Blue Cross and Blue Shield Association


 * Blue Cross redirects here. For other uses, see Blue Cross (disambiguation)

The Blue Cross and Blue Shield Association (BCBSA) is a American federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield healthcare coverage companies, in total covering over 97 million Americans.

History
In 1929, Justin Ford Kimball became vice president of Baylor University in Waco, Texas. An experienced administrator, he headed the Baylor College of Medicine, School of Nursing, College of Dentistry, and the university hospital. Soon after taking the job, he developed a health plan that guaranteed teachers 21 days of hospital care for $6 a year. The plan was extended to other employee groups in Dallas, and similar plans began to spread nationally.

The cross symbol was first used in a 1934 advertisement for the Hospital Service Association, today known as Blue Cross and Blue Shield of Minnesota. Company secretary E.A. van Steenwyk had Viennese artist Joseph Binder create a poster that included a blue Greek cross. Van Steenwyk continued to use the symbol to identify his company's health plans, and the Blue Cross began to be used in other parts of the country.

In 1939, the Chicago-based American Hospital Association began using the Blue Cross symbol to signify that health plans across the country met certain standards. The AHA continued to administrate the use of the symbol until the Blue Cross Association was founded in 1960. The two organizations remained affiliated until 1972.

Another health plan gained popularity in the lumber and mining camps of the Pacific Northwest around the same time that Kimball created his plan. These would provide medical care by paying monthly fees to medical service bureaus composed of groups of physicians. The first of these, Pierce County Medical Bureau (now known as Regence BlueShield) in Tacoma, Washington, was founded in 1917 and is now a part of The Regence Group. The shield symbol was created in Buffalo, New York by Carl Metzger in 1939, and the first official Blue Shield plan was founded in California that same year. In 1948 the symbol was informally adopted by nine plans called the Associated Medical Care Plans, and was later renamed the National Association of Blue Shield Plans.

Current organization
Blue Cross and/or Blue Shield insurance companies are franchisees, independent of the association (and traditionally each other), offering insurance plans within defined regions under one or both of the association's brands. Blue Cross-Blue Shield insurers offer some form of health insurance coverage in every US state. They also act as administrators of Medicare in many states or regions of the U.S., and regularly can be found providing group coverage to state government employees, as well as the U.S. Federal government under a nationwide option of the Federal Employees Health Benefit Plan (FEHBP) established by the association on their behalf. Thus a strong bond exists between the Blue Cross-Blue Shield system and health insurance policy-making bodies at the highest levels of government in the United States.-

Though historically "Blue Cross" was used for hospital coverage while "Blue Shield" was used for medical coverage, today that split only exists for traditional health insurance plans in eastern Pennsylvania, where Independence Blue Cross (Philadelphia) and Blue Cross of Northeastern Pennsylvania each have joint marketing agreements with Highmark Blue Shield (Pittsburgh) for their separate hospital and medical plans. However, Independence Blue Cross, like most of its sister Blue Cross-Blue Shield companies, cover most of their customers under managed care plans such as HMOs and PPOs which provide hospital and medical care in one policy. In most of the country (including western Pennsylvania), one insurer operates under both brands; in the remaining places (including California and central Pennsylvania), the Blue Cross and Blue Shield brands belong to competing insurers. Blue Cross of Idaho even displays the Blue Shield logo alongside the Blue Cross logo, in direct competition with Regence BlueShield of Idaho. Both brand names are used in both CamelCase and traditional forms by both the association and its member insurers, though some members prefer one form or the other.

Some of the state plans have been merged to achieve economies of scale. Many plans are administered by not-for-profit organizations, while others are for-profit companies. (Though all Blue Cross-Blue Shield plans must pay Federal income tax under the Tax Reform Act of 1986, some plans are still considered not-for-profit at the state level.) The 14-state WellPoint is the largest Blue Cross-Blue Shield member, and is a publicly traded company. Other multi-state organizations include CareFirst in the Mid-Atlantic and The Regence Group in the Pacific Northwest. The largest non-investor owned member is Health Care Service Corporation (HCSC), which operates four Blue Cross and Blue Shield Plans in the Midwest and Southwest.

Publicly traded companies

 * WellPoint
 * Anthem Blue Cross Blue Shield
 * Colorado
 * Connecticut
 * Indiana
 * Kentucky
 * Maine
 * Missouri
 * Nevada
 * New Hampshire
 * Ohio
 * Parts of Virginia
 * Wisconsin
 * Blue Cross of California
 * Blue Cross Blue Shield of Georgia
 * Empire Blue Cross Blue Shield (New York)

Multi-state private companies

 * CareFirst
 * District of Columbia
 * Maryland
 * Parts of Virginia
 * Health Care Service Corporation
 * Blue Cross Blue Shield of Illinois
 * Blue Cross Blue Shield of New Mexico
 * Blue Cross Blue Shield of Oklahoma
 * Blue Cross Blue Shield of Texas
 * Highmark
 * Highmark Blue Cross Blue Shield (Western Pennsylvania)
 * Highmark Blue Shield (Eastern & Central Pennsylvania)
 * Mountain State Blue Cross and Blue Shield (West Virginia)
 * Premera
 * Alaska (Premera Blue Cross Blue Shield of Alaska)
 * Washington (Premera Blue Cross)
 * The Regence Group
 * Idaho (Regence BlueShield of Idaho)
 * Oregon (Regence BlueCross BlueShield of Oregon)
 * Utah (Regence BlueCross BlueShield of Utah)
 * Washington (Regence BlueShield)
 * Wellmark Blue Cross and Blue Shield
 * Iowa
 * South Dakota

Single-state or regional companies

 * Blue Cross Blue Shield of Alabama
 * Blue Cross and Blue Shield of Massachusetts
 * Blue Cross Blue Shield of Arizona
 * Arkansas Blue Cross and Blue Shield
 * Blue Shield of California
 * Blue Cross and Blue Shield of Delaware
 * Blue Cross and Blue Shield of Florida
 * Hawaii Medical Services Association
 * Blue Cross of Idaho
 * Blue Cross and Blue Shield of Kansas
 * Blue Cross and Blue Shield of Louisiana
 * Blue Cross and Blue Shield of Massachusetts
 * Blue Cross Blue Shield of Michigan not-for-profit organization|non profit
 * Blue Cross and Blue Shield of Minnesota not-for-profit organization|non profit
 * Blue Cross & Blue Shield of Mississippi
 * Blue Cross and Blue Shield of Kansas City (Missouri)
 * Blue Cross and Blue Shield of Montana
 * Blue Cross and Blue Shield of Nebraska
 * Horizon Blue Cross and Blue Shield of New Jersey
 * Excellus Blue Cross Blue Shield (New York State) not-for-profit organization
 * Blue Shield of Northeastern New York
 * Blue Cross and Blue Shield of Western New York
 * Blue Cross and Blue Shield of North Carolina
 * Blue Cross and Blue Shield of North Dakota
 * Blue Cross and Blue Shield of Oklahoma
 * Blue Cross of Northeastern Pennsylvania
 * Capital Blue Cross (Central Pennsylvania)
 * Independence Blue Cross (Philadelphia, Pennsylvania area)
 * Blue Cross & Blue Shield of Rhode Island
 * Blue Cross and Blue Shield of South Carolina
 * BlueCross BlueShield of Tennessee
 * Blue Cross and Blue Shield of Vermont
 * Mountain State Blue Cross Blue Shield (West Virginia)
 * Blue Cross Blue Shield of Wyoming

Puerto Rico

 * La Cruz Azul de Puerto Rico (Blue Cross)
 * Triple-S (Blue Shield)

Canada
The Canadian Association of Blue Cross Plans is independent of the U.S. association. Its members specialize in travel insurance and individual health plans to supplement the health plans of the various provincial governments.

List of Canadian Association of Blue Cross Plans members

 * Pacific Blue Cross
 * Saskatchewan Blue Cross
 * Alberta Blue Cross
 * Manitoba Blue Cross
 * Ontario Blue Cross (individual plans)
 * Croix Bleue du Québec (individual plans)
 * Medavie Blue Cross
 * New Brunswick
 * Nova Scotia
 * Newfoundland & Labrador
 * Prince Edward Island
 * Ontario (group plans)
 * Quebec (group plans)