Health Insurance Built for People — Not Profit

Being a mutual, not for profit health plan means we're owned by our members — not outside shareholders. Our main focus is to serve you and our community, not to make profits for investors. The premiums you pay go back into your care, running the plan and supporting health programs in Kansas. In short: we don’t have shareholders, we have neighbors.

As a not for profit, premium dollars go towards member care. Most of what you pay—about 88% of every dollar—goes straight to your health needs, like covering medical bills and services. Roughly 11% helps keep things running smoothly (think customer service, technology, securing your information and care programs) and 1% covers taxes. Our charitable giving comes from our earnings on investments, not your premiums.

Our charitable giving is through the Blue Cross and Blue Shield of Kansas Foundation, which was incorporated in 2005 to help all Kansans lead healthier lives. Through its giving, the Foundation focuses on funding key health issues that can impact the lives of many Kansans, such as promoting health improvement, community health access and/or education, healthy behaviors, prevention initiatives and direct health services to the uninsured.

For profits operate to generate profit for owners or shareholders. For profits pay taxes and their primary focus is on financial return.

Non-profits are mission driven and are typically organized for charitable, educational or community purposes. Any surplus is reinvested into the mission. They often rely on donations, grants or fundraising and many qualify for tax exempt status.

Not-for-profit companies (like BCBSKS) do not strive to generate profits and don’t have shareholders. Any surplus is reinvested into operations, member services and community focused programs. Unlike non-profits, not-for-profits do not rely on donations. They pay state and federal taxes, which help support the economy.

Being not for profit means, we promptly and accurately pay your claims first and then put your premiums back into things that help you—like better coverage, improved services and supportive programs for things like tobacco cessation, mental health, or managing chronic conditions – like diabetes. While premiums reflect the cost of health care, your dollars go directly toward supporting your health and the communities we serve.

We understand it’s frustrating when a claim is denied. The majority of our claims are approved. However, claims may be denied when a service isn’t covered by your plan, doesn’t meet medical guidelines, information is missing or the provider is out-of-network. Our goal is to make sure you have access to safe, effective and appropriate care. Sometimes we offer alternatives, like a generic medication instead of brand-name, to keep care affordable and effective. You can always ask questions or appeal if needed. We can walk you through the reasons and your options.

We work to make care accessible and sustainable by managing costs and encouraging smart use of your plan. This includes:

• Promoting lower-cost medications
• Educating members about their benefits, how to use them and how to navigate the healthcare system
• Helping members find affordable services
• Encouraging preventive care to catch problems early

Our focus is supporting your health and keeping coverage cost-effective now and in the future.