Anthem and Blue Cross Blue Shield (BCBS) are related but separate health insurance companies. Anthem owns and operates for-profit BCBS plans in 14 states. In these states, Anthem has an exclusive license from the Blue Cross Blue Shield Association to market plans under the BCBS brand. However, Anthem plans are not the same as the 36 independent, not-for-profit BCBS companies across the country.
What is Anthem Insurance?
Anthem, Inc. is a large for-profit health insurance company based in Indianapolis. It offers employer-sponsored plans, individual health plans, Medicare and Medicaid plans, and specialty products like dental and vision insurance.
Some key facts about Anthem:
- Formed in 2004 as a merger of Anthem and Wellpoint health plans
- Provides coverage to over 106 million medical members
- Operates BCBS plans in 14 states
- Offers plans under the Anthem brand in other select markets
- Employs over 87,000 people
- Reported $141 billion in revenues for 2021
- Ranks 29th on the Fortune 500 list of largest U.S. companies
As one of the nation’s largest health insurers, Anthem has a focus on commercial medical coverage sold to employers and individuals. The company operates health plans under two brands:
- Blue Cross Blue Shield – In 14 states where Anthem is the exclusive BCBS licensee
- Anthem – In states where it offers plans under its own brand
What is Blue Cross Blue Shield?
Blue Cross Blue Shield is a national federation of 36 independent and locally operated health insurance companies united under a single brand. BCBS insurers collectively provide coverage to one in three Americans.
Key attributes of BCBS companies:
- Independently run not-for-profit companies
- Offer individual, employer, Medicare, and Medicaid plans
- Serve every ZIP code in the U.S.
- Control 80% of the BCBS brand’s market share
- Share infrastructure, best practices, and data
The BCBS brand traces back to the 1920s when prepaid hospital coverage plans were created to cover employee medical costs. The American Hospital Association established the Blue Cross brand in 1932. The Blue Shield brand emerged in 1939 when state medical societies developed coverage to pay physician services.
The Blue Cross and Blue Shield trademarks are managed by the Blue Cross Blue Shield Association (BCBSA). The Chicago-based BCBSA licenses independent BCBS companies to market insurance plans under the Cross and Shield brands. To use the national brands, BCBS companies must meet stringent solvency, customer service, technology, and community service standards set by BCBSA.
How is Anthem Related to Blue Cross Blue Shield?
Anthem has an exclusive license from BCBSA to provide BCBS-branded plans in 14 states. These include large markets like California, New York and Ohio. Anthem pays an annual fee to the BCBSA to use the trusted BCBS name in these territories.
However, Anthem is not the same as the non-profit BCBS companies. It operates independently as a for-profit public insurance company accountable to shareholders.
The key differences between Anthem’s BCBS plans and the independent Blues plans are:
Corporate structure – Anthem is a public for-profit company while traditional BCBS plans are private not-for-profit mutual insurers.
Market reach – Anthem’s BCBS plans are limited to 14 states. Independent BCBS companies operate in all 50 states.
State focus – BCBS plans concentrate in their home state. Anthem runs a national business.
Branding – In some states, Anthem sells plans under its own brand rather than the BCBS name.
Local autonomy – BCBS companies are self-governing. Anthem’s plans are centrally managed from its headquarters.
So in the 14 states where it is the Blue licensee, Anthem offers BCBS plans that carry the Cross and Shield trademarks but operate as an Anthem corporation rather than local BCBS mutual company.
Does Anthem sell insurance under its own brand?
In select markets outside of its 14 BCBS states, Anthem sells policies under its own brand name rather than Blue Cross Blue Shield. For example:
In California, Anthem Blue Cross is the BCBS provider. But Anthem HealthKeepers is available to consumers in certain California regions.
In Virginia, Anthem Blue Cross Blue Shield operates as the BCBS carrier. But Anthem HealthKeepers plans are also sold in the state.
In Wisconsin, Anthem plans are sold under the name Anthem Blue Preferred rather than Blue Cross Blue Shield since a local company owns the BCBS license.
So in parts of certain states, Anthem offers plans under subsidiary brands alongside its core BCBS-branded offerings. This can create some consumer confusion around Anthem’s relationship with Blue Cross Blue Shield.
Is Anthem dropping the Blue Cross Blue Shield name?
There were some recent reports that Anthem was rebranding and moving away from using the Blue Cross Blue Shield name in all its markets. However, this is not entirely accurate.
Here are the facts about Anthem and the BCBS brand:
Anthem remains committed to offering BCBS plans in the 14 states where it holds the Blue license.
The company recently introduced uniform branding by adding its name to BCBS plan labels in these states. For example, Blue Cross Blue Shield of California became Anthem Blue Cross Blue Shield of California.
The intent was brand clarity, not removing Blue Cross Blue Shield. Anthem will retain the BCBS names where licensed as this is a strong market advantage.
Anthem does sell plans under its own brand like Anthem HealthKeepers in select non-BCBS states. But those products exist alongside (not in place of) its core BCBS offerings.
So Anthem still relies heavily on the valued BCBS brand while making its own identity more prominent on policies. But it is not broadly dropping the Blue Cross Blue Shield name across all of its markets.
Does Anthem sell Medicare plans?
Yes, Anthem offers Medicare Advantage (Part C) and Medicare Part D prescription drug plans in many states through its BCBS or Anthem branded operations.
Some examples of Anthem Medicare offerings:
- Blue Cross Blue Shield of California Medicare Advantage HMO and PPO plans
- Anthem MediBlue Medicare Advantage plans in Indiana and Virginia
- Blue Cross Blue Shield of Georgia Medicare Rx (Part D) plans
- Anthem Rx Premier Medicare Part D plans in Maine
Anthem uses its size and data resources to develop competitive Medicare products. It sees the Medicare segment as a growth opportunity as more Baby Boomers age into eligibility.
But again, Anthem’s Medicare plans should not be confused with those from local non-profit BCBS companies. The offerings vary by state and insurer even if they contain Blue Cross Blue Shield in the name.
The Bottom Line
Anthem is a major national health insurer that operates BCBS plans in 14 states where it holds the Blue license. In other states, Anthem sells policies under its own brand. While Anthem plans carry the Blue Cross Blue Shield label in select markets, the company differs significantly from the independent, not-for-profit BCBS companies that make up the Blue Cross Blue Shield Association. But Anthem remains committed to leveraging the strong BCBS brand where it has exclusive rights to do so.
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