JACKSONVILLE, Fla. — Since Patrick J. Geraghty arrived here a year and a half ago to lead the state’s largest health insurer, Florida Blue, he has expanded its operations in Medicare and Medicaid, entered arrangements with hospitals and doctors, bought a medical group, and dabbled with a new private sector marketplace that allows employees to choose plans from different insurance companies.

At the same time, he is preparing Florida Blue, a nonprofit Blue Cross and Blue Shield plan, for 2014, when most of the requirements of the federal Affordable Care Act go into effect. Insurers will have to offer a policy to anyone who wants one, regardless of their health, and will not be allowed to charge more in premiums to people with expensive medical conditions. The plans the companies offer will be highly regulated through government-run exchanges that are still getting their final regulatory touches.   Read more