BlueCross BlueShield of South Carolina is more than just the 800-pound gorilla in the Palmetto State's healthcare market – it is parent to a family of successful subsidiary companies that provide insurance, back-office services, government plan administration, Medicare claims processing, and other services nationwide. Through those subsidiaries, it has strengthened itself financially at a time when other nonprofit Blue companies have seen declines in their reserves. As the recession takes hold, health plans in the Carolinas are scrambling to provide low-cost options to employers and individuals as price becomes the primary driver in coverage decisions. The problem-plagued North Carolina State Employee Health Plan will be taking proposals soon from vendors interested in servicing the huge 667,000-member plan. A suggestion from pharmaceutical giant Merck & Co. helped spawn a new medical home pilot project in Charleston, S.C., focused on diabetes care. The program involves BC/BS of South Carolina and Palmetto Primary Care Physicians.