A Blue Shield tax filing and other records I cited in a whistleblower claim made to the IRS reveal possible tax evasion.
The information I dug up about Blue Shield and gave to regulators last month is now the basis of a class action lawsuit.
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.
The most profitable Obamacare insurer in 2014 was a nonprofit health plan--Blue Shield of California.
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 spent just 72% of Obamacare premiums on medical care in 2014, with the rest going to profits and administrative expenses.
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.
Blue Shield has structured its pending acquisition of Care 1st so that despite the recent revocation of its tax exemption it would escape state and federal taxes on its new business.