Blue Cross and Blue Shield of Texas began in 1929, the year of the stock market crash that inaugurated the Great Depression, when Justin Ford Kimball, a former Dallas school superintendent, became the Baylor University official in charge of Dallas hospital units. Kimball devised a plan that would allow teachers to contribute fifty cents a month to a fund that would guarantee them up to twenty-one days of hospital care at Baylor Hospital. After the "Baylor Plan" appeared, planners began to consider the idea of offering community-wide plans to fund members. The prepaid health-care plan received its name in 1933, when E. A. van Steenwyk, head of a Minnesota hospitalization plan, designed a poster using the blue Geneva cross, known as a universal symbol of health care, and a Latin motto meaning "Without the Lord We Can Do Nothing." Eventually, the plan came to be known as the Blue Cross plan. The crest of the American Hospital Association, which set national standards for plans, appeared in the center of the blue cross until 1972, by which time the Blue Cross concept had become independent of the hospital system.
The Texas plan came into being in 1942 when the American Hospital Association approved a group chartered in 1939 as Group Hospital Services, Incorporated, as the Blue Cross Plan of Texas. In 1944 the Baylor Plan dissolved, and its members were transferred to Group Hospital Service. Meanwhile, a California plan that paid physicians instead of hospitals had been introduced in 1939. Its symbol, which became the trademark of the new plan, was a blue shield bearing the ancient medical symbol of a caduceus. In 1945 Group Hospital Service purchased a mutual insurance company and restructured it as Group Medical and Surgical Service, thereby establishing a companion Blue Shield plan to offer benefits for physician care in addition to its other service.
The fully formed Texas Plan expanded rapidly during the 1950s, adding major medical and other types of coverage. In 1960 it was the first plan in the nation to offer life insurance through a comprehensive group-insurance package. This component developed from an earlier enterprise known as the American Savings Life Insurance Company of Houston, a limited-stock life-insurance company, which became a Blue Cross and Blue Shield of Texas subsidiary known as Group Life and Health Insurance Company in 1960. The company later offered individual life, permanent life, short and long term disability coverage, and accidental death coverage, in addition to group term life insurance. By the 1990s Group Life and Health had more than $14 billion worth of life insurance in force. Also in 1960 Blue Cross moved its home office to Dallas, and the enterprise entered the Federal Employee Program, which provided health coverage for Texas government workers. In 1966, with the instigation of Medicare, Blue Cross and Blue Shield of Texas became an intermediary organization. In 1986 the enterprise incorporated a third-party administrator known as HealthCare Benefits and in 1992 established BlueChoice, a network of physicians and health-care professionals offering quality cost-effective care throughout the state. In 1993 a network of dentists known as DentaBlue was first offered to subscribers.