About Care First Care First Blue Cross Blue Shield represents the combination of the Maryland and National Capital Area Blue Cross and Blue Shield plans, two strong companies that have come together to be. Care First, Inc. is the not-for-profit, non-stock, parent company of CareFirst of Maryland, Inc., and Group Hospitalization and Medical Services, Inc., affiliates that do business as CareFirst BlueCross BlueShield. CareFirst, Inc. is governed by a Board of Directors and special statutes regulating its business in Maryland, the District of Columbia and Northern Virginia The Blue Cross Blue Shield Association (BCBSA) is a federation of 38 separate health insurance organizations and companies in the United States. Combined, they directly or indirectly provide health insurance to over 99 million Americans.[3] The history of Blue Cross dates back to 1929, while the history of Blue Shield dates to 1939. The Blue Cross Association dates back to 1960, while its Blue Shield counterpart was created in 1948. The two organizations merged in 1982, forming the current association.