SALISBURY — Businesses peppered a Blue Cross Blue Shield representative with questions Wednesday at an Obamacare seminar, expressing frustration over a lack of information about the health care law.
Dozens of human resources directors and other business leaders turned out for an information session at the Gateway Building. Many said they were confused about requirements, subsidies and other aspects of the Affordable Care Act.
Obamacare health exchanges open Tuesday, marking the beginning of a six-month enrollment period for mandatory health insurance.
Walker Wilson, director of Blue Cross’ health policy office, empathized with her struggling audience and fielded questions for more than hour.
There is no central source of information on Obamacare in North Carolina, where state officials decided not to cooperate with the Affordable Care Act or extend Medicaid coverage to about a half-million residents.
“It’s really hard in North Carolina because no one’s out there talking about this in a comprehensive way,” Wilson said.
While states that are promoting the Affordable Care Act received federal grants for outreach and enrollment, North Carolina turned down millions of dollars in federal assistance for promotional activities.
Also Wednesday, the federal government released a report saying average premiums in North Carolina for a mid-range health insurance plan under Obamacare will be $369 a month before tax breaks are applied. That’s higher than the national average of $328 a month, the U.S. Department of Health and Human Services said.
Federal health officials said overall, the cost of premiums was 16 percent lower than earlier projections. The cost of coverage is higher in North Carolina where only two insurers — Blue Cross and Blue Shield of North Carolina and Coventry Health Care of the Carolinas — will sell plans on the exchange.
The cost is lower in states with more competition, the report said.
Most Americans buying insurance on the exchange will qualify for a tax break. People who earn between 100 and 400 percent of the federal poverty level — $62,040 for a couple or $94,200 for a family for four, for example — will qualify for subsidies that will offset the cost of buying health insurance.
About 500,000 North Carolinians who earn less than the federal poverty level will not qualify for subsidies. They were supposed to be covered by the Medicaid expansion.
That news stunned Mayor Paul Woodson, a small business owner who said he’s been researching Obamacare to find answers for some of his part-time workers and had hoped they would qualify for subsidies.
“There is still a crack that some are going to fall into,” said John Drye, vice president of Central Carolina Insurance Agency, which hosted the seminar.
Drye encouraged people to move beyond the politics surrounding Obamacare as the health exchanges launch.
“Whichever way your political persuasion on this topic, it’s going to be the law, and we’re going to have to comply with it,” Drye said.
Some aspects of the law, including the requirement that insurers allow children to stay on their parents’ plans through age 26, have been in place since 2010.
But more controversial requirements start in 2014, including the mandate that nearly everyone in America purchase health insurance.
For most Americans who already have health insurance through their employer, nothing will change, although the cost may go up or down, Wilson said. Plans that meet federal guidelines will be grandfathered, she said.
Under the Affordable Care Act, insurance plans must cover a wider range of preventive and other medical services and cannot turn away applicants based on prior illnesses, also called pre-existing conditions.
Most people who don’t carry health insurance next year will face penalties, beginning at $95 per year in 2014 and jumping to $695 in 2016. The enrollment period runs until March 31, 2014.
Subsidies are only available to people who buy insurance on the exchange. Health insurance plans will still be available outside of the exchange, and products will cost the same.
“Subsidies don’t lower the cost of coverage, it just changes who pays the bill,” Wilson said. “It’s widely acknowledged that the Affordable Care Act doesn’t go far enough to control healthcare costs. It’s mostly a reform of health insurance.”
Typically, if an employer offers health insurance, employees will not qualify for a subsidy, unless the plan is deemed unaffordable by Obamacare.
“If it would cost more than 9.5 percent of your income, then you and your family would be eligible for a subsidy,” said Will Harrell of Central Carolina.
Help is coming for the uninsured to understand Obamacare, Wilson said. Four organizations in North Carolina won federal grants to provide education and outreach, and new healthcare “navigators” will help people in rural health clinics, she said.
North Carolina health officials have agreed to allow local social service agencies to host navigators at their facilities to assist the public. The navigators, funded by federal grants, are part of the new law’s enrollment program.
Other states opposed to Obamacare are limiting navigators’ access to the public.
Wilson directed people to two websites to better understand the Affordable Care Act: www.nchealthreform.com and www.reform101.com. Starting Tuesday, the health exchange will be online at www.healthcare.gov.
The Associated Press contributed to this article.

Contact reporter Emily Ford at 704-797-4264.