The State of Nevada just went through the same process, different carrier.  One thing for sure in almost any industry though is the fewer the competitors the less number of choices and less price competition.  Would this mean a whole new lot of contracts for doctors and hospitals too?  BD

Amid signs that Pennsylvania's insurance commissioner is laying out a course for Independence Blue Cross and Highmark Inc. to follow as they pursue their proposed and controversial merger, members of the boards of the two insurers are meeting tomorrow.

Even though by law an official decision cannot be rendered until next Tuesday, the Insurance Department has let the insurers know privately that it will not approve the merger unless the new company agrees to make an important change in how it markets health insurance in Pennsylvania, among other conditions.

The marketing change has to do with how the new company, which would become the largest health insurer in the state and one of the largest in the nation, would use the popular "Blue" trademark, according to one knowledgeable source who participated in a conversation on the merger with one of the top officials in the Insurance Department.

Right now, both companies use the "Blue" trademark. Highmark uses Blue Cross and Blue Shield, and Independence, obviously, uses the Blue Cross.  Other insurance companies, especially Highmark rivals Capital Blue Cross in Harrisburg and the University of Pittsburgh Medical Center Health Plan, strongly opposed the merger, saying the combined company's size and clout would discourage insurers from entering the Pennsylvania market.

State sets conditions for health insurance merger | Philadelphia Inquirer | 01/20/2009

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