The Philadelphia-based health insurer says the reductions have nothing to do with its proposed merger with Highmark Inc., of Pittsburgh. Still, the cuts draw attention to layoffs certain to happen if the merger is approved.

The merger would create the largest health insurer in state history and would lead to the elimination of 745 to 1,200 jobs, the companies have projected.

The "Blues" say the job changes will contribute to $1 billion in efficiencies over six years - enough to increase coverage for the uninsured and to stabilize premiums.

"Given current attrition rates, the expected head-count efficiencies could be achieved without significant layoffs," according to a report prepared by Blues consultant Booz Allen Hamilton Inc.

The report does not say which jobs will be affected. The insurers' representatives have declined to comment on staffing changes that could alarm employees, saying they cannot make complete plans without a decision on the merger.

"These are people's lives," said Elizabeth Williams, Independence Blue Cross' spokeswoman.

"Ultimately, there will be positions that will not exist anymore," she said. "As lines of business grow, there will be new opportunities."

She pointed in particular to Independence Blue Cross' fledgling prescription-management program, FutureScripts, as a potential growth area.

The job numbers are spelled out in the Booz Allen report prepared for Pennsylvania's Insurance Department on the impact of the merger.

Among the 54 employees whose jobs were eliminated recently, a handful interviewed for this article spoke on condition that their names not be printed, in part because they feared it would jeopardize their ability to collect severance or unemployment.

"Generally, people were scared about their jobs," said one of the men who was laid off.

Independence Blue Cross, as of last week, employs 9,119 people, including 7,939 in Pennsylvania, most of them in the Philadelphia region, Williams said.

She said she could not confirm that the number of recent layoffs was 54. She did say most people whose positions were eliminated found other jobs in the company.

"Doing widespread layoffs is not who we are, and it's not how we do business," she said, describing the job changes as company responses to changes in technology and procedures driven by customer demand.

"Business owners are asking for more sophisticated analysis of their medical costs," she said. "To do that, we need new equipment, and we need to change staffing."

Independence Blue Cross, she said, typically gives people whose jobs are about to be eliminated two months to look for work in the company. They can apply for any opening.

If they cannot find work, there are counseling and coaching, she said.

According to the Booz Allen Hamilton report, the biggest cuts would come in information technology, where 383 to 461 positions would be trimmed. That is also the area where the two companies report their lowest turnover - 5 percent for Independence Blue Cross and 3 percent for Highmark.

Here are the other positions:

Back-office functions, such as claims processing: 162 to 366 jobs.

Corporate services and procurement: 113 to 192 jobs.

Front-office jobs, including sales, marketing and underwriting: 47 to 108 jobs.

Middle-office jobs in network, medical and disease management: 40 to 80 jobs.

The Booz Allen report does not say how many employees work in each category. Nor does it project employment increases in divisions like FutureScripts, cited by Williams.

The chief author of the report, Booz senior vice president David G. Knott, declined several requests for comment, made in person and over the phone.

In all categories, Independence Blue Cross has more turnover than Highmark.

"Our market is very different," Williams said. "It's a more vibrant market. "There's a lot more job opportunity for people."

Highmark spokesman Michael Weinstein agreed. In the Pittsburgh area, he said, "opportunities are not as robust."

Weinstein said Highmark, which employs 18,500, including 10,500 in Pennsylvania, had not had a layoff since 2002.

About 5,200 to 5,300 of Highmark's employees work in central Pennsylvania in the Camp Hill area, while most of the rest work closer to the company's headquarters in Pittsburgh.

In public hearings last month, Blues executives and their consultants said the companies would achieve efficiencies by adopting each other's best practices. They did not say whether those practices included moving work to where pay scales were lower.

According to a 2007 U.S. Labor Department survey, compensation in all occupational categories is lower in the Pittsburgh area than in the Philadelphia region.

"If there is differences in pay scales based on differences on costs of living, some of these factors have to be looked at," Weinstein said. "That's normal for any companies coming together. But we're not there yet."