BlueCross BlueShield South Carolina: Reporting Fraud

Blue Cross Blue Shield of South Carolina continues to receive reports from both the agent community and from members of consumers being moved to another carrier’s Individual Marketplace plan without their knowledge or consent. This fraudulent practice harms the consumer and, in many cases, prevents them from receiving healthcare.

As you encounter these incidents, ask your members to file a complaint. Consumers can file unauthorized plan switch complaints with the South Carolina Department of Insurance (DOI) and with Centers for Medicare & Medicaid Services (CMS). Below are steps to take to ensure the complaint is filed with both the South Carolina DOI and with CMS. If possible, consumers should include the National Producer Number (NPN) associated with the unauthorized plan switch within the complaint.

How to Report Unauthorized Plan Switch Complaints:

1. Submit the complaint to the South Carolina Department of Insurance using the following form: Insurance Fraud Complaint Online Form 
2. Submit consumer complaint to the South Carolina Department of Insurance using the following form: Consumer Complaint Form
3. Submit the complaint to CMS via email at FFMProdcuer-AssisterHelpDesk@cms.hhs.gov as an Unauthorized Plan Switch