BCBS Settlement Calculator
An informational tool to estimate your potential share of the Blue Cross Blue Shield class action settlement.
Eligible premiums paid between February 7, 2008, and October 16, 2020.
Enter the total amount of health insurance premiums you paid during the relevant class period. Do not use commas or dollar signs.
Premiums Paid vs. Estimated Payout
This is a pro-rata estimate and the actual payout percentage depends on the total number of claims filed.
What is the BCBS Settlement Calculator?
The BCBS Settlement Calculator is a financial tool designed to provide an estimate of the payment a claimant might receive from the $2.67 billion Blue Cross Blue Shield (BCBS) antitrust lawsuit settlement. In 2020, BCBS agreed to settle a class-action lawsuit that accused the association and its member plans of violating antitrust laws by entering into an agreement not to compete with each other, which allegedly led to higher insurance premiums for subscribers. A portion of this fund, approximately $1.9 billion, was set aside for policyholders (individuals and businesses) who filed claims.
This calculator helps former and current policyholders who submitted a claim before the deadline to understand what their share might look like. It’s important to understand this tool provides an estimate, not a guaranteed figure, as the final payment depends on the total value of all valid claims submitted.
BCBS Settlement Formula and Explanation
The payment for each claimant is calculated on a pro-rata basis. This means your payment is proportional to the amount of premiums you paid compared to the total premiums paid by all other claimants. While the exact final numbers are determined by the claims administrator, our calculator uses a widely accepted estimation method.
The simplified formula is:
Estimated Payout = Your Total Premiums Paid * Estimated Payout Percentage
The “Estimated Payout Percentage” is the most complex variable. It is derived from the total net settlement fund divided by the total premiums of all claimants. Based on analysis by legal and financial experts tracking the case, we are using an estimated payout rate of approximately 2.5% of premiums paid. This rate is an educated guess for modeling purposes.
| Variable | Meaning | Unit | Typical Range |
|---|---|---|---|
| Your Total Premiums Paid | The total amount of money you paid for your BCBS health insurance plan during the class period. | USD ($) | $5,000 – $150,000+ |
| Estimated Payout Percentage | The percentage of your paid premiums returned as a settlement. This is an estimate. | Percentage (%) | ~2.5% (variable) |
| Estimated Payout | The final estimated cash payment you may receive. | USD ($) | $5 – $5,000+ |
If your final calculated payment is less than $5.00, no payment will be issued according to the settlement terms.
Practical Examples
Example 1: Individual Policyholder
An individual had a fully-insured plan and paid a total of $35,000 in premiums between 2008 and 2020.
- Inputs: Plan Type = Individual, Premiums = $35,000
- Calculation: $35,000 * 0.025 = $875
- Result: The estimated settlement payout would be approximately $875.
Example 2: Small Business (Fully-Insured)
A small business provided a fully-insured group plan and paid a total of $250,000 in premiums for its employees during the class period.
- Inputs: Plan Type = Individual/Fully-Insured Group, Premiums = $250,000
- Calculation: $250,000 * 0.025 = $6,250
- Result: The estimated settlement payout for the business would be approximately $6,250.
For more detailed calculations, you might be interested in our guide on how to calculate settlement payouts.
How to Use This BCBS Settlement Calculator
- Select Your Plan Type: Choose whether you had an “Individual or Fully-Insured Group Plan” or a “Self-Funded Group Plan.” This is critical as it determines your eligible class period.
- Enter Total Premiums: Input the total amount in U.S. dollars you paid in premiums during the specified class period. You can find this information on your old insurance statements or through the official settlement claims portal if you received a notice.
- Calculate: Click the “Calculate Estimate” button to see your potential payout.
- Review Results: The calculator will display your estimated payout, a breakdown of the numbers used, and a simple chart visualizing the result.
Key Factors That Affect the BCBS Settlement Payout
- Total Premiums Paid: This is the single most significant factor. The more you paid in premiums, the larger your potential share.
- Plan Type and Class Period: The settlement has two different class periods. Your eligibility and total premium calculation depend on which one applies to you.
- Individuals and Insured Groups: February 7, 2008 – October 16, 2020.
- Self-Funded Accounts: September 1, 2015 – October 16, 2020.
- Total Number of Claimants: The $1.9 billion net fund is a fixed pie. The more people who file valid claims, the smaller each individual slice becomes.
- Total Value of All Claims: The final payout percentage depends on the sum of all premiums paid by every single claimant. A higher total claim value reduces the percentage payout for everyone.
- Claim Validity: Only valid, timely filed claims are considered for payment. Any rejected claims do not dilute the settlement pool.
- Administrative and Legal Fees: The net settlement fund of ~$1.9 billion is what remains after attorneys’ fees and administrative costs were deducted from the gross $2.67 billion amount. For insights on other legal cases, see our resources on the {related_keywords}.
Frequently Asked Questions (FAQ)
A: Individuals and companies who purchased health insurance or administrative services from a Blue Cross Blue Shield company during the specified class periods. This excludes government accounts. The deadline to file was November 5, 2021.
A: In a fully-insured plan, the company (or individual) pays a premium to the insurance carrier (BCBS), and the carrier assumes the risk. In a self-funded plan, an employer pays for each claim out-of-pocket and uses the insurance company for administrative services only. The settlement had different class periods and funding pools for each.
A: The final payout percentage is unknown until the claims administrator processes all claims. The payout depends on the total value of premiums submitted by all claimants, a number that is not public. This calculator uses a reasonable estimate for that percentage.
A: No. The deadline to file a claim and participate in the settlement has passed. This tool is for informational use by those who have already filed.
A: Payments began being issued in waves. The distribution process is complex and ongoing. Claimants should check the official settlement website for the most current updates on payment status.
A: It is unlikely to be the exact amount. Your actual payment could be higher or lower depending on the final participation rate and total claimed premiums. Think of this as a ballpark figure.
A: This calculator uses the total premium paid for the policy. The settlement had default rules for allocating payments between employers and employees (e.g., for a family plan, 66% to the employer, 34% to the employee), but this tool simplifies the calculation to an aggregate level.
A: According to the settlement terms, if your calculated share is $5.00 or less, you will not receive a payment.