Settlement Structure: Claims Made
Active: Open
Case Summary:This settlement resolves four class actions against a group of insurance companies, including UnitedHealth Group, Inc., UnitedHealthcare Insurance Company, Oxford Health Insurance, Inc., and others. The complaints alleged that the companies improperly reduced the benefits permitted for behavioral health services under a Tiered Reimbursement Policy, and also denied some patients coverage under a behavioral health services management program known as ALERT. They claimed that the company policies violated mental health parity laws.
Docket Number:17-cv-4160, 21-cv-02791, 21-cv-4533, and 21-cv-4519
Company: UnitedHealthcare Group
Filing Deadline: January 1, 2100
Class Period: November 22, 2013
Objection Deadline: November 22, 2021
Exclusion Deadline: November 22, 2021
Final Approval Hearing: December 16, 2021
Proof of Purchase:You do not have to do anything to be covered by the settlement.
Eligibility:You may be eligible if you belong to any of the three settlement classes below:
- The Doe/Smith Settlement Class is all members currently or formerly enrolled in fully-insured and self-insured ERISA Oxford and United plans who received out-of-network outpatient behavioral health services and whose reimbursements were reduced by 25% or 35% because they were provided by psychologists or master’s level counselors or social workers, respectively, for dates of service from November 22, 2013 on; or by 25% because they were provided by psychologists or master’s level counselors or social workers, for dates of service between November 22, 2013 and May 1, 2015.
- The DOL Settlement Class is all self-insured members of the Doe/Smith Settlement Class plus all fully-insured members whose plan documents did not disclose the Tiered Reimbursement Policy.
- The New York Attorney General Settlement Class is all members currently or formerly enrolled in fully-insured ERISA Oxford and United Plans and non-ERISA commercial Oxford and United plans (state and local government employee benefit plans, individual enrollees, church plans) in New York who received out-of-network outpatient behavioral health services and whose reimbursements were reduced by a certain percentage (including 25% or 35%) because they were provided by psychologists or master’s level counselors or social workers, respectively, from November 22, 2013 on.
United will make two lump-sum payments, of $3.6 million and $10 million, to pay the benefits of the settlement. Payments will cover portions of the alleged underpayments and will be distributed according to a plan of allocation. Those whose share is less than $15 will not receive a payment. United will also make changes to its policies.
Total Settlement Amount: $13.6 million
Class Representative Proposed Incentive Fee:$20,000
Law Firms:
Psych-Appeal Inc.
Zuckerman Spaeder LLP
Case Name: Doe v. UnitedHealth Grp., Inc. et al., Smith v. United Healthcare Ins. Co. et al., James v. UnitedHealth Group Inc. et al., and Walsh v. United Behavioral Health et al.
Settlement Website: United Healthcare Mental Health Parity Settlement Website
Claims Administrator:
Rust Consulting, Inc.
United Tiered Reimbursement Settlement Administrator,
c/o Rust Consulting, Inc. – 7408, PO Box 44,
Minneapolis, MN 55440-0044
mail@unitedoutpatientsettlements.com