North Carolina: *Final* avg. unsubsidized 2024 #ACA rate changes: -1.3% (updated)

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.


  • 2024 Plan Year ACA rate filings assume there will be no risk adjustment provided by the federal government for Plan Year 2024. Final rates may differ from the initial rate filing and will be posted at a later date.

I'd be willing to bet that the recently-passed expansion of Medicaid plays a significant role in North Carolina's overall reduction in 2024 rates for the 2024 calendar year...but that's hard to say since their filings are, once again, heavily redacted (sigh). In any event, overall NC carriers are asking for a 1.3% reduction in individual market premiums and a 3.8% increase for the small group market.

UPDATE 10/31/23: The North Carolina Insurance Dept. has posted the final, approved rates for 2024 (individual market; small group market)...and for the most part they were approved as is, with a few minor tweaks. The most significant change is Blue Cross Blue Shield's small group plans, which jumped from +2% to +4.25%, bringing the overall average increase up from 3.8% to 5.2%: