Blue Shield Of California

A judge ruled Monday that Blue Shield of California could cancel group health insurance for the California Assn. of Realtors, apparently dooming it to the growing list of organization-sponsored health plans that have died in recent years, leaving people uninsured. The association had sued Blue Shield, alleging that it would be illegal for the insurer to cancel the coverage of more than 8,000 people, including real estate agents and family members.

A college student who was dropped by Blue Shield of California after he was hospitalized sued the health plan Thursday, asking a Los Angeles judge to order it to stop canceling the policies of people who get sick and submit claims for treatment. The request for a sweeping injunction is the latest twist in an escalating controversy over a practice that is widespread and has left thousands of California residents with big medical bills and without coverage.

The California Assn. of Realtors said Monday it had sued Blue Shield of California to stop the health plan from canceling its contract and dropping coverage for as many as 8,000 Realtors and family members. The flap is the latest example of how high health costs and changes in the marketplace are eroding the availability of group coverage. "We were abruptly notified -- by mail -- that our insurance coverage was being canceled," said association President Colleen Badagliacco.

Blue Shield of California members are once again welcome at UCLA hospitals in Westwood and Santa Monica, the health plan and university announced. In July, after contract talks failed over how much Blue Shield of California would pay for hospital services, the health plan withdrew the hospital from its network of providers and directed about 4,000 of its members to other regional facilities. The parties renewed negotiations and reached a new contract, they said.

Blue Cross of California said Tuesday that it would change some of its procedures for canceling individual health insurance policies, after allegations that it illegally dumped sick policyholders to avoid expensive claims. The state's largest health insurer said it would make the changes -- including creating an ombudsman and revising its appeal process -- but maintained that it had done nothing wrong.

In 13 lawsuits filed Thursday, former policyholders complained that two health plan operators systematically dumped members after receiving bills for their medical care. The complaints, filed in Los Angeles, Ventura and Sonoma counties, join 10 lawsuits filed last month alleging that Blue Cross of California improperly canceled policies of sick members. All of the suits were filed by William M. Shernoff, a Claremont attorney who specializes in such litigation.

Enrollment in Blue Shield of California rose 24% last year to 3.3 million people, the third consecutive year of membership growth, the nonprofit reported Thursday. The San Francisco-based health insurer also reported net income of $334 million for the year, up slightly from the previous year but well above the $61 million reported in 2001. Revenue was nearly $7 billion, up from $6.9 billion a year earlier.

The California Public Employees' Retirement System voted Wednesday to oust 38 hospitals from its Blue Shield HMO network because they were deemed too pricey -- a step expected to influence healthcare purchasing decisions nationwide. Directors of CalPERS, the nation's third-largest buyer of employee health benefits, said they had taken the action to keep a lid on premium hikes. The pension fund, which provides medical benefits for 1.

To avert an impending crisis, California must ensure that all its residents have health insurance by requiring employers to contribute and by imposing a broad-based tax, the chief executive of one of the state's biggest insurers said Tuesday. Bruce Bodaken, CEO of Blue Shield of California, which covers 2.3 million people, unveiled his plan in San Francisco.