full press release in our Media Center.