More than 1,000 small businesses are now offering health insurance to their employees through Carolina HealthWorks, according to the latest data from the NC Chamber and Blue Cross and Blue Shield of North Carolina.

Across the participating businesses, more than 8,000 lives are covered. This represents a major milestone for the program, which was launched in fall 2025 in response to a gap in the health insurance market for businesses with 2-50 employees.

In a segment over the weekend on Spectrum News’ public affairs program “In Focus,” NC Chamber President and CEO Gary Salamido explained that small businesses have often faced a tough choice between Affordable Care Act (ACA) health insurance plans – which often come with burdensome price tags for both business owners and their employees – or offering no health insurance at all.

That’s changed with Carolina HealthWorks, a multiple employer welfare arrangement, or MEWA, that is the first of its kind in North Carolina. Participating businesses are seeing an average savings of about 20% compared to ACA rates.

“We have received a number of incredible stories from small interior design firms to yoga shops to bakeries to small manufacturers,” said Salamido, a pharmacist by education and the son of a small business owner. “Small businesses have a harder time retaining and adding employees because they oftentimes can’t pay as much or don’t have the same benefits structure that larger employers do. Carolina HealthWorks helps them to offer health insurance, helps them retain their employees and cover their families, and attract people that want to work in a small business.”

Small businesses with 2 to 50 employees are eligible if they are members of the NC Chamber or a local chamber of commerce that is part of its Federation. They must also be headquartered in the state.

Bringing Carolina HealthWorks to fruition required legislative changes from the NC General Assembly, as well as approval by the NC Department of Insurance.

Rep. Kyle Hall (R-Stokes, Forsyth), a real estate broker at a family-owned firm in King, told Spectrum News Anchor Mike Dunston that being part of the bipartisan coalition of legislators who changed the law to make Carolina HealthWorks possible was a no-brainer. For years, his small business constituents have shared concerns about the rising cost of health insurance.

“This is not a Republican issue or a Democrat issue,” Hall said. “This is a pure North Carolina issue, it’s a pure American issue – to try to lower the cost for our small businesses to be able to afford health insurance for their employees.”

Kelly Calabria – Blue Cross NC’s senior vice president and chief communications, marketing, and corporate social responsibility officer – echoed his sentiment, telling Spectrum News that NC is facing a “healthcare cost crisis.”

As the administrator of the Carolina HealthWorks plan, Blue Cross NC provides enrollees with access to its statewide network of providers and ongoing support for small business owners and brokers – all with the operations and customer service excellence its known for.

“It really is special because it’s an option and a creative solution for small businesses to be able to access healthcare coverage for their employees,” she said. “We couldn’t be more excited about that because we know how challenging it can be for small businesses to do that.”