answer:Yes, I think that some, at least, of the Blue Cross-Blue Shield companies have gone from being non-profits to for-profit companies. Edit: From the Wikipedia article: Prior to the Tax Reform Act of 1986, organizations administering Blue Cross Blue Shield were tax exempt under 501©(4) as social welfare plans. However, the Tax Reform Act of 1986 revoked that exemption because the plans sold commercial-type insurance. They became 501(m) organizations, subject to federal taxation but entitled to “special tax benefits”[9] under IRC 833. In 1994, the Blue Cross Blue Shield Association changed to allow its licensees to be for-profit corporations.[5] Some plans[specify] are still considered not-for-profit at the state level. So it is possible. I just don’t know under what circumstance and what the process would be.