{{Short description|American mutual benefit corporation}} {{Use American English|date=May 2021}} {{Use mdy dates|date=April 2021}} {{Infobox company | name = Blue Shield of California | logo = Blue Shield of California logo.png | logo_size = | type = Non-profit health plan (tax exempt status removed in 2014)<ref name=Mission>{{Cite web|url=https://www.blueshieldca.com/bsca/about-blue-shield/corporate/values.sp|title=Mission and Values – Blue Shield of California|website=blueshieldca.com|access-date=March 17, 2016}}</ref><ref name=Stripped>{{Cite web|url=https://www.latimes.com/business/la-fi-blue-shield-california-20150318-story.html|title=With billions in the bank, Blue Shield of California loses its state tax-exempt status|website=Los Angeles Times|date=March 18, 2015 |access-date=September 1, 2016}}</ref> | founder = California Medical Association<ref name=History>{{Cite web|url=https://www.blueshieldca.com/bsca/about-blue-shield/corporate/history.sp|title=Corporate History and Timeline – Blue Shield of California|website=blueshieldca.com|access-date=March 17, 2016}}</ref> | key_people = Mike Stuart<br />Interim President and chief executive | industry = Healthcare | revenue = {{increase}} $21.8 billion USD (2020)<ref name="2020Financials" /> | net_income = {{increase}} $680 million USD (2020)<ref name="2020Financials" /> | members = {{increase}} 4.5 million (2021)<ref name="FactPDF">{{Cite web|date=2021|title=Fact sheet|url=https://s3.amazonaws.com/cms.ipressroom.com/347/files/20212/BlueShieldCA_Fact_Sheet_March+2021.pdf|url-status=live|website=Blue Shield of California|archive-url=https://web.archive.org/web/20210512003139/https://s3.amazonaws.com/cms.ipressroom.com/347/files/20212/BlueShieldCA_Fact_Sheet_March+2021.pdf |archive-date=May 12, 2021 }}</ref> | num_employees = 7,500 (2021)<ref name="FactPDF" /> | homepage = {{URL|https://blueshieldca.com}} | foundation = 1938 (created)<ref name=History /><br />1939 (incorporated)<ref name=History /> | location = 601 12th Street<br />Oakland, California| }}
'''Blue Shield of California''' is a mutual benefit corporation and health plan,<ref name=":1">{{Cite web|last1=Young|first1=Samantha|last2=Hart|first2=Angela|date=March 22, 2021|title=Newsom Awarded the No-Bid Vaccine Contract to Blue Shield, a Trusted and Generous Supporter|url=https://www.kqed.org/science/1973320/newsom-awarded-the-no-bid-vaccine-contract-to-blue-shield-a-trusted-and-generous-supporter|url-status=live|access-date=2021-05-07|website=KQED|language=en-us|archive-url=https://web.archive.org/web/20210323012250/https://www.kqed.org/science/1973320/newsom-awarded-the-no-bid-vaccine-contract-to-blue-shield-a-trusted-and-generous-supporter |archive-date=March 23, 2021 }}</ref><ref>{{Cite web|last=Terhune|first=Chad|date=2015-06-06|title=Blue Shield faces more heat over nonprofit status, $1.2-billion deal|url=https://www.latimes.com/business/la-fi-blue-shield-nonprofit-20150605-story.html|url-status=live|access-date=2021-05-07|website=Los Angeles Times|language=en-US|archive-url=https://web.archive.org/web/20150606011831/http://www.latimes.com/business/la-fi-blue-shield-nonprofit-20150605-story.html |archive-date=June 6, 2015 }}</ref> founded in 1939 by the California Medical Association. It is based in Oakland, California, and serves 4.5 million health plan members and more than 65,000 physicians across the state. Blue Shield of California was founded as a not-for-profit organization. As of 2014, it is no longer tax-exempt in California and has been paying federal taxes for years before that.<ref name="Stripped" />
== History == Blue Shield of California, then known as California Physicians' Service, was created by the California Medical Association in 1938. The organization was incorporated in 1939 and began offering coverage on March 6 of that same year. In 1946, the organization was among the founders of the National Association of Blue Shield Plans, which later became the Blue Cross and Blue Shield Association.<ref name="Blue Shield Timeline">{{cite web|date=September 12, 2011|title=Corporate History and Timeline|url=https://www.blueshieldca.com/bsc/newsroom/newsroom_02.jhtml|url-status=live|access-date=May 3, 2021|work=Blue Shield of California|archive-url=https://web.archive.org/web/20060322045851/https://www.blueshieldca.com/bsc/newsroom/newsroom_02.jhtml |archive-date=March 22, 2006 }}</ref> In 1950, the Blue Shield of California health plan began offering catastrophic coverage.<ref name="Blue Shield Timeline" /><ref>{{Cite book|last=Dickinson|first=Frank G.|url=https://books.google.com/books?id=ZTUghWGjMlAC&pg=PA103|title=Medical Care in Transition|date=1964|publisher=U.S. Department of Health, Education, and Welfare, Public Health Service|others=Reprints from the American Journal of Public Health|volume=1|pages=103|language=en|oclc=1012029666}}</ref> By 1961, it had one million subscribers of its health plan.<ref name="Blue Shield Timeline" /> From 1966 to 2018, the organization was headquartered at 50 Beale Street in San Francisco.<ref name="oakland">{{cite news | url=https://www.bizjournals.com/sanfrancisco/news/2017/03/08/blue-shield-oakland-lease-shorenstein-office-tower.html |title=Blue Shield to move headquarters from San Francisco to Oakland with massive lease | first=Roland | last=Li | work=American City Business Journals | date=March 8, 2017}}</ref>
In 1984, it began covering heart transplantations offered at Stanford University Medical Center.<ref>{{Cite journal|last=Evans|first=Roger W.|date=January 1987|title=The economics of heart transplantation.|journal=Circulation|language=en|volume=75|issue=1|pages=73|doi=10.1161/01.CIR.75.1.63|pmid=3098447 |doi-access=free}}</ref>
The Blue Cross of California, which traditionally covered the hospital portion of insurance as a separate entity, went public in 1992 under the name Wellpoint, with the name later changing to Anthem.<ref>{{Cite web|url=https://www.indystar.com/story/money/2014/12/03/call-us-wellpoint-says-newly-named-anthem/19827633/|title=Don't call us WellPoint, says newly named Anthem|website=Indianapolis Star|access-date=May 24, 2019}}</ref> Blue Shield began offering information on benefits and enrollment on the Internet in 1996, and offering an online enrollment system for agents in 1998.<ref name="Blue Shield Timeline" /> In 1997, Blue Shield acquired the managed care company CareAmerica.<ref>{{cite web | url=https://californiahealthline.org/morning-breakout/blue-shield-of-california-acquires-careamerica/ | title=Blue Shield of California: Acquires Careamerica }}</ref>
In 2006, Blue Shield agreed to a $6.5 million settlement relating to allegedly modifying the risk tier structure of its individual and family health care plans. In 2008, the organization settled for $3 million with the California Department of Managed Health Care to resolve allegations of improper rescission of individual health plan coverage. Further, the organization reinstated coverage to 450 members whose plans had been canceled and agreed to provide compensation for any medical debts incurred by these policyholders due to the rescission.<ref>{{cite news|date=July 18, 2008|title=2 health insurers to pay $13M to Calif. regulators|publisher=AP/Google|url=http://ap.google.com/article/ALeqM5gDBLyPh2QHiIO7azoVYF9Q2TVRSwD9203RSG2|url-status=dead|accessdate=July 18, 2008|archiveurl=https://web.archive.org/web/20080721053636/http://ap.google.com/article/ALeqM5gDBLyPh2QHiIO7azoVYF9Q2TVRSwD9203RSG2|archivedate=July 21, 2008}}</ref>
In 2010, Blue Shield of California, Dignity Health, and Hill Physicians Medical Group formed an Accountable Care Organization that covers 41,000 individuals in the California Public Employees Retirement System (CalPERS). During its first 2 years, this program reduced inpatient use and health care costs significantly.<ref>{{cite web |publisher=Agency for Healthcare Research and Quality |url=https://innovations.ahrq.gov/profiles/accountable-care-organization-featuring-shared-global-risk-stimulates-development |title=Accountable Care Organization Featuring Shared Global Risk Stimulates Development of Initiatives To Improve Care, Reduces Inpatient Use and Costs |date=May 8, 2013 |accessdate=May 9, 2013}}</ref>
In 2015, Blue Shield entered the Medicaid market by acquiring Care1st Health Plan.<ref>{{cite web|url=https://www.blueshieldca.com/bsca/about-blue-shield/media-center/blue-shield-of-california-care1st-acquisition-100815.sp|title=Blue Shield of California Closes on Acquisition of Care1st, Enters Medi-Cal/Medicaid|publisher=Blue Shield}}</ref> Blue Shield sold Care1st Arizona to WellCare in 2017. Care1st California was renamed Blue Shield of California Promise Health Plan in 2019.<ref>{{Cite web| title = Care1st Health Plan Changing Its Name| work = L.A. Care Health Plan| accessdate = June 21, 2019| date = December 13, 2018| url = http://www.lacare.org/tl/node/27946}}</ref>
In 2019, Blue Shield of California launched the healthcare company Altais. In 2020, Altais acquired the San Francisco practice Brown & Tolland.<ref>{{cite web | url=https://www.hcinnovationgroup.com/population-health-management/care-management/article/21164260/in-northern-california-two-organizations-partner-to-support-independent-md-practices-around-value | title=In Northern California, Two Organizations Partner to Support Independent MD Practices Around Value | date=November 25, 2020 }}</ref> In 2021, Altais acquired the Los Angeles County practice Family Care Specialists.<ref>https://altais.com/blog/altais-has-acquired-family-care-specialists/</ref>
== Network == Blue Shield of California's provider network currently includes 65,000 physicians<ref>{{Cite web|last=Pena|first=Luz|date=March 3, 2021|title=Blue Shield CEO explains plan to increase CA's vaccine doses to 4M per week|url=https://abc7news.com/10384170/|url-status=live|access-date=April 30, 2021|website=ABC7 San Francisco|language=en|archive-url=https://web.archive.org/web/20210303034249/https://abc7news.com/10384170/ |archive-date=March 3, 2021 }}</ref> and more than 340 hospitals statewide.<ref>{{cite web|date=June 2018|title=Fact Sheet|url=https://news.blueshieldca.com/internal_redirect/cms.ipressroom.com.s3.amazonaws.com/347/files/20185/Fact%20Sheet%20DRAFT04_graphical_201806201759.pdf|url-status=live|access-date=April 30, 2021|website=Blue Shield of California – News Center|archive-url=https://web.archive.org/web/20191006022039/https://news.blueshieldca.com/internal_redirect/cms.ipressroom.com.s3.amazonaws.com/347/files/20185/Fact%20Sheet%20DRAFT04_graphical_201806201759.pdf |archive-date=October 6, 2019 }}</ref>
In the California Healthcare Quality Report Card 2009 Edition, Blue Shield of California received 3 out of 4 stars in Meeting National Standards of Care and 2 out of 4 stars in How Members Rate Their HMO.<ref>[http://www.opa.ca.gov/report_card/hmorating.aspx State of California – Health Care Quality Report Card 2009 Edition] {{webarchive|url=https://web.archive.org/web/20110719035537/http://www.opa.ca.gov/report_card/hmorating.aspx?utm_source=Wiki-BlueShield&utm_medium=QualityofCare&utm_campaign=Wikipedia|date=July 19, 2011}}</ref>
== Financial == In 2011, Blue Shield announced that it would cap its net income at no more than 2% of revenue, contingent on approval from the board of directors.<ref>{{Cite web|last=Brown|first=Steven E.F.|date=2011-06-07|title=Blue Shield of California to limit profit to 2% of revenue|url=https://www.bizjournals.com/sanfrancisco/news/2011/06/07/blue-shield-of-california-to-limit.html|url-status=live|access-date=2021-05-07|website=San Francisco Business Times|archive-url=https://web.archive.org/web/20110610165344/http://www.bizjournals.com:80/sanfrancisco/news/2011/06/07/blue-shield-of-california-to-limit.html? |archive-date=June 10, 2011 }}</ref> As of 2019, more than $600 million has been returned to customers and the community as a result of the pledge.<ref>{{Cite web|date=2020|title=Financials|url=https://www.blueshieldca.com/bsca/bsc/public/member/mp/contentpages/!ut/p/z1/tVFLc4IwEP4r9eCRyRIohCNaX0ytM1ar5sIkGCQdSBCjtv--wbG9VaeH5rSZ_Xb3eyCK1ogqdpI7ZqRWrLT_DQ1STCZkDOAmM8AAMYF-8hJFhIQhekMU0TqTW7TBgRv6goMTbrHr-BhCJ-KZ70SPImKZ4Dx3eYvOlKlNgTaVqLho0kwrI5RJherCtX5otDZdYFwfTcrLo0gPhRTltgU0tW6YEalUuW6qC88u5FIxlUlWHtDqHmNq2_DLiwEl9wDWEtxM-9Od1c1M4bRE0LrWmT1NL8M_x0eLvgfxaBB7Q7L0iO9fATe2byz9ME0IBJPeDJ7hlYQQPw3mvXiIMYxctDpJcUZL1Yov0esf7R9_C7xhkBUo3_d7Gtuo2jw-DFr_T1Z1VRHv06E8mJPzIi_KXafzBQ4jais!/dz/d5/L2dBISEvZ0FBIS9nQSEh/|url-status=live|access-date=May 7, 2021|website=Blue Shield of California|archive-url=https://web.archive.org/web/20200418231232/https://www.blueshieldca.com/bsca/bsc/public/member/mp/contentpages/!ut/p/z1/tVFLc4IwEP4r9eCRyRIohCNaX0ytM1ar5sIkGCQdSBCjtv--wbG9VaeH5rSZ_Xb3eyCK1ogqdpI7ZqRWrLT_DQ1STCZkDOAmM8AAMYF-8hJFhIQhekMU0TqTW7TBgRv6goMTbrHr-BhCJ-KZ70SPImKZ4Dx3eYvOlKlNgTaVqLho0kwrI5RJherCtX5otDZdYFwfTcrLo0gPhRTltgU0tW6YEalUuW6qC88u5FIxlUlWHtDqHmNq2_DLiwEl9wDWEtxM-9Od1c1M4bRE0LrWmT1NL8M_x0eLvgfxaBB7Q7L0iO9fATe2byz9ME0IBJPeDJ7hlYQQPw3mvXiIMYxctDpJcUZL1Yov0esf7R9_C7xhkBUo3_d7Gtuo2jw-DFr_T1Z1VRHv06E8mJPzIi_KXafzBQ4jais!/dz/d5/L2dBISEvZ0FBIS9nQSEh/ |archive-date=April 18, 2020 }}</ref>
In 2014, Blue Shield of California lost its exemption from California state corporate income tax. This information became public in March 2015.<ref name=":0">{{cite web|last=Terhune|first=Chad|date=2015-03-18|title=With billions in the bank, Blue Shield of California loses its state tax-exempt status|url=https://www.latimes.com/business/la-fi-blue-shield-california-20150318-story.html|url-status=live|access-date=May 7, 2021|website=Los Angeles Times|archive-url=https://web.archive.org/web/20150318173005/http://www.latimes.com/business/la-fi-blue-shield-california-20150318-story.html |archive-date=March 18, 2015 }}</ref> A claimed recent application of the duck test resulted in the denial of Blue Shield's tax-exempt status.<ref name="Seipel">{{cite news|last1=Seipel|first1=Tracy|date=March 19, 2015|title=California drops hammer on Blue Shield tax-exempt status|newspaper=San Jose Mercury News|url=http://www.mercurynews.com/health/ci_27749247/california-drops-hammer-blue-shield-tax-exempt-status|accessdate=March 19, 2015}}</ref> This was after "a lengthy state audit that looked at the justification for Blue Shield's taxpayer subsidy." Blue Shield holds billions in cash reserves and spends millions in executive pay. The organization defended its tax-exempt status, but failed to provide sufficient evidence to California Franchise Tax Board that its actions align with such obligations.<ref name=":0" /> As a result, Blue Shield became a tax-paying nonprofit.<ref name=":1" />
In 2020, Blue Shield of California reported $21.8 billion in revenue and $680 million in net income.<ref name="2020Financials">{{Cite web|date=2020|title=Blue Shield of California Consolidated Financials|url=https://s3.amazonaws.com/cms.ipressroom.com/347/files/20213/Blue%20Shield%20of%20California%20Consolidated%20Financials%202020.pdf|access-date=May 7, 2021|website=Blue Shield of California}}</ref>
== Controversies == In April 2025, Blue Shield of California notified members that it had shared private health data with Google Ads affecting 4,700,000 individuals.<ref>{{cite web |title=Notice of Data Breach |url=https://news.blueshieldca.com/notice-of-data-breach |website=news.BlueShieldCA.com |archive-url=https://archive.today/20250410203814/https://news.blueshieldca.com/notice-of-data-breach |archive-date=10 April 2025 |date=April 9, 2025}}</ref><ref>{{cite news |last1=Roy |first1=Jessica |title=Blue Shield of California shared 4.7M members’ private health data with Google |url=https://www.sfchronicle.com/personal-finance/article/blue-shield-california-data-breach-20290464.php |work=San Francisco Chronicle |date=April 24, 2025 |language=en}}</ref><ref>{{cite news |last1=Whittaker |first1=Zack |title=Blue Shield of California shared the private health data of millions with Google for years |url=https://techcrunch.com/2025/04/23/blue-shield-of-california-shared-the-private-health-data-of-millions-with-google-for-years/ |work=TechCrunch |date=23 April 2025}}</ref>
== References == {{Reflist|30em}}
== External links == *{{Official website|https://blueshieldca.com}}
{{Authority control}}
Category:Health insurance in the United States Category:Members of Blue Cross Blue Shield Association Category:American companies established in 1939 Category:Financial services companies established in 1939 Category:1939 establishments in California Category:Companies based in San Francisco Category:Medical and health organizations based in California