Anthem Blue Cross Settlement Will Refund Calif. Customers $8.3M

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In a recent settlement, Blue Cross of California, doing business as Anthem Blue Cross, has agreed to stop midyear policy changes including raising annual deductible limits as well as increasing the yearly out-of-pocket maximums.

For the nearly 50,000 customers affected by these practices, Anthem will provide reimbursement for these midyear changes in the total amount of $8.3 million, under the terms of the class action settlement.

Back in 2011, two similar class action lawsuits were filed by Anthem Blue Cross policyholders in Los Angeles County Superior Court that claimed the company had increased annual deductibles and other out-of-pocket fees for individual policy holders during the middle of the year. These two class action lawsuits against Anthem were consolidated and together represent the members who were affected by the 2011 mid-calendar-year changes.

One of the plaintiffs in the class action lawsuit, Dave Jacobsen, said he was affected after signing up for a Blue Cross PPO Share $500 individual plan. He says he received medical services in April 2011 and Anthem confirmed he had met his deductible and then paid for 75 percent of his allowed medical expenses. When he went back to have a follow-up testing completed in July 2011, he was allegedly informed that he needed to pay an additional $50 toward his deductible before the company would pay its percentage for the services rendered.

“My deductible had become a moving target,” said Jacobson at a news conference held Tuesday by several plaintiffs and their lawyers. “It’s as if Anthem Blue Cross changed the rules of the game in the middle of the game.”

In Jacobson’s situation, the midyear policy change caused his annual drug prescription deductible to increase from $250 to $275. His yearly out-of-pocket maximum increased from $5,000 to $5,850.

As per the terms of the settlement agreement, Anthem Blue Cross did not acknowledge liability for any of the claims set forth by the plaintiffs. Anthem entered into the agreement “to avoid further expense, as well as the burdens and risk of litigation.”

All eligible Class Members will be mailed notices directly and information will be posted regarding the settlement on a public website.

According to the class action settlement documents, Anthem will mail checks to 50,000 customers identified as Class Members in December. The average amount of the settlement check will be $167, though one member of the class will receive reimbursement in the amount of $19,000 as compensation for high out-of-pocket costs incurred.

If the amount of settlement is less than $5 for a particular policyholder, a check will not be issued. Instead, refund monies in the amount of $5 or less will be gathered and distributed to St. Joseph Children’s Research Hospital as a charitable donation.

Four plaintiffs who were involved in the court case will receive an additional $10,000 for their role in the case, pending court approval.

All members of Anthem Blue Cross will be protected from midyear cost increases in the future as part of the settlement.

More information about how to file a claim for the Anthem Blue Cross class action settlement was not immediately available. Keep checking TopClassActions.com or sign up for our free newsletter for the latest updates. You can also mark this article as a “Favorite” using your free Top Class Actions account to receive notifications when this article is updated.

The Anthem Blue Cross Midyear Policy Changes Lawsuits are Taub v. Blue Cross of California d/b/a Anthem Blue Cross, Case No. BC457809 in the Los Angeles County Superior Court, and Kassouf, et al. v. Blue Cross of California d/b/a Anthem Blue Cross, ,Case No. BC473408 in the Los Angeles County Superior Court.