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The New York City's area's largest health insurer will soon have a new leader.
Brian Griffin, the president and chief executive of Empire BlueCross BlueShield, has been promoted to a position with Anthem Inc., the corporate parent of the New York City health plan, effective Sept. 1.
Mr. Griffin will be executive vice president and chief executive of Anthem's commercial and specialty business — the company's largest and most profitable business segment — which recorded $39.2 billion in operating revenue last year for an operating gain of $3.3 billion. He will also be part of Anthem's executive committee.
He will replace Ken Goulet, who reports directly to Anthem President and Chief Executive Joseph Swedish. Indianapolis-based Anthem announced in May that Mr. Goulet would retire from the company later in the summer.
A spokesperson for Empire confirmed the move and said more information will be announced next week.
Mr. Griffin will be responsible for the company's local group business in Anthem's 13 BlueCross and BlueShield plans, according to his LinkedIn profile. Those plans offer products in the individual, small-group and large-group insurance markets. He will also oversee specialty coverage in areas such as dental, vision, life, disability and workers' compensation, and will lead the company's pharmacy division.
Collectively, the products cover some 30 million people for medical insurance and 17.5 million people in specialty plans, according to his profile.
Anthem agreed to acquire Cigna for about $54.2 billion in July. The new entity would be the nation's largest health insurer with 53 million members, overtaking UnitedHealth Group. The deal must still receive regulatory approval before it is final.
Mr. Griffin joined Empire BlueCross BlueShield in January 2013 as president and chief executive, leading it through the introduction of the Affordable Care Act's insurance marketplaces, in which Empire offers individual and small-group plans. He told Crain's before the rollout of the marketplace that he was spending "50% of my time on ensuring we will be in a position to succeed."
The insurer had 4 million members in the New York City area in 2014, making it the region's largest, with only a small portion of its members coming from the state marketplace. The marketplace had enrolled about 415,000 people in commercial health plans as of Feb. 28, 2015, and Empire BlueCross BlueShield had signed up 10% of those members.
Mr. Griffin's successor will be faced with numerous challenges facing New York's health insurance industry, which continues to grapple with a rapidly evolving regulatory landscape after the implementation of the Affordable Care Act, rising specialty drug costs and consolidation among health care providers.
Closer relationships between New York City hospitals, such as NYU Langone's merger with Lutheran Medical Center in Sunset Park, Brooklyn, and North Shore-LIJ's strategic partnership with Brooklyn's Maimonides Medical Center, give providers more leverage in negotiations with insurers.
Earlier in his career, Mr. Griffin worked on the startup team at U.S. Healthcare and served as chief executive of Franklin Lakes, N.J.-based Medco's international business before the pharmacy-benefit manager was acquired by Express Scripts in 2012. His first job after college was as a sales representative for Empire BlueCross BlueShield.
Jonathan LaMantia writes for Crain's New York Business, a sister publication of Business Insurance.
Fitch Ratings Inc. is holding to its negative view of Anthem Inc.'s credit rating as the Indianapolis-based health insurer moves forward with its proposed $54.2 billion purchase of rival insurer Cigna Corp.