Illinois regulators to conduct 1st broad review of BCBS in 27 years

Illinois will conduct a broad market examination of Chicago-based Blue Cross and Blue Shield of Illinois' compliance with consumer protection regulations, a move it hasn't pursued since 1990, according to a Chicago Tribune report.

The payer, which covers 4.1 million consumers statewide, confirmed last week with Chicago Tribune the Illinois Department of Insurance will commence a broad review of its consumer treatment in areas such as advertising, enrollment, claim payments and complaints. The last time regulators publicly released a widespread review of the insurer's consumer treatment was 27 years ago and involved parent company Chicago-based Health Care Service Corp.

While the Illinois Department of Insurance isn't required to conduct regular reviews, BCBSI is an outlier compared to its competitors, which have been subject to multiple broad market reviews within the same timeframe, according to documents obtained by Chicago Tribune through the Freedom of Information Act. The department conducted at least three broad reviews of UnitedHealthcare of Illinois, at least four of Cigna Healthcare of Illinois, at least two of Aetna Health of Illinois and at least four of Humana. Illinois released a narrow review of HCSC in 2011, but it didn't include a broad examination of the payer.

HCSC had 228 complaints in Illinois in 2016 the insurer addressed directly, according to the report. This is compared to UnitedHealth's 52 complaints. HCSC does hold 63 percent of the market compared to UnitedHealth's 10 percent.

BCBSI spokesperson Colleen Miller told Chicago Tribune the payer is "more than happy to cooperate" with state regulators on the reviews "to make sure we're serving our members the best possible way." Ms. Miller did not comment on the 27-year gap.

For the full Chicago Tribune investigation, click here

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