Blue Cross of California said it will announce a policy decision this week involving a controversial exclusion on maternity benefits for new enrollees.
Blue Cross excludes coverage for prenatal care and maternity benefits for new enrollees holding individual-as distinct from group-policies for a 12-month period.
The Woodland Hills-based insurer is the target of a $200 million class-action suit filed in Los Angeles Superior Court alleging that its policy and that of Blue Shield of California violate state laws, including a law banning sex-based discrimination.
Blue Shield is not named as a defendant in that suit, which was filed last August and amended in January.
Blue Shield, which announced early this month that it's dropping the maternity benefit exclusion, still imposes a special $1,000 maternity deductible during the 12-month period, said Robert McNeill, an attorney for the two class-action plaintiffs. Besides, Blue Shield's new policy is not retroactive, he said.
McNeill said a separate suit will be filed against Blue Shield on March 4.
"We want to recover all the money for people who have been denied those benefits," which is probably close to 1 million people, McNeill said.
Although no amount is mentioned in the suit against Blue Cross, McNeill estimates the insurer owes at least $200 million to individual policyholders since it began offering the plan four years ago.
Patrick Garner, Blue Cross senior vice president, said he couldn't comment on the suit. But he said the maternity policy has been under review and a decision will be announced this week.