The Blue Cross Blue Shield settlement is valid. Below is an excellent explanation from a colleague of mine. For further information or to file a claim go to https://www.bcbssettlement.com
The “settlement fund administrator” has started to send out notifications to both employers and employees of fully insured and individual under 65 major medical policyholders.
Anybody that was insured under a fully insured group plan or an Under 65 individual major medical plan (not Med Supp) for the period of 2/7/2008-10/16/2019 is in the eligible class. For self-funded accounts, the eligible period 9/1/2015-10/16/2020.
Anyone that was insured at any point during that time (you need not be a current member) is an eligible class member—if they elect to do so. The administrator has received the last known mailing address of all entities in the eligible class and is supposed to be sending notifications of “their class rights” to that address.
Note the settlement process is not administered or controlled by BCBSIL. The insurance carrier proposed a settlement amount that was accepted by the plaintiff’s class attorney and certified by the courts. Once the settlement was accepted and funded, the carrier’s responsibilities were fulfilled. Part of the settlement fees were allocated to fund a third party (disinterested party) to manage/administer the entire settlement process. The BCBSIL FSU units are not responsible, equipped, connected to, or trained in the administration or calculation of the settlement process. As your groups or members fill out their claim forms, please do not have your current (or former) insureds call the FSU as they cannot provide any help or direction in the settlement application process!
The protocol currently being followed is: for employers: if they elected the “email option” as the “preferred mode” of communication with BCBS, those groups should be receiving the notifications via email. The settlement administrator is simultaneously sending postcards to the employers and individual employees/policyholders who have not elected email as the preferred communications. BOTH “classes” are entitled to claim—IE, if an employer claims their settlement rights, that does not preclude an employee from being able to claim their settlement class rights or vice versa. The assumption is that the employees were making some contribution towards their group plan premiums.
We have seen some examples of people that a group employed, then left that employer, purchased individual coverage, and subsequently got hired by a different employer with BCBS over the 2005-2019 time period. To maximize that claimants award, that person would have 3 entries on their single claim submission—which is done by going to a website (https://www.bcbssettlement.com). Note, a group/individual/employee does not need to have an official notification to go there. If the insured has been a client, they can go directly to the site and open a claim with or without an assigned claim number, and one will be established/assigned to them at that time.
In the claim form, there are numerous fields to help the administrator make sure they are getting the maximum amount they are entitled to (for example, group number or member number). Not having access to all the information does not preclude you from participating in the settlement; it is strictly for “personalized calculation purposes” (or checks and balances) if you have access to the information. It is fully understood that an employer that left BCBSIL 5 years ago that the employees would not have that information. In that light, the administrator has built-in what they call “default option,” which will calculate the valuation based on “the total class identified and the information they have available to them at time of settlement calculation.” If you do not have any of the optional information available, that does preclude you from claiming.
Along those same lines: for employers, the administrator does have the option of “unique entity calculation” as well, meaning that they will try to calculate the maximum amount you are eligible for based on the number of years you were covered, what your plan designs were, the premiums charged for each plan design, the enrollment in each plan, and the employer contribution by plan, by year, etc. Resource Brokerage has no way of knowing how many eligible employers (or individuals) will respond. Therefore, our professional opinion would be that this could be a great deal of work for a limited return on investment for the amount of time required to locate and upload all optional fields. Instead, IF the employer intends to claim, we suggest they fill out the form with as much information that they have readily available and accept the default option versus taking all the time to dig up and enter all the information for an unquantifiable/unknown gain.
Note the class has until NOVEMBER to respond (in IL); we have no idea what the administrator deadlines are doing for other states. Therefore, we do not expect payments to start flowing anytime soon. After the anticipated hundreds of thousands of respondents are received, logged, and categorized, the calculation process will begin. At that point, they will see how many people responded, the time frame they were insured, and how many people they had on the plan. THEN the individual calculations are done, THEN they will be able to formally divide the approximate $1.9 Billion claim fund (after the plaintiff’s attorneys fees and settlement administrators fees are subtracted from the original $2.67 Billion amount).
We are unable to speculate how much you or any of your clients will receive once calculations are made. In the claim filing process, the administrator has numerous ways to select from (how you want to receive) your payment, but it would not surprise Resource Brokerage if that took into late 2022 before they get to that point.
…. has heard from a number of brokers/individuals that if the members go to the website https://www.bcbssettlement.com and are accepting the “default options” it is designed to be a “quick and easy process to navigate—specifically designed for the insurance novice. If they elect to provide only the required fields and agree to accept the default calculations (which in theory could limit their payout) in many cases this process would take less than 10 minutes to complete from start to finish”.
Updated: April 13th 20201: American Rescue Plan Act:
There is a lot going on in the health insurance industry and we wanted to explain some of it. As you probably know, the American Rescue Plan Act (ARPA) was recently put into law. Part of the Act is intended to assist with the financial costs of health insurance and the government has expanded the eligibility requirements to receive a tax premium credit, also known as subsidies. You may be able to receive an increased subsidy or newly eligible.
One of our insurance carriers has explained it quite well and we have copied that below. Please review for your self and share with your family, friends and colleagues as well. We are here to help you and them save money while being able to afford health insurance.
This does not affect Medicare, Medicare Advantage or the supplemental plans.
As always, we are here to answer any questions and be of further assistance!
Elana and Sheri
The American Rescue Plan (ARP), recently signed into law, increases and expands eligibility for Affordable Care Act (ACA) premium subsidies. The law also temporarily changes the rules for year-end tax reconciliation of Marketplace premium subsidies. These changes, effective April 1, 2021, will improve the affordability of coverage for individuals who are already enrolled in Marketplace health plans, and will provide millions more an opportunity to newly sign up for Marketplace coverage with increased financial assistance this year. For more details and information, download the American Rescue Plan FAQ document.
As a result of these changes, the Department of Health and Human Services (HHS) has extended the Special Enrollment Period (SEP) to August 15, 2021.
•Individuals and families may be eligible for a temporary increase in subsidies (Advance Premium Tax Credits) for this year, with no one paying more than 8.5% of their household income towards the cost of their insurance plan.
•Many customers could become eligible for higher tax credit amounts to help cover their health plan premiums.
•Under the ACA, people with income above 400% FPL were not eligible for Marketplace premium subsidies. These customers may not receive tax credits if the benchmark plan is less than the 8.5% household income threshold.
•If a consumer updates his/her application within a particular month, the updates will not take effect until the first of the following month. As an example, if a consumer updates her application in the month of April, the update will not take effect until May 1.
Updated: Feb 15th 20201: Dental Insurance Options:
We wanted to let you know that there is a new dental plan available through Delta Dental that we think is worthwhile.
You can purchase up to $2500 in benefits
No wait on preventive and basic care
Only a 6 month wait on major services
Most other carriers have a 12 month waiting period on major services and only provide $1,000 or $1500 in benefits.
Please let us know if you have any questions or are interested in this benefit.
We are happy to share more details and assist you with enrollment.
Just a reminder that special enrollment started today (2/15 - 5/15) for individual health insurance under 65.
New special open enrollment period is available for individual health insurance.
From Feb 15 - August 15th you can apply for new coverage or update an existing policy. For example, if you have or are about to have a loss of group coverage, had an occupation change or know of something changing in the future, you can get coverage through this special enrollment period.
We can assist you with purchasing insurance through the marketplace or directly with the insurance carrier.
Out of all of the changes and challenges that 2020 has brought, I have a great change to share! I am delighted to tell you that my daughter, Elana Hokin Cepa, has become a licensed insurance producer. Elana will be working with me and for you for many years to come.