By: Chris Rauber

San Francisco Business Times

10/26/2015

Some Blue Shield of California customers on the Peninsula say their premium rates will jump significantly in January even after Stanford Hospital and Lucile Packard Children’s Hospital are booted out of Blue Shield’s individual and family plan networks.

Early this month, as first reported by the Business Times, Blue Shield said it’s kicking the two Stanford hospitals out of the PPO network because of high costs, effective Jan. 1.

Entities affected include Stanford Health Care, Stanford Medical Center, Lucile Packard, Stanford Medical Group, Lucile Packard Medical Group, and Stanford’s University Health Alliance.

But some Blue Shield enrollees in the area are calling foul.

Blue Shield is decreasing our access to quality health care while raising our premium 29 percent,” said one enrollee who asked not to be identified. It’s ‘not clear how that supports either prong of their so-called mission,” referring to the health plan’s stated missions of ensuring access to care at affordable rates.

To Read More

By: Heather Caspi

10/26/15

Healthcaredive.com

Dive Brief:

• Following months of scrutiny over its nonprofit status, $4.2 billion in reserves, and other financial concerns, Blue Shield of California continues to face questions about its executive compensation.
• CEO Paul Markovich said the company would disclose more information in the future, but specific details regarding past executive pay would remain secret.
• The lack of transparency may not fly with state regulators investigating whether the organization intentionally misled them.

​Dive Insight:

Blue Shield of California raised executive pay by $24 million in 2012, amounting to a 64% increase from the previous year, The Los Angeles Times previously reported. What concerns regulators is whether the company excluded some of its pay data from public filings in order to cloak massive sums paid to outgoing execs, including former CEO Bruce Bodaken.

To Read More

By: Chad Terhume

LA TIMES

10/22/2015

In response to mounting criticism, Blue Shield of California’s chief executive is vowing to improve the nonprofit insurer’s poor ratings from patients and to disclose more about executive compensation.

But CEO Paul Markovich warned that certain details on executive pay will remain secret, portending a potential showdown with regulators.

Markovich has been dogged by questions for months surrounding the insurance giant’s nonprofit status, lack of transparency and repeated rate increases despite holding $4.2 billion in reserve.

The 48-year-old CEO cleared one major hurdle this month when state officials approved his $1.2-billion acquisition of Care1st Health Plan, a Medicaid insurer based in Monterey Park.

Auditors said the company didn’t deserve the lucrative tax break because of its excessive surplus and the failure to provide lower-cost coverage or other substantial community benefits.

To Read More

By: Gail Sullivan

Law360

Law360, New York (October 20, 2015, 10:28 PM ET) — Blue Cross & Blue Shield of Mississippi urged an Alabama federal court Monday to toss seven antitrust suits from multidistrict litigation challenging how the insurance giant divvies up territories among franchisees, saying it didn’t do enough business in certain states to be sued there.

Suits by health care providers accusing the insurance giant and its independent regional units of price-fixing and conspiring not to compete were consolidated in Alabama federal court in 2012.

In May, U.S. District Judge R. David Proctor denied bids by several Blue Cross units to dismiss the suit, saying the providers were entitled to discovery to determine where the cases should be heard. His order noted that the health care providers had also sued those same Blue Cross units, including Blue Cross of Mississippi, in their home states.

To Read More

By: Amy Yurkanin

Al.com

10/15/15

Customers with certain gold and platinum plans from Blue Cross Blue Shield of Alabama will need to shop for new coverage starting next month, the insurer announced last week.

Blue Cross is discontinuing its Blue Choice Platinum and Blue Access Gold plans at the end of the year. Consumers covered by the plans can select new plans during open enrollment, which starts in November.

Clients at AIDS Alabama will be among the customers searching for new coverage at the end of the year. Some HIV-positive patients who had been using the state’s AIDS Drug Assistance Program have been able to purchase insurance through the federal exchange, and all of them had platinum-level plans, said Alex Smith, director of policy and advocacy for AIDS Alabama.

“I’m not sure what we’re going to do next,” he said.

To Read More

By: Susan Haigh

Ap

Washington Post

HARTFORD, Conn. — Connecticut’s Department of Insurance is playing a major role in a deal that could create the nation’s largest health insurer, leading a 26-state review of Anthem Inc.’s proposed merger with Bloomfield-based Cigna.

Since Cigna is based in Connecticut, state insurance regulators are tasked with coordinating the review by other states with legal Cigna entities within their borders, informing them about Connecticut’s evaluation of the massive merger, and hosting conference calls between the various state regulators.

“This transaction has a large number of states,” said Connecticut Insurance Commissioner Katharine Wade. “Having 26 states involved, coordinating among regulators, is significant.”

The application process for the proposed merger includes multiple steps, including approvals from shareholders. The U.S. Justice Department is currently reviewing Anthem’s planned $54.2 billion acquisition of Cigna to determine whether the merger will hurt competition and consumers. About 53 million customers could be affected.

To Read More

By: John Archibald

Al.com

09/30/2015

It’s good to be the king. The big blue king that rolls around on his pile of money and uses it to grab even more.

Think about it.

Just two years ago, the federal Department of Health and Human Services looked at the way Alabama reviewed health insurance rates, and said …

Ugh.

It doesn’t work. It is ineffective. And since Blue Cross Blue Shield of Alabama has a virtual monopoly on health insurance in the state, it meant Alabama regulatory reviews of Old Big Blue were just as …

Ugh. Ineffective.

And now look how far we’ve come.

The top 10 executives at Blue Cross Blue Shield have been very good to themselves in recent years, doubling their own pay between 2011 and 2013. In 2013 – the last year available — they each made more than a million bucks, a combined $19.2 million.

To Read More