What changes for North Carolina's 2027 open enrollment
Open enrollment for 2027 coverage opens on November 1, and this year there is more to look at than the premium. A carrier is leaving North Carolina, the filed rates are up across the board, and the biggest variable for most households is still sitting in Congress.
Cigna is leaving the North Carolina exchange
Cigna is discontinuing individual coverage in North Carolina effective January 1, 2027, and is exiting the Marketplace in every state where it sold plans. State filings put roughly 16,000 North Carolina enrollees on plans that will not exist next year.
If that is your plan, you will not simply be dropped. The Marketplace generally moves you to a similar plan from another company so you do not fall out of coverage. But that automatic match is a safety net, not advice. It has no idea which doctors you see. This is a year to look at the match before it happens rather than after.
Filed rates are up, but the filed rate is not your bill
Across North Carolina's individual market, carriers filed for an average increase of about 15 percent for 2027, with individual companies filing anywhere from roughly 8 to 18 percent. Those are the rates before any premium tax credit is applied, and what you actually pay depends on your household, your income estimate and the plan you pick.
It is also worth knowing that increases are not uniform inside one carrier. Plan-level changes at the largest North Carolina insurer range from about 8 percent to nearly 23 percent, so two plans on the same shelf can move very differently. The plan you have is the one to check first.
The subsidy question is still open
The enhanced premium tax credits that ran from 2021 through 2025 expired at the end of 2025. The original ACA credits are still there, and you may still qualify for them depending on your household income and eligibility. The extra help that sat on top of them is gone unless Congress acts.
The House passed a three-year extension in January 2026. The Senate has not taken it up. Nobody can tell you today how that lands, and anyone who says otherwise is guessing. What you can do is plan around the rules as they stand and revisit it if they change.
The dates, which are now settled
There was real confusion about this earlier in the year. A 2025 federal rule would have closed open enrollment on December 15; a court vacated that part of the rule in June 2026, and in August HHS confirmed that HealthCare.gov states run November 1 through January 15. The appeal is being argued in late October, but it concerns the window a year from now, not this one.
- November 1, 2026 — open enrollment starts
- December 15, 2026 — last day to enroll for coverage starting January 1
- January 15, 2027 — open enrollment ends
What to do with all of that
If you are on a Cigna plan, start early: you are choosing a new plan whether or not you meant to this year. If you are on any other plan, check that it still exists for 2027, that your doctors are still in its network, and that your prescriptions have not moved tiers. And if your income estimate for next year is different from the one on file, that is worth fixing before it turns into a reconciliation at tax time.
If you would rather work through it with someone, that is what we are here for. Our licensed North Carolina producer can walk the plans available to you, in the office in Durham or over the phone.