HEALTH INSURERS CHARGED WITH PRICE FIXING BOTH INSURANCE PREMIUMS AND REIMBURSEMENT RATES

by | Mar 19, 2025 | Blog, Professional License Issues |

If you work for a large company, you probably participate in a health insurance plan through your payroll benefits.  In the Philadelphia region that plan probably is BC/BS.  The insurance premiums you pay as a large, medium, or small company are set by the insurance company with little or no competition.  If you are a medical provider in the same region, you must be a participating provider through the hospital or individually listed provider in that insurer’s network of providers to accept that patient.  The rates you receive for your services are also unilaterally set by BC/BS.

Well, everyone has had enough.  https://eedition.inquirer.com/infinity/article_popover_share.aspx?guid=7453800d-2741-4170-a271-55a7ce9e7c4c&share=true  Both employers paying premiums and health care providers have sued the national and local BC/BS companies for price fixing and anti-trust violations.  I agree.  The amount I pay in health insurance premiums along with the deductible I must reach before my insurance even kicks in is absurd.  It is almost $32,000 per year. Also, if there is a pharmaceutical company co-pay assistance for certain medications, (OR ANY OTHER THIRD PARTY – INCLUDING GRANDMA OR MOM AND DAD)  pays, the insurance company can say that does not count towards your deductible.  That is also absurd.  Keep an eye on these cases.