Small businesses in North Carolina will soon have access to a new health coverage option through a partnership between the NC Chamber and Blue Cross and Blue Shield of North Carolina (Blue Cross NC). The initiative, called Carolina HealthWorks, is designed to help small businesses, their employees, and families manage rising health care costs by pooling resources through a multiple employer welfare arrangement (MEWA).
The MEWA model allows small businesses to join together to access benefits and rates that are usually available only to larger groups. This approach aims to address affordability challenges faced by many small employers.
“Small businesses are the lifeblood of this state,” said North Carolina Insurance Commissioner Mike Causey. “Many small business owners have told me about their struggles to find affordable health care for their employees. I applaud the North Carolina Chamber for partnering with Blue Cross NC to create this new option for its small employer members. I also want to give a special thank you to the review team at the N.C. Department of Insurance for going above and beyond in putting in extra hours to make this approval in record time. We need to continue to look for ways to help get more North Carolinians affordable health care.”
Gary Salamido, president and CEO of the NC Chamber, stated: “North Carolina leads the nation in business—but is one of the most expensive states for health care – a sharp contradiction that hits hardest for small businesses fighting to survive. This moment demands real solutions. The creation of Carolina HealthWorks is a meaningful step in giving small businesses a tangible, more affordable path forward. We appreciate Blue Cross NC’s willingness to partner and find an affordable, thoughtful solution designed to help small businesses support their teams, their families, and stay competitive.”
Carolina HealthWorks will be available starting November 1 for North Carolina small businesses with 2 to 50 employees who are members of either the NC Chamber or participating local chambers. Blue Cross NC will serve as administrator for the plan, offering access through its provider network. Enrollment opportunities will be open throughout the year.
Tunde Sotunde, MD, CEO of Blue Cross NC, commented: “Right now, the health care system is shifting, and our market is experiencing immense volatility. It will take partnerships and new ideas to meet this moment. Our partnership with the NC Chamber, and the launch of Carolina HealthWorks, is an example of a creative collaboration to solve a real problem: the soaring cost of health care for small businesses. Blue Cross NC stands ready to partner with organizations committed to driving down health care costs in North Carolina.”
National research indicates that small businesses face higher relative burdens from health insurance costs compared with larger firms; these expenses represent a greater share of payroll among smaller companies (source). Among those not offering insurance coverage, 65% cite cost as their main reason (source). Small firms make up over 94% of all U.S. businesses and employ more than 27% of private sector workers (source).
In North Carolina specifically, there are over one million small businesses (source). Data from 2022 shows that companies with fewer than 20 employees accounted for 18% of total private employment; those with 20–40 employees made up another 10% (source).
Carolina HealthWorks can be purchased through agents appointed by Blue Cross NC or directly via Blue Cross NC’s website if no agent relationship exists.
Blue Cross NC has been operating since 1933 as a not-for-profit insurer serving over four million members across North Carolina.
The benefits under this plan are provided by the NC Chamber Benefit Trust with excess coverage from an insurer licensed in North Carolina; it is regulated by state authorities but not backed by any guaranty association.
