Apex Health, Inc. v. Atrium Health, Inc.

2026 NCBC 10
CourtNorth Carolina Business Court
DecidedFebruary 11, 2026
Docket24-CVS-23655
StatusPublished
AuthorJulianna Theall Earp

This text of 2026 NCBC 10 (Apex Health, Inc. v. Atrium Health, Inc.) is published on Counsel Stack Legal Research, covering North Carolina Business Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Apex Health, Inc. v. Atrium Health, Inc., 2026 NCBC 10 (N.C. Super. Ct. 2026).

Opinion

Apex Health, Inc. v. Atrium Health, Inc., 2026 NCBC 10.

STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE SUPERIOR COURT DIVISION MECKLENBURG COUNTY 24CV023655-590

APEX HEALTH, INC., APEX MANAGEMENT SOLUTIONS, LLC, J.B. COTTON & COMPANY, LLC, and APEX HOLDINGS, INC. ORDER AND OPINION ON Plaintiffs, PLAINTIFFS’ MOTION FOR LEAVE TO FILE FIRST AMENDED v. COMPLAINT ATRIUM HEALTH, INC.,

Defendant.

1. THIS MATTER is before the Court on Plaintiffs’ Motion for Leave to File

First Amended Complaint pursuant to Rule 15(a) of the North Carolina Rules of Civil

Procedure (Motion), (ECF No. 35).

2. Plaintiffs seek to amend their pleading to add a claim under Chapter 75 of

the North Carolina General Statutes for unfair and deceptive trade practices based

on information obtained during discovery. (Pls.’ Mot. Leave File First Am. Compl.

[Mot. to Am.] 2, ECF No. 35; Mot. to Am., Ex. 1, First Am. Compl. [Proposed Am.

Compl.] ¶ 1, ECF No. 35.2.)

3. Defendant objects to the Motion, arguing that it should be denied for “(i)

undue delay and undue prejudice; (ii) bad faith; and (iii) futility of amendment.”

(Atrium Health, Inc.’s Br. Opp’n Pls.’ Mot. Leave File First Am. Compl. [Def.’s Opp’n]

2–3, ECF No. 44.)

4. The Court, having considered the Motion, the briefs filed in support of and

in opposition to the Motion, the arguments of counsel at a hearing held 13 January 2026, and other relevant matters of record, concludes that the Motion shall be

DENIED with prejudice.

McGuireWoods LLP, by Mark Kinghorn and William Hutchinson, for Plaintiffs Apex Health, Inc., Apex Management Solutions, LLC, J.B. Cotton & Company, LLC, and Apex Holdings, Inc.

Bradley Arant Boult Cummings LLP, by Jonathan Schulz and Robert Marcus, for Defendant Atrium Health, Inc.

Earp, Judge.

I. FACTUAL BACKGROUND

5. The following is a summary of Plaintiffs’ allegations that are relevant to the

Motion before the Court.

6. J.B. Cotton & Company, LLC (J.B. Cotton) is a Michigan limited liability

company that was formed to fund Apex Health, Inc. (Proposed Am. Compl. ¶ 7.)

7. Apex Holdings, Inc. is a Michigan corporation that is a wholly owned

subsidiary of J.B. Cotton. (Proposed Am. Compl. ¶ 8.)

8. Apex Health, Inc. is a North Carolina corporation and a wholly owned

subsidiary of Apex Holdings, Inc. Apex Health, Inc. was authorized to offer Medicare

Advantage (MA) health plans in North Carolina and South Carolina in 2022 and 2023

pursuant to a contract with the Centers for Medicare and Medicaid Services.

(Proposed Am. Compl. ¶ 9.)

9. Apex Management Solutions, LLC is a Michigan limited liability company

that was formed by J.B. Cotton to provide administrative and technical services to

Apex Health, Inc. (Proposed Am. Compl. ¶ 10.) 10. Atrium Health, Inc. (Atrium) is a North Carolina non-profit corporation

that operates an integrated healthcare delivery system. (Proposed Am. Compl. ¶¶

12–13.)

11. Apex 1 was formed in late 2018 for the purpose of offering and operating MA

plans in the Southeast. (Proposed Am. Compl. ¶ 17.) Private health insurers,

including Apex, offer MA plans as an alternative to “traditional” Medicare and earn

a fixed monthly reimbursement for every beneficiary who enrolls in a MA plan.

(Proposed Am. Compl. ¶¶ 18–19.)

12. Beneficiaries are almost exclusively enrolled during the Annual Enrollment

Period that occurs between October and December, making these months the critical

period to ensure as many beneficiaries are enrolled as possible. (Proposed Am.

Compl. ¶ 20.)

13. Health insurers often rely on independent brokers to enroll members in

their plans. However, brokers charge fees for each enrollment, so it is financially

advantageous for insurers to enroll beneficiaries without using independent brokers.

(Proposed Am. Compl. ¶ 21.)

14. In November 2020, Atrium decided to offer its own MA plan but, according

to Apex, Atrium did not want to bear any risk associated with creating that plan.

(Proposed Am. Compl. ¶ 26.) To accomplish this goal, Atrium issued a Request for

Information (RFI) seeking a health insurer to shoulder the financial risk of launching

1 “Apex” is used to reference Plaintiffs J.B. Cotton, Apex Holdings, Inc., Apex Health, Inc.,

and Apex Management Solutions, LLC, collectively, throughout the Opinion. the plan. (Proposed Am. Compl. ¶ 27.) Apex alleges that Atrium specified that it was

looking for a “partner.” (Proposed Am. Compl. ¶ 30.)

15. As a part of the arrangement, Atrium wanted the health insurer to offer a

MA plan that included only Atrium healthcare providers. (Proposed Am. Compl.

¶ 28.) This type of arrangement is known as a “narrow network” plan and can be less

attractive to consumers, and therefore riskier to offer, because the covered providers

are limited. (Proposed Am. Compl. ¶¶ 28, 31, 43.)

16. Despite the risks associated with a narrow network plan, Apex recognized

that a potential partnership with Atrium could be beneficial because Atrium was one

of the nation’s largest and highest performing healthcare systems. (Proposed Am.

Compl. ¶¶ 29–31.)

17. Therefore, on 3 December 2020, Apex submitted a response to Atrium’s RFI,

observing that the relationship needed to be “highly collaborative, with both parties’

full commitment.” (Proposed Am. Compl. ¶ 35.)

18. Over the next several months, Atrium and Apex engaged in numerous

interviews in which Apex continued to make it clear that, for the plan to succeed, it

would need Atrium’s “complete buy in and support as a true partner.” (Proposed Am.

Compl. ¶ 36.) According to Apex, Atrium stated that it was fully behind Apex.

(Proposed Am. Compl. ¶ 37.) Atrium ultimately selected Apex to establish a narrow

network plan. (Proposed Am. Compl. ¶ 38.)

19. Apex alleges that thereafter, in emails and presentations, Atrium referred

to the Plan as “our own MA Product” and to Apex as “the recommended partner for a co-branded MA Product.” (Proposed Am. Compl. ¶¶ 39–40.) Relying on these

representations, Apex shifted its resources to fully pursue the opportunity with

Atrium. (Proposed Am. Compl. ¶ 41.)

20. Apex alleges that during the selection process, Atrium representatives

made repeated statements indicating that they supported a co-branded plan.

(Proposed Am. Compl. ¶¶ 37–38, 43.) Among them was an email sent by one of

Atrium’s representatives, Jennifer Brady, to Apex executives, stating:

[T]he MA Strategy group made the recommendation to the EVP’s and Gene Woods to move forward with ApexHealth as our selected partner to deliver a co-branded Medicare Advantage Plan. They have preliminarily approved our recommendation contingent upon working on the [Letter of Intent] and getting in writing the things that we have agreed upon over the past few weeks.

(Proposed Am. Compl. ¶ 38.)

21. On 10 February 2021, the parties entered into a Letter of Intent (LOI)

identifying Apex as Atrium’s partner and stating that the parties intended to enter

into an “arrangement to form a co-branded, high-performing network Medicare

Advantage health plan.” (Proposed Am. Compl. ¶ 42.) Apex alleges that it was

Atrium that inserted the co-branding language in the final LOI. (Proposed Am.

Compl. ¶ 42.)

22. Over the next several months, the parties negotiated the terms of the

Health Plan Collaboration and Shared Risk Agreement (Agreement). (Proposed Am.

Compl. ¶ 62; Ex.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Spartan Leasing Inc. v. Pollard
400 S.E.2d 476 (Court of Appeals of North Carolina, 1991)
Bob Timberlake Collection, Inc. v. Edwards
626 S.E.2d 315 (Court of Appeals of North Carolina, 2006)
Hoyle v. Bagby
117 S.E.2d 760 (Supreme Court of North Carolina, 1961)
Harris v. NCNB National Bank of North Carolina
355 S.E.2d 838 (Court of Appeals of North Carolina, 1987)
Martin v. Hare
337 S.E.2d 632 (Court of Appeals of North Carolina, 1985)
Chicopee, Inc. v. Sims Metal Works, Inc.
391 S.E.2d 211 (Court of Appeals of North Carolina, 1990)
McLamb v. T.P., Inc.
619 S.E.2d 577 (Court of Appeals of North Carolina, 2005)
Wood v. Guilford County
558 S.E.2d 490 (Supreme Court of North Carolina, 2002)
Mosley & Mosley Builders, Inc. v. Landin Ltd.
389 S.E.2d 576 (Court of Appeals of North Carolina, 1990)
Branch Banking and Trust Co. v. Thompson
418 S.E.2d 694 (Court of Appeals of North Carolina, 1992)
Dalton v. Camp
548 S.E.2d 704 (Supreme Court of North Carolina, 2001)
Smith v. McRary
295 S.E.2d 444 (Supreme Court of North Carolina, 1982)
B & F SLOSMAN v. Sonopress, Inc.
557 S.E.2d 176 (Court of Appeals of North Carolina, 2001)
Terry v. Terry
273 S.E.2d 674 (Supreme Court of North Carolina, 1981)
Strickland v. Hedrick
669 S.E.2d 61 (Court of Appeals of North Carolina, 2008)
Kirby v. North Carolina Department of Transportation
786 S.E.2d 919 (Supreme Court of North Carolina, 2016)
CommScope Credit Union v. Butler & Burke, LLP
790 S.E.2d 657 (Supreme Court of North Carolina, 2016)
Christenbury Eye Ctr., P.A. v. Medflow, Inc.
802 S.E.2d 888 (Supreme Court of North Carolina, 2017)
Hills Mach. Co., LLC v. Pea Creek Mine
828 S.E.2d 709 (Court of Appeals of North Carolina, 2019)

Cite This Page — Counsel Stack

Bluebook (online)
2026 NCBC 10, Counsel Stack Legal Research, https://law.counselstack.com/opinion/apex-health-inc-v-atrium-health-inc-ncbizct-2026.