This average rate decrease will lower total premiums by an estimated $130 million.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is lowering premiums by 4% for individuals and families who enroll in Affordable Care Act (ACA) plans in 2024. This will lower total premiums by an estimated $130 million, plan executives said in a press release. Blue Cross NC is a not-for-profit plan that provides health insurance to 4.2 million members.
Rates are largely determined by the cost of members’ collective medical and pharmacy claims, but they also 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. About 85% of Blue Cross NC’s current customers with individual ACA plans qualify for subsidies for their 2024 plans.
Blue Cross NC said that it has worked to negotiate lower costs with drug manufacturers. While prescription drug costs in the United States grew 9.4% in 2022, Blue Cross NC was able to hold down the overall pharmacy trend for its individual ACA market to 0.7% in 2022 and to 2.9%, so far in 2023, according to the plan.
Open enrollment for people under the age of 65 for ACA plans begins on Nov. 1, 2023, and ends on Jan. 15, 2024. Beginning in 2024, Blue Cross NC will offer its preferred provider organization (PPO) plan, Blue Advantage, in every county. The plan also is working with other local systems to provide Blue Local and Blue Home plans (with monthly rates that are $100 to $200 lower than a similar PPO), as well as Blue Value plans (with monthly rates that are $70 to $90 lower than a similar PPO plan) in some counties in the state.
Conversations With Perry and Friends: Paul Fronstin, Ph.D.
May 9th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. In this episode, his guest is Paul Fronstin, Ph.D., director of health benefits research at the Employee Benefit Research Institute.
Listen
Value-Based Care Adoption is Slow Across Global Health Systems
May 20th 2025Value-based healthcare programs are mostly used in rich countries and usually only in small parts of health systems. According to a study published in JAMA Health Forum, these tools can be harder to implement because of system problems, not enough long-term information and lack of research in low-income countries.
Read More
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen