About Us

Profile of the Blue Cross and Blue Shield System

The 37 independent and locally operated Blue Cross and Blue Shield Plans and the Blue Cross and Blue Shield Association (BCBSA) comprise the Blue Cross and Blue Shield System, the nation's oldest and largest family of health-benefits companies. Blue Cross and Blue Shield Companies represent the full spectrum of health care coverage.

Quick Facts

  • With headquarters in Chicago and offices in Washington, D.C., BCBSA has about 1,000 employees. Member Blue Plans collectively have more than 150,000 employees nationwide, ranking the Blue System as a group among the 20 largest employers in the United States.

  • Collectively the Blue Cross and Blue Shield System provides health care coverage for more than 100 million people — nearly one-third of all Americans — in all 50 states, the District of Columbia and Puerto Rico. The Blue System offers a variety of insurance products to all segments of the population, including large employer groups, small businesses and individuals.

    • 72.3 million in PPOs

    • 10.8 million in traditional, fee-for-service programs

    • 14.5 million in health maintenance organizations (HMOs)

    • 4.8 million in point-of-service (POS) products

  • Nationwide more than 90 percent of hospitals and nearly 80 percent of physicians contract directly with Blue Cross and Blue Shield Companies.

  • Blue Cross and Blue Shield Plans cover more than 70 percent of all Fortune 500 companies and Fortune 100 companies.

Key Initiatives

  • Medicare: Blue Cross and Blue Shield Companies have partnered with the federal government to process Medicare claims and payments since the program's inception in 1965. Today Blue Medicare contractors handle more of the day-to-day work of paying Medicare claims than any other company. In 2008, Blue Cross and Blue Shield Medicare contractors processed nearly 90 percent of more than 181 million total claims from hospitals and other provider institutions (Part A) and 67 percent of the more than 996 million claims from physicians and other health care practitioners (Part B).

  • FEP: The Blue Cross and Blue Shield System's Federal Employee Program (FEP) — the largest privately underwritten health insurance contract in the world — enrolls more than 4.9 million federal government employees, dependents and retirees. Approximately 60 percent of all federal employees and retirees who receive their health care through the government's Federal Employee Health Benefits Program are members of FEP.

  • BCBSA's BlueCard® Program — which links participating health care providers and the independent Blue Plans across the country through a single electronic network for claims processing and reimbursement — enables Blue Plans to serve large national employers, such as Microsoft Corporation, Xerox, United Airlines, UPS and Walmart.

    • In 2008, BlueCard processed more than 253 million claim transactions, up from 226 million in 2007. The vast majority of BlueCard claim transactions represent national account business, with an increasing percentage moving into PPO.

    • To find a BlueCard health care provider anywhere from coast to coast and to view a map with detailed driving instructions visit the National Doctor & Hospital Finder.

  • BlueCard Worldwide®, an international network of doctors and hospitals, includes providers in more than 200 countries and territories. Members can now access inpatient and outpatient services throughout the world — at no additional cost.

  • BCBSA's Technology Evaluation Center (TEC) pioneered the development of scientific criteria for assessing medical technologies through comprehensive reviews of clinical evidence. TEC assessments provide objective information to those who deliver and manage medical care. They are based on clinical and scientific evidence and evaluate whether a technology improves health outcomes.

    • In 1997, BCBSA's TEC became an Evidence-based Practice Center and was awarded a five-year contract by the Agency for Healthcare Research and Quality (AHRQ) to serve as one of the 13 current Evidence-based Practice Centers.

    • To date, TEC has completed more than 400 assessments and 12 AHRQ evidence reports.

Blue Cross Roots

  • In 1929, Justin Ford Kimball, an official at Baylor University in Dallas, introduced a plan to guarantee school teachers 21 days of hospital care for $6 per year. Other groups of employees in Dallas soon joined the plan, and the idea quickly attracted nationwide attention. In 1933, E. A. van Steenwyk, an executive with the forerunner of Blue Cross and Blue Shield of Minnesota, began to identify his hospital care program with a blue-colored cross design. Other groups elsewhere in the country followed suit, and by 1939, the Blue Cross symbol was officially adopted by a commission of the American Hospital Association (AHA) as the national emblem for Plans that met certain guidelines.

  • In 1960, the commission was replaced with the Blue Cross Association, which was independent of the AHA. All formal ties with the AHA were severed in 1972. At that time, the design of the national Blue Cross symbol was revised, and a human figure was placed in the center to represent the role of the Plans in serving human need. The stylized figure is based on Leonardo DaVinci's "Vitruvian Man."

Blue Shield Roots

  • The Blue Shield concept grew out of the lumber and mining camps of the Pacific Northwest at the turn of the century. Employers wanted to provide medical care for their workers and made arrangements with physicians, who were paid a monthly fee for their services. These contracts led to the creation of "medical service bureaus" composed of groups of physicians. The first was organized in Tacoma, Wash., by Pierce County physicians in 1917. Some bureaus, including the Pierce County bureau, still operate today as Blue Shield Plans.

  • These pioneer programs led to the first Blue Shield Plan, which was founded in California in 1939.

  • The Blue Shield symbol was informally adopted in 1948 by a group of nine Plans known as the Associated Medical Care Plans and registered at the federal patent and trademark office in 1951. This group eventually became the National Association of Blue Shield Plans.

  • The Blue Cross and Blue Shield Association, created in 1982, is the result of a merger of the Blue Cross Association and National Association of Blue Shield Plans.

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