The Illinois Department of Insurance is conducting a comprehensive review of how Blue Cross and Blue Shield of Illinois (BCBS) treats its customers. This review is being conducted nearly after 27 years since the regulators last released such a report on the state’s dominant health insurer.
Blue Cross and Blue Shield of Illinois Confirms Review
This week Blue Cross and Blue Shield of Illinois confirmed the review, this confirmation came in response to questions from the Tribune about why it had been almost three decades since the state publicly released a wide-ranging examination of the insurer’s compliance with laws and regulations meant to protect consumers.
What Is The Examination All About?
The state’s leading insurer has gone unreviewed for nearly three decades. These examinations are done to know how insurance companies:
- Pay claims
- Respond to consumer complaints
- Advertise
- Ensure that they comply with consumer-protection laws
Without a review, it is not possible to verify if an insurer is operating within regulatory bounds. Failing to confirm to a customer in a timely manner whether a provider is covered, or failing to adequately explain why a claim was denied are few examples of such problems.
BCBS Competitors Are Examined
The matter was initially reported by the Chicago Tribune. According to them, BCBS competitors haven’t avoided scrutiny. State regulators have conducted several broad reviews of:
- UnitedHealthcare of Illinois
- Cigna Healthcare of Illinois
- Aetna Health of Illinois
- Humana Health Plan
What If Blue Cross and Blue Shield of Illinois Fails Exam?
Blue Cross and Blue Shield of Illinois is the largest insurer in the state. It covers around 4.1 million people and employs almost 10,000 people. According to Chicago Tribune the company has also made at least $254,000 in campaign contributions to state politicians in the year 2015 and 2016.
If an insurer is found to have problems, it is required to work with the regulators to fix it and possibly pay penalties.
Date: 5 June, 2017