Lawsuit Against Blue Cross Blue Shield: How Far Is The Progress?

After several years of litigation, the lawsuit against Blue Cross Blue Shield was out of the woods soon. Whilst the BCBS companies rejected claims made by plaintiffs, they agreed to make payments for eligible people. The settlement decision reached its peak on 16 October 2020 to settle a class lawsuit to license agreement within the system.

As of right now, the affected member will begin receiving notifications about the settlement via email and mail. To check the latest progress and see whether you are eligible or not to claim the payment, scroll to the article below!

Why Lawsuit Against Blue Cross Blue Shield is Necessary? 

Blue Cross’ business structure establishes a licensing agreement between the insurer and its 38 regional member health insurance plans, effectively forming an anti-competitive trade association. Health insurance markets are divided and allocated among different plans that do not compete with one another.

The plaintiffs claim that the structure reduces competition within and outside the network, thus limiting consumer choice. Furthermore, in-network healthcare providers are not permitted to use out-of-network facilities. As a result, the whole story leads to increased premiums and financial injury to both providers and subscribers.

That’s why, a lawsuit emerged against Blue Cross Blue Shield (BCBS). Specifically, it involves a class action lawsuit between BCBS and its member companies, as well as individual Blue Plans. 

Further, the class action settlement includes individuals and businesses who purchased or received health insurance from a Blue Cross Blue Shield company between February 7, 2008, and October 16, 2020.

The accusation is that BCBS violated antitrust laws by entering into agreements not to compete in selling and administrative service health insurance as well as other customers. The violation resulted in less competition and higher prices for corporate and individual consumers.

Who Is The BCBS Class Action Lawsuit Member? 

If someone was covered by the company’s health insurance or any administrative service plans between February 2008, and October 2020, they might be the Blue Cross Blue Shield class action member. 

To ease the classification, the settlement mainly includes two classes namely an injunctive relief class and a damaged class.  

The settlement requires BCBS companies to make monetary payments to specific groups and individuals. The following individuals and groups below may be considered as the damage class members of a lawsuit against Blue Cross Blue Shield and be eligible to submit a claim for payment. 

1. An individual who purchased health insurance directly from BCBS between February 7, 2008, and October 16, 2020. 

2. A fully insured group account (including enrolled employees) with a BCBS between February 7, 2008 and October 16, 2020.

3. A self-funded group account (including listed workers) maintained by BCBS between September 1, 2015 and October 16, 2020.    

Besides, individuals, insured groups, and self-funded accounts who purchased or enrolled in a BCBS insurance or administrative services plan during the applicable class period will benefit from the settlement provisions. This condition obliges settling defendants to change certain alleged anti-competitive practices.

Keep in mind that dependents, beneficiaries, and non-employees are not eligible to receive payment. Exempt payments also include government and Medicare accounts, the BCBSA company (its parent entity or subsidiary), the judge presiding over the case, and members of its judicial staff. 

However, the entirety of the staff is covered by a commercial health product license that is not purchased through a government account during the class completion period. If you are still unsure about which settlement class you fall into, you can contact the claims administrator at BCBS official email.

How to Check Your Lawsuit Against Blue Cross Blue Shield? 

The best way to check the status of a claim is to log in to your member account.  You can easily get the information by going through the website or even the Blue Cross Blue Shield mobile app. You can then click on the button “Check online claim status”. The next step is to submit your unique Blue Cross ID or claim number to sign in. 

For the information, the unique ID is typically sent to you by the administrator. It typically consists of 10 10-digit codes that include both numbers and letters. Fortunately, you can check the status of a claim anytime by using the BCBS automation system. You can also talk with a representative during business hours.   

Don’t worry, filling claim either online or by downloading a form from the website is a simple and quick process. Hence, your task will be done in just a few minutes. 

It is also important to note that due to protected health information requirements, not all plan members may be able to view all claims. For instance, an adult enrolled cannot see the claims of other mature individuals.   

What Are the Benefits of a Lawsuit Against BCBS? 

The class action exists solely to file a lawsuit against Blue Cross Blue Shield. In this case, class members who file valid claims may receive a cash payment from the net settlement fund. It is worth approximately $1.9 billion and will be distributed to damaged class members (i.e. employers and individuals).

Please note that this amount is after deducting certain fees. The gross settlement amount is $2.67 billion, with $ 667 million set aside for the plaintiff’s attorney fees and $100 million allocated to settlement administration costs. 

It is the remaining amount after making deductions of attorneys and administrative costs from the settlement gross of $2.67 billion. However, if you choose to participate in the class action settlement, there is no need to hire outside professionals to facilitate the process. 

Further, this injunctive relief is considered as one of the two settlement classes. In essence, the companies have agreed to make changes in their business practices. For this reason, a monitoring committee will be formed for five years.   

When Will The Lawsuit Blue Cross Blue Shield Over?

The good news is BCBS agreed to make monetary payments to eligible individuals and employers for making system-wide operational changes. The parties reached an agreement on October 30, 2020, to avoid the risk and cost of further litigation. 

For the information, the Eleventh Circuit Court of Appeals recently affirmed their approval of the settlement on October 25, 2023.

It is to determine whether the settlement lawsuit Blue Cross Blue Shield is fair, reasonable, and adequate. Any additional appeals may be made by the first quarter of 2024. The more settlement and payment updates will be notified in February 2024.