Dive Brief:
- Anthem Blue Cross has agreed to reimburse about $8.3 million to 50,000 California customers to as part of a class-action lawsuit settlement. In addition to the $8.3 million, the company will stop making mid-year changes to annual deductibles, co-pays, and other out-of-pocket expenses.
- Two lawsuits were filed by Anthem policyholders in 2011 alleging the insurer raised annual deductibles and additional yearly out-of-pocket expenses on individual policies mid-year. The company was accused of breach of contract and engaging in unfair business practices.
- Consumer Watchdog said checks will be mailed in December. The average amount will be $167 although one consumer will receive $19,000 for very high out-of-pocket expenses.
Dive Insight:
One plaintiff said in a news conference, "My deductible had become a moving target. It's as if Anthem Blue Cross changed the rules of the game in the middle of the game," reported The Los Angeles Times. According to the lawsuit, the plaintiff's yearly out-of-pocket maximum increased midyear from $5,000 to $5,850 and annual prescription drug deductible increased from $250 to $275.
Although only consumers affected by the midyear policy changes will receive settlement checks, all Californians enrolled in individual Anthem health plans will be subject to the agreement that prevents those cost increases in the future.
Ricardo Echeverria, an attorney for the plaintiffs told The Times, "When you look at this settlement, it's such a no-brainer. What this settlement does is it holds the insurance company accountable to the terms they promised."