Highmark

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Highmark Inc.
Non-profit
IndustryHealthcare, Insurance
FoundedJune 22, 1977 [1]
HeadquartersFifth Avenue Place
Pittsburgh, Pennsylvania
Key people
Deborah L. Rice-Johnson, President
ProductsHealth Insurance
RevenueIncrease$18.2 billion USD (2016)[1]
Number of employees
19,500 (2012)
Websitewww.highmark.com
Highmark's headquarters at Penn Avenue and Fifth Avenue in Pittsburgh, Pennsylvania

Highmark is a non-profit healthcare company based in Pittsburgh, Pennsylvania, United States. It is a large individual not-for-profit health insurer in the United States, which operates several for-profit subsidiaries.

Locality[edit]

It is a health insurer in Pennsylvania, and through a purchase in 1996, an insurer in West Virginia and also later Delaware. As Highmark Blue Cross Blue Shield, it is primarily available in 29 counties of western Pennsylvania. As Highmark Blue Shield, it is available in 21 counties in Central Pennsylvania and the Lehigh Valley. It also has a presence in the border areas of eastern Ohio, and all of West Virginia through its subsidiary, Highmark Blue Cross Blue Shield West Virginia. Highmark acquired Blue Cross of North East Pennsylvania, BCNEPA, in July 2015.

Company history[edit]

Highmark was created in 1977 and in the 1990s by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) based in suburban Harrisburg, and Blue Cross of Western Pennsylvania based in downtown Pittsburgh (now Highmark Blue Cross/Blue Shield). The consolidated group is available in 49 of the state's 67 counties.[citation needed] In West Virginia, the company operates as Highmark Blue Cross Blue Shield West Virginia, and in Delaware, it operates as Highmark Blue Cross Blue Shield Delaware. The new company based its head offices in downtown Pittsburgh.

On March 28, 2007, Highmark announced it intended to consolidate with Independence Blue Cross of Philadelphia. The combination of the 2 insurers would have created a new company with over 18,000 employees, dual-headquarters in both Pittsburgh and Philadelphia and an economic impact of over $4 billion throughout the Commonwealth of Pennsylvania.[citation needed] On January 22, 2009, Highmark and Independence Blue Cross withdrew their applications to consolidate due to the unacceptability of conditions that the Pennsylvania Insurance Department was going to place upon the merger: to give up either of their well-known "Blue Cross" or "Blue Shield" trademarks.[2]

In 2011 the company announced it would buy the financially troubled West Penn Allegheny Health System (WPAHS) for about $500 million, expanding from insurance into owning hospitals[3]. This began a period of conflict between Highmark and UPMC, which had expanded from hospitals into insurance, and caused difficulties for patients to access care at the conflicting institutions[4]. The conflict included a lawsuit by Highmark against UPMC alleging that UPMC over-billed it by $300 million for cancer drugs[5][6], arbitrators ordered UPMC to pay $188 million[7].

In 2014, a gay couple criticized Highmark for not providing family coverage under the Affordable Care Act[8]. Highmark later reversed their policy[9].

Organizational Structure[edit]

Highmark Inc. has several wholly owned for-profit subsidiaries: United Concordia Companies, Inc., a dental insurer; Davis Vision, a provider of managed care vision benefits; Visionworks of America, a vision retail provider offering frames, lens and accessories; and HM Insurance Group, a reinsurer providing stop-loss, limited benefit medical plans, worksite, life, disability, and administrative services.

  • Highmark Health Plan
    • Highmark Blue Cross Blue Shield (Western PA)
    • Highmark Blue Shield (Central PA)
    • Highmark Blue Cross Blue Shield West Virginia
    • Highmark Blue Cross Blue Shield Delaware
  • Allegheny Health Network
  • Diversified Businesses

References[edit]

  1. ^ "Archived copy". Archived from the original on 2017-06-14. Retrieved 2017-11-04.
  2. ^ Bill Toland (22 January 2009). "Health giants halt merger". Pittsburgh Post-Gazette. PG Publishing Co., Inc. Archived from the original on 24 December 2014. Retrieved 18 December 2014.
  3. ^ Mathews, Anna Wilde (2011-06-29). "Insurer's Cost-Cut Plan: Buy Hospitals". Wall Street Journal. ISSN 0099-9660. Archived from the original on 2018-04-18. Retrieved 2018-04-17.
  4. ^ Johnson, Carolyn Y. (2018-02-13). "Two visions for the future of health care are at war in Pittsburgh". Washington Post. ISSN 0190-8286. Archived from the original on 2018-04-18. Retrieved 2018-04-17.
  5. ^ "Highmark sues UPMC for cancer treatment 'overbilling'". Pittsburgh Post-Gazette. Archived from the original on 2018-04-18. Retrieved 2018-04-17.
  6. ^ "Highmark sues UPMC over billing for cancer drugs". Washington Examiner. 2014-09-04. Archived from the original on 2018-04-18. Retrieved 2018-04-17.
  7. ^ Venteicher, Wes. "Arbitrators side with UPMC; Highmark must pay $188 million for cancer care". TribLIVE.com. Archived from the original on 2018-04-18. Retrieved 2018-04-17.
  8. ^ "Some States Deny Same-Sex Couples Family Insurance". NPR.org. Archived from the original on 2018-04-18. Retrieved 2018-04-17.
  9. ^ "Highmark to insure same-sex couples in Pennsylvania". Pittsburgh Post-Gazette. Archived from the original on 2018-04-18. Retrieved 2018-04-17.

External links[edit]