Michigan Appeals Court Finds Insurer's Access Fee Allowed In Service Contract

TROY, Mich. - The Michigan Court of Appeals on June 5 overturned a $1.14 million judgment in favor of Calhoun County in its dispute with Blue Cross & Blue Shield of Michigan (BCBSM) over access fees charged for coverage of Medicare-eligible individuals not part of a group insurance plan. The appeals court determined that the access fee, while not specifically spelled out in an administrative services contract (ASC) contract, was agreed to when the parties signed the contract giving BCBSM the duty of insuring Medicare-eligible, nongroup individuals (Calhoun County v. Blue Cross & Blue Shield of Michigan, No. 303274, Mich. App.; 2012 Mich. App. LEXIS 1073).

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