It's now known as IMT Insurance Company and is based in Des Moines. At the urging of groups of employers, the Employers Mutual Casualty Company provided workers' compensation insurance beginning in 1911. Health insurance hit the state in the 1920s when Grinnell College offered plan members pre-paid health coverage. For a fixed monthly premium, members received free hospital care. Wellmark Blue Cross and Blue Shield of Iowa was born in 1939 under the name of Hospital Service Incorporated of Iowa.
Hospitals underwrote the financial risk taken by the organization.
If the corporation failed, hospitals would provide free care to members. Led by the Archdiocese of Sioux City, a similar plan formed simultaneously to serve people in the counties of northwest Iowa and South Dakota. Throughout the evolution of the health insurance industry, hospitals and physicians agreed to provide medical services in exchange for direct payment in full from insurers. Despite all of the changes, the need for protection against financial loss is greater than ever. Today there are 1,607 insurance companies doing business in Iowa.