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FirstCarolinaCare Proposes Plans and Releases Rates for Federal Health Insurance Marketplace/Exchange

| Date Posted: 8/20/2013

PINEHURST – FirstCarolinaCare Insurance Company, a wholly owned subsidiary of Pinehurst-based FirstHealth of the Carolinas Inc., proposed 16 plans to sell in the Federal  Health Insurance Marketplace (also called the “Exchange”) .  All 16 plans have been reviewed and approved by the North Carolina Department of Insurance, which allows FirstCarolinaCare to continue the process to become certified by the federal government to participate in the Marketplace/Exchange for individual/ family health insurance coverage.

Coverage options provided by FirstCarolinaCare include catastrophic plans and three coverage levels of plans: bronze, silver and gold plans.  The catastrophic plans have higher deductibles and are designed for people under age 30 and those with lower incomes. Bronze plans will cover 60 percent of health care expenses; silver plans will cover 70 percent; and gold, 80 percent. FirstCarolinaCare intends to offer each of the plans in Moore, Montgomery, Hoke, Scotland, Richmond and Lee counties.

“Each person may ascertain specific benefit needs differently, so within and between the coverage levels, we have provided some choice for individuals,” says Kenneth J. Lewis, president of FirstCarolinaCare Insurance Company. “One benefit design might include a higher deductible with lower copays; another might be the reverse.”

The full set of rates for FirstCarolinaCare’s products has been approved by the North Carolina Department of Insurance and is available on the FirstCarolinaCare website. The website address is

“Transparency is important to us, and the earlier we communicate our rates, the earlier  people living in our community can begin to take an interest in (and understand) the Marketplace/Exchange process,” says Lewis.  “It is our understanding that the rates approved by the Department of Insurance cannot be changed at this point, therefore, we are taking steps to release them to our community. We do believe, however, that the methodology used to calculate the rates remains protected under N.C. laws.”    

Formed in 1999, FirstCarolinaCare has historically focused on the group insurance market.  Participation in the federal Health Insurance Marketplace/Exchange will be FirstCarolinaCare’s first entry into the individual/ family market. 

“Our parent company’s mission is to care for people,” says Lewis. “We’re not sure FirstCarolinaCare’s rates will be competitive in this new individual market, but we look forward to offering consumers in our service area a level of choice.”

About FirstCarolinaCare Insurance Company
A wholly owned subsidiary of Pinehurst-based FirstHealth of the Carolinas, FirstCarolinaCare offers a wide range of health benefit plans for businesses primarily located in the Sandhills region. In addition to providing coverage alternatives for businesses, FirstCarolinaCare provides a Medicare Advantage product for Medicare-eligible individuals in Moore, Montgomery, Richmond, Hoke, Lee and Scotland counties.  Formed in 1999, FirstCarolinaCare was licensed by the North Carolina Department of Insurance in October 2000 to offer products in 51 counties.  In 2007, FirstCarolinaCare broadened its structure and received its license as a North Carolina insurance company.  Over the years, it has received a number of significant awards for leadership in the health insurance industry.  More recently, FirstCarolinaCare led other insurers and the federal government in making changes even before the Affordable Care Act was passed.  These changes include extending benefits to dependents up to the age of 26 regardless of their student status and offering free workplace health screenings to members and dependents. The changes, coupled with a variety of wellness and chronic condition management programs, were accomplished without premium increases and, in fact, served to slow the growth in health care costs.

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