Blue Cross and Blue Shield is seeking a 6.35 percent rate hike for individuals who buy its Blue Advantage health plan.

If approved by the N.C. Department of Insurance, the higher rates would start Jan. 1. Last year, Blue Cross asked for a 6.97 percent increase but agreed to a 5.37 percent hike as part of a settlement with the DOI.

Rates would remain the same for Blue Options HSA and Blue Saver plans, which are high-deductible plans with lower premiums but fewer benefits. Those plans have about 80,000 members.

Blue Advantage is a traditional co-pay plan with about 265,000 members.

As the state's largest health insurer, Blue Cross dominates the market for individual coverage. Its clout also helps determine rates that other insurers in North Carolina are able to set.

Blue Cross and Blue Shield of North Carolina is tired of playing the scapegoat.

The state's largest health insurer will announce this morning that it's beginning a major marketing campaign to emphasize that many parties share the blame for rising health costs. The message is that those groups, including insurers, doctors, hospitals, drug companies, lawyers and consumers, must work together to reduce medical costs.

The effort will include TV commercials and other advertising with goats portraying the various groups. The Chapel Hill company also is starting a website, www.letstalkcost.com to spur more discussion about how to control medical costs.

The risk is that consumers, physicians and others who already blame Blue Cross for surging insurance premiums may see the ads as the powerful company spending more money on marketing that simply attempts to deflect criticism.

The top boss at Blue Cross and Blue Shield of North Carolina made $1.87 million last year, less half what his predecessor earned during the prior year.

The state's largest health insurer disclosed the pay package for Brad Wilson, who took over as CEO last February, in its annual report with the N.C. Department of Insurance.

Bob Greczyn made $4.08 million in 2009, his last full year as CEO.

Some of the difference is related to their tenure as CEO -- Greczyn had a higher base salary and bigger potential bonus after more than a decade running the company, said chief financial Gerald Petkau. And some of Wilson's total pay package is tied to longer-term incentives, which he will  be in line to receive in coming years.

Blue Cross and Blue Shield of North Carolina reported a surge in net income for 2010, as the state's largest health insurer cut costs and saw stronger returns on its massive investment portfolio.

But membership growth and revenue were essentially flat, as customers continue to shift to cheaper health plan options. Blue Cross lost about 30,000 insured members as the economic downturn continued to hurt, but saw an uptick in membership where it only provides administrative services.

For 2011, the company doesn't expect to see a big rebound, said chief financial officer Gerald Petkau. Individual and corporate customers are still seeking ways to keep premiums affordable, such as shifting to health plans with higher deductibles.

"We're trying to maintain a relatively stable level of profitability to serve our members well," he added. "Stable and modest growth are good in this business."

The state's largest health insurer is taking new steps to embrace social media and networking.

Blue Cross and Blue Shield has started an online forum designed to gather consumers' opinions about health insurance, wellness and other issues. The nonprofit will encourage participation by giving away gift cards, sports tickets and other prizes.

The "crowdsourcing" website went live today. The company will post questions such as "Smokers -- should they pay more for their health insurance?" It allows participants to share feedback through Facebook and Twitter.

One goal is to tap into consumers' opinions about health care and coverage,  and make adjustments accordingly, said chief marketing officer John Roos. But it's also an easy way to market the insurer, and get feedback on various topics and products.

Aetna won't abandon any pregnant women.

In a story on Saturday's front page about the health insurer's contract dispute with the UNC Health Care System, a member who is 35 weeks' pregnant discussed her fears of having to change her doctor and hospital.

Jennifer Marks is scheduled to deliver her baby next month at Rex Healthcare, the Raleigh hospital owned by UNC Health. For Aetna members, Rex is "out of network" now that the insurer's contract has expired, following a fight about how much Aetna should pay UNC Health for medical care.

Marks had filled out several forms with Aetna to make sure she wouldn't face extra charges at the facility and was told she would have an answer within 7 to 10 days.

But Bruce Norman, an Aetna medical director based in North Carolina, called Marks personally today to assure her that her coverage won't change. "He apologized for the confusion," and mentioned seeing the N&O article, Marks said.

At least one major Triangle employer will allow workers to switch their health coverage if Aetna's contract with the UNC Health Care System is terminated next week.

GlaxoSmithKline, which employs about 5,000 people in this region, has told workers who are signed up for Aetna coverage that they can transfer to a similar health plan offered by UnitedHealthcare. Employees chose between Aetna and United for their coverage last fall, said GSK spokeswoman Mary Anne Rhyne.

"Health insurance is an important benefit for our employees," she said. "The company doesn't want them to have any disruption."

The move by GSK could increase pressure on Aetna to settle its contract dispute with UNC Health. The insurer doesn't want to lose members, and has been working to coordinate care with other local physicians and hospitals.

A contract dispute between Aetna and the UNC Health Care System is threatening to disrupt thousands of the health insurer’s members in the Triangle.

The fight, naturally, is over money.

UNC Health, which also owns Rex Healthcare in Raleigh, wants higher fees for its facilities and physicians to treat Aetna members. Aetna is trying to keep costs down for employers that buy coverage for their workers and other customers.

UNC Health estimates the dispute could affect about 10,000 patients across the Triangle. Many won’t experience any problems if the dispute is resolved soon, but it could cause major headaches for seriously ill patients who are undergoing frequent treatment, or people who have procedures scheduled next month.

Blue Cross and Blue Shield is expanding its efforts to attract small businesses interested in tax credits tied to federal health overhaul.

The state's largest health insurer is running ads on TV and elsewhere about the new tax credits, and recently started an online calculator for small business owners.

Blue Cross plans across the country are hoping to stand out among other health insurers that also are competing to win new customers among businesses that previously didn't provide health coverage.

"Small businesses are heavily impacted by health care reform," said Blue Cross CEO Brad Wilson, in a prepared statement. "I hope all North Carolina small businesses will take advantage of these resources to ensure they receive the maximum benefits from this law."

The U.S. Treasury today issued new guidelines on the Affordable Care Act, in an attempt to clear up confusion created by the law passed earlier this year.

The state's largest health insurer on Monday started mailing out refund checks worth $155.8 million to 215,000 customers across North Carolina.

Blue Cross and Blue Shield announced in September it would pay the refunds, which are tied to changes brought by the federal health overhaul.

The size of the refunds are based on rates paid and will equal about 1 1/2 months of premiums for Blue Advantage customers who had policies in effect as of March 23. For a customer paying an average of $380 a month, the refund will be about $690.

In a letter to Blue Cross members, CEO Brad Wilson shares credit for the refunds with N.C. Insurance Commissioner Wayne Goodwin.

"In these challenging economic times, we are honored that you have chosen to place your trust in us," Wilson writes.