Beginning January 1, 2014, individual health insurance plans in North Carolina will have to meet the standards of a Qualified Health Plan (QHP). QHP’s cannot refuse coverage or charge higher premiums due to preexisting conditions. In addition, QHP’s will have to cover a comprehensive package of items and services, known as essential health benefits.
In order to minimize confusion, QHP’s will be classified as “metal plans” designated by how comprehensive the plan benefits are. Plan designations, in order from highest to lowest are as follows: platinum, gold, silver, bronze, & catastrophic. For North Carolina residents that qualify for subsidies, the subsidy amount will be based on the 2nd lowest cost silver plan.
There will be a total of 67 Qualified Health Plans offered in North Carolina between
3 2 different companies: BCBS-NC, Coventry Healthcare of the Carolinas, and FirstCarolina. See update below regarding FirstCarolina 2014 NC health plans. Prices and plan availability will vary by region.
Update 9/12/2013 – First Carolina withdraws Exchange application – will not offer 2014 Health Plans in Exchange.
Press release from First Carolina:
PINEHURST — In a communication to the North Carolina Department of Insurance, FirstCarolinaCare Insurance Company, a wholly owned subsidiary of FirstHealth of the Carolinas, announced today that it is reluctantly withdrawing its application to participate in the Federal Health Insurance Exchange (also called the “Marketplace”).
“This was not a step taken lightly,” says Kenneth J. Lewis, president of FirstCarolinaCare Insurance Company. “When we originally proposed participation in the Exchange, we recognized that there were many unknowns for all of us. However, after months of review, there continue to be uncertainties in the Exchange implementation and processes for insurers. After further assessment of the uncertainties related to the Exchange and consideration of our overall business strategy, we reluctantly came to the conclusion to withdraw our application to participate in the Exchange.”
Participation in the Exchange would have been the first time FirstCarolinaCare sold to individuals rather than to groups.
“FirstCarolinaCare proposed participation in the Exchange to initially ensure coverage options for our local community,” says Lewis. “Despite our withdrawal from the Exchange, we believe our community will have viable options for individual insurance coverage.”
The Pinehurst-based insurance company proposed 16 plans to sell in the Federal Health Insurance Exchange and intended to offer the plans in its six-county service area of Moore, Richmond, Montgomery, Hoke, Scotland and Lee counties.
FirstCarolinaCare was the first in the state to release its premium rates for the insurance plans it proposed to sell on the Exchange.
“Transparency is important to us,” says Lewis. “Although we were unsure of the competitiveness of our proposed rates, we felt it was important to share the information as soon as possible. The earlier we could share information about our proposed plans, the earlier people living in our community could begin to take an interest in the Exchange process.”
FirstCarolinaCare will continue to serve its large and small business customers and will continue to offer a Medicare Advantage product for Medicare-eligible individuals in Moore, Montgomery, Richmond, Hoke, Lee and Scotland counties.
“Our goal for 2014 is to continue to focus our efforts on improving the health of our community and provide coverage options where we can be competitive and add the most value to the market,” says Lewis. “The individual marketplace landscape will undoubtedly change in the coming months, and we will re-evaluate our decision next year to determine if it will be a more competitive environment in which to participate.”