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A $203 million tax refund for Blue Cross Blue Shield of North Carolina. Nearly $1.5 billion in profit for Health Care Service Corp., the parent of five Blues plans. A quadrupling of profit at BCBS of Alabama.

Publicly traded health insurers were not the only ones in the industry that continued to amass large windfalls in 2022. Many nonprofit and private Blue Cross Blue Shield companies ended last year with sizable gains that added to their mountainous cash reserves, according to a STAT analysis of financial filings.

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The results underscore how much financial and political power the Blues still hold in their respective states, and how they broadly remain entrenched household names, particularly within the market for employer-based health insurance.

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