Capital BlueCross

  • Overview

If you dwell in the Lehigh Valley, Capital BlueCross could be your direct link to health care coverage. A licensee of the Blue Cross and Blue Shield Association, the company provides health insurance products to individuals and employer groups, with a total of about 1 million members in central and eastern Pennsylvania. It offers traditional, PPO, HMO, and POS health care plans, as well as dental and vision coverage and Medicare Advantage plans. Capital BlueCross' network includes more than 18,000 health care providers and some 40 hospitals. The company also provides benefits administration services to self-funded customers through for-profit subsidiary Capital Administrative Services (dba NCAS Pennsylvania).

Geographic Reach

The company serves 21 counties in Central Pennsylvania and the Lehigh Valley.

Operations

Capital BlueCross provides additional health care coverage through its Keystone Health Plan Central (including Medicare HMO and Medicaid plans) and Capital Advantage Insurance subsidiaries. Its for-profit Avalon Insurance and Consolidated Benefits subsidiaries, which are not licensed by the Blue Cross and Blue Shield Association, sell life, long-term disability, and accidental death insurance.

The company's supplemental plans include vision coverage provided through a partnership with National Vision Administrators; prescription drug benefits managed by CVS Caremark; and dental benefits administered by Dominion Dental Services USA. Capital BlueCross also runs its own dental plan provider, Dominion Dental, which serves some 500,000 dental plan members in Pennsylvania and in other Mid-Atlantic states).

Sales and Marketing

Capital BlueCross markets its products through its agents, brokers, and doctors.

Strategy

In addition to focusing on customer retention through wellness, education, and support programs, Capital BlueCross is regularly looking to expand its customer base by adding affordable health plan offerings and attracting new members.

Capital BlueCross focuses on improving patient satisfaction, enhancing quality of care and reducing costs.

In 2014 Capital BlueCross and PinnacleHealth teamed up to offer businesses a new health insurance plan for their employees. Marketed as CareConnect Point of Service this plan connects the high-quality benefits and services of Capital BlueCross with the physicians and facilities of PinnacleHealth.

In 2013 the company introduced mobile applications for better serving the customers need.

To promote wellness services to its members, in 2012 Capital BlueCross entered the retail market, opening a 6,700-sq. ft. "first-of-its-kind" health and wellness store called Capital Blue in the Lehigh Valley.

That year the company launched PersonalBlue Saver PPO plan, a new product that caters to people with specific health insurance needs.

Company Background

It widened its offerings in 2010 when it started providing the adultBasic plan, a state-administered plan for low-income adults.

However, at the end of 2010 Capital BlueCross lost its contract to provide the Pennsylvania Employee Benefit Trust Fund's PPO health plan for state employees, which covered about 70,000 people; the company continues to provide HMO options under the program.

In addition, the health plan announced workforce cuts in 2010, laying off about 10% of its employees to reduce its operating costs. Capital BlueCross cited increases in technological efficiency processes (including new claims management and reimbursement systems) that created a reduced need for administrative employees. The move was made in the midst of economic difficulties and uncertainties in the US health care industry, conditions that have caused lower enrollment levels and rising premiums in many markets.

Capital BlueCross has its origins in two hospital service plans that began in the 1930s: Easton Hospital Association (which later became Blue Cross of the Lehigh Valley) and Capital Hospital Service (which was renamed Capital BlueCross in 1965). The two entities merged in 1985.

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Capital BlueCross


2500 Elmerton Ave
Harrisburg, PA 17177-9799
Phone: 1 (717) 541-7000
Fax: 1 (717) 5416072
https://www.capbluecross.com

STATS


  • Employer Type: Private Non Profit
  • President, CEO, and Director: Gary St. Hilaire
  • President, CEO, and Director: Gary St. Hilaire
  • Vice Chairman: Kathryn Taylor

Major Office Locations

  • Harrisburg, PA
  • Harrisburg, PA

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