The insurer financial strength rating on Highmark Inc. (d/b/a Highmark BCBS&Highmark Blue Shield) (Highmark) is based on the company's strong but variable earnings, very strong capitalization, market leadership in western Pennsylvania, diversified business profile, and historically strong (but diminished) competitive position in central Pennsylvania. Partially offsetting these positive factors are its status as the insurer of last resort and the challenging regulatory environment. Highmark's earnings profile is strong based on a Standard&Poor's Ratings Services earnings adequacy ratio of 205% at year-end 2004, compared with 158% in 2003, 142% in 2002, and 184% in 2001. Consolidated pretax GAAP earnings increased dramatically to $416.8 million in 2004 from $137.2 million in 2003 and a pretax loss of $128.7
