By Jordan Meadows
Staff Writer
North Carolina Insurance Commissioner Mike Causey, joined by Gary Salamido, president of the North Carolina Chamber, and Fran Gary, senior vice president of Blue Cross NC, announced the launch of Carolina HealthWorks—a new health insurance initiative designed to help small businesses across the state provide more affordable and predictable health coverage for their employees.
The announcement took place Tuesday afternoon at the N.C. Department of Insurance building in Raleigh.
Carolina HealthWorks operates as a Multiple Employer Welfare Arrangement (MEWA)—a structure that allows small companies to pool their resources to purchase health insurance as a group. In effect, participating small businesses can gain access to the kind of competitive insurance rates typically reserved for large corporations.
“In essence, they’re getting rates like a big company with hundreds of thousands of employees would get,” Commissioner Mike Causey explained. “These smaller employers are able to get that same benefit.”
The North Carolina Department of Insurance (NCDOI) licenses and regulates MEWAs through its Life and Health Division, which reviews initial and renewal applications and oversees ongoing compliance. Causey thanked state legislators, Attorney General Josh Stein, and the Department of Insurance for their swift approval of the plan, calling the turnaround “a record time of approval.”
“We’re constantly working with the insurance industry to keep insurance rates as low as possible,” Causey said. “That’s hard to do when it comes to health insurance because of skyrocketing costs at hospitals and other healthcare costs. But I see this as a good opportunity.”
According to officials, Carolina HealthWorks will be administered through an NC Chamber Health Trust, with Blue Cross NC serving as the plan administrator.
“This is a new and innovative health plan designed specifically for small businesses across our state,” said Gary of Blue Cross NC. “We are proud to be chosen by the NC Chamber to administer this plan, and we appreciate the leadership of Commissioner Causey and his team.”
Gary Salamido, president of the NC Chamber, emphasized the importance of the new initiative to the state’s economic backbone:
“Small businesses are the backbone of the North Carolina economy; yet they face some of the steepest challenges when it comes to affording health coverage for their team,” Salamido said. “With the launch of Carolina HealthWorks, we’re giving small business owners access to affordable, predictable healthcare coverage—something they’ve been needing and asking for a really long time.”
Under the MEWA model, “each company that comes in — their employees and their covered lives — will all be put into one pool to manage risk and allow us to leverage better rates in the marketplace,” Salamido added. In insurance terms, “covered lives” refers to all individuals enrolled in a health plan—including employees, spouses, and dependents—who are entitled to receive benefits.
To be eligible for Carolina HealthWorks, a business must: Have 2 to 50 eligible employees, be headquartered in North Carolina, and be a member of a participating local chamber or the NC Chamber.
The announcement comes at a time of heightened attention on healthcare costs in North Carolina. Over the last few weeks, Republican lawmakers criticized state health officials for implementing Medicaid provider rate cuts—reductions that took effect October 1 and range from 3% to 10%. Lawmakers say these cuts were unnecessary and unfairly distributed.
“I’m still very upset about the rate cut,” said Sen. Donny Lambeth (R-Forsyth), co-chair of the Joint Legislative Oversight Committee on Medicaid. “They have the power to hold off on those rate cuts, and in the 12 years I’ve been here, we have never cut rates.”
The N.C. Department of Health and Human Services (DHHS) defended the cuts, citing a $368 million budget shortfall driven by rising healthcare costs. Pharmacy spending alone has climbed 8.6% annually, according to DHHS Chief Strategy Officer Julia Lerche.
Despite the broader challenges in healthcare financing, state leaders expressed optimism that Carolina HealthWorks represents a positive step toward affordability and access.
“This plan allows small employers to do sbetter on rates than what they might find through the ACA,” Causey said.
As the program rolls out, Blue Cross NC, the NC Chamber, and the Department of Insurance say they will continue to work together to monitor its performance and ensure regulatory compliance.
