Blue Cross/Blue Shield of Michigan: Hidden Surcharges for Self-Funded Insurance Customers
Recent discoveries into the billing practices at Blue Cross/Blue Shield of Michigan (BCBSM) reveal that it fraudulently charged certain administrative charges to its employer-customers who maintained self-funded medical insurance plans for their employees.
Many employers maintain self-funded medical insurance plans for their employees and contract with BCBSM to administer or operate their plans (i.e. process employee claims, make payments to doctors and hospitals etc.). Prior to 1994, BCBSM charged these employers a basic annual administrative fee for its services and in addition, charged various additional fees (“surcharges”) to bolster its (BCBSM’s) revenues to cover losses in its other lines of business. BCBSM disclosed these surcharges on its invoices. When employers complained and objected to the surcharges, BCBSM changed its billing practice by deleting any reference to the surcharges and instead began secretly marking up hospital claims to include the surcharge.
These hidden surcharges constitute a violation of the federal Employee Retirement Income Security Act (ERISA), and the first case involving these claims, Hi-Lex Controls v. BCBSM, went to trial in Detroit in April 2013, resulting in an award for the plaintiff-employer for the full amount of the hidden surcharges– more than $5 million – along with interest and attorneys’ fees.
The attorneys at Sommers Schwartz are actively investigating claims by other employers who maintained self-funded medical insurance plans for their employees and retained BCBSM as their plan administrator, to determine whether they, too, were fraudulently charged these hidden surcharges in violation of the law. If you believe that your company has been the victim of BCBSM’s unlawful billing practices, you need to act quickly to preserve and pursue your rights. Please contact us today to learn how we can help.
We fight hard. And we win.
News & Case Alerts
Read related articles and learn about recently filed cases.
Our attorneys have been featured on local and national media outlets, including:
Recommending Matt Turner
I highly recommend this law firm! Matt Turner was amazing to work with. He fought hard for our family and genuinely cared about us every step of the way. He was knowledgeable, compassionate, and always kept us informed throughout the process. We are incredibly grateful for everything he did and…
Tad Roumayah Is One of the Good Ones
I had a wonderful experience working with Tad. He was knowledgeable, responsive, and professional throughout the entire process, while also being genuinely kind and supportive. I always felt that my concerns were taken seriously and that I had someone wise and resilient in my corner. I’m very grateful for his…
From One of Tad Roumayah’s Clients
Attorney Tad Roumayah did a FANTASTIC job with my case. I highly recommend him!!!
A Client’s Praise for Dina Zalewski
My experience with Dina Zalewski and the Sommers Schwartz team was nothing short of incredible. The way that they showed genuine concern throughout this ordeal made me feel increasingly confident. I highly recommend Dina and her team for any of your legal pursuits.
Working with Tad Roumayah
I can’t say enough good things about working with Tad Roumayah. From our very first conversation, he was attentive, straightforward, and genuinely invested in getting the best outcome for my case. He took the time to explain everything clearly, answered my questions (even the ones I asked more than once)…
Praise for Alexis Amy and Tad Roumayah
I am very happy with the settlement Sommers Schwartz obtained for me in my age and disability discrimination case.Tad Roumayah and Alexis Amy explained every step of the process and answered all my questions along the way.I highly recommend this law firm!
I Cannot Say Enough Good Things About This Law Firm and My Attorney, Matthew G. Curtis.
I cannot say enough good things about this law firm and my attorney, Matthew G. Curtis. From the very beginning, their professionalism, communication, and attention to detail stood out immediately. They kept me informed throughout the entire process, answered my questions promptly, and always made me feel like a priority…
From a Wayne State Medical School Student About Judy Susskind
Law & Medicine was truly one of my favorite rotations – seeing a trial and learning from you was a privilege. Medical students are so lucky to have such an incredible preceptor for this experience. Your firm, colleagues, and clients are lucky to have you. (From a Wayne State University…
Our Clients Say It Best
