Blue Cross Hit With $156 Million in Regulations

Blue Cross To Pay Out Millions

In most cases, patients love to see this kind of thing. Whether you’re the patient of a concierge physician or not, every American has had a rough experience with big insurance companies and has lost money. It’s inevitable that if you have insurance to cover medical costs, you will also have insurance companies telling you that you owe more money. And while a strong majority of the American population is against health care reform, this might be a silver lining to all of the darkness.

According to, health insurance regulators in North Carolina have identified nearly $156 million in refunds owed to Blue Cross policyholders because of changes coming under the nation’s new health law.

Consumers with policies at other companies across the nation also may deserve refunds, says North Carolina Insurance Commissioner Wayne Goodwin. He plans to urge other states to probe potential overcharging for a type of reserve fund.

The health care law will dramatically change how health policies are sold in 2014, and many plans in effect now will cease to exist that year in their current form. Yet state regulators who scrutinized a recent rate increase request by Blue Cross and Blue Shield of North Carolina say they discovered the insurer was collecting reserves to pay claims beyond 2014.

The refund is due to an “active life reserve” that Blue Cross sets aside for each of the patients it insures. The “active life reserve” is supposed to help Blue Cross keep the patient’s payment more stable over the life of the policy, by using that “reserve” as a back-up should the policy rates ever rise. However, regulators in North Carolina found that the money was not being used as was intended, and patient premiums were still incredibly unstable.

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