Other insurers, including Aetna and Blue Shield of California, have also announced large premium hikes.

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Blue Shield of California planned to grade doctors with a blue ribbon if their clinical outcomes are superior.

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Talibah was a project manager at the life insurance subsidiary of Blue Shield of California in San Francisco.

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Last year, Blue Shield of California launched Blue Groove that offers incentives.

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In a public-relations coup, Blue Shield of California announced that it would cap its annual profits at 2%, rebating anything left over to its customers.

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"The need for a smaller network with lower pricing was critical, " said Juan Davila, an executive vice president at Blue Shield of California, which said it hopes to offer a preferred-provider-organization plan for individuals on the exchange.

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In California, Blue Shield has asked regulators to approve premium increases of up to 20 percent.

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