The insurance company focuses its services on state and federally funded health care programs. Most of its participants are in Medicaid.

Anthem Blue Cross Blue Shield has ended its contract with the state effective Dec. 31.

Lindy Schumacher, left of the Lincy Foundation, gets a hug from Three Square Chief Executive Julie Murray during the launch of the Three Square Backpack Collaborative at Roundy Elementary School on Sept. 22 STEVE MARCUS / STAFF PHOTOGRAPHER

Medicaid is a federally subsidized health insurance program administered by states for low-income children and people with disabilities.

Although there aren't any immediate plans to enter the Medicare Advantage program in Nevada, it remains an option, Amerigroup spokesman Kent Jenkins Jr. said. Amerigroup operates in 11 states.

Amerigroup is expected to serve about half of the people enrolled in the state's Medicaid and Nevada Check Up programs in Clark and Washoe counties, or about 50,000. The other managed care provider is Health Plan of Nevada.

Leslie Porras, spokeswoman for Anthem's Medicaid programs, said Anthem decided to withdraw from the program because "the rates weren't keeping up with rising medical costs." Anthem also withdrew from Ohio's Medicaid program for similar economic reasons, she said.

The state could have replaced Anthem three ways: seek out a single managed care operator, seek out two operators or allow Amerigroup - who came in third in the state's latest bid for two Medicaid providers - to rebid for the upcoming vacancy.

The state allowed Amerigroup to bid for the contract, as it was "the best present option for Nevada," Chuck Duarte, the state's health care financing and policy director, said in a statement.

"Under the other options, we would run the risk of higher rates of coverage as a result of the bidding process, a period of noncompliance, or both, and the latter could cost the state many more millions than any increase in payments to (health maintenance organizations)," he said.

Amerigroup and Nevada have two things in common: "Helping financially vulnerable Nevadans live healthier lives and serving Nevada taxpayers in a manner that is fiscally responsible," James Carlson, Amerigroup chairman and chief executive, said in a statement. "We believe that together we have laid the foundation for a successful partnership."

Three Square's Christian Velasquez, left (red shirt), and Steve MacLeod move containers with food during the launch of the Three Square Backpack Collaborative at Roundy Elementary School on Sept. 22. The food will be sent home with needy schoolchildren on Fridays to ensure they have food for the weekend. STEVE MARCUS / STAFF PHOTOGRAPHER

With food bank Three Square as its backbone, a backpack meal program is off to a strong start and is rapidly expanding.

Through the program, volunteers fill backpacks with food for children receiving free or reduced breakfasts and lunches at school.

Julie Murray, Three Square's executive director, said often these children don't have access to food on the weekends, or are left to their own devices to secure food.

"A lot of times the students have to rely on themselves to get food in their stomachs," she said.

There are 132,000 children or 42.5 percent participating in the Clark County School District's free and reduced meal plan.

The bagged food is placed discretely in the students' backpacks by the School District and is nonperishable, ready-to-eat and easily opened in case an adult isn't around to help the child.

Three Square also provides food it collects from grocery stores, the Agriculture Department and other suppliers to nonprofit groups feeding the hungry in the Las Vegas Valley, as well as in the region.

In April, Three Square launched the backpack program, serving children at 10 at-risk schools in the School District. Since then, it has expanded the program to 60 schools. By the end of this school year it expects to include every local school in need of the program.

"Although they get a free or reduced breakfast or lunch, when the weekends roll around, they struggle to find food," Murray said. "So working in a collaborative manner we partnered with several other organizations ... we put together a system whereby Three Square will provide the food, the backpack and the School District will help deliver the food.

"What we envision will happen is that Three Square will become the food provider, ensuring that we have enough food in our warehouse that is nutritional in content and that we get the backpack bags loaded," Murray said.

Three Square is part of the Feeding America network, formerly America's Second Harvest.

Although there are 110 organizations participating nationwide in the backpack program, only one other food bank besides Three Square has gone communitywide, Murray said.

"Las Vegas is setting the bar and working to show others what can be done when you collaborate and come together for something as precious of a resource as our children are," she said.

Supporters of the School District expansion include 100 Black Men, Caring 4 Kids, Communities in Schools, Latin Chamber of Commerce, UNLV and the School District.