CareFirst Lactation Support Class Action Settlement

Breastfeeding mothers may be eligible to have their lactation support bills paid if they were denied coverage under a CareFirst health care plan.

A $3.6 million class action settlement has been reached to resolve claims that CareFirst Inc. and other related companies violated the Affordable Care Act by denying coverage for breastfeeding support and lactation benefits.

The settlement will benefit individuals who were enrolled in certain health plans with CareFirst Inc., Group Hospitalization and Medical Services Inc., CareFirst of Maryland Inc., or CareFirst BlueChoice Inc., and were not provided health coverage for Comprehensive Breastfeeding Support and Counseling Services received between Aug. 1, 2012 and Aug. 31, 2018.

Individuals who were covered by a federal employee health plan or a grandfathered plan are not eligible for this settlement.

The lactation benefits class action lawsuit, which was first filed in October 2016, claimed that CareFirst’s policy of denying coverage for lactation services was a violation of the Affordable Care Act and the Employee Retirement Income Security Act.

Provisions regarding lactation benefits were added to the Affordable Care Act, but Class counsel said that not all companies interpreted the provisions the same. Some companies completely altered their policies to comply while others were less forthcoming.

According to the class action allegations, CareFirst did not include trained lactation professionals in their coverage network. This meant that women reportedly had to see out-of-network providers and foot the bill themselves when CareFirst denied or only partially paid their claims.

In order to receive benefits under the CareFirst class action settlement, consumers need to file a valid claim by July 8, 2019. Proof of insurance claims for lactation benefits may be required to receive full compensation.

“With respect to the settlement’s benefits, plaintiffs highlight that there is no limit on the total dollar amount of the cash settlement payments that CareFirst may make to class members for authorized claims,” the CareFirst class action settlement states.

The settlement will also pay court costs and attorneys’ fees for Class counsel. The amount to be paid to attorneys will be approved by the court. Class representatives will be eligible to receive a service award of $2,500 in addition to payment under the settlement as compensation for their time in litigation.

The deadline to object or exclude yourself from the class action settlement is March 11, 2019.

Who’s Eligible

Individuals who were enrolled in certain health plans with CareFirst Inc., Group Hospitalization and Medical Services Inc., CareFirst of Maryland Inc., or CareFirst BlueChoice Inc., and were not provided health coverage for Comprehensive Breastfeeding Support and Counseling Services received between Aug. 1, 2012 and Aug. 31, 2018.

Individuals with a federal employee health plan or a grandfathered plan, sponsored or administrated by CareFirst, are not eligible for participation in the settlement.

Potential Award

CLS Settlement Payment: Compensation for out-of-pocket copayments, out-of-pocket coinsurance, and out-of-pocket expenses applied to a deductible.

Balance Bill Settlement Payment: 25 percent of the difference between the amount paid to an out-of-network provider and any reimbursement.

Proof of Purchase

Information regarding insurance claims may be required to secure payment under the settlement.

Claim Form

CLICK HERE TO FILE A CLAIM »

NOTE: If you do not qualify for this settlement do NOT file a claim.

Remember: you are submitting your claim under penalty of perjury. You are also harming other eligible Class Members by submitting a fraudulent claim. If you’re unsure if you qualify, please read the FAQ section of the Settlement Administrator’s website to ensure you meet all standards (Top Class Actions is not a Settlement Administrator). If you don’t qualify for this settlement, check out our database of other open class action settlements you may be eligible for.

Claim Form Deadline

7/8/2019

Case Name

Ferrer, et al. v. CareFirst Inc., et al., Case No. 1:16-cv-02162, in the U.S. District Court for the District of Columbia

Final Hearing

4/9/2019

Settlement Website

www.CareFirstBreastfeedingSupportClassAction.com

Claims Administrator

Ferrer, et al. v. CareFirst Inc., et al
CareFirst ACA Settlement Claims Administrator
PO Box 58116
1500 John F Kennedy Blvd, Ste. C31
Philadelphia, PA 19102
Questions@CareFirstBreastfeedingSupportClassAction.com
1-855-441-2329

Class Counsel

Nicholas E. Chimicles
Kimberly Donaldson Smith
Stephanie E. Saunders
CHIMICLES SCHWARTZ KRINER & DONALDSON-SMITH LLP

Defense Counsel

Patrick de Gravelles
CAREFIRST BLUECROSS BLUESHIELD, LITIGATION GENERAL COUNSEL