Insurance commissioner fines former Blue Cross
The Associated Press | Hagadone News Network | UPDATED 11 years, 2 months AGO
HELENA (AP) — Montana Insurance Commissioner Monica Lindeen said Thursday the former Blue Cross Blue Shield of Montana has paid a $250,000 fine for violations uncovered during an audit completed last summer.
The “market conduct exam” revealed the company had a business practice until late 2010 of processing some emergency care claims at the out-of-network coinsurance rate of 40 percent, rather than 50 percent rate listed in the policy, unless the insured filed an appeal.
The audit also found that BCBS entered into an agreement with an association in April 2009 in which the bills it sent to employer groups also included the costs of an association member life insurance policy, an employee assistance program and an administrative fee. BCBS returned the extra money to the association, but reported it as a commission.
State law requires premiums for each type of insurance to be billed separately.
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