Anthem vs Blue Cross Blue Shield: is Anthem the same as Blue Cross?

“Anthem or Blue Cross?” is a common point of confusion when employers see their quotes, and it is understandable: in some states they are the same company, and in others they are rival companies. Here is how it fits together.

What “Blue Cross Blue Shield” actually is

Blue Cross Blue Shield is not one insurer. The Blue Cross Blue Shield Association licenses the Blue names and symbols to 33 independent, locally operated companies (its own count), which together cover more than 100 million people, about one in three Americans, across all 50 states, Washington DC and Puerto Rico (the Association’s own figures).

Each company has its own area, sets its own prices and builds its own local network. Florida Blue, Blue Cross and Blue Shield of Texas, Highmark and Premera Blue Cross are all separate businesses that happen to share the brand.

Where Anthem fits

Anthem plans are owned by Elevance Health, a public company based in Indianapolis that was called Anthem, Inc. until it renamed itself in June 2022. Elevance holds the Blue license in 14 states, and in those states it operates as Anthem Blue Cross and Blue Shield, or Anthem Blue Cross in California.

In most of these states, Anthem and “the Blue company” are the same thing, though another Blue company also operates in the Kansas City area of Missouri, Northern Virginia, parts of New York, and California (Blue Shield). Outside these states, a Blue Cross Blue Shield plan comes from a different company altogether.

The California exception

California is the one Anthem state where Anthem holds only the Blue Cross name. Anthem Blue Cross (Elevance) holds the Blue Cross name there, and Blue Shield of California, a separate company, holds the Blue Shield name. They are competitors with different networks, so a California employer looking at “Anthem” and “Blue Shield” is looking at two genuinely separate insurers.

The New York name change

If you see Empire on an older card, that was Anthem’s New York brand. From January 1, 2024, Empire BlueCross BlueShield became Anthem Blue Cross and Blue Shield, and Empire BlueCross (upstate) became Anthem Blue Cross. The business did not change hands.

Wellpoint: same owner, not a Blue company

Elevance also sells insurance under its own non-Blue brands where it does not hold the Blue license, chiefly Wellpoint (formerly Amerigroup in many states). A Wellpoint plan is not a Blue Cross Blue Shield plan, even though Elevance owns both. Wellpoint’s own site lists mainly individual, Medicare and Medicaid business by state.

Why it matters for an employer

Out-of-state employees. Every Blue company takes part in BlueCard, the program that links the Blue companies’ local networks across the country. Anthem reported about 6.6 million BlueCard members, other Blues’ members using its networks, at September 30, 2026.

Which companies are involved. In one of Anthem’s 14 states, “Anthem” and “Blue Cross Blue Shield” on two quotes may be the same company, or one may be a neighboring Blue. Outside those states, Anthem does not sell Blue plans to ordinary employers, and the Blue company there is the local Blue.

Funding types and size. Anthem sells fully insured and self-funded plans to employers, and a level-funded product line, Anthem Balanced Funding, in some states. Its employer business covered about 24.4 million people at September 30, 2026, most of them in self-funded plans (our sum of Elevance’s reported figures).

How Anthem plans score

In J.D. Power’s 2026 commercial member study, Anthem plans ranked highest in three regions: the Northeast (Anthem Blue Cross and Blue Shield Connecticut), Ohio, and the Southwest (Anthem Blue Cross and Blue Shield Nevada). AM Best affirmed the financial strength rating of Elevance’s Blue-branded insurers at A (Excellent) in December 2025.

How to tell which company issued a card

An Anthem Blue card carries the Blue Cross symbol, plus the Blue Shield symbol outside California. Wellpoint, Simply Healthcare or Amerigroup on a card means it is not from a Blue company.

Questions to ask a broker about these two carriers

1. Which Blue company or companies cover the areas where our business and employees are located?
2. Are the quotes we have from Anthem and a Blue company from the same company or from two different ones?
3. Which of our employees’ doctors and nearest hospitals are in each network?
4. Which funding types will each carrier offer a group our size in our state?
5. How have renewals run for similar groups here?

Our group health insurance quotes form connects you with a licensed broker who can answer these for your business.

How we write these: every comparison uses the carriers' own published information, their parent companies' filings and independent surveys, each listed below with its date. We are not paid by, affiliated with or endorsed by any carrier, and we do not rank them, describe their plan benefits or recommend any plan. Carrier and product names are trademarks of their owners. Plans, networks and prices vary by state, county and group size: only a licensed broker or the insurer can say what is available to your business and explain its terms.