What can happen if Blues compete

In a swath of Pa., Capital and Highmark both offer health insurance. Users have varied opinions.

June 09, 2008|By Jane M. Von Bergen, Inquirer Staff Writer

When public hearings on the proposed merger of the state's two largest health insurers begin next month, speakers opposed to the deal are sure to complain that a combination of Independence Blue Cross and Highmark Inc. would quash competition.

In the Philadelphia marketplace, Independence Blue Cross dominates its competitors, commanding a lion's share of the business, though both it and Highmark say they need to get bigger to fend off national insurers such as Aetna Inc., which is gaining market share.

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Independence has no Blue rival in the region - important in a state such as Pennsylvania, where loyalty to the "Blue" brand is strong.

However, in a broad swath from Harrisburg to Easton, two Blues insurers, Harrisburg's Capital Blue Cross and Pittsburgh's Highmark, are rivals. Besides the Blues, other insurers also have a noticeable presence. Competition not only exists, it is fierce.

And that's just the way car dealer Greg Kelly likes it.

Right now, Kelly has a bid in his office from Capital that would save him $25,000 to $30,000 on the annual premium he now pays Highmark to cover 180 employees of Kelly Automotive Group's seven Lehigh Valley car dealerships.

"We have an offer in hand from Capital, but we'll go back to Highmark and see if they can match it," he said. Kelly had been with Capital before, but left it four years ago when Highmark produced a better bid.

"Capital's margins are tight and Highmark keeps them honest," said Kelly's broker, Jonathan P. Warner, of JP Warner Associates Inc., which has offices in the Lehigh Valley and in Wayne.

Now it's contract-renewal time.

"We're getting the best of both worlds," Kelly said. "Can you imagine that happening if there was just one Blue? It would never happen."

In 2007, Capital had a million subscribers enrolled and Highmark had 800,000, according to their annual reports. Capital estimates that the two Blues have two-thirds of the market.

While other insurers, including Aetna and, in the Lehigh Valley, the home-grown Valley Preferred, help create a robust marketplace, the two Blues compete neck-and-neck for the bulk of business.

The Blue rivalry had its roots in the 1996 birth of Highmark, the product of a merger between Blue Cross of Western Pennsylvania and Blue Shield, a statewide insurer for doctor bills.

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