Anthem Blue Cross on the chopping block

Before you go pitying what could happen to the poor, aggrieved health insurance companies in the United States as a result of healthcare reform, take a minute to see what they actually do. And this is typical. Anthem Blue Cross is no different from any of the other mass-production health plan overlords; they just got caught screwing up.

Sure, we don’t need any kind of checks and balances on these motherfuckers, right? Free market, baby!

Anthem Blue Cross of California allegedly violated state consumer protection laws more than 700 times between 2006 and 2009, according to the California Insurance Department.

Failure to pay claims within 30 days; failure to pay interest on unreimbursed claims; misrepresenting facts or policy provisions to customers; unreasonably low settlement offers; and other delays and claims handling violations are among the accusations brought by the state.

In addition, the Woodland Hills, Calif.-based insurer allegedly failed on 143 occasions to respond to the state agency in a reasonable time so these issues could be investigated.

The maximum penalty for each violation is $10,000. The state’s complaint will be heard before an administrative judge.

“It’s just really critical health insurance companies pay claims on time and fully,” California Insurance Commissioner Steve Poizner said at a news conference. “There’s lots of examples where these deadlines came and went.”

Anthem Blue Cross, a subsidiary of Indianapolis-based WellPoint, is under state and federal scrutiny for raising rates on individual consumers this spring by up to 39%. Those premium increases are on hold until May pending an independent actuarial review.

The claims investigation has been under way for more than one year, and was launched based on consumer complaints, Poizner said. A similar state investigation of UnitedHealth Group’s PacifiCare, is ongoing.

WellPoint reported that it paid claims, on average, in 42.3 days as of the end of 2009, according to company financial statements. California insurance code requires insurers to pay claims within 30 days.

WellPoint said that it takes the issues raised by Poizner very seriously. “As the largest insurer in California, our responsibility is to pay the many millions of claims on behalf of our members each year fairly, fully and promptly,” said Kristin Binns, a WellPoint spokeswoman, in an e-mail. “While this review represents a small fraction of those claims, it is nonetheless very important to us to make sure we take any corrective action that may be necessary.”

Advertisements
  1. #1 by threlkeld on February 23, 2010 - 7:06 pm

    Thanks for this. I hate those fuckers. I’m thinking that once our monthly premiums go above a certain level, it’s time to get hitched, move to England (where Jonathan’s still a citizen) and start taking advantage of “socialized medicine.”

    I would *love* a government plan if it meant I got the same shitty coverage for, oh, maybe $200 less per month? My parents pay $60 a month for Medicare and bitch about it. Try $1100 for two people who are young and healthy.

    Argh.

  2. #2 by kemibe on February 23, 2010 - 7:27 pm

    So if my math is right, these assholes will have to pay a $7 million fine. Big fucking deal. They won’t blink.

    What needs to happen is strangulation. If they can’t legally provide a viable service to the people they are supposedly helping, then kick their asses to the curb and strip them outright. Yet people can’t just reject their providers.

    I doubt Kaiser Permanente and CIGNA are any different. That’s just what these people do. They’ll fuck you any way possible. I hate the industry so much.

  3. #3 by jim on February 24, 2010 - 3:54 pm

    B-b-bu-but, it’s all about the free market! How can anything work without a profit incentive? The invisible hand of the market knows all! Don’t you get it? It’s just like Jeebus! The market knows if you’ve been bad or good. No wait, that’s Santa. The market will weed out the bad from the good, just like Jeebus! You gotta have faith in the market just like you have faith in Jeebus! I mean, heck, Jeebus loves the market. Jeebus IS the market, the market IS Jeebus. It’s two, two, two deities in one!

    I mean, people working together for the common good without making money on it? I’ve never heard such crazy talk! Why, why that’s downright UnAmerican! Maybe that’s spelled UN-American, as in “United Nations”. That would explain a lot. It’s socialism, I tell ya, and that starts with “S” and that rhymes with “Less” and that’s what we’re all going to get!

    It’s just making my head spin.

%d bloggers like this: