Blue Shield of California
From Wikipedia, the free encyclopedia
Blue Shield of California is a not-for-profit health insurance provider headquartered in San Francisco, California. An independent licensee of the Blue Cross and Blue Shield Association, Blue Shield of California is an incorporated, wholly owned subsidiary of California Physicians' Service, Inc. The current President and CEO is Bruce G. Bodaken.
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[edit] Accreditation
The National Committee for Quality Assurance (NCQA) recently awarded Blue Shield an "Excellent" rating for service and clinical quality for its Health maintenance organization (HMO) and Point of Service (POS) lines of business, a status given to health plans which meet or exceed the NCQA's requirements for consumer protection and quality improvement.
[edit] History
Blue Shield of California was founded in 1939 as California Physicians' Service (CPS). CPS was among a handful of companies that helped to found the National Association of Blue Shield Plans, which later became the Blue Cross and Blue Shield Association.
The Blue Shield of California health plan was the first in the nation to offer catastrophic coverage in 1950, provide coverage for a heart transplant in 1984, offer online benefit and enrollment information in 1996, and offer an online enrollment system for agents in 1998 [1]. Blue Shield of California was also the first to offer a cross-border HMO, Access Baja, which provides coverage for individuals in both the United States and Baja California, Mexico [2] [1].
In 2006, after a class action lawsuit alleged that Blue Shield engaged in unlawful, unfair and fraudulent business practices by modifying the risk tier structure of its individual and family health care plans, Blue Shield agreed on a settlement of $6.5 million on behalf of former and current Blue Shield subscribers residing in California. The settlement received overwhelming support from the class members. The Honorable James L. Warren granted final approval of the settlement in March 2006.
[edit] Statistics
[edit] Membership (as of January 2006)
- HMO: 1,300,000
- PPO: 1,200,000
- TRICARE: 500,000
- Other: 300,000
- Total: 3,300,000
[edit] Provider Network (as of November 2005)
- HMO, PPO
- Primary Care Physicians: 10,838 (HMO), 18,719 (PPO)
- Specialists: 18,677 (HMO), 42,828 (PPO)
- Total: 29,515 (HMO), 61,547 (PPO)
[edit] Hospital Network (as of November 2005)
- HMO: 279
- PPO: 344
[edit] Locations
Blue Shield has offices in Chico, El Dorado Hills, Folsom, Fresno, Gold River, Irvine, Hemet, Lodi, Monterey Park, Orange, Petaluma, Redding, Riverside, Sacramento, San Diego, San Francisco, San Jose, Santa Barbara, Walnut Creek, Woodland and Woodland Hills. The Chico office will be shut down effective 10/31/2008
Blue Shield of California is headquartered in San Francisco, 50 Beale Street. Corporate headquarters are undergoing an extensive renovation. BSC will boast a state of the art green building by 2010.
