News/Pubs/Events

Online Claim Form Available: Blue Cross Blue Shield Antitrust Settlement

The claims administrator released the online claim form for the Blue Cross Blue Shield Antitrust Settlement on March 19, 2021. The claim form is available at https://www.bcbssettlement.com/. The deadline to submit a claim form online or by mail is November 5, 2021.

The online claim form allows both employers and individuals to file claims. Eligible employers and individuals may receive a Unique ID via email or postcard in the coming days which may be helpful (but is not required) for the filing. This memo provides a brief summary of the process.

Background
The proposed settlement is $2.67 billion. After expenses, the net settlement fund is estimated to be approximately $1.9 billion. Approximately 93.5% of the net settlement fund will be paid to fully insured groups (including employees) and individual policyholders that had coverage with the Blue Cross Blue Shield Association (BCBSA) between February 7, 2008 and October 16, 2020. The remaining 6.5% of the net settlement fund will be paid to self-funded groups (including employees) that worked with BCBSA between September 1, 2015 and October 16, 2020.

Employers
An eligible employer is required to submit its: (a) mailing address; (b) contact person; (c) health plan name; (d) group number; (e) coverage dates; (f) participation in a purchasing entity (if applicable); (g) allocation of premiums; and (h) method of payment.

The allocation of premiums section requires the employer to accept the default option or apply for an alternative contribution. Under the default option, 100% of premiums for employees who do not file claims are allocated to the employer. If an employee does file a claim, a portion of the premium is allocated to the employee depending upon the type of coverage (see below). If the employer chooses the alternative contribution percentage, it must submit supporting documentation.

Individuals
Individuals must submit:(a) how the individual purchased insurance; (b) contact information; (c) health plan name; (d) group number; (e) employer information (if applicable); (f) member ID; (g) coverage dates; (g) allocation of premiums (if applicable); and (h) method of payment.

If an individual received coverage through an employer, the individual must elect whether to accept the default option or apply for an alternative contribution percentage. Under the default option, employees with single coverage are allocated 15% of the total premium for fully-insured health insurance or 18% of self-funded plans. Employees with family coverage are allocated 34% of the total premium for fully insured health insurance or 25% for self-funded plans.