- Oscar will appeal its case against Florida Blue over the use of exclusive broker policies, which Oscar alleges is anticompetitive, company officials said Tuesday.
- The startup health insurer said it's filing an appeal because it "refuses to stand by as Florida Blue enforces this anti-consumer, anti-competitive policy."
- In September, a federal judge in Florida ruled against Oscar in siding with Florida Blue to dismiss the case. Exclusive broker policies are shielded from antitrust scrutiny under federal law, the judge ruled.
The central issue in the case is whether it is lawful for Florida Blue, a dominant insurer in the state, to restrict brokers from working with other carriers like Oscar.
Oscar has alleged the exclusive broker policies hinder competition in the state of Florida. The New York-based insurance group decided to begin selling Affordable Care Act exchange plans in the Orlando area this year.
But more than 190 brokers backed out of their agreements with Oscar after Florida Blue threatened to cut them off from selling other Florida Blue product lines throughout the state, the original lawsuit alleged.
Oscar has said that the restrictive covenants are harmful for consumers in the state because they are unaware of other coverage options, particularly if the competitors' coverage is less expensive and offers more robust options than Florida Blue's plans.
The Department of Justice even weighed in by filing a statement of interest in May asking the judge not to toss the case. The DOJ was worried about whether the McCarran-Ferguson Act would be applied correctly. The act shields the business of insurance from some federal regulation, including antitrust laws. Florida Blue has argued its exclusive broker policy should be exempt from antitrust enforcement.
Judge Paul Byron of the Middle District of Florida ruled in favor of Florida Blue and said the exclusive broker policies are lawful.
Despite the arrangements, Oscar has continued to expand its ACA offerings in Florida and elsewhere. In Florida, it's expanding into Miami, Tampa, Daytona and Ocala.
The relative newcomer to insurance was co-founded by Josh Kushner, brother to Jared Kushner, President Donald Trump's son-in-law.