The Blue Cross Blue Shield Association is not a single insurance company but a federation of 33 independent, community-based and locally operated Blue plans that together cover roughly 115 million people across all 50 states, Washington D.C. and Puerto Rico. Each member plan is separately licensed, sets its own rates, networks and products, and answers to its own state regulator, which is why your Blue coverage in one state can look very different from a neighbor’s in another. What the Association itself does is license the Blue Cross and Blue Shield brands and operate shared national programs including BlueCard, Blue Distinction and the Federal Employee Program, so a card issued by one plan is honored by providers contracted with another. Blue Cross traces to 1929 and Blue Shield to 1939, the two consolidated operations in 1978 and formally merged into the Association in 1982. Since the Association does not underwrite policies, it carries no AM Best rating of its own, and financial strength ratings belong to each member plan individually.
