Blue cross blue shield lawsuit: How do the companies reach an agreement?

Blue cross blue shield lawsuit: How do the companies reach an agreement?

Blue Cross Blue Shield companies finally agrees to pay the compensation to its plaintiff against the Blue cross blue shield lawsuit after 8 years of litigation on October 30, 2020. Blue Cross Blue Shield Association does not agree on their faults but they agree to settle the legal dispute, make changes to its operating association, and provide the allocated payments to the class members.

The settlement agreement is about $2.67 billion, which is one of the significant amounts that come into light after years of trials and prosecutions.

Blue Cross Blue Shield Lawsuit class members

The following are some BCBS class members for the reason that they were insured by the BCBS health care policies during the insurance period.

  • Health plans of the insured groups and individuals insured between Feb. 8, 2008, and Oct. 16, 2020.
  • Self-funded plans that were made between Sept. 1, 2015, and Oct. 16, 2020.

To get the compensation amount, there is so much that employers and employees need to do in order to receive the compensation and prove that they are eligible to get payments. Whether you are an employer or employee, you must check out the following;

Do employers need to inform employees about the compensation?

The classified members of the Blue cross blue shield lawsuit are expected to receive a formal notice as an owner/employer. Once you get this notification, possibly, some other employees of your company may also get this notification. However, as an employer, you are not responsible legally to notify your workers about the settlement. Communication between the claim administrator and employees about the compensation or even claim can initiate many questions that may raise to HR.

How will Employees receive their compensation?

Workers of an organization covered under the health plans will receive a settlement notification once the compensation would be finalized. Along with the notification via email or mail, there could be an option for a direct claim.

If all or some of the employees file the settlement claim, then they have to visit the official settlement website to file the claim through an online form or send the claim via mail. The online form may have several optional fields. However, the required fields that you must fill include:

  • Identifying information (contact details and name)
  • Health insurance plan information selected from the available options
  • Payment details
  • Signatures
  • Employer details for the group policy

Precisely, it is not necessary to provide coverage data and policy details, and premium allocation information.

How much information should be shared with employees?

A common question may be raised: If an owner of the organization receives the compensation amount, how much it is necessary for the employer to notify his workers? Referring to FAQs # 35, detailed on the settlement website, NO.

Since the employees are allowed to file the claim on their own and contribute in the litigation directly and get the payments from the expected settlement, if the employers choose to file a claim, they reserve the right to retain the settlement received.

How much settlement amount each plaintiff would get?

The important question boggling everyone’s mind – The amount each plaintiff would get depends on the number of plaintiffs filing the claim to join the suit as class action members. Although, for a comprehensive idea, the following are some of the calculations that are shared to refer:

  • 158,000,000 individuals who are covered under the Employer-sponsored plan. Although the analysis is rough so it may not include ASO plans or individual plans
  • 52,666,67 people are covered under BCBS plans (1 in 3)
  • $2,677,000,000 is the total compensation amount of the BCBS lawsuit
  • $1,900,000,000 is an expected distributable settlement amount (for those groups and individuals who have submitted the valid claims timely)
  • $146,154,000 of expected award on yearly coverage (up to13 years)
  • $2.78: Total individuals covered annually or annual total award

And then again, these are rough numbers. The total settlement award for class members will be calculated based on the claimants and the premium volume. That’s being said, the calculations are an expected analysis of the $2.6 billion settlement amount.

Do you need to hire a firm or attorney for legal representation?

If you are influenced by many resolved cases of a law firm or an attorney, then you must be aware that these firms often charge the case with a no-upfront cost which means they deliver contingency-based service. Some firms also ask for the advance payments from the expected settlement amount for which they represent you. However, the fee for a legal representation in these cases is generally 20% of the received amount.

Although, you don’t have to hire any firm or an attorney for your legal representation to have potential benefits. In such cases (as most of the plaintiffs do) just visit the settlement website and simply register yourself as a class action member or group and claim the benefits.

Tips for filing a financial compensation claim

Once you have received a formal notification in your email, it must be a unique ID in your email that you should look for. While sometimes it is not always necessary to have a personalized ID but if it has it will definitely make claiming easier.

If you are filing your claim online, there can be many optional fields to fill for both employees and employers. For instance,

  • Member ID
  • Coverage dates
  • Group number
  • Allocation or Premiums

However, without providing these pieces of information in detail, employees would be able to submit their online compensation claims. 

The information that an employee must provide include:

  • Employer Name &
  • Name of the Health Plan

Additionally, employers can proactively issue the respective information to their employees to lessen the number of queries that can be raised individually.

References of the Blue cross blue shield lawsuit

Blue Cross Blue Shield lawsuit formal settlement resources can be checked from the following links. The links include Frequently Asked Questions, Important reference documents, and a link for filing the claim.

Details about the Blue cross blue shield lawsuit

The Litigation

The process of the litigation was expensive as well as hard-fought. This is because it involved the creation of over 120 depositions, above 15 million pages, and more than a dozen pleas to dismiss claims of the plaintiffs. This is one of the unique kinds of an antitrust lawsuit and is said ‘historic’ in the court filing.

What was BCBS alleged for?

The lawsuit alleges BCBS for the violation of antitrust laws through the Blue Cross Blue Shield Association of Health plans. The lawsuit signifies that the companies associated with BCBS plotted their own significant locations to work and regions for business within the United States, which refers to the antitrust law’s violation.

The claim further described that the insured group health plans, individuals, and the self-funded plans ended up paying higher premium amounts and ASO costs that eventually put BCBS associations at higher positions in the competitive market.

Details of the Anti-competitive amendments

 Not only BCBS agreed to alter and modify the competitive practices that the company had been alleged for but the payment of around $2.67 bln. to the respondents.

Particularly, BCBS has decided to bring changes in two of its procedures that are said to be ‘pretty flatly anticompetitive’ according to the subscribers of Blue plan.

The first modification is to be made in the agreement to remove the BCBS association term that asks for 2/3 of the insurer’s revenue that comes from Blue-Branded plans.

Secondly, BCBS also agreed to discard the setup that compels the subscribers of the national employer plans to work with them due to the fact that they cover the territories of their headquarters.

Once the declaration comes into practice, this will allow the competition among smaller in-state and outer-state Blue insurers to cover commercial businesses and build an even opportunities for everyone.

Potential Impact on Marketplace

Whilst the monetary compensation or the settlement for the Blue Cross Blue Shield lawsuit is potentially significant, similarly, the impact on the health insurance marketplace would be moving forward. Plus, it is also expected that the competition between the BCBS companies and other in and out of state insurers will be significantly higher. However, the significance that is notable here is that the BCBS competition would stimulate the competitive market even for regional and national health plan providers and insurance companies other than in-state and outer-state insurance providers.

FAQs

The Blue Cross Blue Shield lawsuit settlement is legit. Many plaintiffs have received notification through mails and emails who filed the claim before the deadline.

Individuals, health plan groups, self-funded accounts, and insured groups enrolled in Blue Cross Blue Shield insurance services between February 2008 and October 2020 would be eligible to become a part of the claim. However, the settlement amount and period can vary depending on the classes and accounts. It is also important to note here that the beneficiaries, dependents, and nonemployees won’t be able to claim or get the settlement.

Blue Cross, however, does not specifically announce the number of payments that every claimant would receive. But it does say that the amount would be based on the following factors;

  • Total numbers of the claimant filed
  • Payments made on the premiums during the class period
  • The status of the insurance, whether it is self-funded or fully insured.

 

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