The Blue Cross Blue Shield Association (“BCBSA”) has reached a proposed settlement in a class-action lawsuit, alleging its member organizations (which includes Anthem, Inc.) engaged in anticompetitive behavior in violation of federal antitrust law. You may have recently received a settlement notice, via email or postcard, indicating that your employer-sponsored health plan and participating employees may be eligible to file a claim. The settlement reached is $2.67 billion, which is estimated to leave a $1.9 billion net settlement fund after deducting attorney’s fees and expenses.
We expect most our clients will receive the settlement notice via email (Notice@BCBSsettlement.com). While we are unaware of phishing attempts or other scams related to the settlement, please be wary of emails purporting to be related to the settlement and use reasonable diligence before clicking links.
Two classes are eligible to file a claim for payment from this settlement:
- Fully insured individuals and groups (and their employees) that were covered between February 7, 2008, through October 16, 2020. Approximately $1.78 billion of the net settlement fund (or 93.5%) will be apportioned to fully insured individual and group claims.
- Self-funded groups (and their employees) that were administered by BSBCA between September 1, 2015, through October 16, 2020. Approximately $120 million of the net settlement fund (or 6.5%) will be apportioned to self-funded group claims.
BCBSA insurance products and administrative services which qualify under the class periods above include but are not limited to medical, pharmacy, dental, and vision benefits (as well as stop-loss for self-funded groups). Government and Medicare accounts are excluded.
Anthem, Inc. is the largest BCBSA affiliate and is the largest insurer in the Indiana market. Blue Cross Blue Shield of Arizona is the largest insurer in that state and is an independent licensee of the BSBCA. Accordingly, we anticipate that many of our clients (and their employees) will be eligible to submit a claim.
Filing Claims and Additional Information
Claims must be filed online or by mail postmarked by November 5, 2021. Claim forms and additional information about the settlement is available online, at BCBSsettlement.com. The settlement notice you received will contain a ten-digit, unique ID code which will aid but is not necessary in identifying you as an eligible claimant.
With respect to group plans who meet the eligibility criteria, both employers and employees that were enrolled in the plan may file claims for settlement payments. Employers have no legal obligation to notify employees: Both employers and employees will receive notice of the settlement through a court-approved notice program.
Settlement Allocation for Group Plans and Employee-Participants:
The Proposed Plan of Distribution (the “Distribution Plan”) sets forth the method of calculating payment allocations between an employer and employees. If no employee makes a claim, the employer will be allocated 100% of the total premiums/fees used in calculating settlement payments.
If, however, one or more employees also makes a claim, the calculation will be adjusted to include an allocation of total premiums/fees to the individual employee. The Distribution Plan prescribes a default option for making allocations of total premiums between an employee and employer:
- Fully Insured Plans:
- Single Coverage – 15% Employee/ 85% Employer
- Family Coverage – 34% Employee/ 66% Employer
- Self-Funded Plans:
- Single Coverage – 18% Employee/ 82% Employer
- Family Coverage – 25% Employee/ 75% Employer
A claimant may choose to elect an alternative option for calculating the appropriate allocation, which must be supported by adequate documentation supplied by the claimant. This option is available to both employers and employees if they believe the default method does not properly reflect their respective contributions.
MJ will continue to provide information regarding the BCBSA antitrust settlement as we learn more. We intend to reach out to our clients for whom our records indicate may be an eligible class member.