Blue Cross Blue Shield of North Dakota pursues affiliation with Oregon health care

FARGO — A new partnership between Blue Cross Blue Shield of North Dakota and a nonprofit health company in the Pacific Northwest will provide “greater value and more solutions” to members of both, company leaders said.

Dan Conrad, BCBSND president and CEO, said a “strategic affiliation” is being pursued with Cambia Health Solutions of Portland, Oregon.

He said BCBSND informed its employees of the news the morning of Thursday, Aug. 21.

Conrad made it clear a strategic affiliation is not a merger or an acquisition.

“A lot of what’s done is still going to be local. It’s just going to be done by a combined team,” he told The Forum.

Ryan Benbo, senior vice president and chief marketing officer at BCBSND, said Cambia currently provides management and shared services to health insurance plans in Oregon, Washington, Idaho and Utah.

“It’s a combination of four affiliated ‘Blues’ plans that comprise Cambia, and we’ll be the fifth to join that,” Benbo said.

Conrad told The Forum it’s too soon to know what efficiencies will be gained with the new affiliation.

“We have not talked about layoffs as a part of this,” he said, when asked about possible staff reductions.

Approximately 900 people are employed by BCBSND, more than half of them working in Fargo, West Fargo and Moorhead; Cambia employs around 4,600 people, a company spokesperson said.

If the affiliation is approved by insurance regulators, policy holders won’t see major changes, Conrad said. They’ll retain their current health care coverage and keep using their BCBSND insurance card as they do today. Medicare Advantage will continue to be offered through NextBlue of North Dakota.

BCBSND will keep its local plan name, board of directors and philanthropic foundation, and remain governed by voting policyholders rather than investors.

“Our assets and reserves are all staying here, but we’re going to combine our teams and create a more efficient operation to serve all the plans in the Cambia family,” Conrad said.

Blue Cross Blue Shield of North Dakota is the market share leader in the state but one of the smallest health insurers in the country, significantly smaller than Cambia.

Founded in 1940, BCBSND serves more than 380,000 members compared with Cambia, founded in 1995, serving more than 3.6 million members.

While policy holders won’t lose the BCBSND identity, employees will.

Upon regulatory approval, BCBSND employees will become employees of Cambia, which will manage and operate the North Dakota company in areas of policy and claims administration, financial reporting, IT and plan-performance reporting, among others.

Still, the company pledges to maintain a strong North Dakota presence, including at its Fargo headquarters at 4510 13th Ave. S.

Jared Short, president and CEO of Cambia, said the two companies will be a good fit in terms of employee teams.

“BCBSND’s culture and vision fit perfectly as we work together to innovate and transform health care for the communities we serve,” he said in a news release.

Conrad said the move toward a “strategic alliance” began internally with the BCBSND board of directors around three years ago. Direct negotiations with Cambia have been going on for more than a year.

Health care has been a “volatile” industry for some time, Conrad said, and investments, including in technology, are expensive and difficult for a smaller company to make.

While BCBSND remains “financially healthy,” Conrad said they want to make sure it stays that way.

“We wanted to be able to control our own destiny and make decisions that made the most sense for our members, and not have to be in a position of financial weakness, or feeling like we had to do something,” he said.

The specific structure and roles of the blended management team will be determined at a later date, the nonprofit groups stated.

BCBSND will get a seat on the combined board of directors and there will be North Dakota representation on the Cambia management team, Conrad said.

Short will remain in his role as president and CEO of Cambia.

Conrad, who started at BCBSND in 2013 and in his current position since 2020, will become Cambia’s chief administrative officer upon close of the deal, working out of the Fargo office and leading Cambia’s legal, government affairs and human resources teams.

The BCBSND board of directors will also search for a North Dakota market president to oversee strategy and growth for the health plan.

The strategic affiliation is subject to regulatory approval by Jon Godfread, North Dakota’s insurance commissioner, and is expected to close in 2026.