Highmark

Highmark was created in 1977 and in the 1990s by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) based in suburban Harrisburg, and Blue Cross of Western Pennsylvania based in downtown Pittsburgh (now Highmark Blue Cross Blue Shield).

The consolidated group is available in 62 of the state's 67 counties. In West Virginia, the company operates as Highmark Blue Cross Blue Shield West Virginia, and in Delaware, it operates as Highmark Blue Cross Blue Shield Delaware. The new company has based its head office in downtown Pittsburgh.

On March 28, 2007, Highmark announced it intended to consolidate with Independence Blue Cross of Philadelphia. The combination of the 2 insurers would have created a new company with over 18,000 employees, dual-headquarters in both Pittsburgh and Philadelphia and an economic impact of over $4 billion throughout the Commonwealth of Pennsylvania. On January 22, 2009, Highmark and Independence Blue Cross withdrew their applications to consolidate due to the unacceptability of conditions that the Pennsylvania Insurance Department was going to place upon the merger: to give up either of their well-known "Blue Cross" or "Blue Shield" trademarks.

In 2011 the company announced it would buy the financially troubled West Penn Allegheny Health System (WPAHS) for about $500 million, expanding from insurance into owning hospitals. This began a period of conflict between Highmark and the University of Pittsburgh Medical Center (UPMC), which had expanded from hospitals into insurance, and caused difficulties for patients to access care at the conflicting institutions. The conflict included a lawsuit by Highmark against UPMC alleging that UPMC over-billed it by $300 million for cancer drugs, arbitrators ordered Highmark to pay $188 million.

In 2014, a gay couple criticized Highmark for not providing family coverage to same-sex couples under the Affordable Care Act. Highmark later reversed their policy.

In January 2020, the company earned distinction as "Best Place to Work for LGBTQ Equality" from the Human Rights Campaign Foundation, receiving a perfect score of 100 points in the national Corporate Equality Index.

In 2021, Highmark acquired HealthNow, which operated BlueCross BlueShield in Western New York and Northeastern New York.

On March 29, 2021, the Buffalo Bills of the National Football League announced that their stadium's new name would be Highmark Stadium after reaching a 10-year agreement with Highmark Blue Cross Blue Shield of Western New York. It was later announced in June 2023 that this naming agreement would extend into the construction and opening of the Bills' new stadium, which was called Highmark Stadium once it opened for the 2026 NFL season.