Blue Cross Blue Shield of North Dakota introduced the idea of prepaid health care to the state in the 1940s. After the Great Depression, many North Dakotans were unable to pay for adequate health care, and some hospitals struggled to stay open as a result.
Through the years, BCBSND has affiliated with several companies to offer expanded services and more products, such as long-term care and life insurance, to help members maintain financial security during difficult situations.
BCBSND has always worked to face every challenge and turn it into an opportunity to make this industry better. There have been countless key events that have shaped who we are. View them all in our Corporate Timeline.
Yet, these six events, in particular, stand out in demonstrating our advocacy--which began with the company’s inception and continues today.
In the 1930s, the US experienced record unemployment and an economy in shambles. The crises went on for more than a decade and by 1940, 70% of North Dakotans were on some form of public assistance and unable to afford their health care bills.
Luckily, leaders from business, civic, faith and health care organizations pooled their resources to pay for the care of individual members. With that social mission, the concept of prepaid health insurance was born in North Dakota.
The company that administered it—later known as Blue Cross Blue Shield of North Dakota—set up shop in downtown Fargo in the 1st International Bank building with three employees.
By the end of our first year in business, we insured 9,000 North Dakotans.
In the years after World War II, jobs were plentiful. Businesses needed ways to attract and retain new workers and for that, they turned to employer-sponsored insurance.
By the mid-1950s, health insurance enrollment skyrocketed. After just 10 years, BCBSND had 100,000 members and nearly three-quarters of the ND population was covered.
Around this time, BCBSND moved to a new location on 8th Street.
BCBSND began with our first computer system in 1964. Technology advancements shape many industries, but for us, early adoption means being able to keep costs low for our members.
By the late 1970s, we were outgrowing our downtown location and needed a space that would help us advance technologically. We settled into our Fargo headquarters where we still operate today.
In the years that followed, our numbers continued to grow:
In 2010, the most sweeping legislative change ever in health care was enacted with the passage of the Affordable Care Act, sometimes referred to as Obamacare. To help North Dakota employers understand and comply with the changes, BCBSND quickly stepped into the role of trusted ACA advisor.
By 2025, we insured well over a quarter million members and approached our current employment figure of just over 800 people.
The rising cost of health care is a complex issue that has grown in significance since the 1990s. With this change, we have developed a mission with three major goals:
In many ways, our work today echoes back to our origins during the Great Depression. It’s during challenging times that we create our best solutions. Over the past decade, we've introduced valuable tools for our members and the providers we work with such as digital tools, Worksite Wellness and value-based care.
As we look to the future, we continue to build on a strong past.
In 2025, BCBSND announced plans to join Cambia Health Solutions as an affiliated single-state Blue plan.
Established in 1995 by four Blue Cross Blue Shield licensees, Cambia is a nonprofit health solutions company that provides management and shared services for local Blue plans across the Pacific Northwest and Mountain West, all connected by a common focus on delivering more for members.
By sharing operations teams and core technology platforms, this collaboration of five locally based Blues plans will enhance customer and member experience, support broader access to high-quality care, and work to contain costs for members and customers.
