Blue Cross Blue Shield to Pay Out $2.6B: Who Is Included?

Blue Cross Blue Shield payments are set to begin two years and a half years after the insurer reached a settlement of $2.6 billion with subscribers.

Newsweek reached out to Blue Cross Blue Shield via email for comment.

Why It Matters

The settlement comes from a class-action lawsuit alleging that over 35 of the company's health insurance plans violated antitrust laws. It is the largest antitrust settlement in the United States' health care history.

What To Know

A recent update on the settlement's website said that "claim determination notices are being emailed on a rolling basis." No date has been provided for when all notices will be sent.

The Blue Cross Blue Shield Association is a national group of health insurers that are independent, community-based and locally operated.

Why Is Blue Cross Shield Paying Out $2.6 Billion?

The health insurance company was faced with a class-action lawsuit. The lawsuit alleged that the company had broken antitrust laws by limiting market competition. The lawsuit argued that this practice drove up premiums, reducing options for consumers and, in turn, creating fixed prices for health care services.

The defendants in the lawsuit, Blue Cross Shield Association, Blue Cross and Blue Shield companies, deny all wrongdoing. They argue their practices lower health care costs and improve access.

The court has not ruled on liability, but both sides reached a settlement to avoid the costs and risks of continued litigation. Litigation first began in 2013.

Blue Cross Blue Shield Association and the companies have now established a $2.67 billion settlement fund, which will be paid to customers who filed a claim.

Who Is Eligible?

If you had a Blue Cross Blue Shield health insurance or administrative services plan between February 2008 and October 2020, you might be eligible for a payment from a class-action settlement.

Eligible Members Include:

• Individuals, Insured Groups (and their employees), and Self-Funded Accounts (and their employees), but not government accounts.

The Settlement Period Varies:

• February 7, 2008 - October 16, 2020, for Individuals and Insured Groups
• September 1, 2015 – October 16, 2020, for Self-Funded Accounts.

How Much Money Will Be Individually Received In The Settlement?

Around six million people filed a claim.

$667 million in attorney fees are to be deducted from the total fund, which means that, individually, people can expect to receive $333 per claim.

One settlement class member, David Behenna, objected to the amount set aside for legal fees and appealed it. But it was ultimately denied by the U.S. Supreme Court.

What People Are Saying

A Blue Cross Blue Shield spokesperson, in a press release on October 14, 2024: "This settlement ends a long-running legal challenge to the Blue Cross Blue Shield Association license agreements and related rules. We deny the allegations made in the lawsuit. However, to reach a settlement and put years of litigation behind us, we have agreed to make some operational changes and a monetary payment to the provider class involved in the case.

"Our members and health care provider partners can rest assured that Blue Cross and Blue Shield companies continue to be strong and ready to deliver exceptional services. We remain committed to providing access to affordable, high-quality care and improving the health of the communities we serve, just as we have for 90 years."

What Happens Next

A separate settlement of $2.8 billion has also been reached. This settlement relates only to health care providers. Eligible parties can file claims for a share of the payout as part of the provider settlement.

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