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Blue Cross of Jamaica Limited is registered as a company limited by guarantee under the Companies Act of Jamaica.
As a not-for profit entity, nearly all the money that Blue Cross of Jamaica Limited collects as premiums is paid out in benefits for its members. On average, this is about 90 cents of every dollar. The remainder, about 10 cents of every dollar is used for operating expenses and reserve funds which the Plans are required to maintain to keep them Plans in sound financial condition.
The Blue Cross® Blue Shield® Association
Blue Cross of Jamaica Limited is an independent licensee of the Blue Cross® and Blue Shield® Association. The Blue Cross® and Blue Shield® Association is a network of individual corporations, each of which serves its community as a non-profit organization. These local corporations are called “Plans” and they contract with hospitals, physicians and other health care providers to offer health care services to their members. All of the Plans are members of the Blue Cross® Blue Shield® Association, which is the coordinating and licensing body for the Blue Cross® Blue Shield® organization.
This relationship enables our members to receive health care coverage anywhere in the United States and Canada while traveling. The BlueCard programme allows our members with overseas coverage to visit a participating provider anywhere they travel and maintain the level of coverage and benefits they enjoy at home.
If you are interested in learning more about the Blue Cross® and Blue Shield® Association, or seeing a list of providers participating in the BlueCard Programme, visit the Association's Web site at www.bluecares.com.
Blue Cross of Jamaica Limited had its genesis in an enterprising hospital administrator, Sydney Anderson, who in 1956 introduced a prepaid health care system which functioned through the Federated Health Insurance Association Limited. The Plan provided access to affordable medical services for the majority of under-privileged Jamaicans in what was a conservative business environment.
Its first aim was to work closely with the government hospital service in an effort to provide better facilities for patients and staff by reimbursing them the cost of the health care they provided. With the commitment of hospitals and clinics, the government welcomed this move and gave strong support to the programme.
1956 – 1965
Policy-making years
The first decade was dedicated to setting up the structures necessary for the plan to work, as this was one of the first Blue Cross® type schemes outside of North America. A Board of Trustees was appointed to establish the policies by which Federated would operate. The Board was organized on a tri-partite basis, representing hospitals, the medical profession and the members. There was also the establishment of two Advisory Committees: the Medical Advisory Committee and the Hospital Advisory Committee.
The support from the trade unions was critical. Trade unionists Hugh Shearer and Thossy Kelly were both members of the initial steering committee. The Introduction of the multinational bauxite companies into the Jamaican economy was a boon to Federated Health Insurance Association as they knew the value of the scheme in their own country and were willing to join the local scheme for the benefit of their employees.
However by 1964, the Medical Association of Jamaica, an umbrella group for health care practitioners withdrew from active participation in the Blue Cross® Plan. Influenced by the activities of competing insurance companies and the support of newspaper columnists the public were misguided about matters relating to the Plan.
By 1965, the scheme had grown from a small group of ten subscribers to several thousands. It became necessary to develop an educational programme for its members, health care providers and the public that would educate them about the value of the Federated Health/Blue Cross® Plan.
1966 –1975
Meeting the challenges
The second period opened with a thrust by Federated Health/Blue Cross® to improve its image and to differentiate itself from other commercial insurance companies driven by the profit motive.
By 1967, Blue Cross® had implemented policies which were to have a tremendous impact on the health care landscape while strengthening its value with stakeholders. In keeping with its emphasis on community involvement the Blue Cross® Advisory Board was created by the end of that year. It was a useful link between the Blue Cross® administration and the community. By the first half of 1968, the nearly 20,000, Blue Cross® subscribers had formed their own association from which the Advisory Board selected two members to represent subscribers’ interests at the policy-making level.
The responsibility of the Advisory Board in the 1970 was to evaluate the interest of subscribers and matters relating to insurance coverage. It hoped that this would serve to increase the membership of the organization and ultimately the number of individuals benefiting from reduced cost of health care.
Initially, Federated Health/Blue Cross® designed three types of plans, which were based on the income levels of subscribers: high, middle and low income respectively. Blue Cross® also established the "Usual and Customary or Prevailing Fees" which allowed all doctors to be paid in full and in accordance with their usual fees.
In 1969, a community health plan was introduced in St. Catherine supported by a network of information centers established through the Barclays bank and the pharmacies in the parish.
As membership continued its steady climb, there was renewed confidence in the Blue Cross® system. In that same year, a joint effort between Blue Cross® and the Credit Union League provided coverage for all credit union members. Membership was increased by 40,000 subscribers.
In 1970 the introduction of the Automated Laboratory Tests (ALT) was to expand the Blue Cross® philosophy to generate interest in preventative as well as curative health measures.
The third decade represented challenging times for Blue Cross®. The company was affected by the economic downturn of the country, coupled with the death of its founder, Sydney Anderson. The constant rounds of devaluation drove up health care costs, which could not be recovered by health insurance premiums because salaries and profits were being out-paced by the increased cost. Blue Cross®, which focused exclusively on health care, did not have the cushioning effects of other forms of insurance to offset the effects of a weakened economy.
The Company sought assistance from Group Hospital Medical Services Incorporated (GHMSI) and the Blue Cross® Blue Shield® Association (BCBSA) and in 1987 received a grant of three million dollars (US$3M) from the Washington-based group. In 1989, Blue Cross® received a further US$3 million, which enabled the company to cover its outstanding commitments. In return for this grant, the Washington-based body was given the right to nominate two-thirds of the members of the Blue Cross® Board.
In 1990, the company welcomed a new President, Dr. Henry Lowe. He immediately employed a Consultant to assist the company in the process of reorganization in order to improve efficiency, productivity and profitability. The new President recognized that Blue Cross® had to quickly regain its position of leadership within the industry if it was to regain the trust and confidence of its subscribers and service providers.
Three main activities were necessary for the organization to return to a growth path and profitability. These were:
For the first time since the end of the second decade, Blue Cross® developed new products as well as improved its product offerings. This quickly re-established its dominance in the health insurance industry. The company rebounded and today, Blue Cross of Jamaica Limited is the largest and oldest established health insurance organization in Jamaica and the CARICOM region.
In 1998, the Blue Cross of Jamaica Limited alliance with Independence Blue Cross® (IBC) of Philadelphia allowed IBC's President to assume Chairmanship of the Board and appoint trustees. The partnership has enabled Blue Cross of Jamaica Limited to better serve its members through expansion of its product offerings and benefit from best practices.
November 2002 brought changes in the leadership structure with President Henry Lowe retiring to become the Vice Chairman of the Board. The presidential baton was passed to Richard K. Powell.
By 2003, the Environmental Health Foundation (EHF) Limited acquired the right to appoint the majority of Blue Cross of Jamaica Limited’s Board of Trustees from Independence Blue Cross® (IBC) of Philadelphia. Henry Lowe assumed the role of Chairman of the Board.
