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

While remaining 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 is positioned to meet the needs of our members and communities in new ways and fulfill our mission of making health care more affordable, easier to navigate and accessible to all.

The NC General Assembly and Governor Cooper recently passed and signed into law the Reorganization & Economic Development Act (HB 346 / SL 2023-33) which received strong bipartisan support. This law allows for the creation of a not-for-profit holding company with subsidiaries that give us the flexibility to more quickly partner and invest in innovative health solutions to benefit North Carolinians.

“We will remain North Carolina’s not-for-profit, home state insurer. We will walk beside the communities we serve, partnering and supporting them in meaningful ways, while introducing innovative solutions that make care more affordable and accessible. And we will continue to live our mission to improve the health and wellbeing of North Carolinians, as we always have.”

Dr. Tunde Sotunde, Blue Cross NC President and CEO

Modernizing Blue Cross NC

Modernization allows Blue Cross NC to bring more partnerships and innovation to North Carolina, for the health and well-being of everyone in the state.

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. Now, we can continue to be strong, stable and maintain our commitment to North Carolina.

We will maintain our same not-for-profit status.

Blue Cross NC remains deeply committed to improving the health and well-being of our customers and communities and will continue its longstanding mission as North Carolina’s home state, not-for-profit health care insurer.

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

We ensured that this law would not cause premiums to increase. This modernization does not take away rate review authority and approval from the NC Department of Insurance. It also requires the holding company and all investments to be in service of the Blue Cross NC mission for the health and well-being of the community.

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.

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. This law doesn’t change that for our members.

Transparency and accountability are top priorities.

As required by this new law, DOI has 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

Blue Cross CEO travels the state, marks a big political win

David Mildenberg, Business NC

“The new law enables us to remain sustainable as a mission-driven, not-for-profit in a hyper-competitive landscape.” 

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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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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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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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Modernizing our structure allows us to

deliver solutions for the next 90 years 

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

To fulfill our mission of making health care more affordable, easier to navigate, and accessible to all, we will modernize our structure to ensure we can move more quickly to enter partnerships and invest in opportunities that allow us to deliver the service and care our members deserve. 

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 Faces Serious Health Care Challenges

Fortunately, lifesaving 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 Our Purpose-Driven Modernization

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