One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers. Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of approximately 7 million members in Pennsylvania, Delaware, New York and West Virginia. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses.
Our history began during the Great Depression of the 1930s and the genesis of the Blue Cross and Blue Shield movement when our predecessor companies were established to help Pennsylvania's residents pay for health care.
To ensure the availability of funds to pay for hospital and medical services, respectively, a hospital association based in Pittsburgh sponsored the formation of an organization later known as Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). The Pennsylvania Medical Society backed the founding of Pennsylvania Blue Shield (now Highmark Blue Shield). In 1996, the two Blue plans were consolidated, forming Highmark Inc. Highmark is now one of the largest health insurers in the United States.
These two plans were unique organizations from the outset — nonprofit corporations structured along traditional business lines. Without shareholders to satisfy, margins were held in reserve, applied to subsidize the cost of coverage for poor health risks, or reinvested in the business.
Leading the way
As independent organizations from the mid-1930s to the mid-1990s, Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield introduced several innovations, including a children's health insurance program that became the model for the national CHIP program and a dedicated program for seniors that predated Medicare, which helped to ensure access to health care services for the widest possible cross section of the community.
The consolidation of Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield, approved by the Pennsylvania Insurance Department on November 27, 1996, resulted in a new company — Highmark Inc. Highmark began operations on December 6, 1996, conducting business in Western Pennsylvania as Highmark Blue Cross Blue Shield and in the rest of Pennsylvania as Pennsylvania Blue Shield, partnering with three Blue Cross plans to provide complete coverage.
Upon forming a partnership with Mountain State Blue Cross Blue Shield in 1999, Highmark became the primary licensee of the Blue Cross and Blue Shield service marks in West Virginia. In January 2011, after a nearly 12-year affiliation, Mountain State Blue Cross Blue Shield changed its name to Highmark Blue Cross Blue Shield West Virginia (Highmark West Virginia).
Blue Cross Blue Shield of Delaware signed an affiliation agreement with Highmark in 2010. In late 2011, the agreement was approved and Blue Cross Blue Shield of Delaware joined Highmark. To reflect its relationship with Highmark, Blue Cross Blue Shield of Delaware became Highmark Blue Cross Blue Shield Delaware (Highmark Delaware) in 2012.
In 2015, Highmark secured final approval from the Pennsylvania Insurance Department to merge with Blue Cross of Northeastern Pennsylvania (BCNEPA). Upon completion of the agreement, the newly merged company operates as Highmark Blue Cross Blue Shield and continues to provide health insurance coverage and administrative services to nearly 550,000 individuals in BCNEPA's 13-county service area. This merger helped to create greater health care efficiencies and new products and services for customers in northeastern and north central Pennsylvania.
In March of 2021, Highmark Inc. announced the completion of its affiliation with HealthNow New York Inc. The newly affiliated organization was rebranded Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York and serves members in 21 counties in northeastern and western New York. The affiliation brought Highmark health plan membership to more than 6 million people at the time.
In January of 2023, Highmark announced plans to offer customers located in Southeastern Pennsylvania a full suite of health insurance products and solutions as Highmark Blue Shield, including Medicare Advantage, Medicaid dual eligible, Individual Affordable Care Act, Small Group Affordable Care Act, Large Group Fully Insured, Large Group Self-Insured across 2024 and 2025.
Dan Tropeano has been named the organization’s first ever Southeastern Pennsylvania segment president, a major milestone as Highmark plans to strengthen its statewide presence and community-focused service by offering a wide range of health insurance solutions in Southeastern Pennsylvania starting in 2024.
Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.
This website is operated by Highmark, Inc. and is not the Health Insurance Marketplace website. This website does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov.
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