Blue Cross Blue Shield Settlement Payments Remain Delayed

Millions of individuals and businesses who filed claims in a $2.67 billion antitrust settlement with Blue Cross Blue Shield (BCBS) are still waiting for their payments. The settlement administrator is currently reviewing a large volume of claims, and no specific date for the distribution of funds has been announced.

The class-action lawsuit, which alleged that BCBS plans engaged in anti-competitive practices that led to higher insurance premiums, was initially settled in October 2020. Despite the final appeals being resolved in June 2024, the complex process of verifying claims continues, leaving approximately six million claimants waiting.

Current Status of Settlement Payments

Claimants in the massive Blue Cross Blue Shield settlement have been met with a consistent message: patience is required. The settlement's official website states that payments will not be sent until the review of all claims and the resolution of any disputes are complete. This process has been ongoing since early 2024.

JND Legal Administration, the firm responsible for managing the settlement, has been sending claim determination notices via email and postcards. These notices inform claimants of the status of their individual claims. However, many claimants report their status has remained "in review" for several months.

According to the administrators, the sheer volume of claims and the need to accurately verify the premium amounts paid by each claimant contribute to the lengthy timeline. The process involves confirming eligibility and calculating individual payment amounts based on premiums paid during the specified class periods.

Background of the Antitrust Lawsuit

The legal action centered on allegations that the Blue Cross Blue Shield Association and its member plans violated antitrust laws. The core of the lawsuit claimed that the insurers illegally agreed not to compete against one another in designated territories.

The Blue Cross Blue Shield Association is a federation of 35 independent health insurance companies. The lawsuit argued that these companies used their licensing agreements to divide the market, meaning a BCBS insurer in one state would not compete for business in another's territory. Plaintiffs contended this arrangement stifled competition, leading to fewer choices and artificially inflated premiums for customers.

The lawsuit consolidated numerous cases filed by individuals, families, and small businesses who purchased BCBS health insurance. The legal battle spanned nearly a decade before the settlement was reached.

Details of the Settlement Agreement

The $2.67 billion settlement was a significant outcome of the litigation. While BCBS did not admit to any wrongdoing as part of the agreement, the funds are intended to compensate eligible class members who may have overpaid for their health insurance plans.

In addition to the financial payout, the settlement also requires the Blue Cross Blue Shield Association to implement changes to its rules to foster more competition. These changes include eliminating a rule that prevented member plans from earning more than one-third of their national revenue from businesses outside their designated Blue-branded territories.

This structural change is designed to allow for greater competition among Blue Cross Blue Shield plans in different regions, potentially benefiting consumers in the long term.

"We won't begin sending payments until we have reviewed all claims and resolved disputes. This process takes time. Please be patient." - Statement from the official BCBS settlement website.

Who Is Eligible and What to Expect

Eligibility for a payment extends to individuals, insured groups (including employees), and self-funded accounts that purchased a Blue Cross or Blue Shield health insurance or administrative services plan during specific periods. The class period for individuals and insured groups is from February 7, 2008, through October 16, 2020. For self-funded accounts, the period is from September 1, 2015, through October 16, 2020.

The deadline to file a claim was November 5, 2021. Those who successfully filed a claim can expect to receive a payment, though the exact amount will vary. While early estimates suggested an average payout of around $333 per claim, the final amount will depend on the total number of approved claims and the premiums paid by each claimant.

Claimants were given an opportunity to dispute the premium or fee information provided by the administrators. This dispute resolution process adds another layer of complexity and time to the overall distribution schedule.

A Separate Settlement with Providers

This consumer-focused settlement is not the only large-scale legal agreement involving Blue Cross Blue Shield. The association also reached a separate $2.8 billion settlement with healthcare providers, including hospitals and physicians.

That lawsuit, filed in 2012, made similar claims of anti-competitive behavior. The providers alleged that BCBS plans conspired to limit competition among themselves to suppress reimbursement rates for medical services. This parallel case highlights the broad impact of the territorial agreements that were at the center of the litigation.

As millions of insurance customers await their checks from the consumer settlement, the extensive administrative review continues without a firm end date. Claimants are encouraged to monitor the official settlement website for the most current updates.