North Carolina employer health plans: what they cost and who gets paid
Updated plan year 2024, the most recent complete year
1,587 North Carolina employers filed health plans with 100 or more participants for plan year 2024, covering 2,195,772 participants. They reported $321M in insurance premiums and $184M in broker commissions and fees. The median broker rate on commission-paying, fully insured medical plans was 4.5% of premium, 0.7 points above the national median of 3.8%.
Largest brokers
Reported commissions and fees, with the number of employer plans naming each.
Largest medical carriers
Medical premium written.
Cities in North Carolina
Every North Carolina city where 15 or more employers filed a health plan, by the sponsor's mailing address. Each page lists the city's largest plans, brokers and carriers.
| City | Employer plans | Premiums |
|---|---|---|
| Charlotte | 317 | $113M |
| Raleigh | 178 | $64M |
| Greensboro | 101 | $20M |
| Durham | 86 | $10M |
| Winston Salem | 64 | $4.2M |
| Cary | 39 | $6.7M |
| Morrisville | 33 | $852,667 |
| Hickory | 32 | $4.4M |
| Wilmington | 32 | $2.6M |
| Asheville | 29 | $2.4M |
| High Point | 22 | $125,657 |
| Mooresville | 21 | $27M |
| Huntersville | 20 | $3.1M |
| Burlington | 17 | $740,094 |
| Concord | 17 | $104,507 |
| Chapel Hill | 16 | $0 |
| Gastonia | 16 | $497,420 |
| Greenville | 16 | $0 |
Largest employer plans
By health plan participants.
Highest broker pay
Employers reporting the most broker commissions and fees.
Highest commission rates
Fully insured medical plans with at least $500,000 in premium, ranked by broker compensation as a share of premium.
Source: DOL Form 5500 and Schedule A, plan year 2024; built October 24, 2026. Methodology.
What do North Carolina employers pay health insurance brokers?
Across 36 fully insured medical plans in plan year 2024, among commission-paying fully insured medical plans, the median broker compensation for North Carolina employers was 4.5% of premium (middle half 2.8% to 7.0%), against a national median of 3.8%. In dollars, the median employer that disclosed broker pay reported $64,516.
Which North Carolina employers paid the most in broker commissions?
Charter Communications, Inc. reported the most in 2024, $3,295,743, followed by Old Dominion Freight Line, Inc. ($2.6M) and Lowes Companies Inc ($2.5M).
Which brokers and carriers dominate North Carolina?
By reported compensation, the largest brokers are Marsh McLennan Agency, USI Insurance Services, Mercer. By medical premium, the largest carriers are Blue Cross Blue Shield of Florida, Cigna Health and Life Insurance Company, Blue Cross and Blue Shield of North Carolina.
Which North Carolina cities have the most employer health plans?
Charlotte (317 employer plans, $113M in premiums); Raleigh (178 employer plans, $64M in premiums); Greensboro (101 employer plans, $20M in premiums); Durham (86 employer plans, $10M in premiums); Winston Salem (64 employer plans, $4.2M in premiums). 18 North Carolina cities with 15 or more employer plans have their own page listing the largest plans, brokers and carriers.
Is your company on this page? Get its Form 5500 read next to the North Carolina medians.
Tell us the company and a specialist writes up what the public Form 5500 record shows for it, if it files one: broker pay against the medians above, fee disclosure and filing timeliness, in a form you can forward to your CFO or counsel. Tick the box if you also want a 15-minute walkthrough call.
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