Law Street Media

Opt-Out Plaintiffs File Antitrust Suit Against Blue Cross Blue Shield

Blue Cross Blue Shield's logo on a building.

"Lansing, Michigan, USA - March 14, 2012: The Blue Cross Blue Shield location in Lansing, Michigan. Founded in 1929, the Blue Cross Blue Shield Association is a network of insurance organizations that insure almost 100 million Americans."

More than two dozen individuals have sued Blue Cross Blue Shield (BCBS) entities, including ten state and regional members of the health insurance heavyweight, for violations of the Sherman Act. The Southern District of Florida complaint dovetails on a settlement reached in a sprawling antitrust case last November, wherein BCBS agreed to pay $2.67 billion to resolve the multidistrict litigation pending against it.

That lawsuit alleged that BCBS, across its many related entities, decreased competition in health insurance markets by allocating geographic territories, placing restrictions on member plans, and enforcing other ancillary restraints on trade. The Northern District of Alabama court agreed, declining to dismiss the case on numerous occasions and ruling that the defendants’ market allocation scheme together with certain other output restrictions was subject to the per se standard of review.

This week’s filing explains that while the opt-out plaintiffs agree with that ruling, “they do not approve of the settlement reached with the Defendants in the class action because it fails to adequately compensate their damages.” The complaint states that the plaintiffs are former and  current enrollees in health insurance policies issued by or included in employee benefit plans administered by the defendants.

Similar to allegations made in the multidistrict litigation, the instant complaint alleges that the defendants have engaged in per se illegal market division and per se illegal output restrictions. The opt-out plaintiffs allege violations of the Sherman Act Sections 1 and 3 for restriction of trade and Section 2 for monopolization, attempted monopolization, or conspiracy to monopolize the relevant health care insurance markets.

The lawsuit seeks injunctive relief halting the allegedly ongoing anticompetitive practices, treble damages, and an award of the legal fees and costs associated with the litigation. The opt-out plaintiffs are represented by Gulisano Law PLLC.

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