If Blue Cross Is Sued Does the Association Take Part

Basic Information

• 1. Why was the Notice issued?

  The Court authorized the Notice because Class Members have a right to know about the proposed Settlement of certain claims against Settling Defendants in this class action lawsuit and about Class Members' options before the Court decides whether to approve the Settlement. If the Court approves the Settlement, and after objections and appeals are resolved, Class Members will be bound by the judgment and terms of the Settlement. The Notice explains the lawsuit, the Settlement, Class Members' legal rights and options, and the deadlines for Class Members to exercise their rights.

• 2. What is this lawsuit about?

  This class action is called In re: Blue Cross Blue Shield Antitrust Litigation MDL 2406, N.D. Ala., Master File No. 2:13-cv-20000-RDP and is pending in the United States District Court for the Northern District of Alabama Southern Division. U.S. District Court Judge R. David Proctor is overseeing this class action.

  Plaintiffs allege that Settling Defendants violated antitrust laws by entering into an agreement where the Settling Defendants agreed not to compete with each other in selling health insurance and administration of Commercial Health Benefit Products in the United States and Puerto Rico, as well as agreeing to other means of limiting competition in the market for health insurance and administration of Commercial Health Benefit Products. Settling Defendants deny all allegations of wrongdoing. They assert that their conduct results in lower healthcare costs and greater access to care for their customers. The Court has not decided who is right or wrong. Instead, Plaintiffs and Settling Defendants have agreed to a Settlement to avoid the risk and cost of further litigation.

• 3. What is a class action, and who is involved?

  In a class action lawsuit, one or more people or businesses called class representatives sue on behalf of others who have similar claims. All of the people or businesses who have similar claims together are a "class" or "class members" if the class is certified by the Court. Individual class members do not have to file a lawsuit to participate in the class action settlement or be bound by the judgment in the class action. One court resolves the issues for everyone in the class, except for those who exclude themselves from the class.

• 4. Why is there a Settlement?

  The Court did not decide in favor of the Plaintiffs or Settling Defendants. Instead, both sides have agreed to the Settlement. Both sides want to avoid the risk and cost of further litigation. The Plaintiffs and their attorneys think the Settlement is best for the Settlement Classes.

• 5. I received a notice about the Settlement. How do I know it is legitimate?

  Notice of the Settlement was recently issued to potential Class Members through email and mail. The Claims Administrator sent emails using the Blue Cross Blue Shield logos from Notice@BCBSsettlement.com. The Claims Administrator also sent postcards containing Blue Cross Blue Shield logos with the return address "Blue Cross Blue Shield Settlement, c/o JND Legal Administration, P.O. Box 91390, Seattle, WA 98111". An example of the email notice and postcard notice can be found on the Important Documents page of this website.

• 6. What information does the Claims Administrator have about me and why?

  As part of the preliminary approval process, the Court ordered Settling Defendants to produce the following information to the Claims Administrator in order to notify potential Class Members of the Settlement and process claims: names; last-known mailing addresses; last-known email addresses; last-known phone numbers; insurance and/or healthcare coverage products purchased; group, member, and subscriber ID numbers; covered lives; employer headquarters or billing addresses; and premium or premium-equivalent information of settlement class members. The Claims Administrator is required to keep this information confidential and use it only for the purposes of effectuating a notice plan, administering and calculating claims, distributing Settlement funds, and otherwise carrying out the work necessary to administer the Settlement. The Claims Administrator is prohibited from using the information for any other purpose and is required to destroy the information upon completion of Settlement administration. The Court's data production order can be found here.

Who is in the Settlement Classes?

• 7. Am I part of the Settlement Classes?

  If you were covered by certain Blue Cross Blue Shield health insurance or administrative services plans between February 2008 and October 2020, you may be a Class Member.

  You may be eligible to receive payment if you are an Individual, Insured Group ¹ (and their employees) or Self-Funded Account ² (and their employees) that purchased or were enrolled in a Blue Cross or Blue Shield health insurance or administrative services plan during one of the two Settlement Class Periods. Government accounts are excluded from the Class.

  The Settlement Class Period for Individuals and Insured Groups is from February 7, 2008, through October 16, 2020. The Settlement Class Period for Self-Funded Accounts is from September 1, 2015 through October 16, 2020. Dependents, beneficiaries (including minors), and non-employees are NOT eligible to receive payment.

  All Individuals, Insured Groups, and Self-Funded Accounts that purchased or were enrolled in a Blue Cross or Blue Shield health insurance or administrative services plan during the applicable Class Period will also benefit from the parts of the Settlement requiring Settling Defendants to change certain of their practices that were alleged to be anticompetitive. Dependents, beneficiaries (including minors), and non-employees will benefit from this part of the Settlement.

  If you are still not sure if you are included in the Settlement Classes, please review the detailed information in Question 5 of the Long Form Notice and Sections A.1.v. and A.1.pp. of the Settlement Agreement, available on the Important Documents page. You may also contact the Claims Administrator at info@BCBSsettlement.com or call toll-free at (888) 681-1142.

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  ¹Insured Groups include both employers and other groups (e.g., Taft-Hartley plans, multi-employer welfare arrangements, association health plans, retiree groups, and other non-employer groups).

  ²Self-Funded Accounts include both employers and other groups (e.g., Taft-Hartley plans, multi-employer welfare arrangements, association health plans, retiree groups, and other non-employer groups).

• 8. How do I know if my group is a Government Account?

  Government Accounts (states, counties, municipalities, unincorporated associations performing municipal functions, Native American tribes, or the federal government) are excluded from the Settlement. However, quasi-government accounts (some examples are utility companies, school districts, government-funded hospitals, public retiree benefit plans, public libraries, port authorities, transportation authorities, waste disposal districts, police departments, fire departments, etc.) that independently decide to purchase fully-insured or self-funded products are included to the extent they meet the other criteria for inclusion. If you have particular questions about whether a group is excluded or included, please contact the Claims Administrator at info@BCBSsettlement.com or toll-free at (888) 681-1142.

• 9. Are Medicare Advantage and Medicare Supplemental ("Med Supp") subscribers within the scope of the Settlement classes?

  Medicare Advantage policies are not within the scope of products included in the Settlement classes. However, Medicare Supplemental policies are within the scope of products included in the Settlement classes, so long as they meet the other criteria (e.g., dates of coverage).

Settlement Benefits

• 10. What does the Settlement provide?

  Class Members who submit valid claims may receive a cash payment from the Net Settlement Fund. The Net Settlement Fund is estimated to be approximately $1.9 billion. This is after deducting attorneys' fees, administration expenses and other costs from the $2.67 billion Settlement Fund. For more detailed information, please see the Proposed Plan of Distribution, Question 7 of the Long Form Notice, and Section D of the Settlement Agreement, available on the Important Documents page.

  Settling Defendants also agreed to make changes in the way they do business to increase the opportunities for competition in the market for health insurance. For more information about this Injunctive relief portion of the Settlement, please see FAQ 13.

• 11. How much can Damages Class Members get from the Settlement?

  Damages Class Members who submit valid and timely claims will receive payment from the Settlement Fund if the Settlement is approved. Individual payment amounts depend on several factors including, among other things, the number of valid claims that are filed, the premiums you paid to one or more of the Settling Defendants during the class period, and whether your insurance was fully insured or self-funded.

  More information regarding claim payments is available in the Proposed Plan of Distribution, Question 8 of the Long Form Notice, and Section D of the Settlement Agreement, available on the Important Documents page.

  If the total payment for any claimant is equal to or less than $5.00, no payment will be made to the claimant.

  No distributions will be made until there is a final resolution of all determinations and disputes that could potentially impact the Claims Payments. Please be patient.

• 12. How will the Net Settlement Fund be allocated?

  The approximately $1.9 billion Net Settlement Fund will be split into two separate Settlement Funds. A $1.78 billion fund will be created for Individuals, Insured Groups, and their employees. A $120 million fund will be created for Self-Funded Accounts and their employees.

  The funds will be distributed independently. A smaller payout to one fund will not increase the payout to the other.

  More information regarding how the funds will be distributed is available in the Proposed Plan of Distribution and Question 7 of the Long Form Notice, available on the Important Documents page.

• 13. What is the Injunctive Relief?

  Injunctive Relief means the Settling Defendants have agreed to make changes in the way they do business. These changes will increase the opportunities for competition in the market for health insurance.

  As part of the Injunctive Relief, a Monitoring Committee will be established for five years to mediate any disputes resulting from the implementation of the Injunctive Relief. If the Monitoring Committee Process approves any systems or rules, that information will be included in the Release. It will also be posted in a report of Monitoring Committee Actions on this website. Additional information is detailed in the Settlement Agreement.

• 14. How do I get a payment?

  The deadline to file a claim was November 5, 2021.

• 15. What am I giving up by staying in the Settlement Classes?

  Unless you exclude yourself, you remain in the Settlement Classes. This means that you cannot sue, continue to sue, or be part of any other lawsuit against Settling Defendants that makes claims based on the facts and legal theories involved in this case or any of the business practices the Settling Defendants adopt pursuant to the Settlement Agreement. It also means that all of the Court's orders will apply to you and legally bind you. The Released Claims are detailed in the Settlement Agreement. For purposes of clarity, if a Self-Funded Account that opts out meets the criteria to request a Second Blue Bid under the terms of the Settlement Agreement, that Self Funded Account does not release any claims for declaratory or injunctive relief to request a Second Blue Bid during any time it meets the criteria to request such a bid under the terms of the Settlement Agreement. All other claims for declaratory or injunctive relief released under the Settlement Agreement are released.

• 16. What happens if I did nothing at all?

  If you did nothing, you remained a member of the Settlement Classes and are bound by the Settlement. However, if you had been entitled to share in the Settlement proceeds, you will not get a payment.

Making a Claim

• 17. How do I file a claim?

  The deadline to file a claim was November 5, 2021.

• 18. How do I upload supporting documentation?

  If you have already filed a claim and indicated you would upload supporting documentation later, or if you need to submit additional supporting documentation for your claim, you may upload your documentation at the Upload Supporting Documentation page. You will need the claim number that was provided to you on the claim submission page. If you no longer have your claim number, you may contact the Claims Administrator for your claim number or you may mail your documentation to the Claims Administrator.

  You do not have to submit any documentation in order for your claim to be processed and approved for payment. If you are an Employer or Employee, you may choose to submit documentation showing the percentage of premiums you paid if you do not want to accept the Default Option, but it is not required. The Default Option provides pre-set percentages to be applied to your claim without any documentation being required by you, as provided in Section III.A.19.f of the Proposed Plan of Distribution.

• 19. How do I find my Unique ID?

  If you received a postcard or email notice from the Claims Administrator, your Unique ID was provided to you. If you received a postcard notice, your Unique ID is on the upper left corner of the inside of your postcard. If you received an email notice, the Unique ID was provided toward the top of the email body. It is a ten-digit code with both letters and numbers.

• 20. Do I need to collect and submit premium/administrative fee data to submit a claim?

  No, but you have the option to do so. Settling Defendants have produced premium and administrative fee data as maintained in the normal course of business, and the Claims Administrator will use that data to calculate claim payments. Claimants will be able to review the Total Premiums Paid and/or Total Administrative Fees Paid used to calculate their award before the distribution of the Net Settlement Fund. If a claimant disagrees with their Total Premiums Paid and/or Total Administrative Fees, they must provide the necessary documentation to support the amount they believe it should be. The Claims Administrator will review any data submitted and determine whether to change the Total Premiums Paid and/or Total Administrative Fees for that Authorized Claimant.

• 21. Do I need my subscriber or group ID to fill out the claim form?

  No, you do not need your subscriber or group ID to file a claim, and you should not reach out to your BCBS plan for that information. If you do not have that information, leave it blank and your claim will still be processed.

Second Blue Bid

• 22. What is a Second Blue Bid?

  Following final approval of the settlement, certain large, self-funded national Employers will be able to request a bid for coverage from a second Settling Individual Blue Plan, in addition to their local Settling Individual Blue Plan. Employers headquartered in areas where there are already two licensed Settling Individual Blue Plans are unaffected by this process.

• 23. Who is eligible to receive a Second Blue Bid?

  The Second Blue Bid provision of the Settlement Agreement was designed to enable 33 million Members of large, geographically dispersed, self-funded national Employers to have the opportunity to receive a Second Blue Bid. This represents approximately half all membership from large self-funded national Employers in the U.S. and approximately one-third of Members of all Self-Funded Accounts. The Settlement Agreement provides the final list of eligible accounts at this time and for two years following final approval including appeals. After two years, the list will be refreshed every two years. You may search the list of Qualified National Accounts on the Second Blue Bid eligibility page.

  While non-Employer accounts may be members of the Damages Class and eligible to receive monetary payments from the Settlement Fund, they are not eligible to request a Second Blue Bid. Non-Employer accounts, include, but are not limited to, Taft-Hartley trusts, multiple employer welfare arrangements, association health plans, retiree groups, and Opt-Outs.

• 24. What is the difference between Class Member Eligibility and Eligibility for the Second Blue Bid?

  If you were covered by certain Blue Cross Blue Shield health insurance or administrative services plans between February 2008 and October 2020, you may be a Class Member. The Court certified two Settlement Classes in this case, a Damages Class and an Injunctive Relief Class. You may be included in both Settlement Classes.  The Second Blue Bid provision of the Settlement Agreement was designed to enable 33 million Members of large, geographically dispersed, self-funded national Employers to have the opportunity to receive a Second Blue Bid. This represents approximately half all membership from large self-funded national Employers in the U.S. and approximately one-third of Members of all Self-Funded Accounts. The Settlement Agreement provides the final list of eligible accounts at this time and for two years following final approval including appeals. The list will be refreshed every two years. You may search the list of Qualified National Accounts here. This search function should only be used to determine if your company is one of the certain large, self-funded national Employers who are eligible to request a bid for coverage from a second Settling Individual Blue Plan and should not be used to identify your plan or determine if you are a Class Member.

• 25. When will the Second Blue Bid be available?

  Eligible Employers will not be able to request a Second Blue Bid until three months after the Effective Date of the Settlement. These agreements take time to secure final approval, and we do not have exact timing. The website will continue to be updated so please check back.

• 26. How will eligible Employers get a Second Blue Bid?

  Once the Settlement Agreement is approved and the terms go into effect, eligible Employers – directly or through their broker or consultant – can contact the Blue Cross Blue Shield Association or their local Settling Individual Blue Plan, documenting their choice of a second Settling Individual Blue Plan. After the Blue Cross Blue Shield Association confirms the Employer is eligible to receive a Second Blue Bid and the second Settling Individual Blue Plan agrees to provide a bid, the Employer or its broker will work directly with both Settling Individual Blue Plans through the bid intake process. The Employer will receive separate bids from both Settling Individual Blue Plans and will be able to select whichever bid it desires. If an Employer is headquartered in an area where there are two licensed Settling Individual Blue Plans, they already have the opportunity to request two Blue bids and there will be no changes to that Employer's current processes with those companies.

• 27. What will change for Employers that are not eligible for a Second Blue Bid (i.e., fully insured Employers or those that do not meet eligibility criteria)?

  The settlement will not adversely impact any existing benefits or coverage. Class Members, including those not eligible for a Second Blue Bid, will benefit from operational changes being made as a result of the settlement, such as the elimination of the National Best Efforts Requirement. Additionally, Class Members eligible for payments from the Settlement Fund will be able to receive those benefits by submitting a valid and timely claim.

Excluding Yourself from the Damages Class

• 28. How do I exclude myself, or "opt out", from the Damages Class?

  The deadline to exclude yourself from the Damages Class has passed.

Objecting to the Settlement

• 29. How do I tell the Court that I do not like the Settlement?

  The deadline to object to the Settlement has passed.

The Lawyers Representing You

• 30. Do I have a lawyer in this case?

  The Court has appointed (1) Michael Hausfeld of Hausfeld LLP and (2) David Boies of Boies Schiller Flexner LLP as Co-Lead Counsel on behalf of the Plaintiffs and Settlement Class Members. Their contact information is provided below.

  You do not need to hire a lawyer because Co-Lead Counsel is working on your behalf.

  If you wish to pursue your own lawsuit separate from this one, or if you exclude yourself from the Settlement Classes, these lawyers will no longer represent you. You will need to hire a lawyer if you wish to pursue your own lawsuit against Settling Defendants.

  Plaintiffs' Co-Lead Counsel

  Blue Cross Blue Shield Settlement
  c/o Michael D. Hausfeld
  Hausfeld LLP
  888 16th Street NW, Suite 300
  Washington, DC 20006
  (202) 849-4141
  BCBSsettlement@hausfeld.com

  Blue Cross Blue Shield Settlement
  c/o David Boies
  Boies Schiller Flexner LLP
  333 Main Street
  Armonk, NY 10504
  (888) 698-8248
  BCBS-Settlement@bsfllp.com

• 31. How will the lawyers be paid?

  Settlement Class Counsel may submit an application(s) to the Court ("Fee and Expense Application") for: (i) an award of attorneys' fees plus (ii) reimbursement of expenses and costs, up to a combined total of 25% of the $2.67 billion fund (i.e., $667,500,000) created by the Settlement. This fee will include Self-Funded Class Counsel's application. You will not have to pay any fees or costs.

The Court's Fairness Hearing

• 32. When and where will the Court decide whether to approve the Settlement?

  The Court held a Fairness Hearing to consider whether the Settlement is fair, reasonable, and adequate on October 20-21, 2021. The Settlement is pending Court order.

• 33. Did I have to come to the hearing?

  No. Co-Lead Counsel attended the hearing and answered any questions the Court had.

Employer/Employee

• 34. Do employers have an obligation to notify employees of the settlement?

  The Settlement and the Court's preliminary approval order do not obligate employers to notify employees of the settlement. Both employers and employees will receive notice of the Settlement through a Court-approved notice program. To the extent employers or employees have questions about the Settlement, they can review the Court-approved Long Form Notice, these FAQs, or contact the notice and claims administrator at (888) 681-1142.

• 35. Do employers have an obligation to provide historical premium/administrative fee data to employees?

  The Settlement and the Court's preliminary approval order do not obligate employers to provide historical premium/administrative fee data to employees. As discussed in FAQ 20, claimants are not required to provide this information in order to make a claim.

• 36. If an employer group opts out of the settlement, can employees still receive payment?

  Yes. The Proposed Plan of Distribution allows for calculation of an employee's claim value independent of whether their employer opts out of the Settlement.

• 37. How will a payment to the employee differ from payments to employer?

  The Proposed Plan of Distribution provides the methodology for the Claims Administrator to use in order to make separate payments to the employer and its employees. For a full discussion of how these formulas will be used in calculating claims, and for information concerning how a claimant can request a different contribution percentage, please refer to Question 8 of the Long Form Notice as well as to paragraphs 18 and 26 of the Proposed Plan of Distribution on this website.

• 38. Is an employer obligated to share any recovery with its employees?

  No. As described above, employees are eligible to participate in the Settlement and receive a payment for their estimated portion of premiums.

• 39. Are employers who purchased insurance or administrative services through a purchasing entity eligible for payment from the Settlement?

  Yes. The Claim Form allows for a claimant to indicate whether they purchased through a purchasing entity or are a purchasing entity that purchased on behalf of employers. Paragraph 21 of the Proposed Plan of Distribution outlines a process for determining the allocation of premiums between the purchasing entity and the employer if both make claims. The Settlement Administrator will make an allocation determination in light of all the facts and circumstances and available data that can be collected by the Claims Administrator and provided to the Settlement Administrator.

• 40. Are non-employer groups eligible to file a claim for insurance or administrative services purchased for their own employees?

  Yes. If a purchasing entity is also a damages class member in its own right, that purchasing entity can make its own claim as an employer, as can its employees.

Getting More Information

• 41. How do I get more information about the Settlement?

  The Notice summarizes the proposed Settlement. More details are in the Settlement Agreement. You can find a copy of the Settlement Agreement and other important documents on the Important Documents page. You may contact the Claims Administrator at info@BCBSsettlement.com or toll-free at (888) 681-1142. You may also contact Co-Lead Counsel at the address, phone number, and email address provided in FAQ 30.

• 42. I reached out to my Blue Cross Blue Shield plan for information about the Settlement and they referred me to the Claims Administrator. Are they supposed to provide me with information about the Settlement?

  The Court has appointed JND as the Claims Administrator and authorized JND to provide potential Class Members with notice of the Settlement. If you continue to have questions about filing a claim for a Settlement payment, you may contact the Claims Administrator at info@BCBSsettlement.com or toll-free at (888) 681-1142. You may also contact Co-Lead Counsel at the address, phone number, and email address provided in FAQ 30.

Deceased Class Members

• 43. Can I file a claim on behalf of a deceased class member?

  You are not a Class Member if you are beneficiary of the Class Member's plan. However, a claim may be filed on behalf of a deceased Damages Class Member by providing a copy of the Class Member's death certificate, and any other supporting documentation that indicates that you have the right to submit the claim on behalf of the Estate or deceased person. Please file in the name of "Estate of [Class Member]".

  If you have already filed a claim, a copy of the death certificate may be uploaded to the Supporting Documentation page at www.BCBSsettlement.com. You may also email the death certificate to the Claims Administrator at info@BCBSsettlement.com, or mail a copy of it to the Claims Administrator at:

  Blue Cross Blue Shield Settlement
  c/o JND Legal Administration
  PO Box 91390
  Seattle, WA 98111

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Source: https://www.bcbssettlement.com/faq

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