Anthem Blue Cross & Blue Shield

What Anthem Blue Cross & Blue Shield does

Anthem Blue Cross and Blue Shield is the health plan brand of Elevance Health (NYSE: ELV), operating through state-level licensed Blue Cross and Blue Shield Association entities across 14 states — Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York (17 southeastern counties), Ohio, Virginia, and Wisconsin. The company sells individual and family plans, small business (2–100 employees) and large group/National Accounts employer coverage, Medicare Advantage (including D-SNP and chronic condition plans), Medicare Supplement and Part D, Medicaid, and Federal Employee Health Benefit Program plans, with revenue generated primarily through recurring monthly insurance premiums across these subscription-based segments. Its technology platform centers on the Sydney Health App (launched 2013), an AI-powered mobile application that integrates benefits access, ID cards, pharmacy tools, cost transparency (Find Care and Virtual Care), live chat, and care navigation, with adjacent digital products including Sydney Care, LiveHealth Online virtual visits, and the Whole Health Index.

The go-to-market is multi-channel: direct employer sales teams for National Accounts, a broker/producer network for mid-market and individual segments (including sponsorship in The Council of Insurance Agents & Brokers), digital self-service through anthem.com and the Sydney app, and government program enrollment channels. Anthem actively pursues value-based care arrangements — evidenced by the Mount Sinai three-year contract (2026-04-14) embedding quality and outcomes reimbursement, the HealthSync Designated Orthopedic Network in Indiana with OrthoIndy and Franciscan Health/Forté (up to 50% lower cost), and partnerships with Positive Development for autism services and Somatus for kidney care management. Distribution also extends through corporate subsidiaries including CarelonRx Services (pharmacy benefit management) and Carelon Global Solutions (third-party claims processing). Recent strategic activity includes the 2024-12-31 acquisition of Indiana University Health Plans, investments in Zócalo Health and Solace Health, and leadership refreshes across Georgia, Indiana, and Connecticut state plans.

Name

Anthem Blue Cross & Blue Shield

Legal name

Anthem Insurance Companies, Inc.

Website

https://anthem.com

Company type

Private

Founded year

1940

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Anthem Blue Cross and Blue Shield is a multi-state health insurance subsidiary of Elevance Health selling individual, employer, Medicare, and Medicaid plans across 14 states through the Sydney Health digital platform, broker networks, and value-based provider partnerships.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

Accident & Health Insurance (6321)

akta.pro primary industry

MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)

Keywords

• Health insurance plans
• Medicare advantage coverage
• Medicaid managed care
• Employer group benefits
• Pharmacy benefit management

Headquarters

HQ city

Indianapolis

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Supply Chain, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Premiums: Anthem generates revenue primarily through insurance premiums paid by individuals, employers, and government programs. The company offers various plan types including medical, dental, vision, pharmacy, and supplemental health insurance.
2. Medicare Advantage Plans: Medicare Advantage plans with Medicare contract, offering coverage to Medicare-eligible individuals including those with chronic conditions and dual eligibility
3. Medicaid Plans: State-sponsored Medicaid coverage for eligible children, adults, and families

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels6 records

Core offering

Anthem Blue Cross & Blue Shield underwrites and distributes health insurance coverage to individuals, families, employers, Medicare beneficiaries, Medicaid members, and federal employees across 14 states. Core products include medical, pharmacy, dental, vision, supplemental health, life and disability plans, with member service delivered through the Sydney Health mobile app and digital self-service platforms.

Product overview

Anthem Blue Cross and Blue Shield operates as a health insurance company offering a comprehensive portfolio of health coverage products across individual/family, Medicare, Medicaid, and employer group segments. The core product offerings include health insurance plans with medical, pharmacy, dental, vision, and supplemental health benefits. The company provides technology-enabled member services through its Sydney Health mobile app, which serves as a unified digital portal for accessing benefits, ID cards, live chat support, cost transparency tools, and wellness programs. Additional digital products include Sydney Care (care navigation through Carelon Digital Platforms), LiveHealth Online for virtual care consultations, and the Whole Health Index for health tracking. Anthem also offers value-based care networks such as the HealthSync Designated Orthopedic Network, along with specialized programs like the BabySTEPs Digital Helpline for substance use support and the ELEVATE program for foster care communities. The product architecture combines traditional insurance products with technology-driven member engagement tools to provide comprehensive healthcare coverage and navigation services.

Differentiator

Problem solved

Functional benefit

Brands

• Sydney Health: Mobile application for members to access benefits, ID cards, pharmacy information, and live chat support.
• Sydney Care
• Whole Health Index

Products and services

• Individual & Family Health Insurance Affordable health, dental, and vision coverage for individuals and families, with potential financial assistance to lower coverage costs. Sold by state and ZIP code with options for medical, pharmacy, dental, and vision benefits.
• Medicare Advantage Plans

Quantifiable outcome

• U.S. healthcare spending exceeds $5 trillion annually with hospital costs rising nearly 10% in 2023-2024; Anthem addresses these pressures through provider negotiations and value-based care models
• +5 more outcomes

Named customers9 records

Segments6 records

Ideal customer profiles6 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability1 record

Feature3 records

Partnerships

16 partnerships are on record, tiered core and minor.

• Golden State Imaging Associates (GSIA)coreStrategic or Co-development Partner · 1 June 2026Golden State Imaging Associates, a Radiology Partners-affiliated practice, and Anthem Blue Cross finalized a multi-year agreement restoring in-network access to subspecialized radiology services for Anthem members across California, effective June 1, 2026. The partnership ensures seamless access to diagnostic and interventional radiologists and supports hospitals, referring physicians, and patients statewide.
• Northeast Georgia Health SystemcoreStrategic or Co-development Partner · 5 May 2026Anthem Blue Cross and Blue Shield of Georgia and Northeast Georgia Health System announced a new multi-year agreement ensuring Anthem commercial and Medicare Advantage members retain in-network access to NGHS hospitals, physicians, and specialty services. NGHS is a nonprofit health system serving more than one million people across Northeast Georgia.
• Mount Sinai Health SystemcoreStrategic or Co-development Partner · 14 April 2026Anthem and Mount Sinai reached a new three-year contract agreement restoring in-network coverage for approximately 200,000 Anthem enrollees after physicians went out-of-network in March. The deal includes updated reimbursement models that reward quality and outcomes while incorporating reasonable price increases alongside value-based care models.
• Children's Hospital ColoradocoreStrategic or Co-development Partner · 7 April 2026Anthem Blue Cross and Blue Shield in Colorado expanded its provider network to include Children's Hospital Colorado for Pathway Exclusive Provider Organization members, giving thousands of employer-sponsored plan members in-network access to pediatric specialty care at over 10 locations across the Front Range.
• Athens Orthopedic CliniccoreStrategic or Co-development PartnerAnthem Blue Cross and Blue Shield of Georgia partnered with Athens Orthopedic Clinic to expand orthopedic services across Georgia, including new outpatient and surgical centers. The collaboration aims to improve access, quality, and affordability of orthopedic care in the region.
• Pediatric Specialists of VirginiacoreStrategic or Co-development PartnerAnthem Blue Cross and Blue Shield in Virginia and Pediatric Specialists of Virginia announced a renewed partnership ensuring continued access to specialized pediatric care for Anthem members in Northern Virginia. PSV operates outpatient locations in Ashburn, Fairfax, and Woodbridge.
• Premier Health NetworkcoreStrategic or Co-development PartnerAnthem Blue Cross and Blue Shield of Georgia and Premier Health Network announced a new partnership to enhance access and support value-based care initiatives in Georgia.
• United DigestivecoreStrategic or Co-development PartnerAnthem Blue Cross and Blue Shield and United Digestive announced a multi-year provider network agreement keeping United Digestive in-network for Anthem members across Georgia. United Digestive supports gastrointestinal providers with 61 clinics, 22 ambulatory surgery centers, and over 220 providers.
• Solace HealthcoreStrategic or Co-development PartnerSolace Health, a patient advocacy platform, expanded its services to commercially insured patients partnering with major health plans including UnitedHealthcare and Anthem Blue Cross Blue Shield. The expansion moves Solace beyond its previous focus on Medicare patients to help navigate care coordination, billing, and insurance issues.
• Zócalo HealthminorStrategic or Co-development PartnerZócalo Health, a technology-enabled primary care provider focused on underserved populations, partnered with Anthem Blue Cross and Health Net. The company expanded from two regional health plan partnerships in 2024 to more than a dozen in 2025.
• 3Strands Global FoundationminorStrategic or Co-development Partner3Strands Global Foundation launched the ELEVATE program, a specialized education and training initiative for the foster care landscape, supported by health benefits company Elevance Health. The program addresses trauma-informed practices, mental health needs, and youth empowerment, launching first in Virginia.
• Positive DevelopmentcoreStrategic or Co-development PartnerAnthem Blue Cross and Blue Shield signed a national agreement with Positive Development to provide developmental therapy services to autistic children, initially serving members in Virginia enrolled in employer-based and individual health plans. The value-based arrangement rewards performance through outcomes measurement.
• Ohio UniversityminorStrategic or Co-development PartnerOhio University and Anthem Blue Cross and Blue Shield announced a $400,000 incremental investment over three years to expand their experiential learning program for healthcare students serving rural and underserved populations in Ohio.
• SomatuscoreStrategic or Co-development PartnerSomatus, a kidney care management provider, announced a no-cost care management program for Medicare Advantage patients with chronic or end-stage kidney disease, delivered in partnership with Anthem Blue Cross and Blue Shield.
• Partnership to End AddictionminorStrategic or Co-development PartnerBabySTEPs, a digital helpline for pregnant and postpartum individuals facing substance use challenges, launched in New York state with a $300,000 three-year grant from Anthem Blue Cross and Blue Shield Foundation. The program offers confidential text-based support.
• The Council of Insurance Agents & BrokerscoreChannel Partner/ Reseller/ DistributorAnthem Blue Cross and Blue Shield joined as a sponsor organization in The Council of Insurance Agents & Brokers' spring membership drive, participating alongside other sponsors like Verisk, The Prudential Insurance Company of America, and Factory Mutual Insurance Company.

Scale indicators5 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• UnitedHealthcare (UnitedHealth Group): Largest U.S. health insurer by premiums and members, offering Medicare Advantage, employer, individual, and Medicaid plans nationally. Direct competitor to Anthem across all major commercial and government segments with broader geographic coverage.
• Cigna (Evernorth): Large national carrier focused on employer-sponsored health, behavioral, pharmacy (Express Scripts), and supplemental benefits. Competes with Anthem in commercial and stop-loss segments, less direct overlap on Medicaid.
• Kaiser Permanente: Integrated payer-provider offering commercial, Medicare, and Medicaid plans with owned hospital/physician network. Competes with Anthem on employer-sponsored and senior segments, particularly in CA and CO where Anthem also operates.

Direct peers

• Humana: Major Medicare Advantage-focused carrier and a top-3 MA insurer, also serving employer, Medicaid, and TRICARE populations. Highly comparable to Anthem on Medicare Advantage product design, Stars strategy, and supplemental benefits.
• Aetna (CVS Health): National health insurer offering employer, individual, Medicare, and Medicaid plans; integrated with CVS Health's pharmacy, PBM (Caremark), and MinuteClinic assets. Competes head-to-head with Anthem on commercial group and Medicare Advantage markets.
• Molina Healthcare: Government-focused health plan specializing in Medicaid managed care and Medicare (D-SNP, MA). Highly comparable to Anthem's Medicaid and dual-eligible offerings across overlapping states.
• Centene Corporation: Largest U.S. Medicaid managed-care insurer with growing Medicare presence through WellCare. Direct competitor to Anthem in state Medicaid contracts and Marketplace plans.
• Health Care Service Corporation (HCSC): Customer-owned BCBS licensee operating in TX, IL, MT, NM, OK; the largest mutual BCBS plan. Comparable to Anthem as a Blue Cross licensee offering commercial, Medicare, and Medicaid in non-overlapping geographies, making HCSC a partner-or-competitor on national accounts.
• Blue Shield of California: Independent BCBS licensee covering California with commercial, individual, Medicare, and Medi-Cal plans. Direct peer to Anthem within the Blue system, competing in California where Anthem Blue Cross also operates.
• Highmark Inc. BCBS licensee operating in PA, WV, DE, and NY (Western/Northern regions) offering commercial, Medicare Advantage, Medicaid, and individual plans. Comparable to Anthem as a multi-state Blue plan with integrated provider assets.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/anthembcbs
• YouTubeyoutube.com/@Anthem_BCBS
• Facebookfacebook.com/AnthemBlueCrossBlueShield
• Instagraminstagram.com/anthembcbs

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Subsidiaries3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments17 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Anthem Blue Cross & Blue Shield