The national antitrust settlement of a long-running antitrust suit against the Blue Cross Blue Shield Association and the nationos Blue plans is forcing significant strategic changes for the Blues, including Health Care Service Corp., the nationos second-largest owner of Blue Cross Blue Shield plans. The settlement agreement, hammered out among the BCBSA, plaintiff groups including both providers and policyhold-ers, and the Blue plans themselves, was approved in 2020. In addition to awarding $2.7 billion to the plaintiff class, the agreement re-writes the BCBSA-enforced rules that have kept the territorially-defined Blue plans from competing against each other to offer Blue-branded products to multi-state employer groups. It also ends BCBSA rules restricting the amount of onon-Blueo branded business a BCBSA member can do. This is a game-changer for HCSC, which has sufficiently deep pockets to make good strategic acquisitions and investments, but who will have to defend its huge base of national clients from Blue competitors, including Anthem.