RALEIGH, N.C. – With small businesses feeling the impacts of rising health care costs, the NC Chamber has partnered with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to provide a new, more affordable health plan option for small businesses, their employees and their families.
Carolina HealthWorks brings together North Carolina small businesses to access more affordable health care through a multiple employer welfare arrangement (MEWA) model. A MEWA offers an alternative to small businesses that allows them to pool their resources and provide access to the rate advantages and benefits typically only enjoyed by larger groups.
“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.”
“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.” said Gary Salamido, president and CEO of the NC Chamber. “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 to North Carolina small businesses that have 2 to 50 employees and are members of either the NC Chamber or a participating local chamber. Carolina HealthWorks has chosen Blue Cross NC to be the administrator for this health plan, offering access to Blue Cross NC’s broad network. Small business owners have opportunities to enroll in the plan throughout the year.
“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,” said Tunde Sotunde, MD, CEO of Blue Cross NC. “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.”
According to a national analysis, small businesses bear higher burdens from health insurance costs, representing a higher percentage of payroll costs when compared to larger businesses.[i] In fact, among small businesses that do not offer health insurance, 65% cited cost as the most important reason.[ii] The impact of those decisions is significant since more than 94% of businesses in the United States have fewer than 50 employees and more than 27% of private sector employees work in firms with 1 to 49 employees.[iii]
In North Carolina, small businesses are an important part of the economy. The state has more than 1 million small businesses.[iv] Data from 2022 showed that businesses with fewer than 20 employees represented 18% of total private employment, and those with 20 to 40 employees represented 10%.[v]
Carolina HealthWorks is sold through Blue Cross NC appointed agents, allowing businesses to continue working with their existing Blue Cross NC agent. Direct enrollment is available through Blue Cross NC for those not currently working with an agent. More information about Carolina HealthWorks is available on the Blue Cross NC website or the NC Chamber’s website.
About Blue Cross and Blue Shield of North Carolina: Blue Cross NC, the leading not-for-profit health plan in North Carolina, is committed to making health care more affordable, easier to navigate and accessible for all. Since 1933, the health insurer has created programs and initiatives to provide North Carolinians the opportunity to be healthy. Blue Cross NC serves its customers and communities of more than 4.2 million members, including approximately 1.1 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at bluecrossnc.com. All other marks are the property of their respective owners.
About NC Chamber: The NC Chamber works to research, develop, advocate, and communicate for solutions and policies that produce a nationally competitive business climate in North Carolina. For more information, visit ncchamber.com.
Disclaimer: Benefits are provided by the NC Chamber Benefit Trust, with excess coverage from a licensed insurer. The Trust isn’t backed by a guaranty association but is regulated by the NC Department of Insurance.
The NC Chamber is the sponsor and plan administrator of Carolina HealthWorks, which is a self-insured non-plan Multiple Employer Welfare Arrangement. Third-party administrative services are provided by Blue Cross and Blue Shield of North Carolina. The NC Chamber and Carolina HealthWorks are separate entities and do not provide Blue Cross or Blue Shield products or services.
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Gary Salamido President & CEO
- November 04, 2025
