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Modernizing to Meet the Health Care Needs of North Carolina through the Reorganization & Economic Development Act

While ensuring we stay a mission-driven, not-for-profit health insurer.

Business transformation is everywhere, particularly in the world of health care, where the environment has changed dramatically in recent decades, along with consumer needs and expectations.

As North Carolina’s homegrown, not-for-profit insurer for the past 90 years, Blue Cross and Blue Shield of North Carolina must modernize its structure in order to fulfill our mission to make health care more affordable, easier to navigate and accessible to all.


The Reorganization & Economic Development Act (HB 346/SB 296), recently introduced in the NC General Assembly, seeks to address this challenge. The legislation allows us to create a not-for-profit holding company with subsidiaries that would give us the flexibility to rapidly invest in innovative health solutions that North Carolinians need and deserve, without changing our not-for-profit mission.

A Message from Blue Cross NC President and CEO, Dr. Tunde Sotunde, on the Reorganization & Economic Development Act

Key Facts About This Bill

This bipartisan legislation will bring more partnerships and innovation to North Carolina, for the health and well-being of everyone in the state.

Fact 1: We are here to stay in NC.

Millions of North Carolinians, spread across all 100 counties, place their trust in Blue Cross NC every day. Even when others left the insurance market, we’ve stood by our home state to ensure all counties had coverage. With this bill, we will continue to be a strong, stable and local not-for-profit presence.

Fact 2: We will maintain our same not-for-profit status.

Blue Cross NC is committed to improving the health and well-being of our customers and communities — we won’t stop until health care is better for all. Blue Cross NC will continue its mission as North Carolina’s home state, not-for-profit health care insurer

Fact 3: We are laser-focused on making health care affordable and accessible.

This bill does not contain any measures that would increase premiums. It does not take away rate review authority and approval from the NC Department of Insurance. And, it will require all investments and the holding company be in service of the Blue Cross NC mission for the health and well-being of the community.

Fact 4: Our investments will improve the health of members and the communities where they live.

Building on a culture of innovation, we have already launched programs to reduce administrative costs for doctors and to add more substance abuse and addiction centers in 13 new counties. With this change, we can do more to treat the root causes behind rising health care costs.

Fact 5: Surplus health dollars will still belong to members, following existing law.

Rebates are required by federal law if an insurer fails to spend a minimum of 80% of every premium dollar on medical care. Nothing in the bill changes that requirement.

Fact 6: Transparency and accountability are top priorities.

The bill has numerous provisions for oversight and visibility into the companies’ activities, including an annual report from the restructured company showing where Blue Cross NC has made strategic investments and how much top executives are paid.

Support for Blue Cross NC

North Carolina Needs a Strong, Not-for-Profit Blue Cross NC

“Blue Cross NC has been an important partner. We stand with [them]…  to continue improving the health and wellbeing of all North Carolinians.”

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CEO: Bill to reorganize Blue Cross NC will help, not hurt, our state | Opinion

Dr. Tunde Sotunde, Charlotte Observer 

“[HB 346] allows us to update our structure and invest more rapidly in new health solutions that North Carolinians deserve. Importantly, the bill reaffirms our unique not-for-profit mission to improve the health and well-being of our communities.” 

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Blue Cross bill makes good sense

John Hood, Carolina Journal   

“[House Bill 346] reduces the probability that some out-of-state entity will end up owning and controlling North Carolina’s largest health insurer. That’s why Republican and Democratic leaders have lined up behind it.”    

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The State Shouldn’t Interfere with Blue Cross Restructuring

Jim Stirling, John Locke Foundation

“In the era where politics has become increasingly tribalistic, we seldom see significant bi-partisan support from leadership within both parties. The Reorganization and Economic Development Act, House Bill 346, is one exception.”  

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Key Vote Alert

NC Chamber

“The NC Chamber supports this legislation because it works to improve the competitive business climate among health insurers, which could generate more business and revenue in the state.”

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To deliver solutions for the next 90 years,

we must modernize our structure 

For nearly a century, we’ve been committed to North Carolina—and that commitment will not change.

However, we are currently operating under a charter and laws that have not been updated in decades and we are the only insurance company restricted in these ways. 

To fulfill our mission of making health care more affordable, easier to navigate, and accessible to all, we need a modernized structure. 

As a modernized not-for-profit, we can
improve access and do more, for more people

Improve access while maintaining affordability in an unstable market

More quickly invest in technology and services to keep pace with changes in health care

Partner with providers, physicians, and health care organizations to improve services and patient outcomes

Continue to raise the bar for innovation and competition to serve North Carolinians' evolving health needs

Meet consumer expectations in convenience, access and ease of use

North Carolina is Facing Serious Health Care Challenges

Yet life-saving and cost-saving solutions are within reach.     

Provider Shortages

Within a decade, the state could be short 12,500 nurses, impacting rural and underserved communities the hardest.

Rural Access to Care

In rural North Carolina, 20 counties do not have a pediatrician and 26 counties do not have an OB-GYN.

Mental and Behavioral Health

Cases of anxiety and depression in NC exceed the national average, yet 94 out of 100 counties have no mental or behavioral health providers.

Learn More About The Bipartisan Plan for
Purpose-Driven Modernization

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