By reporting costs resulting from administrative errors as medical expenses, Blue Shield appears to have shortchanged customers on rebates required by Obamacare’s limits on profits and administrative expenses.
Blue Shield made a huge Obamacare profit in 2014 partly by hindering access to care. That triggered a $107-million-excess-profit tax that it then forced enrollees to pay, at a cost of $223 each.
Nonprofit Blue Shield is planning to include in its Obamacare rates for next year the highest profit and administrative expense margin of any California health insurer.
Blue Shield must pay rebates of over $100 per enrollee and hand over to the government $93 million in excess profits because it overcharged for Obamacare coverage in 2014.