Blue Cross of Idaho

What Blue Cross of Idaho does

Blue Cross of Idaho is a not-for-profit, member-owned mutual health insurance company headquartered in Meridian, Idaho, founded in 1945 as Idaho Hospital Service and operating today as an independent licensee of the Blue Cross and Blue Shield Association. It is the largest health insurer in Idaho and the only one headquartered in the state, serving more than 600,000 members across all 44 Idaho counties through a workforce of 1,400+ employees. The company offers a full product stack: ACA-compliant individual and family plans (Gold, Silver, Bronze, Catastrophic tiers), employer-sponsored group plans for businesses of 2 to 50+ employees, Medicare Advantage and Medicare Supplement plans, dual-eligible special needs plans, and ancillary dental, vision, and international travel coverage via GeoBlue/BCBS Global Solutions.

Underlying the product stack is a health insurance administration platform integrated with a proprietary pharmacy benefit manager (Blue Cross of Idaho Rx, launched 2020 and operated with CarelonRx), a member-facing mobile app for claims, ID cards, and provider search, and a Healthcare Economics Department that runs value-based contracting with providers — covering over 90% of in-network providers in quality-outcome reimbursement arrangements. Clinical review decisions use licensed Change Healthcare InterQual Criteria, and advanced imaging, musculoskeletal, and sleep-study reviews are routed through Carelon Medical Benefits Management. The company also holds minority investments in Primary Health Medical Group and Treasure Valley Hospital, extending its footprint into care delivery.

The business model is subscription-based recurring revenue: monthly premiums from individuals, families, and employer groups, plus capitated payments from CMS for Medicare Advantage and D-SNP members. Distribution runs through four parallel channels — direct sales teams in district offices, an appointed broker network, the Idaho health insurance exchange (yourhealthidaho.org), and direct website enrollment — plus an Online Enrollment Center for group administrators. Following a 2024 corporate restructuring under new President and CEO Paul Zurlo, the company now operates as a mutual insurance holding company, a structure designed to enable additional healthcare-related investments and partnerships.

Name

Blue Cross of Idaho

Legal name

Blue Cross of Idaho Health Service, Inc.

Website

https://bcidaho.com

Company type

Private

Founded year

1945

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Blue Cross of Idaho is a not-for-profit mutual health insurer headquartered in Meridian, Idaho, serving 600,000+ members statewide through individual, employer group, Medicare Advantage, and supplemental plans, distributed via brokers, direct sales, and the state exchange.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411), Insurance Agencies and Brokerages (52421)

SIC

Accident & Health Insurance (6321)

akta.pro primary industry

Disability Buy-Sell / Business Continuation Insurance (FSAIAIAL)

Keywords

• Health insurance plans
• Medicare Advantage coverage
• Pharmacy benefit management
• Employer group insurance
• Individual health coverage

Headquarters

HQ city

Meridian

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others

Revenue model

1. Individual & Family Health Insurance Premiums: Blue Cross of Idaho collects monthly premiums from individual policyholders for ACA-compliant health plans, Access short-term plans, and dental/vision coverage. Revenue is recurring based on membership enrollment and premium payments.
2. Employer Group Health Insurance Premiums: The company provides employer-sponsored health insurance to businesses of all sizes (2-50 employees and 50+ employees), collecting recurring premiums from employer groups for medical, dental, and vision coverage.
3. Medicare Advantage Plans: Blue Cross of Idaho offers Medicare Advantage plans (Part C) that provide Medicare benefits with additional coverage, including some plans with Part D prescription drug coverage. The company receives capitated payments from CMS.
4. Medicare Supplement Plans: Medicare Supplement plans help fill gaps in original Medicare coverage, generating premium revenue from enrolled Medicare beneficiaries.
5. International Health Plans via GeoBlue: Through partnership with GeoBlue/BCBS Global Solutions, Blue Cross of Idaho offers short-term and long-term international health plans for travelers, earning revenue through plan premiums.

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels6 records

Core offering

Blue Cross of Idaho is a not-for-profit mutual health insurance company that sells medical, dental, vision, and pharmacy benefit coverage to individuals, families, employers, and Medicare beneficiaries across Idaho. Its offerings span ACA-compliant individual plans (Gold/Silver/Bronze/Catastrophic), enhanced short-term Access plans, employer-sponsored group plans for businesses of all sizes, Medicare Advantage and Medicare Supplement plans, dual-eligible Special Needs Plans, an in-house PBM (Blue Cross of Idaho Rx), and international travel coverage via GeoBlue. The company serves over 600,000 members through direct sales, an appointed broker network, online enrollment, and the Idaho health insurance exchange.

Differentiator

Problem solved

Functional benefit

Products and services

• Individual & Family ACA Health Plans (Gold, Silver, Bronze, Catastrophic) ACA-compliant health insurance plans offered to Idaho individuals and families across metal tiers (Gold, Silver, Bronze, Catastrophic), available on the Idaho health insurance exchange with potential premium tax credits and cost-sharing reductions, plus off-exchange direct purchase options.
• Access Enhanced Short-Term Plans (Access Fit, Access Nurture, Access Pathway) Enhanced short-term health insurance plans for individuals and families who do not qualify for ACA tax subsidies, offering three tiered options (Fit, Nurture, Pathway) with features such as $0 child primary care, $0 preventive care, maternity coverage, and integrated prescription drug benefits.
• Employer-Sponsored Group Health Insurance (Small 2–50 and Large 50+ Employers) Group medical, dental, and vision insurance plans for Idaho employers of all sizes (2–50 employees and 50+ employees), including COBRA continuation coverage and access to the Online Enrollment Center for administrators and brokers.
• Medicare Advantage Plans (Part C, with optional Part D) Medicare Advantage health plans for Idaho residents eligible for Medicare, providing Medicare Part A and Part B benefits with additional coverage including some plans with Part D prescription drug coverage; the company receives capitated payments from CMS for enrollees.
• Medicare Supplement Plans Medicare Supplement (Medigap) plans that help fill coverage gaps in Original Medicare for Idaho Medicare beneficiaries, generating recurring premium revenue from enrolled members.
• Dual-Eligible Special Needs Plans (True Blue D-SNP, Blue Cross Idaho Medicaid Plus) Medicare-Medicaid integrated plans for Idaho individuals dually eligible for Medicare and Medicaid, including the True Blue Special Needs Plan (HMO D-SNP) and Blue Cross Idaho Medicaid Plus, providing coordinated benefits across both programs.
• Blue Cross of Idaho Rx (Pharmacy Benefit Management) Proprietary pharmacy benefit manager providing integrated prescription drug benefit administration for Blue Cross of Idaho members, controlling rising drug costs through mail-order services (via CarelonRx) and partnerships like Amazon Pharmacy home delivery.
• Dental Coverage (including Dental Blue Connect via Willamette Dental) Dental insurance plans offered to individuals, families, and employer groups in Idaho. Dental Blue Connect (administered by Willamette Dental) provides an individual plan with clear upfront copays for each service, offered independently by Willamette Dental.
• Vision Coverage (via Vision Service Plan / VSP) Vision insurance for Blue Cross of Idaho members offered through a partnership with Vision Service Plan (VSP), covering regular eye exams, prescription glasses, contacts, and laser vision correction surgery savings. VSP products are offered independently by VSP.
• International Health Plans (via GeoBlue / BCBS Global Solutions) Short-term and long-term international health insurance plans for Blue Cross of Idaho members traveling abroad, offered through a partnership with GeoBlue and BCBS Global Solutions.
• MDLIVE Virtual Care Telehealth Virtual care service enabling Blue Cross of Idaho members to connect with board-certified doctors 24/7 for non-emergency issues including mental health, common cold, flu, allergies, and ear problems, delivered through a partnership with MDLIVE.
• Blue365 Wellness Discount Program Health and wellness discount program offering exclusive deals to Blue Cross of Idaho members to help maintain a healthy lifestyle, with some Medicare Advantage plans including gym membership discounts through this program.

Named customers2 records

Segments5 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration9 records

Feature4 records

Partnerships

13 partnerships are on record, tiered core and minor.

• GeoBlue (BCBS Global Solutions)coreGTM or Marketing PartnerThrough partnership with GeoBlue and BCBS Global Solutions, Blue Cross of Idaho offers short-term and long-term international health plans to cover travel needs for members traveling abroad.
• MDLIVEcoreTechnology or IntegrationMDLIVE provides virtual care services enabling Blue Cross of Idaho members to connect with board-certified doctors for non-emergency issues including mental health, common cold, flu, allergies, and ear problems - any time day or night.
• Amazon PharmacycoreTechnology or IntegrationAmazon Pharmacy provides home prescription delivery services for Blue Cross of Idaho members, allowing them to manage refills, auto-refills, and get medications delivered to their door for free (members pay usual copay or coinsurance).
• CarelonRxcoreTechnology or IntegrationCarelonRx administers pharmacy benefits and provides mail-order prescription services through Blue Cross of Idaho Rx's pharmacy benefits manager.
• Vision Service Plan (VSP)coreTechnology or IntegrationVSP provides vision coverage including regular exams, prescription glasses, contacts, and laser vision correction surgery savings. VSP products are offered independently by VSP, which is solely responsible for the vision products.
• Idaho College of Osteopathic Medicine (ICOM)coreStrategic or Co-development PartnerPartnership to establish the Primary Care Initiative (PCI), a not-for-profit foundation addressing the critical shortage of primary care physicians in rural Idaho by funding scholarships for medical students planning to go into primary care.
• Primary Health Medical GroupcoreStrategic or Co-development PartnerBlue Cross of Idaho made a minority investment in Primary Health Medical Group to help improve access to primary care providers across Idaho.
• Treasure Valley HospitalminorStrategic or Co-development PartnerInvestment in Treasure Valley Hospital supporting efforts to bring more primary care providers and independent doctors closer to more Idahoans.
• Camp Rainbow GoldminorGTM or Marketing PartnerNonprofit providing emotionally empowering summer camp experiences to Idaho children diagnosed with cancer. Blue Cross of Idaho supports campers and infrastructure updates including a new medical facility.
• Idaho FoodbankminorGTM or Marketing PartnerThe Idaho Foodbank's mission is to feed, educate and advocate to end food insecurity in Idaho. Blue Cross of Idaho supports through volunteer efforts to deliver fresh and nutritious food to Idahoans.
• Boys and Girls Clubs of Ada CountyminorGTM or Marketing PartnerProvides young people with safety net during out-of-school time. Blue Cross of Idaho supports free youth counseling services, healthy lifestyle programs, and financial support so more kids can attend.
• Ronald McDonald House Charities of IdahominorGTM or Marketing PartnerHelps families with injured or ill children stay together during times of medical need. Blue Cross of Idaho supports through event sponsorships and volunteer activities.
• Blue Cross of Idaho Foundation for HealthcoreOthersFoundation established in 2001, committed to addressing root causes of Idaho's most pressing health issues. Blue Cross of Idaho supports through charitable giving and community investment.

Scale indicators7 records

Recent moves9 records

Expansion highlights4 records

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Customer concentration

• Xtwitter.com/bluecrossidaho
• YouTubeyoutube.com/channel/UCvjgCNBpB6fblpJvYPzgi1g
• Facebookfacebook.com/BlueCrossofIdaho
• LinkedInlinkedin.com/company/blue-cross-of-idaho
• Instagraminstagram.com/bluecrossidaho

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Subsidiaries3 records

Funding overview

Funding rounds

Investors

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

M&A

Investments2 records

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

Frequently asked questions about Blue Cross of Idaho