Blue Cross Blue Shield Agrees To $2.67 Billion Settlement In Antitrust Suit

Blue Cross Blue Shield has agreed to a $2.67 billion settlement in an antitrust lawsuit that is expected to increase competition in the health insurance industry and yield a tiny payout to the system's members.

The settlement stems from a suit filed in 2013 in Alabama on behalf of its policyholders against 36 independent Blue Cross Blue Shield insurers across the country. The suit claimed that the companies conspired to thwart competition and raise prices for policyholders. The Blue Cross Blue Shield Association, the companies' licensing and lobbying group, said the settlement was not an admission of guilt.

“We reject claims plaintiffs made in the lawsuit,” the association said in a statement. “However, to reach a settlement, we’ve agreed to make some operational changes and provide payment to members of the class involved in the case.”

The settlement affects four Blue Cross Blue Shield insurers in the Northwest: Premera Blue Cross, Regence BlueShield, Regence BlueShield of Oregon and Regence BlueShield of Idaho, Inc. Together they insure 1.8 million policyholders. The Regence companies are nonprofits. Blue Cross Blue Shield companies insure more than 100 million nationwide, accounting for one-third of the market.

They include plans offered by Anthem, a for-profit giant that operates in 14 states, including California and New York. Another big operator is Health Care Service Corp., which runs nonprofit Blue Cross plans in five states, including Texas.

Washington state Insurance Commissioner Mike Kreidler said the biggest benefit will be increased competition among health insurers, especially in markets dominated by Blue Cross Blue Shield companies.

“This settlement should increase competition, which is great news,” Kreidler said in a statement. “The settlement should put all companies on notice that they need to do right by consumers. Hopefully, it will also lead to more transparency throughout the health care market.”  

The Department of Consumer and Business Services in Oregon did not comment on the settlement. Instead, a spokesman released a statement saying: “Oregon has a healthy and competitive insurance market. Regence Blue Cross Blue Shield is one of six insurers on Oregon’s individual market and one of nine on its small group market. They are also one of multiple companies offering plans in each of Oregon’s 36 counties in 2021.”

Open enrollment for individuals and small group plan policyholders runs through Dec. 15.

(See also: Open Enrollment On Federal Marketplace Starts On Verge Of ACA Case Before Supreme Court.)

Blue Cross Blue Shield said the settlement won’t damage the system.

“Regardless of today’s settlement, BlueCross and BlueShield companies remain strong, and the exceptional services and capabilities they provide will continue,” the statement said.

The settlement has to be approved by the individual companies. Blue Cross Blue Shield said that policyholders will be notified and a website set up with details of the settlement.

Payments to Individual policyholders are not expected to amount to much, with policyholders getting at least $5,  Kreidler’s office said.

The settlement does not affect separate litigation against Blue Cross Blue Shield by hospitals and doctors. 

You can reach Lynne Terry at [email protected] or on Twitter @LynnePDX.

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