80 Years, One Idaho Story.
It Started With Doctors: $100 and a Vision
For the leading health insurance provider in Idaho, Regence BlueShield had a quiet, humble beginning.
The birth of the company was in February 1946, 80 years ago.
Picture this: Twenty-seven Lewiston-area physicians met at downtown Lewiston’s Lewis-Clark Hotel. They had a common concern. Idaho residents, as well as those throughout the U.S., had a need that was apparent to all in the medical profession following World War II.
Their concern: the need to provide ways and means for ordinary citizens to obtain adequate medical care on a prepaid budget basis. The idea was a new one, in both Idaho and the nation, although it had been pioneered by physicians in parts of Washington and Oregon as early as 1930.
The caring physicians took action. Each personally contributed $100 to underwrite the founding of the infant Medical Service Bureau. That was on Feb. 13, 1946.
Eighty years ago, Regence got its start in Lewiston with phyicians hoping to help people gain access to medical care.
coverage of two major mining companies in the Silver Valley near Kellogg-Wallace: Bunker Hill Mining Co. and the Hecla Lucky Friday, in addition to other smaller mining operations.
A.L.
Medical Service Bureau had a suite of offices in downtown Lewiston’s Breier Building for its first two-plus decades. Growth came after the 1969 announcement that a company headquarters, a 19,000-square-foot building, would be built a couple of years later on 2 acres of land in central Lewiston. In 1988, a second 15,000-square-foot building was constructed, connected to the first by a 60-foot tunnel, creating a Regence campus.
It was in 1997 when Regence BlueShield of Idaho became the company’s new name, succeeding Medical Service Bureau.
The name Regence was selected with care. It is a combination of the words “region” and “alliance,” reflecting Medical Service Bureau’s decision to form an affiliation with other Blues companies in Oregon and Washington.
The first president was the late Dr. W.S. Douglas, a Lewiston family physician and surgeon. Dr. Joseph E. Baldeck, of Lewiston, was vice president; Dr. W.H. Pierce was secretary; and other directors were Dr. D.K. Worden, of Lewiston, and Dr. C.C. Armstrong, of Moscow.
The first contracts were with a few Lewiston businesses: COD Laundry, Jane’s Cleaners, Evergreen Tire, McMonigle Chevrolet, Lewiston Grain Growers and the Lewiston Tribune. The Lewiston Tribune is the only one still in business today, a customer for all 80 years.
The initial service area consisted of six counties: Nez Perce, Latah, Idaho, Clearwater and Lewis counties in north central Idaho and Asotin County in southeastern Washington.
Medical Service Bureau became North Idaho Medical Service Bureau two years later, expanding in 1948 to cover a territory north of the Salmon River to the Canadian border. That was enabled by
Regence BlueShield of Idaho now has offices in Boise, Lewiston, Coeur d’Alene and Pocatello.
The 27 physicians who contributed $100 apiece in 1946, almost all of them doctors who had completed tours of military duty in World War II? Each is deceased.
But, if able, how would they feel that they gave birth to a company committed to all communities throughout Idaho, not just five mostly rural counties?
Would they have imagined their start would today pay more than $1 billion annually in health care for insured members? Some $2,500 of underwriting per member? And serve more than 360,000 people throughout Idaho, with more than 600 local employees?
It is truly 80 years, One Idaho Story.
In 1946, the Idaho Regence story started with commitment to Idaho families. In 2026, the mission is the same: quality medical and preventative care for Idaho families.
Alford is president of TPC Holdings, parent company of the Lewiston Tribune. He may be contacted at alajr@lmtribune.com or (208) 848-2250.
“Butch” Alford Jr.
Mark H. Ruszczyk
Celebrating 80 Years of Service to Idaho
A few words from the president of Regence BlueShield of Idaho
Aswe mark the 80th anniversary of Regence BlueShield of Idaho, I’m honored to reflect on the remarkable journey that has brought us to this milestone. This is a moment to celebrate not only our achievements, but also the people and partnerships that have shaped our legacy and our future. On behalf of Regence, I extend my deepest gratitude to all those who have contributed to our mission over the decades.
To our dedicated employees — past and present — thank you for your unwavering commitment and integrity. Your compassion, expertise and resilience have driven our organization forward, ensuring that Idahoans receive the care they deserve. Our previous leaders and physician-founders laid a strong foundation of service and innovation, inspiring us to pursue excellence in everything we do. Their vision and leadership continue to influence our path, and we honor their enduring contributions.
We are grateful to the many Idaho organizations and families who have placed their trust in Regence BlueShield of Idaho. For generations, your partnership and faith in us have guided our efforts and strengthened our resolve. You are the heartbeat of our communities, and your well-being is at the center of our purpose.
Throughout our history — across both prosperous and challenging times — Regence has stood firm in its commitment to providing high-quality, affordable health care. We have navigated change and adversity with a steadfast focus on access, equity and compassion. Our legacy is defined by the promise to put people first, and by the difference we make together for Idaho.
As we look to the future, our commitment remains clear. We will continue to build and innovate, working collaboratively to create a better, more sustainable health care system for all Idahoans. Together, we will meet tomorrow’s challenges and embrace new opportunities, always guided by the values that have shaped our organization for eight decades.
With pride in our past and optimism for the future, I thank you for being part of the Regence BlueShield of Idaho story. Here’s to the next chapter!
— Mark H. Ruszczyk President,
Regence BlueShield of Idaho
“Throughout our history — across both prosperous and challenging times — Regence has stood firm in its commitment to providing highquality, affordable health care.”
The Regence BlueShield office in Lewiston is seen in this recent photo.
Finding a Home in the L-C Valley and With Regence
Jackie Heaven-Ah Hi was born in New Zealand, but her home and career are in Lewiston valley. Regence career Lewiston
By Erin Mullins
New Zealand is known for exceptionally blue skies and surrounding blue seas.
But one New Zealander has found her home away from home in the Lewiston-Clarkston Valley working for Regence BlueShield.
Jackie Heaven-Ah Hi, vice president and site manager for Regence BlueShield, moved to America from New Zealand after marrying her husband, Tai Ah Hi. The couple settled in the valley.
Before joining Regence BlueShield in 2005, she had taken some time away from her career as a stay-at-home mom for her daughter, Tiana Dudley, who is now 24 years old.
At the time, her daughter was heading toward school age and Heaven-Ah Hi was ready to reenter the workforce.
Jackie Heaven-Ah Hi (second from right) poses with her family. In the photo are son-in-law Colton Dudley, daughter Tiana Dudley, husband Tai Ah Hi, Jackie Heaven-Ah Hi and son Tai Ah Hi Jr. Photo courtesy of Jackie Heaven-Ah Hi
Before her daughter was born, Heaven-Ah Hi was working evenings for the local Hollywood Video. She knew when she was ready to return to work that it was time for a new start, with a career that had more flexibility for family.
“And it’s a good thing, right?” Heaven-Ah Hi said. “Because no one rents movies anymore.”
Her work life started out fully in the office and later transitioned to being remote.
Now, she works with a hybrid structure, coming into the office in Lewiston three days a week and working from home two days a week.
In Heaven-Ah Hi’s roles as both vice president and site manager, she plans overall company strategy, supports insurance enrollment and sales, and ensures the company supports the needs of insured members.
While her role involves travel quarterly, or more frequently if needed, day to day she is often closely supporting the company’s enrollment and sales teams.
“Executing on our initiatives and goals and strategies to deliver not only our expected targets, but to build our business for the future of growing and staying relevant and current for what the market looks like and our customers need,” she said.
Heaven-Ah Hi said she has enjoyed her nearly 21 years with the company and felt supported in her family, personal and career goals. She feels grateful to have been able to build herself up at a local company while growing her family.
Time has passed in the blink of an eye, she said.
Heaven-Ah Hi recently celebrated the birth of her grandson, Sutton Dudley, who was born at St. Joseph Regional Medical Center in Lewiston in December 2025.
Members of the Ah Hi family go rafting on the Selway River in Idaho. Photo courtesy of Jackie Heaven-Ah Hi
Jackie Heaven-Ah Hi (right) attends a meeting at Regence. Photo courtesy of Jackie Heaven-Ah Hi
“I would have to say,” she said, “that the best title I have ever received is Grandma.”
Heaven-Ah Hi truly worked her way up at Regence BlueShield.
She started out on the frontlines in the call center and then earned various promotions until moving into her current roles as both vice president and site manager.
Heaven-Ah Hi said it was always her goal to do something with the company within operations.
Now, she has reached the pinnacle, and plans to retire in seven to 10 years.
But Heaven-Ah Hi didn’t just dream of working in operations. She always knew she wanted to do a career that made a difference and served others.
“I would have to say that the best title I have ever received is Grandma.”
Working at Regence BlueShield, Heaven-Ah Hi isn’t just supported in her own life by the company, but helps make sure every member gets equitable access to the health care they need.
In her final years with the company, she hopes to continue to help provide members with affordable and expansive access to health care.
After retirement, Heaven-Ah Hi plans to continue to stay connected to the community — both with her friends and family and with local organizations she works with like the Young Women’s Christian Association and the Boys and Girls Club of America.
In June, Heaven-Ah Hi will reach her 21st year with the company and Regence BlueShield will have eclipsed its 80th birthday.
The L-C Valley will be headed toward the brightest and warmest days of the year while her home country of New Zealand heads toward the winter months.
But, whether living and working in Lewiston or visiting family back on the island nation, Heaven-Ah Hi will be surrounded by expansive blue skies.
Blue skies not just in the day-to-day weather, but in the future Heaven-Ah Hi has created for herself and the ways her legacy of expanding equitable access to health care will live on in the services members receive at Regence BlueShield for years to come.
Jackie Heaven-Ah Hi third from the left) poses with her family. They are, from left, son-in-law Colton Dudley, daughter Tiana Dudley, Jackie Heaven-Ah Hi, husband Tai Ah Hi, and son Tai Ah Hi Jr.
Photo courtesy of Jackie Heaven-Ah Hi
How Regence Brought Health Care to Idaho
What began as a modest postwar idea became a lasting commitment to health care access for Idaho families
By Erin Mullins
Emerging from World War II, Idaho was rebuilding, and with that came a need for affordable health care for all residents.
It was a new idea, both in the Gem State and across the country. While the idea for accessible health care had been pioneered as early as 1930 in Washington and Oregon, it did not gain mainstream traction until after the war.
As the country heads toward its 250th anniversary, Regence BlueShield is celebrating 80 years of helping Idahoans young and old, from all walks of life.
Weathering recessions, societal change and huge technological growth, Regence has remained steady in its mission of providing prepaid health care for anyone who needs it.
While technology has improved by light-years, from the first basic computers that helped the Allies win the war to abundant handheld smartphones, Regence has expanded its reach and services.
Regence BlueShield, originally known as the Medical Service Bureau, was incorporated in February 1946.
This black-and-white photograph dated July 1963 shows a roadside billboard advertising the Medical Service Bureau, part of North Idaho’s Blue Shield Plan.
This vintage manual dates from the early days of the organization now known as Regence BlueShield. The nonprofit group was originally known as Medical Service Bureau when it was founded in Lewiston in 1946.
Above:
Left:
whom had served in World War II,
A group of 27 physicians, many of whom had served in World War II, contributed $100 toward providing accessible insurance in north central Idaho. Insurance was originally provided in Nez Perce, Latah, Idaho, Clearwater and Lewis counties in north central Idaho and Asotin County in southeastern Washington and has since expanded across the state.
The physicians founded the nonprofit organization to act in perpetuity, so that Idahoans would never face a gap in care.
Founders of the company now known as Regence meet during the company’s 20th anniversary in 1966. The men in the photo are Drs. Joseph E. Baldeck, W.S. Douglas, D.K. Worden and W.H. Pierce.
The specific purpose of the corporation, they wrote in the founding document, was to, “provide an organization through which duly licensed physicians and surgeons of the State of Idaho who are or become members hereof can render their professional services and make available benefits of medical and surgical care and hospitalization to individuals or groups of persons.”
An office was established in downtown Lewiston with health care provided in exchange for affordable monthly dues. ration, they wrote in the founding
Members of the complete staff of the Medical Service Bureau pose for a group photograph inside Lewiston’s Breier Building in 1963.
By the end of its first year, various businesses had enrolled for services and 4,000 individuals had subscribed. In 1949, maximum monthly dues were $7, regardless of family size, and services had expanded to 16,000.
By the 20-year mark, expansion was steady, with new hospitals being built in Clarkston, Bonners Ferry, Coeur d’Alene, St. Maries, Shoshone County and Orofino. Hospitals in Lewiston and Moscow had been expanded.
During the 50th anniversary at the tail end of the millennium in 1996, insurance was provided to 245,000 residents with two new programs to help young families having been established.
Building Blocks offered comprehensive prenatal care through education on nutrition, exercise, prenatal care and child care information, as well as incentives for regular prenatal examinations.
The second, Caring Program for Children, provided primary and preventive health care services to uninsured young people throughout the state.
Three decades later, with access to affordable health care in limbo across the country, Regence BlueShield continues to do what it originally did: provide expansive care to all with affordable monthly dues.
Life is unpredictable and no individual or family deserves to go bankrupt because of needed medical care. BlueShield was a pioneer in helping everyday folks access health care – and that’s still the company’s mission today. The Gem State is one with abundant mineral diversity and a rich history, and so are those who choose to call it home. Regence BlueShield is proud to provide health care to the “Gem of the Mountains,” and will continue to expand its services, all at an affordable price for those of all income levels.
The front doors of building A of the Medical Service Bureau of Idaho in Lewiston from the early 1980s.
Regence President John Stellmon helps breaks ground on the construction of a 50,000-square-foot office building in Lewiston. Regence broke ground on the project on Aug. 17, 2005. Stellmon served as the President of Regence BlueShield of Idaho from November 2003 until retirement in April 2012
Nonprofit and Local: The Underpinnings of Regence’s Model
Organization’s longheld tenets will continue to guide it in the future, says medical director
By Erin Mullins
Nonprofit health care undergirded the founding of Regence BlueShield insurance in 1946. And the mission to provide quality health care without the pressure of profit is key to Regence’s future.
Dr. Daniel Meltzer, executive medical director for Regence BlueShield of Idaho, who also works separately as a practicing doctor, said many health insurance companies operate on a for-profit model, in particular those which are national.
“Most of the national health plans that people are familiar with, companies like UnitedHealthcare, Cigna and Aetna, to name a few, are public companies,” Meltzer said. “In the same spirit of, you know, Coke and Pepsi and Chevron. And you see them on the stock market.”
Because of their relationship to the public market and responsibilities to shareholders, these public, for-profit insurance companies have different strategic priorities compared to those with a nonprofit model like Regence BlueShield.
Typically, nonprofit health care insurance is more affordable for insured individuals than for-profit plans, he said. Not having a profit model, as well as focusing
their health plans at the regional level rather than the national level, allows Regence to focus on affordable health care for the people who live in Idaho and run by those who live in the Gem State.
“So when you see Blue Cross, Blue Shield ... most of the Blue plans, but not all, are not-for-profit,” he said. “Which allows us to focus on ensuring affordability. It allows us to operate on thinner margins, because we don’t have to drive profits to pay shareholders.”
Dr. Daniel Meltzer is the executive medical director for Regence BlueShield of Idaho, and also a practicing physician. Photo courtesy of Dr. Daniel Meltzer
Regence BlueShield is committed to providing the communities it serves with affordable, accessible and quality health care, Meltzer said.
It is good that Regence plans are mostly locally based, he said, because an employee who lives in New York is living a much different life than a member who needs insurance in Idaho. Hundreds of Regence employees live in Idaho and are neighbors with the communities they serve, he said.
Regionally based Blue plans operate not just in Idaho but across the country, with care provided to bordering states like Oregon and ranging to states as far as South Dakota, North Carolina or Arkansas.
Besides being locally based and not-for-profit, Regence BlueShield provides insured members with health care services that are typically hard to reach.
In Idaho, it can be particularly difficult compared to other states for residents to access women’s health care and behavioral health, Meltzer said.
One way Regence bridges this gap is by covering more than 90% of physicians in the state as in-network, he said.
Historically, Idaho has had a relatively small capacity in terms of undergraduate and graduate medical education, Meltzer said.
Regence has been working with legislators and using its foundation to help support the training of physicians and other health care clinicians, he said. The foundation also supports programs like integrated behavioral health, where physicians and behavioral health clinicians meet patients’ needs.
Telehealth is a big part of Regence’s model and the organization is committed to expanding it in the future, Meltzer said. This both helps patients who live in areas where brickand-mortar health care is far away and those who are afraid to seek certain types of medical care, like counseling, because of social stigma.
Even some primary care, urgent and acute care services can be provided virtually, he said.
When it comes to accessing women’s health care, Idaho has a smaller per-capita amount of specialized women’s health physicians compared to other states, Meltzer said.
Regence is focused on providing a wide range of women’s health care coverage, informing members of their women’s care options and providing services beyond the typical OB-GYN visit.
The services include programs which help women understand their pregnancies, allow them to access at-home monitoring for things like weight or blood pressure and proactively access care before complications arise.
Regence’s campus in Lewiston is seen in their aerial photo.
From the Archives
Here is some vintage Lewiston Tribune reporting about Medical Service Bureau, the original name of Regence BlueShield, during the initial years of its founding in 1946.
May 1, 1946
T.V. Dean has been named manager for the newly organized five-county medical service bureau, sponsored by the north Idaho district medical society, which has opened its offices in the Salsberg building in Lewiston. More than 30 physicians and surgeons from eight north Idaho towns are available to those who are included under employee group contracts now being arranged. Members of workers’ families, in addition to the workers themselves, will be covered by the program, it is announced.
June 29, 1946
Medical Service Plan Approved
Employees of the Clearwater unit of Potlatch Forests, Inc., and members of their families, will receive medical care for non-industrial illnesses and injuries under coverage obtained through the Lewiston Medical Service bureau, an announcement yesterday revealed.
The plan will become effective August 1 with enrollment of employees and their families taking place in the meantime. The service will include maternity care.
Individuals Get Choice
More than 30 physicians and surgeons are participating in the medical service bureau, which is operated on a non-profit basis, and employees will have the privilege of selecting the doctor and hospital of their choice.
IWA-CIO local 10-364, Dave Troy, manager of the Clearwater unit mill, and T.V. Dean, medical service bureau manager, concluded the arrangements.
Serving on the union committee in charge of the negotiations were Louis Lunders, Charley R. Moore, Carl Winkleman, Chauncey Knoll, George Kreisher, George Griffin, and Harold Ford.
Other Firms Enroll
The group had made a detailed study of various medical plans before accepting the service of the medical bureau.
Potlatch Forests, Inc., has agreed to the employee payment of fees on a monthly payroll deduction plan.
Dean announced that approximately 75 per cent of the eligible firms in Lewiston have enrolled their employees under the plan, which provides for prepaid medical care with the monthly fees paid through payroll deductions. The medical service bureau is located in the Salsberg building.
Oct. 16, 1946
Medical Bureau Manager Explains Organization
T. V. Dean, Lewiston representative for the medical service bureau, was the speaker at the Nurses association district No. 4 meeting last night at the nurses annex.
Dr. Dean pointed out the advantages offered through the bureau and explained the method of operation.
At the board meeting preceding the general session, members discussed setting up better nursing standards through graduate nurses setting better examples for student nurses.
June 22, 1947
Medical Service Bureau Explained At Convention
Activities of the Medical Service bureau were displayed by six Lewiston physicians and Tom Dean, bureau manager, at the Idaho State Medical association convention at Sun Valley Monday through Thursday.
Development and operation of the bureau, which is the only one in the state, were explained to convention delegates by Drs. Don T. Roberts, Paul G. Haury, W. S. Douglas, D. K. Worden, A. J. White and R. T. Scott, who attended from Lewiston.
After the convention Dr. Douglas departed for Salt Lake City. Other delegates returned to Lewiston Friday and yesterday.
What do we mean when we say Regence is not-for-profit?
People are confused sometimes when reading about a company being not-for-profit.
Not-for-profit does not mean absence of profit. Profit is the accounting term for the money left over after the bills are paid. Any not-for-profit that ends in the red year after year is in danger of failing. Even not-for-profits need a little profit to carry out their mission.
The company that became Regence BlueShield of Idaho was incorporated as a 501c4 nonprofit until the Tax Reform Act of 1986 made a special category for Blue plans as 501m corporations. Regence today is a not-for-profit company, but one that pays taxes, filing the same federal tax forms as for-profit companies.
Regence says it chose to be not-for-profit because of its allegiance to the members it serves. To fulfill its mission, company leaders say they aim for a small profit from operations, just above the break-even point. Management targets 1% operational profit per year—that’s one penny per dollar. The actual amount fluctuates year to year.
Company leaders say this small profit adds up to big security for Regence members: security that the company will be around to pay member claims year after year; security to invest in better service and quality; security to face the unexpected—from pandemics to medical advancements—and still be well-positioned to take care of members’ everyday needs.
Lewiston Tribue — Dec. 3, 1949.
