State slaps Anthem Blue Cross Blue Shield with $5M in fines

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ATLANTA — An insurance company that many of you use is being forced to pay a $5 million fine -- the largest in the agency’s history.

The Georgia Insurance Commission said Anthem Blue Cross Blue Shield violated state law.

The insurance commissioner told Channel 2′s Dave Huddleston that he’s been looking into the company’s practices for more than a year.

The state agency said the insurance company failed to comply to consumer complaints in a timely manner, improper claims settlements and violation of the prompt pay act.

“We will hold insurance companies accountable when their actions are unfairly impacting Georgians,” Georgia Insurance and Fire Safety Commissioner John King said.

“We did find a number of violations, 78,000 just in the focus areas that we looked,” King said.

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King said Blue Cross Blue Shield could be hit with even more fines if they fail to fix the problems in a certain amount of time.

He said the insurer also failed to keep its list of network doctors up to date for patients.

“That employee had to choose whether to pay out of network costs or go and select another doctor. So, it was incredibly frustrating. It was keeping people from access from the health (coverage) they deserve in our state,” King said.

Huddleston contacted Anthem Blue Cross Blue Shield for a comment on this story. They sent him a statement, saying in part:

“We have since migrated to a new platform with the goal of improving accuracy and transparency. We are dedicated to those we serve and partner with, and we believe the recent enhancements we have made will create an improved overall care provider experience.”

King said the insurance company has a new president and he hopes things will run smoother from now on.

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