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June 18, 2013 | Los Angeles Times
Blue Shield of California, already facing a Los Angeles ethics complaint over potential conflicts of interest, is poised to take a lucrative health insurance contract for city workers away from rival Anthem Blue Cross. The proposed three-year deal is still subject to approval by L.A. Mayor Antonio Villaraigosa. Under Blue Shield's offer, the city would pay 2% more, or $112 million, in premiums next year for these HMO and PPO plans. That was nearly $9 million less than Anthem's $121-million bid, which represented a 10% increase over the current year.
July 4, 2012 | By Chad Terhune, Los Angeles Times
California Insurance Commissioner Dave Jones denied Blue Shield of California's plan to close several of its health policies to new customers, saying it violated state rules designed to protect consumers from large rate increases. Regulators routinely scrutinize efforts by health insurers to stop enrollment on some policies because the pool of existing customers can face escalating premiums as policyholders get older and incur more medical claims, without healthier applicants to offset those costs.
March 6, 2013 | By Chad Terhune, Los Angeles Times
Despite objections from regulators, health insurers Blue Shield of California and Aetna Inc. are proceeding with double-digit rate increases that state officials said were unreasonable. Officials at the California Department of Managed Health Care said increases that average more than 11% for about 47,000 individual and small-business policyholders of Blue Shield and Aetna were unreasonable. But state officials don't have the authority to reject changes in premiums, and increasingly health insurers refuse state demands to lower rates.
April 9, 2013 | David Lazarus
Health insurers don't exactly enjoy a reputation for timely payouts when people submit claims. They've been known to make policyholders jump through all sorts of hoops before coming across with a little cash. But when you owe them money, that's another story. Karen Fairbank, 60, of Pacific Palisades discovered this recently when Blue Shield of California sent her a letter demanding that she return a payment of more than $2,400, and that she do it pronto. Plus $4.70 in interest.
January 19, 2014 | By Chad Terhune
The gig: As chief executive of Blue Shield of California, Paul Markovich leads one of the country's largest nonprofit health insurers, and he is a major player in the state's rollout of Obamacare. Dakota days: Markovich, 46, grew up in Grand Forks, N.D., the son of two professors at the University of North Dakota. His father taught political science, and his mother lectured on economics and finance. Much of his childhood was spent skating at the local hockey rink. His first jobs included serving as a hockey camp counselor and refereeing youth hockey games.
In what one executive jokingly described as a "man-bites-dog" merger, a major nonprofit health-care firm--Blue Shield of California--announced plans Tuesday to acquire a for-profit managed-care firm and turn it into a nonprofit business. "We are bucking a trend," said Wayne R. Moon, Blue Shield's chairman and chief executive, of the company's purchase of CareAmerica Health Plans of Woodland Hills for $175 million.
Wayne R. Moon, president and chief operating officer of Kaiser Foundation Health Plan, on Thursday was named president and chief executive of rival Blue Shield of California. It is telling that San Francisco-based Blue Shield, one of California's largest fee-for-service insurers, tapped the giant health maintenance organization for a new leader. Like other traditional carriers, Blue Shield has shifted focus toward managed care, the likely model for federal health reforms.
July 8, 2010 | By Duke Helfand, Los Angeles Times
A Los Angeles woman sued Blue Shield of California on Wednesday, accusing the nonprofit health plan of overcharging thousands of policyholders who bought safety-net insurance for people who were sick or jobless. Amalia Lample said in her lawsuit that Blue Shield, the state's second-largest not-for-profit insurer, knowingly exceeded maximum insurance rates set by the state and falsely reported to regulators that the charges stayed within official guidelines. Lample, 64, argued that she is owed $4,475 in excess charges she paid from 2007 to 2009.
October 29, 2013 | By Matthew Fleischer, guest blogger
The Obama administration came out with a report Monday arguing that 1 million single adults between the ages of 18 and 35 will be eligible for an Obamacare insurance plan costing less than $50 a month. That's news to me. I'm a healthy 34-year-old with a taxable income hovering right around the Obamacare subsidy level who, for the last several years, has purchased a relatively inexpensive catastrophic health insurance plan from Blue Shield. I get to see the doctor four times a year for a $30 co-pay, and I won't have to spend the rest of my life working off the debt if I get hit by a bus. Last month, however, I received a letter from my insurance company informing me that my plan was “no longer available” due to “new requirements for health coverage under the Affordable Care Act.” I am being funneled into the closest equivalent plan under the new California health exchange, and my monthly premium is going to rise by nearly 43% to $214 a month.
December 13, 2007 | Lisa Girion, Times Staff Writer
California's top insurance regulator has accused Blue Shield, one of the state's largest health plans, of 1,262 violations of claims-handling laws and regulations that resulted in more than 200 people losing their medical coverage. Calling the allegations "serious violations that completely undermine the public's trust in our healthcare delivery system and are potentially devastating to patients," Insurance Commissioner Steve Poizner said he would announce today that he would seek a $12.
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