Your State Government's Oversight of Health Insurance in North Carolina
The North Carolina state-level Government is in charge of preparing and managing insurance requirements and regulations applicable to the state. In fulfilling this obligation, the State Government generally chooses to balance consumer protections with a business environment that promotes strong financial and economic growth. With regards to health care insurance, the State Government must serve three separate constituent groups: consumers, insurance companies, and independent licensed brokers.
The Government's main control factor for promoting a beneficial health insurance market is the licensing and review of health insurance companies and independent brokers. For managing insurance companies, the State Government prepares basic standards for health insurance products and performs routine financial statement reviews, to assure that tax requirements are being complied with. For health insurance brokers, the State Government sets professional and licensing qualifications, takes care of broker license testing and issuance of licenses, sets and reviews continuing education needs, and is responsible to collect license fees for brokers. The State level Government is in charge of identifying and investigating insurance fraud schemes, especially as it pertains to consumers or when it threatens the state business environment.
For state insurance consumers, the State Government publishes health insurance guidelines for consumers to help residents understand their best insurance choices. The Government will also help consumers file insurance appeals with their insurance company when there is a dispute relating to the policy coverage or terms. And, the State-level Government has the duty of managing the Federal Medicare program within the state where Federally funded insurance is available to children without health insurance and low income families, qualified seniors, or self-employed persons.