The Blue Cross Blue Shield (BCBS) settlement is a landmark $2.67 billion agreement finalized in 2024.
It resolves a class-action lawsuit accusing BCBS of limiting competition, which led to higher premiums.
For claimants, understanding the BCBS settlement ASO amount is key to knowing their potential payout. This article explains the settlement, the ASO amount, and what to expect in simple terms.
What Is the BCBS Settlement?
The BCBS settlement stems from a 2013 antitrust lawsuit. It claimed that BCBS plans agreed not to compete, raising costs for policyholders. The settlement, finalized on June 24, 2024, after Supreme Court approval, benefits millions. It covers individuals and groups with BCBS plans from 2008 to 2020.
The lawsuit alleged BCBS divided markets to avoid competition. This reportedly increased premiums and limited consumer choices. BCBS denied wrongdoing but settled to avoid further litigation costs. The agreement includes $1.9 billion for payouts and reforms for fairer competition.
Eligible groups include individuals, insured groups, and self-funded accounts. Claimants had to file by November 5, 2021, to qualify. Payments are expected to start in mid-to-late 2025. The settlement also introduces changes to improve market transparency.
Understanding the ASO Amount
ASO stands for Administrative Services Only. In the BCBS settlement, the ASO amount refers to fees paid by self-funded plans for administrative services. These plans, common among larger employers, involve employees paying premiums to their employer, not directly to BCBS. A portion of these premiums covers BCBS’s administrative fees.
Self-funded accounts differ from fully insured (FI) plans. In FI plans, BCBS collects premiums directly and covers claims. For self-funded plans, employers cover claims, and BCBS handles tasks like claims processing. The BCBS settlement ASO amount determines payouts for self-funded claimants.
If your notice shows a $0 ASO amount, you’re likely in the FI class. Your payout will be based on premiums, not ASO fees. Understanding your plan type is crucial for reviewing your settlement notice. Always verify the amounts listed in your notice for accuracy.
How the Settlement Fund Works
The total settlement fund is $2.67 billion. After legal fees and administrative costs, about $1.9 billion remains for claimants. This net fund splits into two pools: $1.78 billion for FI claimants and $120 million for self-funded claimants. Payments depend on the total claims filed.
For FI claimants, payouts are based on premiums paid from February 7, 2008, to October 16, 2020. Self-funded claimants’ payouts use ASO fees paid from September 1, 2015, to October 16, 2020. The more you paid, the larger your potential share.
Claimants won’t receive full reimbursement due to the large number of claims. On average, claimants may receive around $333, though amounts vary. Payments under $5 won’t be issued to avoid processing costs. Larger employers with high ASO fees could see bigger payouts.
How Payouts Are Calculated
Payouts are calculated proportionally based on contributions. For self-funded claimants, the formula is straightforward. Your ASO fees are divided by the total ASO fees from all claimants. This ratio is multiplied by the $120 million self-funded fund to determine your payment.
For example, if you paid $1,000 in ASO fees and the total ASO fees are $1 billion, your payout is ($1,000 ÷ $1,000,000,000) × $120,000,000 = $120. FI claimants follow a similar formula using premiums and the $1.78 billion fund. Actual amounts depend on total claims filed.
The settlement administrator, JND Legal Administration, reviews claims for accuracy. Disputes over ASO or premium amounts must be filed within 30 days of receiving your notice. Documentation, like pay stubs or plan statements, is required to support disputes.
Key Dates and Deadlines
The settlement process follows a clear timeline. The Supreme Court finalized the settlement on June 24, 2024, after resolving appeals. Claim determination notices are being sent on a rolling basis. Claimants must respond within 30 days to dispute amounts.
Payments are expected to begin in mid-to-late 2025. No exact date is set, as the administrator is still reviewing claims. Claimants who filed by November 5, 2021, will receive updates via email or postcard. Keeping your contact information updated is essential.
If you miss the dispute deadline, you may lose the chance to correct errors. Check your spam folder for emails from Notice@BCBSsettlement.com. For paper claims, contact the administrator at (888) 681-1142 for status updates.
Who Qualifies for the Settlement?
The settlement covers two main groups: FI and self-funded accounts. FI claimants include individuals and groups with BCBS coverage from February 7, 2008, to October 16, 2020. Self-funded accounts include employers and groups with plans from September 1, 2015, to October 16, 2020.
Government accounts, like federal or state entities, are excluded. Medicare Advantage plans are also not covered, but Medicare Supplemental plans qualify if they meet other criteria. Entities like trade associations and unions may also be eligible.
To confirm eligibility, review the Long Form Notice or Settlement Agreement on www.BCBSsettlement.com. If unsure, contact the administrator at info@BCBSsettlement.com or (888) 681-1142. Providing your claim number speeds up the process.
Steps to Ensure a Smooth Payout
Claimants can take simple steps to avoid delays. First, check your email, including spam folders, for notices from Notice@BCBSsettlement.com. Postcards are sent if email isn’t available. Verify the ASO or premium amounts in your notice promptly.
If you spot errors, dispute them within 30 days. Gather documentation, like plan statements, to support your claim. Update your contact and payment details on the settlement website to ensure timely delivery.
Payments will be sent via direct deposit, paper checks, or digital wallets like PayPal. If you’ve moved or changed banks, update your details immediately. Missing deadlines or outdated information could delay or reduce your payout.
Common Issues with ASO Amounts
Some claimants find the BCBS settlement ASO amount confusing. A $0 ASO amount often means you’re in the FI class, not self-funded. This is normal if you paid premiums directly to BCBS. Always confirm your plan type with the administrator.
Incomplete records can lead to incorrect ASO amounts. If you believe you’re self-funded but your notice shows $0, submit documentation to correct it. Disputes must include your claim number and clear evidence. Acting quickly prevents delays.
Settlement Reforms for the Future
Beyond payouts, the settlement includes reforms to improve competition. BCBS can no longer divide markets among its plans. They must follow clearer pricing and operational guidelines. These changes aim to lower costs and improve service quality.
Reforms also include better prior authorization processes. Standardized appeal forms and internal messaging systems will streamline communication. These changes benefit policyholders and providers in the long run.
Table: Comparison of FI and Self-Funded Payouts
| Aspect | Fully Insured (FI) | Self-Funded (ASO) |
|---|---|---|
| Settlement Fund | $1.78 billion | $120 million |
| Class Period | Feb 7, 2008 – Oct 16, 2020 | Sep 1, 2015 – Oct 16, 2020 |
| Basis for Payout | Premiums paid | ASO fees paid |
| Average Payout | ~$200–$300 (varies) | Lower, e.g., $120 for $1,000 ASO fees |
| Eligibility | Individuals, insured groups | Employers, self-funded groups |
This table highlights the key differences between FI and self-funded payouts. It helps claimants understand which pool applies to them.
Avoiding Scams and Staying Safe
The high-profile settlement has attracted scammers. Legitimate emails come from Notice@BCBSsettlement.com. Postcards use the address: Blue Cross Blue Shield Settlement, c/o JND Legal Administration, PO Box 91390, Seattle, WA 98111. Always verify the source.
Never share personal details with unsolicited contacts. Report suspicious emails or calls to the administrator and the FTC. Check the settlement website for examples of legitimate notices. Staying vigilant ensures you safely receive your payout.
What to Expect Moving Forward
Payments will roll out in 2025, likely mid-to-late year. Claimants will receive updates as reviews progress. Larger employers may see higher payouts due to significant ASO fees. Individuals typically receive smaller amounts due to the claim volume.
The settlement’s reforms promise a more competitive healthcare market. This could lead to lower premiums and better services over time. Claimants should stay patient and keep records of all settlement-related communication.
Summary
The BCBS settlement ASO amount is a critical factor for self-funded claimants expecting a payout from the $2.67 billion agreement. Finalized in 2024, the settlement addresses antitrust violations by BCBS, offering $1.9 billion to eligible claimants. FI claimants rely on premiums, while self-funded claimants use ASO fees for payouts. Payments, expected in 2025, vary based on contributions, with an average of $333 per claimant. To ensure a smooth process, verify your notice, dispute errors within 30 days, and update contact details. The settlement also brings reforms for a fairer healthcare market, benefiting consumers long-term.
FAQ
What does ASO amount mean in the BCBS settlement?
ASO stands for Administrative Services Only, referring to fees paid by self-funded plans for BCBS’s administrative tasks. These fees determine payouts for self-funded claimants. Check your notice to confirm your ASO amount.
Why is my ASO amount $0?
A $0 ASO amount likely means you’re in the Fully Insured class, not self-funded. Your payout will be based on premiums paid. Contact the administrator to verify your status.
How are BCBS settlement payouts calculated?
Self-funded payouts divide your ASO fees by total ASO fees, then multiply by $120 million. FI payouts use premiums and the $1.78 billion fund. Amounts vary based on claims filed.
When will I receive my BCBS settlement payment?
Payments are expected in mid-to-late 2025. Notices are sent on a rolling basis, and disputes must be filed within 30 days. Update your contact details to avoid delays.
How can I avoid BCBS settlement scams?
Legitimate notices come from Notice@BCBSsettlement.com or the official Seattle address. Never share personal details with unsolicited contacts. Report suspicious activity to the administrator and FTC.