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Blue Cross Blue Shield Forced to Reimburse Montanans

Company paid back more than $700,000, more coming

August 9, 2013

HELENA, Mont. – Blue Cross Blue Shield of Montana has reimbursed Montanans more than $700,000 so far after Montana Insurance Commissioner Monica J. Lindeen discovered the company had been wrongly charging customers for services that were advertised as free.

The company sold certain insurance policies that, in some cases, were advertised as not having any deductible or co-pays for "professional services," such as physical therapy which do not require a physician. But when customers sought such services, they were asked to pay a $500 deductible.

Customers began complaining to Lindeen's office early in 2012 – just weeks after the policies went into effect.

"Montanans expect to get what they bargained for. That's how we do business in this state," said Lindeen. "Montanans expect to get what they bargained for. That's how we do business in this state."

Lindeen's office conducted an investigation and discovered Blue Cross had proposed changing the policy to eliminate the deductible-free professional services stipulation. Such changes to a policy must be approved by Lindeen's office. In this case, the change was never approved.

However, Blue Cross handled the policies as though the change was final. The company told some of its agents the policies had changed. Other agents were not told and continued to sell and advertise the policies as having no deductible for the selected services

Lindeen's office fined Blue Cross Blue Shield $5,000 and forced the company to reimburse all affected Montanans for the deductible they had wrongly paid. The company began sending out checks several months ago and has already paid out more than $700,000, with more reimbursements coming.

Only Montanans who were insured under the "Blue Dimensions" plans sold to small businesses were over charged and will be getting reimbursements. Blue Cross Blue Shield has until next July to repay everyone affected.