North Carolina: *Final* avg. unsubsidized 2025 #ACA rate changes: +7.0% (updated)

Originally posted 9/09/24

Ah, at last, another state which includes both the average requested rate changes for 2024 as well as the number of enrollees each carrier has for both the individual and small group markets in clear, transparent language!

Generally, according to NC 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.

Overall, individual market carriers in North Carolina are requesting 7% rate increases in 2025 for unsubsidized policies, while small group market carriers are asking for a 6.5% bump. It's worth noting that one of the three (!) UnitedHealthcare divisions is pulling out of the NC small group market next year for whatever reason.

It's also worth noting that North Carolina's total individual market (including off-exchange enrollees) is only 778,516 people, which is smaller than its on-exchange only effectuated enrollment as of February of 987,666. This is due to the state finally expanding Medicaid to residents earning up to 138% of the Federal Poverty Level last winter, which had over 520,000 people enrolled as of August. Since ACA exchange subsidies start at 100% FPL, that means a significant chunk of the 987K enrolled in exchange plans in February have since transitioned over to Medicaid instead.

UPDATE 10/29/24: With just 3 days to go before the 2025 Open Enrollment Period launches, the North Carolina Insurance Dept. has published their final/approved 2025 rates for both the individual and small group markets...and practically nothing has changed.

The individual market carrier rate requests were approved practically as is, while small group plans were bumped up slightly more than the carriers requested (the only significant change was to Aetna Life Insurance Co, which asked for a 13.2% bump but ended up raising rates by 15.5%).