Blue Cross Blue Shield North Dakota


Beginning in 2009, after a year of negative news, coupled by health care reform and overall insurance industry angst, brand reputation was dismal for Blue Cross Blue Shield of North Dakota (BCBSND).

North Dakotans had lost trust and blamed BCBSND for rising costs. Research revealed that affordability was a primary concern for both members and employers, including the perception that BCBSND didn’t offer enough options. Members were also looking to BCBSND to help families, businesses, communities and political leaders advocate for healthier lifestyles.

It was time for a dramatic shift in the way it did business.


BCBSND partnered with Flint Group to develop Bolder Shade of Blue, a multiyear integrated communications plan to repair the brand and create engagement. The primary communication strategies were to listen, educate and demonstrate, beginning with a member survey, followed by town hall meetings, advertorials and a storytelling approach to mass messaging that resonated with the overall North Dakota mindset.


Through storytelling, like the Queens of Colonoscopy print ad and community outreach with a Blue Insights blog, BCBSND reignited trust and improved its reputation with robust brand management.

Highlights from a BCBSND brand image tracking study:

  • In 2011, BCBSND had a 76 percent negative image association. In 2013, it had a 52 percent positive image association – a 128 percent shift in two years.
  • Total sales in 2012 increased 66 percent from 2011 and continue to increase.
  • In 2013, BCBSND enrolled a record 500,000 members.
  • In 2011, BCBSND was seen as the primary reason for rising costs; by 2013, health care in general was seen as the primary reason for rising costs.
  • News coverage about BCBSND shifted from 76 percent negative coverage in 2009 to 90 percent positive in 2013.
  • Since 2011, BCBSND has reached 200,000 Facebook and 8,000 Twitter users.
  • A vast majority viewed Bolder Shade of Blue as credible, relevant and compelling.
  • Participants related to the real stories and personal approach, which made them in turn feel good about BCBSND.
  • Participant quote: “BCBSND really cares about people and [the ads] kind of take away their corporate image and come down to an individual level.”

BCBSND and Flint Group also earned the prestigious Public Relations Society of America Silver Anvil Award in the reputation/brand management category for the Bolder Shade of Blue campaign.


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