The dominant health insurer in the Bay State, Blue Cross and Blue Shield of Massachusetts (BCBSMA), covers some 3 million members. The company, an independent licensee of the Blue Cross and Blue Shield Association, offers a variety of individual and employer-sponsored health care plans, including HMO (HMO Blue), PPO (Blue Options), and point-of-service (Blue Choice) plans, as well as various hybrid options and personal spending accounts to cover out-of-pocket costs. BCBSMA also provides Medicare options and dental, vision, and prescription drug coverage. Its provider network includes more than 21,000 physicians and more than 75 hospitals across the state. The health care firm was founded in 1937.
BCBSMA offers a variety of group indemnity plans, preferred provider networks, non-group plans, Medicare extensions, dental, and other supplementary programs for its members. Its HMO plans are offered through its Blue Cross and Blue Shield of Massachusetts HMO Blue subsidiary. The company's dental plans are provided under the Dental Blue banner, and the vision coverage options are available through a partnership with Davis Vision. In addition to health-related coverage, BCBSMA provides life and disability policies through an affiliation with Indigo Insurance Services and USAble Life.
The company processes 47 million claims annually.
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The insurer offers its products to both individuals and groups. It counts among its customers nine of the 12 Fortune 500 companies headquartered in Massachusetts.
BCBSMA's earnings have remained relatively stable over the past several years. In 2013, premiums earned fell 3% to $2.3 billion. Net income, which has been more erratic than premiums, fell 38% to $28 million that year, largely due to a decline in net investment income and an increase in income tax expenses.
The company reported a cash outflow of $55 million in 2013 as it spent on general purposes and claims adjustments.
The company strives to help employers keep health care costs down by finding ways for members to control what they spend on health care. It partners with other organizations to promote health and wellness and has introduced low cost plans, zero premium plans, and other initiatives to help consumers choose it over other options now available through the Affordable Care Act. In 2014 it introduced a suite of Medicare options which included HMO and PPO plans, Medex Medicare supplement plans, dental plans for seniors, and Part D Medicare Prescription Drug plans.
Also in 2014 BCBSMA expanded its comprehensive behavioral health and substance abuse programs.