Group Health Insurance North Carolina

This Group Health Insurance Census Form may be used for groups of 25 or fewer employees. For groups larger than 25 employees, complete the 26+ Census Form and fax to 919-287-2777.

To provide the fastest possible service we will send your Quote via Email. In order to deliver the most competitive pricing, we may need to contact you via telephone. Only one of our representatives will call to verify your quote or get any additional information needed.

Total Number of Employees
(Total number employed by company)

Number of Eligible Employees
(employed 30 hrs per week or more)

Employer Contribution for Employee:

Employer Contribution for Dependents:

NCHealthplans is an independent authorized producer/agency licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (Blue Cross NC). The content contained in this site is maintained by NCHealthplans. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield® Association. ® Registered mark of the Blue Cross and Blue Shield Association (SM) Service mark of the Blue Cross and Blue Shield Association®.

We do not offer every plan available in your area. Currently we represent Blue Cross Blue Shield of North Carolina which offer Medicare Advantage, Medicare Supplement, and Part D Prescription Drug Plans in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.