Blue Cross Blue Shield Association Class Action Lawsuit: What You Need to Know

On November 5, 2020, an eight-year long anti-trust litigation with Blue Cross Blue Shield Association (BCBSA) reached a settlement. As per terms of the settlement, BCBSA agreed to a $2.67 billion settlement fund, a portion of which will go back to eligible class action members.

Here?s what you need to know:

What brought about the lawsuit? To simplify, a group of plaintiffs believes that the various Blues plans had internal agreements between them that stifled competition and led to people paying higher prices.

Did BCBSA lose?  Not technically. The Blues did not admit guilt, but they did agree to resolve the lawsuit by making certain operational changes as well as paying monetary compensation to the Class members.

Who might be owed a portion of the settlement funds? The eligible class members appears to encompass all BCBSA policyholders during a specific time frame as noted in the next question.

It?s not entirely clear whether or not the internal Blues agreements actually harmed members so it cannot be determined what, if any, specific damages were caused. However, the Blues have agreed to pay $2.7 billion to the settlement fund. Once the Court approves the final step, the amount of the individual payments and method of allocation will become clear.

Who is an eligible class member?  As of now, we know that 93.5 percent of the net settlement fund will be paid to fully insured groups, including employees and individual policyholders that had coverage under a ?Blue-branded commercial health benefit product? (unless the person or entity?s only products during this period was a stand-alone vision or dental product) between Feb. 7, 2008, and Oct. 16, 2020.

Additionally, 6.5 percent will be paid to self-funded groups, including employees that had coverage under a ?Blue-branded commercial health benefit product? (unless the person or entity?s only products during this period was a stand-alone vision or dental product) between Sept. 1, 2015, to Nov. 16, 2020.

Anthem and Blue Shield of California are both independent members of BCBSA. Therefore, we?ve concluded that employers and employees of any Anthem or Blue Shield of California group health product as described above, are potential class action members.

What steps should an eligible class action member take next?  We are aware that some third parties are soliciting employers to become an agent on their behalf regarding the settlement. We cannot advise a client on the merits of doing so, and we caution employers to examine what services these third parties provide and at what cost.

A timeline has been set forth in the court that notices to eligible class action members will be distributed by May 31, 2021, and the claims filing deadline will be Nov. 5, 2021. This is subject to change, and we will continue to monitor any updates.


About Michelle Cammayo

Michelle Cammayo has more than 13 years of Employee Benefits experience specializing in all lines of health and welfare benefits. Today, Michelle works closely with clients and partners to provide guidance in areas of the law including ERISA, HIPAA, COBRA, FMLA and PPACA. She also oversees the Compliance Department at life insurance view& Company to ensure we are helping our clients manage and eliminate risk with regards to employee benefit compliance.