North Carolina Small Group Health Insurance 2027 | Thrive

North Carolina · Small group · 2027

North Carolina Small Group Health Insurance: 2027 Carriers, Plans and Rates

Updated October 9, 2026

Two carriers filed 2027 small group plans in North Carolina. Blue Cross NC and UnitedHealthcare are selling.

Proposed 2027 increases by carrier: UnitedHealthcare +18.8% to +19.6%; Blue Cross NC +20.9%. Regulators can still lower them.

Get quotes from all two carriersFree. We quote the carriers that didn't publish prices.

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Which carriers sell small group health plans in North Carolina?

One row per brand. Proposed change is each company's average as filed on ratereview.healthcare.gov. Regulators can still lower them.
CarrierNetworks and plan typesWhere it sells2027 plan designsProposed 2027 changePrices
Blue Cross NCNetworks and plan typesBlue Options PPO statewide; Blue HPN EPO in metro marketsWhere it sellsAll 100 counties (Blue HPN: Charlotte, Triad, Triangle, Hickory)2027 plan designsNot publicProposed 2027 change+20.9%PricesQuote only
UnitedHealthcarePOS: UnitedHealthcare Insurance Co. · HMO: UnitedHealthcare of North CarolinaNetworks and plan types-Where it sellsNot published in public filings2027 plan designsNot publicProposed 2027 change+18.8% to +19.6%PricesQuote only

What's changing for North Carolina small group health insurance in 2027?

  1. Average proposed 2027 changes range from +18.8% to +20.9%, as filed. Your group's change also depends on employee ages and the plan you pick.

  2. All three filers proposed averages near 20%: Blue Cross NC +20.9%, UnitedHealthcare Insurance Co. +18.8%, UnitedHealthcare of North Carolina +19.6%. All are still pending state review.

  3. Every North Carolina small-group carrier asked the state to keep its rate tables trade secret. Prices come from a quote.

  4. Blue Cross NC's 2027 filing says broker commissions will be billed as a separate agent fee instead of built into premium.

Charlotte skyline at dusk with the Bank of America tower and city lights reflecting on the water

North Carolina small group rules employers ask about

Who counts as a small employer

  • 1 to 50 employees, counted as full-time equivalents.
  • You need at least one employee who isn't the owner or owner's spouse.

G.S. 58-50-110(22b); 29 CFR 2510.3-3

How premiums are set

  • By age (federal 3:1 curve), rating area (16 areas), family size and plan.
  • Tobacco load capped at 1.2:1; Blue Cross NC charges none for 2027.
  • Your rate is locked for 12 months from issue or renewal.

G.S. 58-50-130(b1), (i); CMS state rating

Participation rules

  • Carriers may set participation and contribution minimums by group size.
  • Employees with other qualifying coverage (a spouse's plan, Medicare, Medicaid) don't count against you.

G.S. 58-50-130(a)(4a)

When you can enroll

  • Any month if you meet participation and contribution rules.
  • Miss those rules and you can still enroll November 15 to December 15 for a January 1 start.

45 CFR §147.104; NCDOI

Level-funded plans start at 12

  • North Carolina bars stop-loss for groups under 12 eligible employees unless it meets small-group rating rules.
  • Blue Cross NC Balanced Funding starts at 12 eligible employees.

G.S. 58-50-130(a)(5)

Tax credit and SHOP

  • The credit pays up to 50% of premiums but needs a SHOP plan.
  • No North Carolina carrier offers SHOP medical for 2027.

IRS Small Business Health Care Tax Credit; carrier filings

North Carolina small group health insurance FAQ

  1. Blue Cross NC and UnitedHealthcare filed 2027 small-group plans.

  2. Proposed averages run from +18.8% to +20.9%, depending on the carrier. Regulators can still lower them.

  3. Their 2027 rate tables aren't public in the state's filing system. We can quote them for your group.

  4. Only if the one person is an employee other than the owner or the owner's spouse. A sole proprietor with no employees uses the individual market.

  5. All three carriers marked their rate tables trade secret, and the state had not finished its review as of October 9, 2026. Prices come from a quote.

  6. It is a self-funded multiple employer plan run with the NC Chamber and Blue Cross NC for chamber members with 2 to 50 employees. It is not an ACA small-group plan, so state small-group rating rules don't apply to it.

Small group health insurance in other states

Buying for yourself or your family instead? See the Marketplace plan directory.

Where these numbers come from

Reviewed by Jacob Guidi, licensed health insurance agent (NPN 19902041), Thrive Benefits Group.

Thrive Benefits Group is a licensed broker, not a carrier or government agency. Rates shown are filed 2027 rates for one employee before the employer contribution. Your group's quote depends on employee ages, location, plan choice and carrier rules. Proposed rate changes can still be lowered by regulators.