FirstCarolinaCare has made the difficult decision to discontinue commercial lines of business effective 12/31/2025. This change will not terminate coverage today and FirstCarolinaCare is committed to continuing a high level of service to you and your clients leading up to and through the transition.

This message is to inform you that FirstCarolinaCare is required under state law to notify all commercial members of our decision 180 days in advance of coverage ending. The notice will be mailed to all fully insured employer group contacts and members. The notice will not be mailed to self-funded plan members or Medicare Advantage Plan Members. The notice that fully-insured commercial employer group contacts will receive can be viewed here and the notices fully-insured commercial employer group members will receive can be viewed here.

In accordance with regulatory requirements, we intend to mail the notice in time for it to arrive to recipients by July 4^th, 2025. The notice will:

• Clearly outline that the recipient’s health insurance with FirstCarolinaCare is ending by 12/31/2025.
• Advise what recipients need to do to prepare, such as checking with their employer to understand coverage options through their employer or shopping for coverage through the individual Marketplace.
• Direct FirstCarolinaCare members with questions to call our member services team.

If you have any questions, please reach out to Client Support at FCCClientSupport@FirstCarolinaCare.com.

We hope this communication will help you prepare to meet your employees’ needs.

Important Information:

The purpose of this correspondence is to notify you that your group’s current Medicare Advantage group plan will not be renewed. Beginning January 1, 2026, FirstMedicare Direct will no longer offer Medicare Advantage coverage in your area. This means your group must enroll in a new Medicare Advantage plan from another insurance company in order to maintain coverage beginning January 1, 2026. Please read this letter carefully and review your options.

This information does not impact your current coverage. As long as premiums continue to be paid to FirstMedicare Direct, coverage will continue through December 31, 2025.

To keep group health coverage, your group must choose a new plan from another Medicare Advantage company for 2026.

To have continued Medicare Advantage coverage for your group, you should have a new Medicare Advantage plan in place with coverage starting by January 1, 2026. Your group can choose to buy a new plan with the help of an agent or broker or directly from another insurance company.

We are notifying all group enrollees.

FirstMedicare Direct is required to notify all group enrollees who have this coverage that FirstMedicare Direct will no longer offer the enrollee’s plan after December 31, 2025. Because FirstMedicare Direct might not know about other coverage decisions the group has made, enrollees should check with the plan sponsor or administrator about coverage options that might be available through your organization.

Questions?

• You may contact the North Carolina Office of Consumer Health Insurance at (855) 408-1212.
• Alternatively, you can contact FirstMedicare Direct at (800) 481-1092 (TTY 711), Monday – Friday, 8 a.m. to 5 p.m., or visit FirstMedicareDirect.com for help with any questions.

Today, FirstCarolinaCare employer group members will receive an email that reminds them about the importance of setting up their annual screenings and exams. The email outlines things to consider and include in their appointments.

To view a sample email, click here.

Today, FirstCarolinaCare employer group members will receive an email that focuses on benefits members have that can save them money. The email highlights mail-order prescriptions, fitness rewards and the OTC benefit/discount.

To view a sample email, click here.

Today, FirstCarolinaCare employer group members will receive an email about Going Green with paperless health plan materials.

To view a sample email, click here.

Carle Health has announced after careful consideration, as of January 1, 2026, our health plans will cease operating all lines of business except for Medicare Advantage.

Throughout the remainder of 2025, the health plans will maintain a level of operations to support claims processing and meet ongoing business needs, regulatory mandates and contractual obligations.

As a leader in healthcare, Carle Health has an obligation to set the standard for excellence. We continually evaluate and expand on successful components of our organization while addressing areas that may fall short. Every action and strategy we pursue is rooted in our mission to be a trusted partner in healthcare decisions, ensuring we effectively utilize our resources to best serve our patients, families and communities.

What this means to you:

Health Alliance and FirstCarolinaCare will continue to provide a high level of service to existing customers through the end of the year. This includes processing of claims, as well as renewing fully insured plans to support employers and individuals seeking to obtain new or maintain current health plan products.

Your Broker or Health Alliance / FirstCarolinaCare Client Consultant will reach out to you as your renewal approaches with additional information about what this means for your group coverage.

Please contact your Client Consultant with any questions.

Beginning March 15, 2025, the payment vendor currently used within our FirstCarolinaCare Employer Portals will be changing. Our current vendor, RevoPay, will be discontinuing their services.

The portal will now utilize Epic’s Tapestry Link as the billing vendor. This will not change or interfere with how you log in to your employer portal or the link you select to access your billing today. You will notice a change in the look of this feature, but it will still have the same functionalities you are used to utilizing.

Employers currently enrolled in autopay must re-enroll with Tapestry Link to continue automatically withdrawing premiums each month after March 15, 2025. 

To make this transition easier for employers, we are offering two options for autopay set up:

1. To have us re-enroll in autopay for you, please fill out the attached Automatic Premium Payment Authorization form and return it to FCCClientSupport@FirstCarolinaCare.com
2. You may also wait until on or after March 15 – the go-live date for this transition – and re-enroll through your employer portal.
   • Please Note – Enrolling in autopay online through the employer portal does require payment at the time of enrolling.

If you have any questions, please reach out to Client Support at FCCClientSupport@FirstCarolinaCare.com.

Today, FirstCarolinaCare employer group members will receive an email highlighting Hally® health. The email explains what Hally health is and describes some of the resources Hally health provides. The email also talks about connecting with FirstCarolinaCare on social media.

To view a sample email, click here.

Today, FirstCarolinaCare employer group members will receive an email that highlights benefits they can use from the convenience of their home. The email also reminds members to submit any receipts for claims they paid out of pocket for 2024.

To view a sample email, click here.

FirstCarolinaCare Insurance Company has been made aware of important changes to FirstHealth of the Carolinas’ virtual care program, FirstHealth On the Go. Please share these important changes and gentle reminders with your health plan participants.

After careful review and consideration, FirstHealth of the Carolinas has determined that the vast majority of our communities’ virtual urgent care needs can be met through:

• Condensed Hours:
  • Available 6 a.m. – midnight, seven days a week.
  • No appointment needed.
• Condensed Location:
  • Services provided by an established network of licensed FirstHealth of the Carolinas providers in North Carolina only; no longer available out of state.

Reminders:

• FirstHealth On the Go gives patients quick access to trusted providers, allowing them to avoid time-consuming clinic visits or unnecessary emergency department visits.
• FirstHealth of the Carolinas providers can help with conditions like flu, bronchitis, allergies, rashes and more.
• For new and established patients of all ages.
• To learn more about your plan’s coverage and/or request a visit, please sign in to your secure Hally® member portal.
• Important: Benefits and coverage vary from plan to plan.
  • To learn more about whether your group’s plan is eligible for the 2025 fully insured small group ACA or fully insured large group virtual care copay enhancements, as well as other virtual care visit options, please contact your dedicated account representative.

These fliers provide additional information:

FirstHealth On the Go

Hally Member Account and Mobile App

FCC Zero Dollar