Just down from the Target and Gander Mountain big-box stores and between a nail salon and dental office, North Carolina's largest health insurer opened its first retail store.
It has some exercise offerings - step aerobics classes and stationary bike workouts - but for now, its main product is providing in-person information about changes coming in October with the health insurance overhaul law.
Blue Cross and Blue Shield of North Carolina is opening half a dozen of these offices in strip malls statewide to first educate and then, starting in October, enroll consumers shopping for coverage because of the federal Affordable Care Act, also known as "Obamacare." Blue Cross affiliates in Florida and Pennsylvania have had similar stores open for years.
The North Carolina company also hauls an air-conditioned showroom trailer to fairs and farmers markets to reach out to the estimated 600,000 people who will be newly shopping for individual policies - some of them subsidized by the government for consumers who might have trouble affording a policy. Many of the individual policies will be sold on a statewide Internet marketplace designed to make buying coverage comparable to finding a hotel room or rental car.
North Carolina's Republican General Assembly and governor oppose the law and so the federal government is running the state marketplace where insurers will sell policies.
As people who have been uninsured or had their coverage provided by employers start shopping around, BCBSNC is reaching out like never before to expand on its 375,000 insurance policies for individuals, marketing director Bruce Allen said. The goal is explaining the federal law, which requires everyone to have coverage or pay a fine and subsidizes many middle-class consumers who might otherwise not be able to afford policies on their own. The law also prohibits insurers from rejecting customers who have pre-existing health conditions.
"There's a big segment of the population that really wants to talk to someone face to face about it," Allen said. "It's a new market that's entering that doesn't have health insurance, never had it, and really needs kind of that step-by-step walk-through to understand a really critical decision for them to make."
Across the country, Blue Cross companies are among the health insurers most aggressive in reaching out to build consumer trust and capture their spending on policies. Spots for a broad new print, television and online advertising campaign are multiplying. Meetings with civic organizations community groups, and religious institutions are taking place from Vermont to Texas. The North Carolina company has rented movie theaters and invited guests to watch first-run films, with the addition of a 15-minute ad explaining the Affordable Care Act and laptop-ready staffers in the lobby offering individual guidance on the law.
The Blue Cross and Blue Shield Association, the umbrella organization for the country's 38 Blue Cross companies, launched a campaign last month with the Walgreen Co. drugstore chain, with signs and brochures in about 8,000 stores.
WellPoint, the largest operator of Blue Cross Blue Shield health plans, is teaming up with Spanish-language TV and radio network Univision in California, New York, Colorado and Georgia for meetings, broadcast advertisements, and newscast segments describing what coverage means and how to buy insurance on an online exchange.
Blue Cross Blue Shield companies already are some of the country's biggest sellers of health insurance policies for individuals. Seven Blue Cross companies, including North Carolina's, were among the top 10 at the end of 2011, according to Atlantic Information Services Inc., which specializes in health industry data and news.
"For other insurers, the majority of their experience is in the employer-provided market, so they don't know the individual market as well and are unsure whether this will be profitable, so they're moving very carefully," said David Ridley, director of the health sector management program at Duke University's Fuqua business school. "In contrast, Blue Cross Blue Shield - with their experience in the individual market, its experience interacting with government as the insurer of last resort - is moving much more aggressively and creatively."
Outside the Blue Cross Blue Shield world, Humana Inc. has signaled plans to station representatives in grocery stores and pharmacies in the 14 states where its policies will be sold on online insurance marketplaces. Pittsburgh-based UPMC Health Plan has set up kiosks in six western Pennsylvania malls to reach insurance consumers with questions, and it launched a computer application in an effort to offer a fun way to understand the details of the law and its polices.
Spokesmen for Assurant Health and Aetna described no novel marketing twists tied to the upcoming changes.
Government, too, is ramping up efforts to reach the working poor, young people and others with no health coverage. President Barack Obama's administration and many states are launching campaigns this summer to get the word out. Grassroots organizers are recruiting pastors, barbers and mothers to convey the message. In some neighborhoods, volunteers organized by a coalition of health companies and advocates hand out brochures.
But any company marketing efforts come as most Americans are confused or uninformed about what the new health insurance law means to them. Only about one in five had heard about the health insurance marketplaces as of June, according to a poll by the Kaiser Family Foundation.
"There is a lot of misinformation out there. One of the things that we hear often is that I have to go buy a government plan on the marketplace," Allen said. "We spend a lot of time explaining to people, 'You're going to buy a private insurance plan. There is no government plan.' "