RALEIGH – The North Carolina State Health Plan is asking a Wake County judge to halt Atrium Health’s new affordability program and has extended 2027 open enrollment through Nov. 6 for its roughly 750,000 members.
The plan requested a temporary restraining order in Wake County Superior Court on Oct. 9. The Department of State Treasurer says Atrium’s Affordability Protection Program would improperly change member copays, deductibles and coinsurance and could increase costs for the plan and taxpayers.
Atrium disputes that characterization. The Charlotte-based health system says it created the program to absorb additional member costs and keep Atrium care affordable for nearly 100,000 State Health Plan members who use its providers.
The dispute comes as the plan prepares to move to a three-tier provider network for 2027. UNC Health and Novant Health are preferred providers. Atrium says it submitted proposals to match the preferred providers’ discounts; the plan says Atrium’s offers came after other contracts were signed and did not match those discounts.
Under Atrium’s program, the system says enrolled members who continue using its providers would receive lower copays and cost-sharing. The State Health Plan says Atrium would still charge the plan higher underlying rates, shifting costs to the plan even if individual members pay less out of pocket.
WRAL reported that open enrollment begins Monday, Oct. 12, and that the plan extended the deadline to Nov. 6 while members evaluate their options. Atrium told WRAL it was reviewing the lawsuit and continues to defend the program as an affordability measure.
The court request is pending. The current record does not establish whether a judge has issued the temporary restraining order or whether Atrium has changed the program. The immediate business consequence is uncertainty for members choosing 2027 coverage and for the plan and health system over who bears the cost of Atrium care.