Blue Cross and Blue Shield Association (BCBSA) is a federation of 34 independent, community-based, and locally operated Blue Cross and Blue Shield companies. They provide health insurance to over 106 million members across the United States, making money primarily through premiums paid by individuals, employers, and government contracts. Founded in 1929, BCBSA has a long history of pioneering health insurance and advocating for healthcare reform. The association is known for its comprehensive coverage options and commitment to improving healthcare access and quality.