T-Mobile Autism Therapy Benefits Coverage Class Action Settlement

A $676,935 class action settlement in a case alleging that T-Mobile’s employee benefit plan failed to cover Autism therapy has been preliminarily approved.

In February 2015, plaintiff A.D., through his parents and guardians, E.D. and H.D., filed the class action lawsuit alleging that T-Mobile USA Inc. Employee Benefit Plan, T-Mobile USA Inc. and United Healthcare Services Inc. failed to comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

The class action lawsuit contended that T-Mobile adopted a uniform policy excluding any coverage for applied behavior analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD), including any coverage that may be medically necessary. The plaintiffs alleged they were denied coverage for ABA therapy to treat ASD.

The T-Mobile Autism therapy benefits settlement agreement provides prospective relief following a “best practice” model for delivery of ABA therapy, as well as a settlement fund of $676,935 to address claims for reimbursement for any members who paid for ABA services out-of-pocket. Any attorney fees, costs, claims administrative costs and incentive awards are expected to be drawn from the settlement fund.

Class Members may not ask to exclude themselves from the settlement but those who wish to comment on, support, or object to, the settlement agreement, must do so by Dec. 22, 2016.

Who’s Eligible

You are an eligible Class Member if you or your dependent:

• Have been participants or beneficiaries in the T-Mobile Employee Benefits Plan at any time between Jan. 1, 2010 and the date the settlement is granted final approval by the court; or
• Had an Autism diagnosis and received ABA therapy to treat Autism during the Class Period; or
• Are participants or beneficiaries in the T-Mobile Employee Benefits Plan and qualify for future ABA therapy to treat Autism

If you have unreimbursed claims for ABA therapy from Jan. 1, 2010 through Dec. 31, 2014, then you are eligible to make a claim for reimbursement.

Potential Award

Varies.

It is expected that the $676,935 settlement will be sufficient to pay all valid and timely submitted claims at 100 percent, even after payment of attorneys’ fees, court and claims administration costs, and incentive awards.

However, if the settlement fund is not sufficient enough to pay all Class Members who filed valid claims at 100 percent after the payment of attorneys’ fees, court and claims administration costs, and incentive awards, then the settlement will be distributed pro rata among eligible Class Members.

Proof of Purchase

In addition to filing a Claim Form, you must verify that the person who received the ABA therapy had a DSM diagnosis for Autism and provide proof of the following information:

• The date of service (month/year)
• The name of the provider on that day and each provider’s address and phone number, if available
• A short description of the service
• The amount paid or debt owed related to the service

Proof of ABA therapy dates can be evidenced by clinical notes, an appointment schedule/log created at the time of treatment, invoices seeking payment that include dates of service, or other evidence of similar reliability.

The identity of the provider of ABA therapy can be evidenced by identification on clinical notes, appointment schedule/logs, invoices, or other documents of similar reliability.

Proof of payment or debt owed may consist of: cancelled checks, credit card account statements, provider ledgers, invoices stamped “paid” or showing amounts due, checking account statements, signed letters from the provider or provider’s employer documenting the amount paid or debt incurred (so long as the letter clearly connects payments or debt with specific ABA therapy dates), or other evidence of similar reliability and containing similar specificity connecting payments/debt to the ABA therapy date(s).

Claim Form

CLICK HERE TO FILE A CLAIM »

Claim Form Deadline

12/22/2016

If you have unreimbursed claims for ABA therapy from Jan. 1, 2010 through Dec. 31, 2014, then you should make a claim for reimbursement.

Case Name

A.D., et al. v. T-Mobile USA Inc. Employee Benefits Plan, et al., Case No. 2:15-cv-00180 RAJ, in U.S. District Court for the Western District of Washington at Seattle

Final Hearing

1/5/2017

Settlement Website

www.symslaw.com/T-MobileSettlement

Claims Administrator

T-Mobile USA Inc. Employee Benefit Plan Settlement Claims Processor
1700 7^th Avenue, Suite 116 #330
Seattle, WA 98101

If you have questions regarding the settlement or the claims process, please call Class Counsel at 206-223-0303 or you can also email Class Counsel at rspoonemore@sylaw.com or ehamburger@sylaw.com.

Class Counsel

Richard E. Spoonemore
Eleanor Hamburger
SIRIANNI YOUTZ SPOONEMORE HAMBURGER

Defense Counsel

Barbara J. Duffy
Ryan P. McBride
LANE POWELL PC