Rate Information for Public Disclosure

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Federal Health Care Reform in North Carolina

Many North Carolina consumers, insurance industry professionals, employers and Medicare beneficiaries have questions about federal health care reform, also known as the Affordable Care Act.

The information on this website is based on what the North Carolina Department of Insurance has learned from the federal government and is meant to provide a very broad overview of key features of the law. For the most complete and up-to-date information, please visit the federal website www.hhs.gov/healthcare.

Initial Rates - Individual and Small Group Markets

2027 Plan Year ACA Rate Filings

North Carolina Department of Insurance – Life & Health Division

Insurer NameMarketSERFF Filing NumberInitial % Change FiledOn or Off ExchangeProjected Number of Members in Products
Ambetter of North Carolina Inc.#IndividualCECO-1349555838.500%On & Off182,167
AmeriHealth Caritas North Carolina, Inc.IndividualAHCR-1349371029.260%On & Off12,075
Bankers Reserve Life Insurance Company of Wisconsin*IndividualCECO-134955561NewOff857
Blue Cross Blue Shield of NC#IndividualBCNC-13494295917.686%On & Off255,482
Blue Cross Blue Shield of NC#Small GroupBCNC-13493953720.901%Off134,034
Oscar Health Plan of NC, Inc.#IndividualOHIN-13493595716.478%On & Off28,207
UnitedHealthcare Insurance Company#Small GroupUHLC-13493677418.830%Off23,142
UnitedHealthcare of NC, Inc.#IndividualUHLC-13493508027.410%On & Off23,056
UnitedHealthcare of NC, Inc.#Small GroupUHLC-13493676419.560%Off5,319

Generally, according to North Carolina insurance laws, health insurance rates must not be excessive, inadequate, or unfairly discriminatory, and must exhibit a reasonable relationship to the benefits provided in the policy.

Notes

# Insurers whose filings contain any product with any plan with a proposed rate change of 15% or more. Note that the rate filing may also include other plans covering additional North Carolina lives that have proposed rate increases that are less than 15%. This information is also available at the Centers for Medicare & Medicaid Services (CMS) website.

* Insurers filing Individual Coverage Health Reimbursement Arrangements (ICHRAs). Employers fund employee health benefits using tax-free stipends, allowing employees to purchase ACA-compliant plans on the open market.
Final rates may differ from the initial rate filing and will be posted at a later date.

Revision Date: July 28, 2026

Final Rates - Individual and Small Group Markets

Approved ACA Rates for Plan Year 2026 - Individual Market

Approved ACA Rates for Plan Year 2026 - Small Group Market

Rate Filings with Increase of 15 % or More

ACA Rates with Increase of 15% or more for Plan Year 2026

As an "Effective Rate Review State" under federal health care reform, the North Carolina Department of Insurance must make public the information contained in Parts I, II and III of the federal Rate Filing Justification for comprehensive health insurance rate filings with significant rate increases. The threshold for this requirement is 15%.

The information for filings that are subject to this disclosure may be accessed at "Find Rate Review Information at HealthCare.gov"

Click on "SEARCH ACA-COMPLIANT PRODUCTS" if you are searching for products where the plans are compliant with all ACA requirements.

Click on "SEARCH TRANSITIONAL PRODUCTS" if you are interested in plans that began coverage before 2014 or products provided to educational institutions of higher learning which cover students and their dependents, i.e., Student Products.

All Final Rate Filings

Additionally, the North Carolina Department of Insurance must make public the information contained in Parts I, II and III (as applicable) of the federal Rate Filing Justification for all FINAL ACA-compliant comprehensive health insurance rate filings.

"Information - Final Comprehensive Health Insurance Rate Increase Filings"

Users will need to scroll to the bottom of the page under the "Data" section to access the information.

Consumers will find information relating to prior years’ filings at this same link.

For an explanation of the information contained in each Part, please refer to The Center for Consumer Information & Insurance Oversight - Rate Review Data

Provide Public Comment On Comprehensive Health Insurance Rate Filings

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