Class Action Filed Against Anthem On PPO Terminations

A class action lawsuit has been filed against Anthem Blue Cross of California by the Santa Monica-based advocacy group Consumer Watchdog over keeping its individual PPO plans in force in 2017.

The suit, filed in Los Angeles County Superior Court, accuses the health plan of practicing a “bait-and-switch” scheme with its enrollees.

“Customers are being transitioned from coverage that provides comprehensive coverage for doctors and hospitals that are not participating in Anthem’s provider network, to coverage that provides no out-of-network care whatsoever,” the suit claims, contending that Anthem has merely said that coverage was being changed rather than reduced. “This change leaves customers potentially facing thousands of dollars or more in medical bills that would have been covered under their existing plan.”

The suit claims Anthem is breaching contracts with its PPO enrollees by not adequately informing them of a switch over to an EPO plan, and by also raising premiums.

Consumer Watchdog has regularly engaged in litigation with Anthem over the years regarding moving enrollees into less comprehensive coverage. Anthem has not issued a statement in response to the litigation.