Large and small group and individual plans are written by commercial insurers, as are most HSA/HDHPs (health savings account/ high-deductible health plans). The largest commercial insurers in North Carolina are: Blue Cross Blue Shield of North Carolina, Aetna, Cigna, FirstCarolinaCare, UnitedHealthcare. Data, graph courtesy: America’s Health Insurance Plans (AHIP), Center for Policy and Research, March 2019