Following BCBS antitrust settlement, the competitive insurance landscape could look different

The settlement would allow plans in the BCBS ecosystem to compete in territories once the domain of other BCBS plans.

BCBS’s two largest plans might find employers are more willing to work with them if they can offer large, multistate networks that competitors have previously had a lock on.

Insurers are gearing up for increased competition following Blue Cross Blue Shield’s antitrust settlement. Back in September, the Blue Cross Blue Shield Association tentatively agreed to a $2.7 billion settlement to resolve antitrust claims levied by over 1 million individual and corporate policyholders.

The settlement would allow plans in the BCBS ecosystem to compete in territories once the domain of other BCBS plans, according to Crain’s Chicago Business. It would also ease restrictions on acquisitions and revenue caps for business not associated with BCBS plans.

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The agreement could put pressure on smaller BCBS plans that would find themselves competing with larger plans in the association, as well as other non-BCBS insurers.

“Large national employers that currently work with smaller Blues might now look to an HCSC or Anthem for a broader national plan,” Stephanie Goldberg wrote for Crain’s.

At 6.3% of the U.S. health insurance market, Anthem is almost twice as large as fellow BCBS plan Health Care Service Corp., which holds 3.4% of the market. Goldberg writes that BCBS’s two largest plans might find employers are more willing to work with them if they can offer large, multistate networks that competitors have previously had a lock on.

Citing Anthem’s third-quarter earnings report, Goldberg wrote that the insurer is expected to cover 22% of the $2.7 billion settlement, or $594 million. Spokespersons for other insurers declined to say how much of the settlement they would be responsible for, but “sources say the charges likely are being allocated by size,” Goldberg found.

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