C. Problems of MESSA’s Operating Agreement with Blue Cross

Any discussion of MESSA cannot neglect the role of the health care corporation which underwrites the majority of MESSA's business: Blue Cross/Blue Shield of Michigan ("Blue Cross"). Now that MESSA and Blue Cross have a commercial affiliation by virtue of an underwriting agreement, there is relatively no competition among underwriters for health insurance administration to educational employees. As shown in Appendix II, Blue Cross, has acquired a dominant share of the market by contracting directly with school districts or by underwriting all of MESSA's group policies.⁴⁷ According to Blue Cross's corporate headquarters, MESSA is one of its largest accounts, although it would not specify how large. Given this degree of interest, Blue Cross will almost certainly defend MESSA against criticism and oppose any attempt to regulate MESSA's operations.