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New Blue Shield Policy Refunds Customers If Rates Are Too High

Blue Shield of California has announced a new policy where customers will get refunds if their rates are found to be too high. The health insurance group announced the refund policy after being heavily criticized for filing a large rate increase request with the state.

Blue Shield is seeking a rate increase of up to 59 percent for some customers. That rate increase request was greeted with fierce criticism from California Insurance Commissioner Dave Jones. Blue Shield’s Tom Epstein said the health plan group will now ask an independent actuary to review its rates, and if the actuary finds them to be too high, affected customers will get reimbursement.

“We want both the insurance commissioner and our members to feel confident that the rates we’re charging are fair, accurate and justified,” Epstein said.


Almost 200,000 enrollees could be eligible for the refund offer. Blue Shield has hired the same actuary who found mistakes in Blue Cross’s rate request of almost 40 percent for some customers. Blue Cross greatly lowered its request after his audit.