It is based in Oakland, California, and serves 4.5 million health plan members and more than 65,000 physicians across the state.

[11] The Blue Cross of California, which traditionally covered the hospital portion of insurance as a separate entity, went public in 1992 under the name Wellpoint, with the name later changing to Anthem.

[13] In 2006, Blue Shield agreed to a $6.5 million settlement relating to allegedly modifying the risk tier structure of its individual and family health care plans.

Further, the organization reinstated coverage to 450 members whose plans had been canceled and agreed to provide compensation for any medical debts incurred by these policyholders due to the rescission.

[21] In 2011, Blue Shield announced that it would cap its net income at no more than 2% of revenue, contingent on approval from the board of directors.

[24] A claimed recent application of the duck test resulted in the denial of Blue Shield's tax-exempt status.

The organization defended its tax-exempt status, but failed to provide sufficient evidence to California Franchise Tax Board that its actions align with such obligations.