HOverview
HCSC is a health insurance provider active in Illinois, Montana, New Mexico, Oklahoma, and Texas. It sells health insurance plans to individuals, families, and businesses, funding its services through member premiums. The company works by offering a range of plans tailored to different needs and by investing in wellness programs and care initiatives aimed at improving member health and reducing overall costs. Compared with others, HCSC emphasizes its long history, broad regional footprint, and its focus on quality care, cost management, and wellness-driven outcomes, distinguishing itself through sustained service and programs that support healthier living. Its goal is to help people live healthier lives by delivering reliable coverage, improving member outcomes, and controlling healthcare costs.
Work here?Claim your company
About HCSC
Industries
Company Size
N/A
Company Stage
N/A
Total Funding
$511.7M
Headquarters
Chicago, IL
Founded
1936
Get referred to HCSC
See people who can refer or advise you
Simplify's take
What believers are saying
- HCSC launched Edge plans for January 1, 2027, targeting employer cost pressure.
- Unity Health Hub uses one contract for 20-plus solutions, simplifying employer buying.
- July 2026 grants expanded prenatal access in Texas and New Mexico, strengthening community ties.
What critics are saying
- Montana regulator is investigating the 462,000-member Conduent breach; penalties reach $25,000 each.
- Public trust and employer retention weaken if HCSC mishandles another privacy incident.
- ACA and Medicare competitors pressure margins; one pricing mistake can erode enrollment quickly.
What makes HCSC unique
- Customer-owned Blue Cross franchise spans Illinois, Montana, New Mexico, Oklahoma, Texas.
- HealthSpring rebrands acquired Medicare products across 49 markets and 48 Medigap states.
- Easify and Unity Health Hub integrate benefits, care navigation, and digital-health purchasing.
Help us improve and share your feedback! Did you find this helpful?
Funding
Total Funding
$511.7M
Above
Industry Average
Funded Over
0 Rounds
Benefits
- Health Insurance
- 401(k) Retirement Plan
- 401(k) Company Match
- Paid Vacation
- Paid Holidays
- Paid Parental Leave
- Disability Insurance
- Supplemental Life Insurance
- Employee Assistance Program
- Tuition Reimbursement
- Professional Development Budget
Company News
Omada Health (NASDAQ:OMDA) announces quarterly earnings results. Omada Health (NASDAQ:OMDA - Get Free Report) announced its quarterly earnings data on Thursday. The company reported $0.10 earnings per share for the quarter, beating the consensus estimate of $0.02 by $0.08, FiscalAI reports. Omada Health had a net margin of 1.39% and a return on equity of 2.60%. The firm had revenue of $91.31 million for the quarter. Here are the key takeaways from Omada Health's conference call: * Positive Sentiment: Omada reported record Q3 revenue of $91 million, up 34% year over year, and adjusted EBITDA of $12 million. It raised 2026 guidance to $344-$346 million in revenue and $32-$34 million in adjusted EBITDA. * Positive Sentiment: Total members reached 1.134 million, up 36% year over year, while average program tenure rose to about two years and four months. Management said the stronger mix of diabetes and hypertension programs and lower cost to serve helped drive gross margin expansion and profitability. * Positive Sentiment: Omada cited broader distribution through its PBM relationships and an HCSC agreement that could add an estimated 1.5 million covered lives across three states in 2027. The company said the fully insured benefit arrangement enables eligible members to enroll directly when it launches. * Negative Sentiment: Management expects Q4 revenue below Q3 levels and a slight sequential decline in total members, reflecting typical seasonality and fewer new enrollments. The selling season has also extended into Q4 as employers take longer to weigh GLP-1 coverage and rising healthcare costs, leaving 2027 enrollment visibility unsettled. Omada Health stock performance. NASDAQ:OMDA traded down $0.48 during trading on Thursday, reaching $18.95. The company's stock had a trading volume of 1,862,389 shares, compared to its average volume of 1,008,486. The firm has a market cap of $1.16 billion, a price-to-earnings ratio of 242.88 and a beta of 2.13. Omada Health has a 12 month low of $10.28 and a 12 month high of $25.45. The firm has a 50 day moving average of $20.33 and a 200-day moving average of $17.74. Insider buying and selling. In related news, President Wei-Li Shao sold 8,866 shares of the stock in a transaction dated Wednesday, August 12th. The shares were sold at an average price of $25.02, for a total transaction of $221,827.32. Following the completion of the transaction, the president owned 307,372 shares in the company, valued at approximately $7,690,447.44. This represents a 2.80% decrease in their ownership of the stock. The transaction was disclosed in a filing with the Securities & Exchange Commission, which can be accessed through this link. Also, CFO Steven Cook sold 15,235 shares of the firm's stock in a transaction dated Monday, August 10th. The stock was sold at an average price of $25.03, for a total transaction of $381,332.05. Following the sale, the chief financial officer owned 187,209 shares of the company's stock, valued at $4,685,841.27. This trade represents a 7.53% decrease in their position. Additional details regarding this sale are available in the official SEC disclosure. In the last ninety days, insiders have sold 114,698 shares of company stock valued at $2,651,143. 6.38% of the stock is owned by insiders. Institutional inflows and outflows. A number of institutional investors and hedge funds have recently modified their holdings of the stock. China Universal Asset Management Co. Ltd. purchased a new stake in shares of Omada Health during the 3rd quarter worth approximately $70,000. Sterling Capital Management LLC grew its holdings in Omada Health by 1,161.6% during the third quarter. Sterling Capital Management LLC now owns 1,577 shares of the company's stock valued at $33,000 after purchasing an additional 1,452 shares during the period. Robeco Institutional Asset Management B.V. bought a new position in Omada Health during the third quarter valued at $1,100,000. Counterpoint Mutual Funds LLC bought a new position in Omada Health during the third quarter valued at $595,000. Finally, State of Alaska Department of Revenue purchased a new stake in Omada Health in the third quarter worth $59,000. Wall street analysts forecast growth. A number of research firms recently weighed in on OMDA. Robert W. Baird upped their price target on Omada Health from $15.00 to $25.00 and gave the stock a "neutral" rating in a research note on Wednesday, August 12th. Citigroup reissued an "outperform" rating on shares of Omada Health in a research note on Friday, August 14th. Needham & Company LLC restated a "buy" rating and set a $28.00 price objective on shares of Omada Health in a report on Friday, September 11th. BTIG Research reaffirmed a "buy" rating and set a $35.00 target price on shares of Omada Health in a research report on Friday, September 11th. Finally, BMO Capital Markets restated an "outperform" rating and issued a $24.00 target price on shares of Omada Health in a report on Friday, August 7th. One analyst has rated the stock with a Strong Buy rating, eleven have assigned a Buy rating, two have assigned a Hold rating and one has issued a Sell rating to the company's stock. According to MarketBeat.com, Omada Health currently has a consensus rating of "Moderate Buy" and an average price target of $26.42. About Omada Health. Omada Health, Inc (NASDAQ: OMDA) is a digital health company that provides virtual care programs for people managing chronic conditions. Its platform combines personalized health coaching, clinical support, behavioral-change tools and connected devices to help members monitor and improve their health. The company's offerings focus primarily on cardiometabolic conditions, including diabetes, prediabetes, hypertension and obesity, as well as musculoskeletal conditions. Depending on the program, members may receive access to digital lessons, health tracking, remote monitoring, care teams and clinical guidance through Omada's technology platform. Omada Health was founded in 2011 and serves employers, health plans and other healthcare organizations in the United States. Receive News & Ratings for Omada Health Daily - Enter your email address below to receive a concise daily summary of the latest news and analysts' ratings for Omada Health and related companies with MarketBeat.com's FREE daily email newsletter.
BenaVest Announces Direct HCSC ACA Contracting for BCBS Texas and Illinois in 2027. BenaVest announces direct HCSC ACA contracting for Blue Cross and Blue Shield of Texas and Illinois, strengthening agent support in both states. HOLLYWOOD, FL, UNITED STATES, October 21, 2026 /EINPresswire.com/ - BenaVest, a national Field Marketing Organization (FMO) specializing in ACA, Medicare, Life, and Ancillary insurance solutions, announces a direct appointment with Health Care Service Corporation (HCSC), expanding Affordable Care Act (ACA) contracting opportunities through Blue Cross and Blue Shield of Texas (BCBSTX) and Blue Cross and Blue Shield of Illinois (BCBSIL). The direct relationship enables BenaVest to support licensed insurance agents seeking ACA Marketplace contracting opportunities in Texas (TX) and Illinois (IL). The announcement comes as agents prepare for the 2027 ACA Open Enrollment Period, providing an additional pathway for carrier appointments and Marketplace business development. HCSC is one of the nation's largest customer-owned health insurers and operates Blue Cross and Blue Shield plans in multiple states. Through this direct appointment, BenaVest strengthens its relationship with an established health insurance organization while expanding contracting opportunities for agents serving individuals and families. Direct HCSC ACA Contracting Through BenaVest The appointment includes two Blue Cross and Blue Shield markets: - Blue Cross and Blue Shield of Texas (BCBSTX): ACA Marketplace contracting opportunities for eligible Texas-licensed agents. - Blue Cross and Blue Shield of Illinois (BCBSIL): ACA Marketplace contracting opportunities for eligible Illinois-licensed agents. Agents must satisfy applicable state licensing, carrier appointment, certification, and other requirements before marketing or enrolling consumers. Plan availability, provider networks, premiums, and benefits vary by service area and product. What the Direct HCSC Appointment Means for Insurance Agents BenaVest's direct relationship with HCSC provides an additional carrier contracting pathway for agents preparing to serve ACA Marketplace consumers. Through BenaVest, agents can access: - ACA contracting opportunities for BCBS of Texas and BCBS of Illinois - Agent onboarding and carrier appointment assistance - ACA Marketplace training and educational resources through InsureUniversity - Marketing and enrollment support resources - Guidance on applicable certification and compliance requirements - Ongoing broker assistance throughout Open Enrollment and eligible Special Enrollment Periods The relationship adds to BenaVest's existing carrier portfolio and supports agents seeking to expand their ACA business in Texas and Illinois. Supporting ACA Marketplace Enrollment for 2027 The 2027 ACA Open Enrollment Period creates an opportunity for licensed agents to help individuals and families review available health insurance options. With access to BCBSTX and BCBSIL contracting opportunities through HCSC, BenaVest agents can prepare to serve consumers in their respective licensed markets. BenaVest supports agents through contracting assistance, educational resources, and ongoing operational guidance. Its training platform, InsureUniversity, provides resources covering ACA enrollment procedures, compliance responsibilities, and insurance business development. About Health Care Service Corporation Health Care Service Corporation (HCSC) is a customer-owned health insurance company and an independent licensee of the Blue Cross and Blue Shield Association. HCSC operates Blue Cross and Blue Shield health plans in several states, including Texas and Illinois. Its health insurance offerings include coverage solutions for individuals, families, and employer groups, with product availability varying by market. About BenaVest BenaVest is a national Field Marketing Organization (FMO) supporting insurance agents across ACA, Medicare, Life, Dental, Vision, Retirement, and Ancillary product lines. Through carrier contracting, agent training, marketing resources, and broker assistance, BenaVest helps agents develop their businesses and serve clients. Powered by Gyde, BenaVest also provides access to AI-driven agent resources and technology designed to support efficiency, client engagement, and ongoing service. Through InsureUniversity, agents can access carrier education, compliance training, webinars, and business development resources. Insurance agents interested in ACA contracting opportunities with Blue Cross and Blue Shield of Texas (BCBSTX) or Blue Cross and Blue Shield of Illinois (BCBSIL) through BenaVest can get started using the dedicated contracting links below: Agents can also visit InsureUniversity for additional carrier training, onboarding resources, and ACA Marketplace education. For contracting assistance or questions about carrier appointments, contact the BenaVest Broker Support Line at (800) 893-7201. Pamela Hoeve BenaVest | Health, Life & Retirement +1 800-893-7201 Visit us on social media: Facebook X YouTube LinkedIn TikTok Instagram Other Legal Disclaimer: EIN Presswire provides this news content "as is" without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.
Rehab insurance fraud in California: lessons from the CodeMax lawsuit. Posted on October 21, 2026 I have spent more than 30 years in the substance use disorder field. Fourteen of those years were inside state government, with the Department of Alcohol and Drug Programs and the Department of Health Care Services. In my last four years there, I ran the Licensing and Certification Division. Insurance fraud was a problem back then, and it still is today. The schemes have new names and new tricks, but the core idea hasn't changed: bill for care that never happened, or for patients who were never really there. A new federal lawsuit filed this summer shows how big the problem has become. I want to walk through it, because every facility owner in California should learn from it. That goes double for anyone thinking about opening a program. What the CodeMax lawsuit alleges. On August 28, 2026, Health Care Service Corporation filed a civil lawsuit against CodeMax Medical Billing in federal court in the Central District of California. HCSC does business in Oklahoma as Blue Cross Blue Shield of Oklahoma. CodeMax bills insurance for addiction treatment businesses. The suit also names more than 70 other businesses, almost all of them California treatment providers. The complaint names 74 businesses in total, all based in California, and alleges CodeMax took a cut of the claims. I want to be clear before going further. These are allegations. Nobody in this case has been found liable for anything. The defendants will have their chance to respond in court. According to the complaint, the scheme had three parts: manufacture the patients, manufacture the claims, and maximize the profits. Here is what the insurer claims happened: * Patients who started treatment right after enrolling. The suit alleges that people enrolled in Oklahoma insurance plans began treatment in California the next day, and that some gave temporary or throwaway email addresses. * Claims for care that may not have happened. The insurer alleges inflated or fake charges, the same patient billed by two facilities on the same day, and facilities billing for more patients than their license allowed. It questions whether some patients existed at all.
Blue Shield of California Foundation appoints Kassie Maroney to Board of Trustees. Blue Shield of California's chief actuary brings two decades of health plan finance leadership to the Foundation SAN FRANCISCO (Oct. 28, 2026) - Kassie Maroney is joining Blue Shield of California Foundation's Board of Trustees, to help guide the Foundation's mission of building lasting and equitable solutions to make California the healthiest state and end domestic violence. Her financial and business acumen will strengthen the Board's stewardship of the Foundation. Her healthcare cost expertise will also bring valuable insight into how affordability shapes Californians' access to needed services. "Kassie is a seasoned leader who deeply understands finance and business performance and also brings valuable insight into how healthcare business and operational decisions directly affect Californians. She approaches those decisions with care and a strong sense of responsibility, and I know she will bring that same commitment to ensuring our work continues to support the most vulnerable communities in our state," said Debbie I. Chang, MPH, president and CEO of Blue Shield of California Foundation. "Her ability to navigate complexity and find solutions will be invaluable as we advance equity, drive systems change, and deepen our impact across California." Maroney is senior vice president, chief actuary officer and Blue Shield of California Finance at Blue Shield of California, where she oversees business and financial performance and analysis for nearly 6 million members in the state's commercial, individual, and government markets, representing more than $28 billion in annual revenue. Her experience navigating complex financial and operational challenges in healthcare brings a crucial perspective to the Foundation's work supporting Californians. She is also executive advisor of the company's Elevating Women employee resource group. "Blue Shield of California Foundation's commitment to advancing health equity and creating stronger, healthier communities resonates deeply with me," said Maroney. "I'm inspired by this opportunity to help improve people's lives, especially during moments when access to care, stability, and support matter most. I look forward to working alongside my fellow trustees and Foundation leadership to create a more just and equitable future for Californians." Before joining Blue Shield of California, Maroney served as divisional senior vice president and chief actuary for Health Care Service Corporation, an independent licensee of the Blue Cross Blue Shield Association serving five member markets: Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma and Texas. She holds a Bachelor of Science in business administration with a major in actuarial science from Drake University. Maroney is a fellow of the Society of Actuaries, an emeritus trustee of The Actuarial Foundation and a sustainer of the Junior League of Jacksonville. Blue Shield of California Foundation is governed by an independent Board of Trustees composed of at least two members of the Blue Shield of California board of directors, two executive-level employees of the company and at least four public trustees. About Blue Shield of California Foundation Blue Shield of California Foundation supports lasting and equitable solutions to make California the healthiest state and end domestic violence. When Blueshieldcafoundation work together to remove the barriers to health and well-being, especially for Californians most affected, Blueshieldcafoundation can create a more just and equitable future. For more information, visit blueshieldcafoundation.org, sign up for its bimonthly newsletter Intersections, and please join Blueshieldcafoundation on LinkedIn and Instagram.
How HCSC is expanding access to prenatal care. July 31, 2026 Limited access to basic maternal health services and prenatal care remains a problem across the country and is especially dire in some areas, contributing to poor outcomes for babies and their mothers. In New Mexico and Texas, Health Care Service Corporation is addressing these issues at the community level by providing grant funding to clinics in regions where patients struggle to receive care before, during and after pregnancy. Grants to Gallup Community Health Center and East Texas Community Clinic have helped increase the availability of prenatal and preventive care, identified and addressed behavioral health needs in soon-to-be mothers and built up the local maternal health workforce. The investments are part of HCSC's expanded maternal and infant health initiative. Launched in 2023, the program collaborates with organizations focused on improving maternal and infant health access and outcomes in Illinois, New Mexico and Texas communities. Physician-led nonprofit Gallup Community Health Center opened in 2022 to address limited access to primary care and maternal health services. Data from New Mexico shows that more pregnant patients are visiting the clinic during their first trimester and all patients are being screened for behavioral health needs. In Texas, a family medicine obstetrician is developing prenatal clinics capable of seeing up to 45 additional appointments weekly. "The state of maternal health in New Mexico and Texas is especially challenging in our rural communities where access to health care services is limited," says Dr. Angela Moemeka, HCSC's chief medical officer of government programs. "These capacity-expanding and scope-enhancing grants are driving improved outcomes for moms and babies through access to integrated preventive health, behavioral health, and obstetric services." About 23% of pregnant New Mexicans receive inadequate prenatal care. Gallup and surrounding McKinley County rank among the worst areas in the state for prenatal care access. Gallup Community Health Center received a grant from HCSC to bolster its primary care and maternal and infant care services. The nonprofit opened in 2022, offering ultrasounds, fetal monitoring, screenings, lactation support and newborn wellness visits, among other services. Since opening, the clinic has seen a large uptick in first trimester visits, says Gallup OB-GYN Dr. Marcie Richmond. In the past 12 months alone, 78% of pregnant patients have visited the clinic during their first trimester, up from the 44% previously estimated by the New Mexico Department of Health. "Patients were desperate for care," says Dr. Richmond. "Gallup Community Health has not only filled a prenatal care gap but a huge primary care gap in the community." In Texas, East Texas Community Clinic used a Special Beginnings grant to hire a family medicine obstetric physician in January at its Canton clinic. Trained in providing maternal and infant health services along with primary care, the hire has been an immediate boost to a region without an OB-GYN doctor, says Dr. Douglas Curran, an East Texas Community Clinic family medicine physician who provides OB-GYN services. "There are so many rural, maternal care deserts in our state," says Curran, who co-founded East Texas Community Clinic in 2020. "It's unacceptable for a state that has the resources of ours to not be working on this problem." New prenatal clinics in Athens, Canton and Gun Barrel City will each see up to 15 patients each day, providing needed care and education. The added capacity expands access and the number of babies that can be delivered while training physicians and residents in providing obstetrics care. "At the end of the day if we're successful with this, we'll see healthier babies, healthier mothers and reduced costs," says Curran. "This is an opportunity to improve care in Texas - that's exciting." Gallup Community Health Center also put grant funding toward the local workforce, training its new and existing staff in preconception counseling, pregnancy-related medical conditions, intrafamily violence, medications for opiate use disorder and Native American perspectives on health, among other topics. Community health workers screen for needs related to social determinants of health like food access, housing or substance misuse and connect patients to local resources. Every pregnant patient who comes through the door is also screened for behavioral health needs. They can be connected to in-house therapists or psychiatrists, support groups or referred to community organizations. "It's important to get patients in while they're pregnant, especially if there's any possibility that they could face postpartum depression," says Behavioral Health Director Kris Pikaart. "That way we have a safety net for them before they give birth."
HCSC is Hiring for 184 Jobs on Simplify!
Find jobs on Simplify and start your career today
Don't see your dream role? Check out thousands of other roles on Simplify.Browse all jobs
About HCSC
Industries
Company Size
N/A
Company Stage
N/A
Total Funding
$511.7M
Headquarters
Chicago, IL
Founded
1936
HCSC is Hiring for 184 Jobs on Simplify!
Find jobs on Simplify and start your career today
Don't see your dream role? Check out thousands of other roles on Simplify.Browse all jobs