How much Blue Cross settlement?
– A $2.67 billion settlement to resolve antitrust charges against health insurer Blue Cross Blue Shield will result in payments to some consumers of Premera and Regence health plans in Washington. The settlement signed in U.S. District Court for the Northern District of Alabama affects the 36 Blue Cross Blue Shield insurers nationwide.
Why is BCBS being sued?
The lawsuit claims that Blue Cross violated antitrust laws by reducing competition in their areas, allowing for higher rates on some plans. However, Blue Cross denies allegations of wrongdoing, claiming its actions resulted in lower health care costs and greater access to customers and has agreed to a settlement. Here’s what you should know:
Does Blue Cross Blue Shield over Viagra?
This allows us to help CPAP patients with different insurance carriers in all 50 states, instead of being limited to one service area..It means they have medication coverage A drug list, is a list of drugs available to Blue Cross and Blue Shield of Illinois (BCBSIL) members.Sponsored and administered by: The Blue Cross and Blue Shield does federal blue cross blue shield cover viagra Association and participating Blue Cross and Blue Shield Plans.Visit your primary care physician 2020 Blue ...
Does Blue Cross Blue Shield cover the IUD?
My insurance does cover it fully ($400). I am opting for the copper IUD, which my Blue Cross insurance will cover. It depends on your plan. I have Blue Cross / Anthem and I was told that the cost of inserting the IUD is covered 100%, but Mirena itself isn't covered until I've met my $1000 deductible.
What is total premiums paid?
The total premiums paid will be the sum of premiums paid for commercial health benefit products (including medical, pharmacy, vision, and dental plans) to any of the defendants for coverage during the class coverage periods described above (pro -rated for the partial months of February 2008 and October 2020). This amount will be calculated based on data provided by the Blue Cross member plans. Claimants will not have to submit any premium data unless it is specifically requested.
What is a proposed settlement?
The Notice of Proposed Settlement was issued to inform employers and individuals who are eligible for payment (the damage class) about the proposed settlement and give them time to decide what action (if any) they wish to take and the deadlines for doing so. If the settlement is approved, class members will be bound by the terms of the settlement unless they affirmatively opt out of the settlement. The following table describes the options these class members have.
Can an employer elect an alternative option for calculating the allocation?
For both fully insured and self-funded claimants, employers and employees have the option, when filing, to elect an alternative option for calculating the allocation. In this case, the Claims Administrator will contact them and provide them the opportunity to submit additional evidence to support their case before making a final determination. If the request for the alternative option is rejected, the calculation will revert to the default allocation.
Can an employer ask for settlement information?
Employers may receive questions from their employees about this settlement, including advice on whether to file a claim or requests for information the employee needs to submit as part of their claim submission. While employers do not have any formal obligations to provide any notice/information, it may be helpful to provide some type of notice explaining the settlement to employees and informing them that they may have the right to file their own claims. Employees may also request certain information from employers (e.g., group numbers, policy numbers, coverage dates, etc.) that they need to file their claims. If employers have this information readily available, they may wish to provide it to employees (although again, there is no specific requirement to do so). Employers should be cautious in any communications with employees and should avoid saying or doing anything that appears to dissuade employees from filing their own claims.
When is the Blue Cross Blue Shield settlement?
The final hearing on the settlement will be held on October 20, 2021. Multiple different damages classes including fully insured and self-funded plans are eligible to receive payment under the settlement.
When are self funded accounts due for Blue Cross?
Self-Funded Accounts [2] (and their employees) that purchased or were enrolled in a Blue Cross or Blue Shield health insurance or administrative services plan between September 1, 2015 – October 16, 2020.
When is Notice of Intent due?
Notice of Intent due July 28, 2021. Of note here is the fact that while those who choose to do nothing will not be eligible for payment, it is only when somebody actively opts out of the settlement that they will retain the right to sue and not be bound by the settlement’s terms.
What is alternative option in FI?
The Alternative option allows the claimant to submit data or records supporting a contribution higher than the Default. The below scenarios are examples of how an estimated premium may be calculated for use in determining a claimant’s proportional share of the FI Net Settlement Fund. In any case where an FI Group makes a claim, it will receive credit for any premiums not otherwise allocated to claiming employees.
How did settlement defendants violate antitrust laws?
Plaintiffs allege that Settling Defendants violated antitrust laws by entering into an agreement not to compete and to limit competition among themselves in selling health insurance and administrative services for health insurance.
How will FI payments be distributed?
Payments will be distributed on a proportional basis across all FI Authorized Claimants based on their estimated premiums.
What is a self funded account?
Self-Funded Accounts encompass any account, employer, health benefit plan, ERISA plan, non-ERISA plan, or group, including all sponsors, administrators, fiduciaries, and Members thereof, that purchased, were covered by, participated in, or were enrolled in a Self-Funded Health Benefit Plan during the Self-Funded Settlement Class Period.
What is a self funded health plan?
A Self-Funded Health Benefit Plan is any Commercial Health Benefit Product other than Commercial Health Insurance, including administrative services only (“ASO”) contracts or accounts, administrative services contracts, or accounts (“ASC”), and jointly administered administrative services contracts or accounts . For associational entities (e.g., trade associations, unions, etc.), the Self-Funded Account includes any member entity which was covered by, enrolled in, or included in the associational entity’s Blue Branded Commercial Health Benefit Product. A Self-Funded Account that purchased a Blue-Branded Self-Funded Health Benefit Plan and Blue-Branded stop-loss coverage remains a Self-Funded Account.
What happens if you do nothing in the settlement?
If you do nothing, you will remain a member of the Settlement Classes and be bound by the Settlement. However, if you had been entitled to share in the Settlement proceeds, you will not get a payment.
What happens if you select the alternative option?
If you select the Alternative Option, you must submit relevant data or records showing a higher contribution percentage. Otherwise the Default Option will be used. Instructions for submitting your claim are on the claim form and on the Settlement Website. When required, sufficient documentation shall include an attestation signed under penalty of perjury when other documentation is no longer available.
Introduction
Background
- In 2012, plaintiffs alleged that the Blue Cross Blue Shield Association and its 35 member companies violated the Sherman Antitrust Act by agreeing not to compete in selling health insurance and administration of commercial health benefit products in the United States and Puerto Rico, as well as agreeing to other means of limiting competition in the health insurance …
Key Provisions of The Settlement
- Under the terms of the settlement, the Blue Cross Blue Shield Association and its member plans would agree to: 1. Make changes to the way they do business to increase opportunities for competition in the health insurance market; and 2. Allow qualified national self-funded accounts to request a second bid for coverage from a member plan of their cho...
Damages Classes
- The following classes may be eligible for payment from the settlement amount: 1. Individuals that purchased or were enrolled in a Blue Cross or Blue Shield health insurance or administrative services plan between February 7, 2008 – October 16, 2020; 2. Insured Groups (and their employees) that purchased or were enrolled in a Blue Cross or Blue Shield health insurance or a…
Options For Damage Class Members
- The Notice of Proposed Settlementwas issued to inform employers and individuals who are eligible for payment (the damage class) about the proposed settlement and give them time to decide what action (if any) they wish to take and the deadlines for doing so. If the settlement is approved, class members will be bound by the terms of the settlement unless they affirmatively …
What Can/Should Employers do?
- Employers may receive questions from their employees about this settlement, including advice on whether to file a claim or requests for information the employee needs to submit as part of their claim submission. While employers do not have any formal obligations to provide any notice/information, it may be helpful to provide some type of notice explaining the settlement to …
Next Steps
- Next steps for employers who are eligible to file a claim: 1. Decide whether to: 1.1. File Claim 1.1.1. If filing a claim, determine whether to use default assumptions or elect an alternative option for calculating allocation. 1.2. Do Nothing 1.3. Opt Out 1.4. Object 1.5. Speak at Hearing 2. Decide whether to communicate to employees 2.1. If communicating upfront, determine what informati…
Conclusion
- It is important for employers to keep in mind that any individual settlement amount is likely to be relatively small – e.g., a few hundred dollars for a large employer, and under $100 for any individual employee. So, while it will be important to understand the allocation methods and the filing options, perspective is needed when determining whether to propose an alternative allocat…