FARGO — The Blue Cross Blue Shield Association and its affiliated companies have agreed to a $2.67 billion settlement in a class-action lawsuit that alleged the health insurer engaged in anti-competitive practices that hurt consumers.
The association and Blue Cross Blue Shield of North Dakota reject the claims in the lawsuit, but agreed to the settlement, which calls for some operating changes and payment to members of the class.
“Settling now is the right action at the right time because it allows us to remain focused on the goal we have had for more than 80 years — improving access to quality health care for all Americans and the health of our local communities,” Blue Cross Blue Shield of North Dakota spokeswoman Andrea Dineen said in a statement.
A class notice campaign has begun to ensure that individuals and companies that might be members of the damages class are notified of their rights and know where they can learn about the settlement as well as file a claim, she said.
The notifications are handled by the plaintiffs through their claims administrator, JND Legal Administration. The campaign also will include print, television, radio, online and social media advertising.
A pair of lawsuits were filed in 2015 in U.S. District Court in Alabama by providers as well as by individual and small-group purchasers of health insurance. The lawsuits contend that exclusive territorial agreements, in which Blue Cross Blue Shield plans agree to stick to their own territories, violate federal antitrust laws.
Most of the 37 Blue Cross Blue Shield plans in the United States limit their operations to a single state, including those in North Dakota and Minnesota.
The only reason for the self-imposed geographical marketing restrictions, the providers' lawsuit contends, is to protect the insurers from competition. The restrictions are maintained by an illegal "market allocation conspiracy," the doctors and clinics argue.
At the time the lawsuits were filed, Blue Cross Blue Shield of North Dakota commanded a statewide market share of 56%, according to the providers' lawsuit.
Blue Cross Blue Shield of Minnesota's market share was 44% statewide, but in certain areas ran higher, including 56% in the Rochester area, 48% in the St. Cloud area and 46% in the Duluth area, according to figures cited by the providers' lawsuit.
Blue Cross Blue Shield of Minnesota didn’t immediately respond to a request for comment about the settlement, but posted a statement on its website. “While we reject claims made by the plaintiffs in the case, we agreed to provide monetary payments to eligible individuals and groups and to make some operational changes across the Blue Cross and Blue Shield system.”
Blue Cross Blue Shield of North Dakota is unable to estimate any potential payout amounts, since each claimant’s award is subject to eligibility and fee analysis, which will be done by the claims administrator, Dineen said.
“That analysis will be provided to the claimants once the notice period has lapsed,” she said.
Those covered by Blue Cross Blue Shield can learn more about the settlement by going online to www.bcbssettlement.com or by calling 1-888-681-1142.