• Source: Blue Cross Blue Shield Association

blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States–based federation with 33 independent and locally-operated BCBSA companies that provide health insurance in the United States to more than 115 million people as of 2022.
It was formed in 1982 from the merger of its two namesake organizations: blue" target="_blank">Blue Cross was founded in 1929 and became the blue" target="_blank">Blue Cross Association in 1960, and blue" target="_blank">Blue Shield emerged in 1939 and the blue" target="_blank">Blue Shield Association was created in 1948. Its headquarters are at the Aon Center at 200 E. Randolph Street in Chicago, Illinois.
BCBSA claims to control access to the blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield trademarks and names across the United States and in more than 170 other countries, which it then licenses to the affiliated companies for specific, exclusive geographic service areas. It has affiliated plans in all 50 states, Washington, D.C., and Puerto Rico, and licensees offering plans in several foreign countries; it also participates in the nationwide health insurance program for employees of the United States federal government.
BCBSA manages communications between its members and the operating policies required to be a licensee of the trademarks. This permits each BCBSA company to offer nationwide insurance coverage through its BlueCard provider network and claims reimbursement program even though it operates only in its designated service area.




History



blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield developed separately, with blue" target="_blank">Blue Cross providing coverage for hospital services and blue" target="_blank">Blue Shield covering physicians' services.
blue" target="_blank">Blue Cross is a name used by an association of health insurance plans throughout the United States. Its predecessor was developed by Justin Ford Kimball in 1929, while he was vice president of Baylor University's health care facilities in Dallas, Texas. The first plan guaranteed teachers 21 days of hospital care for $6 a year, and was later extended to other employee groups in Dallas, and then nationally. The American Hospital Association (AHA) adopted the blue" target="_blank">Blue Cross symbol in 1939 as the emblem for plans meeting certain standards. In 1960, the AHA commission was superseded by the blue" target="_blank">Blue Cross Association. blue" target="_blank">Blue Cross severed its ties with the AHA in 1972.
blue" target="_blank">Blue Shield was developed by employers in lumber and mining camps of the Pacific Northwest to provide medical care by paying monthly fees to medical service bureaus composed of groups of physicians. In 1939, the first official blue" target="_blank">Blue Shield plan was founded in California. In 1948, the symbol was informally adopted by nine plans called the Associated Medical Care Plan, and was later renamed the National Association of blue" target="_blank">Blue Shield Plans.
In the 1960s, the U.S. government chose to partner with blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield companies to administer Medicare.
In 1982, blue" target="_blank">Blue Shield merged with The blue" target="_blank">Blue Cross Association to form the blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield Association (BCBS).
Prior to 1986, organizations administering BCBS were tax exempt under 501(c)(4) as social welfare plans. The Tax Reform Act of 1986 revoked the exemption, however, because the plans sold commercial-type insurance. They became 501(m) organizations, subject to federal taxation, but entitled to "special tax benefits" under IRC 833.
In 1994, BCBS changed to allow its licensees to be for-profit corporations. During 2010, Health Care Service Corporation, the parent company of BCBS in Texas, Oklahoma, New Mexico, Montana and Illinois, nearly doubled its income to $1.09 billion in 2010, and began four years of billion-dollar profits. In the final spending bill for FY 2015 after much lobbying since 2010, nonprofit blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield plans continue to have special tax breaks that were understood to be threatened by the Affordable Care Act of 2010.




Current organization


blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield insurance companies are licensees, independent of the association and traditionally of each other, offering insurance plans within defined regions under one or both of the association's brands. blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield insurers offer some form of health insurance coverage in every U.S. state. They also act as administrators
of Medicare in many states or regions of the U.S.
The blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Federal Employee Program (FEP) is a nationwide option under the Federal Employees Health Benefits Program (FEHB) for U.S. federal government employees and retirees, and has been part of FEHB since FEHB's inception in 1960. FEP enrolls over half of the federal workforce, with over 5 million members, making it the largest insurer of federal employees and the largest single health plan group in the world.
The association is headquartered in the Michigan Plaza complex in the Chicago Loop area of Chicago, Illinois.




Multi-state member organizations


blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Michigan
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Vermont
CareFirst
District of Columbia
Maryland
Parts of Virginia (Alexandria City, Arlington County, Falls Church City, and parts of Fairfax County)
Elevance Health (formerly Anthem)
Anthem blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield
Colorado
Connecticut
Georgia
Indiana
Kentucky
Maine
Missouri (excluding 30 counties in the Kansas City area)
Nevada
New Hampshire
New York (eastern and southeastern counties)
Ohio
Virginia (excluding Alexandria City, Arlington County, Falls Church City, and parts of Fairfax County)
Wisconsin
Anthem blue" target="_blank">Blue Cross (California)
GuideWell
Florida blue" target="_blank">Blue
Triple-S Management (includes Puerto Rico and the US Virgin Islands)
Health Care Service Corporation
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Illinois
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Montana
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of New Mexico
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Oklahoma
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Texas
Highmark
Highmark blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield (Western and Northeastern Pennsylvania)
Highmark blue" target="_blank">Blue Shield (Eastern & Central Pennsylvania)
Highmark blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Delaware (Delaware)
Highmark blue" target="_blank">Blue Shield of Northeastern New York (New York)
Highmark blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield West Virginia (formerly Mountain State blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield) (West Virginia)
Highmark blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Western New York (New York)
Premera
Premera blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Alaska
Premera blue" target="_blank">Blue Cross of Washington
Cambia Health Solutions
Regence BlueShield of Idaho
Regence BlueCross BlueShield of Oregon
Regence BlueCross BlueShield of Utah
Regence BlueShield (Washington)
Wellmark blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield
Iowa
South Dakota




Single-state member organizations


Single-state members include the following organizations.

blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield of Alabama
blue" target="_blank">Blue Shield of California
blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield of Kansas City
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Massachusetts
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of North Dakota
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of South Carolina
BlueCross BlueShield of Tennessee
Capital blue" target="_blank">Blue Cross (Central Pennsylvania)
Hawaii Medical Service Association
Horizon blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of New Jersey
Independence blue" target="_blank">Blue Cross (Philadelphia, Southeastern Pennsylvania)




= Arizona

=
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Arizona (BCBSAZ) is a non-profit healthcare organization founded in 1939. BCBSAZ partners with non-profit "Discovery Triangle Development Corporation" to launch a Farm Express mobile market (formerly Fresh Express).




= Arkansas

=
Founded in 1948, Arkansas blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield (ABCBS) is an independent licensee of the blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Association, and the largest healthcare provider in the state. It donated $1.98 million to The Walton College of Business toward founding its Robert L. Shoptaw Master of Healthcare Business Analytics Program. In August 2022, more than 12,000 members of Arkansas blue" target="_blank">Blue Cross were affected by a ransomware attack on a former affiliate, North Highland Company, LLC.




= Idaho

=
blue" target="_blank">Blue Cross of Idaho and Regence BlueShield Idaho are separate companies and compete throughout the state.




= Kansas

=
blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield of Kansas (BCBSKS) was founded in 1942 by Sam Bartham, later becoming an independent licensee of the blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Association.




= Louisiana

=
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Louisiana is a tax-paying non-profit that was founded in 1934 in New Orleans. An independent licensee of the BCBSA, it is a privately held mutual company without shareholders, which is wholly owned by its policyholders.




= Minnesota

=
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Minnesota (BCBSMN) was founded in 1933, with 3,500 employees reported in 2022.




= Mississippi

=
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Mississippi (BCBSMS) was formed as a privately held company in 1954. In 1948, it was converted to a non-profit. In 1973, its name was changed from Mississippi Hospital and Medical Service to blue" target="_blank">Blue Cross & blue" target="_blank">Blue Shield of Mississippi, Inc., which, in 1996, was converted from a non-profit membership corporation to a mutual insurance company, with the name again changed, to blue" target="_blank">Blue Cross & blue" target="_blank">Blue Shield of Mississippi, A Mutual Insurance Company. During 2022, BCBS and University of Mississippi Medical Center (UMMC) network entered conflict over who is to blame for an increasing lack of covered care in the state. Media reported that UMMC had paid close to $279,000 for digital advertising, commercials, and billboards to attack BCBS, which, in subsequent months, sued the hospital for defamation.




= Nebraska

=
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Nebraska was founded in 1939. On July 1, 2018, BCBS Nebraska formed GoodLife Partners Inc., a mutual holding company, to conduct its noninsurance businesses. The company retained the blue" target="_blank">Blue Cross brand, converting from mutual ownership to a stock company wholly owned by GoodLife.




= New York

=
Excellus BlueCross BlueShield (Excellus BCBS, or Excellus) is a non-profit health insurance company headquartered in Rochester, New York. It is part of the blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Association. In 2010, Excellus was Upstate New York's largest nonprofit health plan.
In 2001, Excellus merged with Univera Healthcare, (formerly North AmeriCare), based in Buffalo, New York. Univera retained its name and is separate from Excellus BCBS. Excellus was the target of a cyberattack in 2015, in which 10.5 million records were hacked, and cost the company 17.5 million dollars. The company's blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield subsidiaries have been known as:

BlueCross BlueShield of Central New York
BlueCross BlueShield of the Rochester Area
BlueCross BlueShield of Utica-Watertown




= North Carolina

=
By September 2010, BCBS licensee blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield of North Carolina announced that it would refund $156 million to their policyholders following documented charges: they had been sued and fined for denying due medical treatments to their customers and for underpaying doctors. As of 2019 they were overseeing well over half of all payments for medical services in their state. BCBSNC invests in chronic and underlying condition research, telehealth and artificial intelligence (AI) for digital healthcare.
In 2019, blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield of North Carolina agreed to enter into a partnership with Cambia Health, but cancelled the agreement later that year. Dr. Patrick H. Conway, who had served as CEO from 2017, was scheduled to become CEO of the merged company, replacing retiring Cambia CEO Mark Ganz, but resigned after a DWI arrest in June 2019, putting the merger on hold.




= Pennsylvania

=
Though historically "blue" target="_blank">Blue Cross" was used for hospital coverage while "blue" target="_blank">Blue Shield" was used for medical coverage, today that split only exists for traditional health insurance plans in Pennsylvania. Two independent companies operate in central Pennsylvania, Highmark blue" target="_blank">Blue Shield in Pittsburgh and Capital blue" target="_blank">Blue Cross in Central Pennsylvania. In southeastern Pennsylvania, Independence blue" target="_blank">Blue Cross in Philadelphia has a joint marketing agreement with Highmark blue" target="_blank">Blue Shield in Pittsburgh for their separate hospital and medical plans. However, Independence blue" target="_blank">Blue Cross, like most of its sister blue" target="_blank">Blue Cross blue" target="_blank">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.




= Rhode Island

=
blue" target="_blank">Blue Cross & blue" target="_blank">Blue Shield of Rhode Island was founded in 1939. The insurer is headquartered in Providence, Rhode Island.




= U.S. Virgin Islands

=
BlueCross BlueShield of the U.S. Virgin Islands is administered by BlueCross BlueShield of Puerto Rico.




= Wyoming

=

blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Wyoming (BCBSWY) is a non-profit founded in 1945. In 2022, BCBSWY penned opposition to the Pharmacy benefit managers act enhancements (Wyoming Senate File 0036).




Companies outside of the United States


blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Costa Rica
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Panama
blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield of Uruguay
Canadian Association of blue" target="_blank">Blue Cross Plans
GeoBlue




Nonprofit status debate


While only some members retain nonprofit status, the ones that do have been criticized for holding excessive amounts of cash or excessive executive compensation. For instance, the CEO of BCBS Michigan, Daniel Loepp, earned over 19 million USD in 2018, more than the CEO of Ford or Fiat Chrysler during the same year.
In 2014, BC/BS of Illinois (Health Care Service Corporation) was sued over its nonprofit status. The lawsuit was dismissed, with prejudice, and the dismissal ruling was upheld on appeal. Similar suits occurred with similar results in other states such as Oregon.




For-profit conversions


Conversions into for-profit corporations typically results in distribution of some of the assets into a charitable foundation. When blue" target="_blank">Blue Cross of California was converted, it initially had no distribution, but subsequently The California Endowment and California Health Care Foundation were endowed with $3.2 billion. Proceeds ranged from $3.2 billion (California) to $1.5 million (Nevada).: 63 
An exceptional case occurred in the Empire blue" target="_blank">Blue Cross conversion, where the proceeds went to fund wage increases for union workers.




Antitrust settlement


In 2022, the group of 34 companies that make up the BCBS Association settled an antitrust investigation by allowing competition among member companies under non-blue" target="_blank">Blue names while retaining regional exclusivity for regional licenses.




Claim denial controversies


In 2018 Robert Salim was diagnosed with stage 4 throat cancer, however the proton therapy ordered by his doctor was denied by blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield. Salim sued. In July 2022 the United States District Court, Western District of Louisiana ruled that "Because Salim showed that PBT was a nationally accepted standard of care for advanced head and neck cancer in 2018, BCBSLA abused its discretion in finding Salim's PBT treatment was not medically necessary." A Propublica investigation found that blue" target="_blank">Blue Cross and blue" target="_blank">Blue Shield of Louisiana used guidelines from an outside company called AIM Specialty Health to reject appeals for denial, and that this practice was widespread.




See also



blue" target="_blank">Blue Cross Canada




References






External links



Official website
"How Much Is Too Much? Consumersunion.org; July 2012.
"BCBSA History Fact Sheet" blue" target="_blank">Blue Cross blue" target="_blank">Blue Shield Association; March 1997.

Kata Kunci Pencarian:

• AirMed International
• Sydney
• Korps Marinir Amerika Serikat
• Detroit
• Daftar permainan video paling laris
• Blue Cross Blue Shield Association
• Wellmark Blue Cross Blue Shield
• Blue Cross Blue Shield of Massachusetts
• Elevance Health
• Blue Cross Blue Shield of Michigan
• Independence Blue Cross
• Blue Cross and Blue Shield of Alabama
• Blue Shield of California
• Premera Blue Cross
• BlueCross BlueShield of South Carolina