Curated cohort / fixed public roster
North Carolina marketplace issuer cohort
The Patient Access and Provider Directory APIs of every issuer selling an individual-market qualified health plan on HealthCare.gov in North Carolina for 2026, graded on the same public surfaces as every other endpoint here.
6organizations reviewed
5published a base URL we could verify
8endpoints listed
7answered on this run
5 of 6 member organizations publish a FHIR base URL this project could verify from public documentation, which is a curation record with a date on it, not a live figure; 8 verified endpoints are listed below. Of those, 7 answered when this page was generated, which is the measured number: it comes from this run's probes, and it moves when the endpoints do. The rest of the roster is recorded with the reason it could not be listed, because for a cohort whose membership is public and finite, the gap is itself a finding.
Membership is CMS's own file, not a list assembled here. Filtered to North Carolina, the QHP Landscape PY2026 Individual Medical dataset carries 4,859 plan-county rows, 6 HIOS issuer IDs, and 6 issuer names. The roster was frozen before any URL was probed and is committed beside this file as north-carolina-marketplace.roster.csv.
Every member either points at registry endpoints or carries an exclusion with a dated review record and the source that was read. An exclusion is a statement about what this project could find on the date it looked, never a statement about whether an issuer meets an obligation.
Several members point at endpoints already in the registry. Where a carrier publishes one national surface, the same entry is cited from more than one cohort rather than duplicated, because listing one address under several names would misstate how many endpoints exist.
Membership sources
- CMS / CCIIO: QHP Landscape PY2026 Individual Medical (individual_market_medical.zip, issued 2026-08-04, modified 2026-08-10) (retrieved 2026-09-04)
Listed endpoints
| Plan | Programs | Endpoint | Category | Grade |
|---|---|---|---|---|
| Ambetter of North Carolina (Centene) | North Carolina individual marketplace (HealthCare.gov) | Centene Provider Directory API (Ambetter) | Payer Provider Directory APIs | not observed |
| AmeriHealth Caritas Next | North Carolina individual marketplace (HealthCare.gov) | AmeriHealth Caritas Next North Carolina Patient Access API | Payer Patient Access APIs | B |
| AmeriHealth Caritas Next | North Carolina individual marketplace (HealthCare.gov) | AmeriHealth Caritas Next North Carolina Provider Directory API | Payer Provider Directory APIs | C |
| Blue Cross and Blue Shield of NC | North Carolina individual marketplace (HealthCare.gov) | Blue Cross and Blue Shield of North Carolina Patient Access API | Payer Patient Access APIs | B |
| Blue Cross and Blue Shield of NC | North Carolina individual marketplace (HealthCare.gov) | Blue Cross and Blue Shield of North Carolina Provider Directory API | Payer Provider Directory APIs | A |
| Cigna Healthcare | North Carolina individual marketplace (HealthCare.gov) | Cigna Patient Access API | Payer Patient Access APIs | A |
| Cigna Healthcare | North Carolina individual marketplace (HealthCare.gov) | Cigna Provider Directory API | Payer Provider Directory APIs | A |
| UnitedHealthcare | North Carolina individual marketplace (HealthCare.gov) | UnitedHealthcare Provider Directory API | Payer Provider Directory APIs | C |
Grades are comparable within a category only: a Patient Access API and a Provider Directory API answer to different expectations and are never ranked against each other.
What "did not answer" was
The condition each listed endpoint that did not answer was observed in on this run, kept apart by category and never added together. An endpoint that answered and declined this request is running; an endpoint that produced no document is a different fact about a different thing. This project reports the condition and reads neither of them as a choice or as a defect.
| Endpoint | Condition | What it means |
|---|---|---|
| Centene Provider Directory API (Ambetter) | Answered, and declined this request | the surface answered, and declined to serve this request |
What the listed endpoints declare
How many of the listed endpoints with a readable CapabilityStatement declare each resource and each interaction on it, counted within a category and never across one. Declared, not tested.
- What its Payer Patient Access APIs endpoints declare
- What its Payer Provider Directory APIs endpoints declare
Members reviewed and not listed
Each exclusion records how far the review went, on what date, and where to check it. A review that found nothing is not proof that nothing exists: if one of these plans publishes a base URL we missed, please tell us.
| Plan | Programs | Why it is not listed |
|---|---|---|
| Oscar Health Plan of North Carolina, Inc | North Carolina individual marketplace (HealthCare.gov) | Oscar publishes two brand-level interoperability pages and no base URL on either; Patient Access is delegated to a third-party platform reachable only by creating an account with that vendor, and no Provider Directory API is documented anywhere on the site. (the plan's own documentation was reviewed, 2026-09-04; source) |
Observational snapshots of public discovery surfaces. Not audits, not compliance determinations, and not statements about care quality. Publishing a base URL to unregistered visitors is not required by any rule this project reads, and a plan that does not is not violating anything; it is only not independently checkable from outside.