NC insurance regulator launches investigation into Blue Cross

NC insurance regulator launches investigation into Blue Cross

NC insurance regulator launches investigation into Blue Cross North Carolina Insurance Commissioner Wayne Goodwin announced this week that his office has launched an investigation of Blue Cross and Blue Shield to find out why the insurer happened to suffer from a series of ill-timed technological issues, setting back thousands of consumers from purchasing or verifying their health insurance coverage.

The NC Office of the Insurance Commissioner received more than 1,000 formal complaints related to Blue Cross. The Office also took over 4,000 calls from disgruntled customers.

Goodwin said that the investigation would probably take months, and Blue Cross would be billed for any investigative work outsourced to specialists.

“We’re at that point where it is what I need to do,” said Goodwin. “This is akin to a deep dive audit where we determine what worked, what didn’t work, whether any laws were broken, and how the process can be improved.”

Blue Cross confirmed that it would cooperate with the agency’s investigation.

The insurer issued a statement, saying that it would “. . . continue working hard to address [its] customers’ concerns and deliver the level of service they expect.”

In January, Blue Cross suffered a catastrophic software failure when it was in the middle of transferring 400,000 customers from an older system to a newer platform. Since then, the insurer had focused on reducing its surfeit of applications, but is still experiencing issues with billing and invoicing.

Blue Cross lost $123 million on NC’s ACA market in 2014. Overall, the insurer took an operating loss of $50.6 million, and is expected to report further losses in the weeks to come. CEO Brad Wilson stated last week that the company may be forced to withdraw from NC’s ACA market if it continues to lose money.
  • I sanders 2/12/2016 8:31:23 PM
    Add Acupuncture coverage and see how the books balance like Maryland and Maine.
    Post a reply