In 2024, Blue Cross NC is reducing ACA plan premiums by 4%, saving enrollees an estimated $130 million. This not-for-profit insurer, serving 4.2 million members, negotiates lower drug costs, keeping pharmacy expenses minimal despite national increases. Subsidies based on federal premium levels benefit around 85% of ACA policyholders. Open enrollment for under-65s runs from Nov 1, 2023, to Jan 15, 2024. Blue Cross NC expands its offerings, including the Blue Advantage PPO, and collaborates to provide cost-effective plans, promoting accessible healthcare options.
In 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is implementing a significant reduction of 4% in premiums for individuals and families who choose to enroll in Affordable Care Act (ACA) plans. In a recent press release, plan executives revealed that this move is expected to result in a substantial decrease of approximately $130 million in total premiums. Blue Cross NC, operating as a not-for-profit entity, extends health insurance coverage to a vast membership base of 4.2 million individuals.
The determination of these rates primarily hinges on the cumulative costs associated with members’ medical and pharmacy claims. However, additional factors such as geographical location, age, and specific plan selections also play a role. For individual ACA policyholders, the ultimate premium amounts are contingent upon the levels of federal premium subsidies, which will be established by the Centers for Medicare and Medicaid Services in October. It’s noteworthy that approximately 85% of Blue Cross NC’s current individual ACA plan customers are eligible to receive subsidies for their 2024 plans.
Blue Cross NC has been actively engaged in negotiations aimed at reducing expenses with pharmaceutical manufacturers. Remarkably, despite the 9.4% surge in prescription drug costs across the United States in 2022, Blue Cross NC managed to cap the overall pharmacy cost trend for its individual ACA market at a minimal 0.7% in 2022 and a still modest 2.9% thus far in 2023.
The open enrollment window for individuals under the age of 65, seeking ACA plans, is set to commence on November 1, 2023, and conclude on January 15, 2024. Starting in 2024, Blue Cross NC will extend its Preferred Provider Organization (PPO) plan, known as Blue Advantage, to every county. Additionally, the plan is collaborating with local healthcare systems to offer Blue Local and Blue Home plans, which come with monthly rates that are $100 to $200 lower compared to similar PPO plans. Furthermore, Blue Cross NC is introducing Blue Value plans, available in select counties within the state, offering monthly rates that are $70 to $90 less than similar PPO plan options.