Anyone Have a Clue When it Comes to Blue Insurance?

by John Kiernan on March 28, 2012

Blue Cross Blue Shield Insurance ConfusionDo you know who your insurer is? This is neither a trick question, nor a bungling of the famous 1970s parenting PSA. Rather, it’s an honest question that I’d hazard to guess a large segment of the 100 million consumers under the Blue Cross and Blue Shield umbrella would be unable to answer due to the confusing corporate structure behind this association.

I mean, do you know the difference between Anthem Blue Cross Blue Shield, Blue Cross Blue Shield, Blue Cross Blue Shield of Illinois, Premera Blue Cross Blue Shield, and Blue Cross Blue Shield of Nebraska? Probably not, but don’t feel bad.

You see, the aforementioned names all denote distinct insurance companies who operate in different states yet are all under the umbrella of the Blue Cross and Blue Shield Association, which was formed in 1982 and is altogether comprised of 38 independently operated insurance providers as well as a federal employee program.

The independent providers operating under this overarching association use an exceedingly confusing naming convention filled with a hodgepodge of “blues,” “crosses,” “shields,” and company names in order to create a national brand for products offered by 38 different companies.

Such an approach works fine for physical products, as no matter where you buy a Pepsi, for example, it’s going to be a Pepsi, and you know that the buck eventually stops with PepsiCo. However, the most important features of an insurance policy – in addition to coverage, of course – are customer service and claims management. Just think: Even the best policies can end up driving you crazy if customer service isn’t helpful and you have to jump through a million hoops to receive payment for a covered incident.

So while the Blue Cross and Blue Shield symbols have become instantly recognizable from coast to coast and beyond, it can obviously be difficult to differentiate one particular provider from another. All of this contributes to a situation in which consumers not only might be unaware of who is insuring them but might even think that Blue Cross and Blue Shield is a single company. Even if they know better, many will inevitably assume that all Blue Cross and Blue Shield providers are created equal.

Consider, for example, what this would mean for a Blue Cross Blue Shield of Texas customer who moves to Oregon. He might assume that Blue Cross Blue Shield of Oregon provides the same level of service and that he may even be able to keep his original policy, but since these two providers are owned by different companies, the customer experience could be drastically different. The Blue Cross Blue Shield naming confusion therefore muddies the waters, misleading consumers along the way.

While the current confusion can only truly be remedied by a clarified naming system, we should at least try to decode the current landscape given how important it is to know who is insuring the 100 million of us with Blue Cross Blue Shield insurance and what their reputation is. With that being said, if your insurance statement contains the name Anthem, CareFirst, Health Care Service Corporation, Highmark, Premera, the Regence Group, or Wellmark, then you’re insured by one of the seven major companies offering Blue Cross Blue Shield insurance in more than one state. Otherwise, odds are that you’re insured by one of the thirty-two privately owned providers that offer Blue Cross Blue Shield insurance at the state or local level.

Either way, it’s clear that while Blue Cross Blue Shield has created a strong national brand that benefits its disparate member companies, it has also created an environment in which customers of these companies do not know what to expect or from whom to expect it. As long as insurance is regulated ineffectively at the state level, regulators should require that companies brand their policies in a way that makes it clear which company is behind them.

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