Highmark has staked its claim as the largest health insurer in the Keystone state. A licensee of the Blue Cross and Blue Shield Association, the not-for-profit firm covers some 5.3 million people in its core service areas in central and western Pennsylvania and the Lehigh Valley. It serves additional customers in West Virginia, Delaware, and other areas of Pennsylvania through its subsidiaries and affiliates, and it provides administrative and network-access services nationally. In addition, Highmark sells Medicare Advantage and prescription drug plans to seniors. Other subsidiaries (not operating under a BCBS license) provide dental insurance, vision care, and other products and services nationwide. The firm is owned by Highmark Health.
Highmark also operates some 650 optical retail stores (Visionworks) in 40 states and four US-based eyewear manufacturing facilities. In the optical arena, subsidiaries include managed vision care organization Davis Vision (with 19 million members), and eyewear manufacturer Viva Optique.
Another unit, HM Insurance Group, offers employer health risk solutions such as stop-loss insurance and a limited benefit medical plan, while United Concordia Companies provides dental coverage to around 8 million members across the US.
The company maintains multiple collaborative agreements with neighboring Blues Independence Blue Cross and Hospital Service Association of Northeastern Pennsylvania. Another affiliate, Gateway Health Plan, is a partnership with Mercy Health System that provides Medicaid HMO coverage in Pennsylvania.
Highmark processes about 96 million health care claims a year.
The company's core Pennsylvania service areas are served through wholly owned subsidiaries Highmark Blue Cross Blue Shield (which serves 29 counties of western Pennsylvania) and Highmark Blue Shield (which serves 21 counties of central Pennsylvania and the Lehigh Valley). It reaches nearby states through its Highmark Blue Cross Blue Shield West Virginia (which also operates in Washington County, Ohio) and Highmark Blue Cross Blue Shield Delaware subsidiaries.
Highmark Blue Shield serves more than 1.1 million members through the company's health care benefits business. Its health, dental, vision, and supplemental health products businesses serve 35 million customers nationwide.
The company operates call centers in Pittsburgh, Camp Hill, Erie, and Johnstown, Pennsylvania; and in Wilmington, Delaware.
Sales and Marketing
Highmark's customers include Celtic Healthcare, dck worldwide, Excela Health, and MARC USA.
In 2013, Highmark's revenue decreased 0.8% to about $15 billion, as both operating revenues and earnings from investments decreased due to a lower margin rate and increased spending on member care. Net income fell 32% that year to $294 million. Cash flow from operations totaled $298.3 million.
The company has been working to expand its core health insurance operations through a number of measures, including introducing new programs and increasing involvement in government health programs such as Medicare and strengthening partnerships with other insurance companies. Its strategy for growth includes offering products in five key areas: health insurance markets, health solutions, integrated medical care delivery, government and exchange business, and diversified businesses.
In 2014 Highmark launched Total Health, an insurance product designed to reward members who choose practices that have adopted the patient-centered medical home (PCMH) model.
That year the company also entered into contracts with various providers such as Geisinger Medical Center, Conemaugh Health System, and Armstrong County Memorial Hospital to provide its members with an expanded range of services.
Highmark provides an impressive array of specialty services through its non-Blue subsidiaries, and the company is experiencing strong growth in its dental and vision care businesses.
In 2014 the company agreed to combine with Blue Cross of Northeastern Pennsylvania (which will be merged into Highmark) in a deal that will expand its Blue coverage in Pennsylvania.