Anthem Blue Cross Class Action Alleges False Advertising

With the passage of the Patient Protection and Affordable Care Act, better known as Obamacare, insurance companies their policy holders both had to scramble to ensure that they were compliant. However, a new false advertising class action lawsuit alleges that Anthem Blue Cross Life & Health Insurance Co., a subsidiary of Wellpoint Inc., misled plan buyers regarding the benefits.

The three primary types of health insurance plans are HMO, PPO and EPO, with PPO offering a variety of choices in terms of medical providers both in Anthem’s network and favorable rates for other doctors and treatments. While only differing by one letter, an EPO is significantly different because there is no out-of-network coverage.

According to the Anthem Blue Cross class action lawsuit, the issue with an EPO was exacerbated by Anthem’s alleged changes to its provider network. If Californians bought policies on the assumption that the same list of doctors would remain, they might consider the less expensive alternative to a PPO to reduce their monthly bills.

However, it goes beyond the change in doctors within the Wellpoint and Anthem network. The issue, according to Anthem Blue Cross insurance the class action lawsuit, is that Anthem’s plans do not count out-of-pocket costs from out-of-network visits. Even if that were not an issue, the delay in the rollout of plans that would comply with Obamacare regulations meant that patients were paying premiums even though they did not receive proof of insurance and thus also had to pay out of pocket until they were able to submit claims, a painstaking process, according to the class action lawsuit.

The proposed class action lawsuit is seeking to represent all customers who signed up for an Anthem Blue Cross and Blue Shield insurance plan and were affected by the alleged false advertising between Oct. 1, 2013 and Mar. 31, 2014.

The plaintiffs are represented by class action attorneys Michael J. Bidart and Travis M. Corby of Shernoff Bidart Echeverria Bentley LLP and Jerry Flanagan and Laura Antonini of Consumer Watchdog.

The Anthem Blue Cross Insurance Class Action Lawsuit is Betsy Felser, et al., v. Blue Cross of California, Case No. BC550739, California Superior Court, Los Angeles

UPDATE July 25, 2016: A settlement has been reached in the Anthem Blue Cross Fraud class action lawsuit.  Settlement specifics can be found here: https://felseranthembluecrossacasettlement.com/