Our mission is to give members peace of mind through better health, and providing access to affordable, quality health care is just the beginning.
We have a duty to look at every decision through the lens of financial responsibility because we know: every dollar we use comes from you.
It’s your health. It’s your money.
For every dollar we receive in premiums, we pay 85 cents for medical care.
Of the remaining 15 cents:
- 4 cents go to pay local, state and federal taxes
- 4 cents are net income
- 7 cents cover operating costs
We know our members cover our operating costs, so we work hard to manage them well. That’s why BlueCross BlueShield of Tennessee is ranked in the top 25% of Blue plans for administrative (cost) efficiency.
Reserves keep us financially stable
As a not-for-profit company, we don’t have shareholders or private owners who benefit from our business operations, so our net income goes into our reserve fund. This allows us to:
- Remain fiscally responsible
- Pay member claims and
- Lower our profit margins
Our 5-year average for net income is 2.1%
We go above what’s required, so you have peace of mind.
Safety nets aren’t just a way to give our employees and members peace of mind — we’re required by the state of Tennessee to maintain a certain level of reserves based on how many members we have, and how much we have to charge in premiums.
That requirement provides a safety net for members by ensuring we can pay all our claims and sustain operations in case of a disaster, epidemic or market downturn.
We have $267 per member in total reserves, which would cover our members’ claims for 88 days. Our required reserves would only cover claims for 60 days.
Our reserves – built over nearly 75 years – now total $3 billion, but $2 billion of those are required by law based on how many members we have and how much we have to charge in premiums.
Paying claims quickly
As an insurer, our top priority is member health, and that starts with paying our share of your claims.
We provide health plans for 11,000 Tennessee employers and partner with 29,000 providers to make that process as cost-effective and simple as possible.
- We pay more than 56 million claims per year on behalf of members
- Our claims payments total around $14 billion each year
- 84% of claims are processed within 1 day
Want to learn more about claims?