Anthem agrees to $13M settlement to end mental health class action

Anthem class action settlement overview:

• Who: Anthem agreed to pay nearly $13 million to end a mental health class action lawsuit.
• Why: A class of health plan participants alleged Anthem applied overly restrictive criteria to claims for residential inpatient behavioral health treatment.
• Where: The class action settlement was filed in New York federal court.
• How to File a Claim: The settlement website isn’t live yet. Subscribe to our free newsletter, and we’ll notify you as soon as claim instructions are available.

Anthem agreed to pay nearly $13 million to end a class action lawsuit alleging the insurer’s coverage denials for inpatient mental health and substance use disorder treatments violated federal benefits and mental health parity laws.

A class of participants in employer-provided, Anthem-administered health plans filed a motion for preliminary approval of the class action settlement in New York federal court.

The Anthem mental health class action lawsuit was initially filed in April 2020. The plaintiffs alleged Anthem applied overly restrictive criteria to claims for residential inpatient behavioral health treatment, which went against their own plans’ stated terms for coverage and violated the Employee Retirement Income Security Act (ERISA).

The class also alleged the coverage denials violated the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which states health plans’ limitations on behavioral health treatment cannot be more restrictive than what is applied in the medical and surgical context.

Anthem mental health class action settlement provides nominal payments to class members

Under the terms of the Anthem mental health settlement agreement, Anthem will make a lump sum payment of nearly $13 million, which will be deposited in a settlement fund after subtracting administration costs, attorney fees and other expenses, including case contribution awards for the lead plaintiffs in the case.

All settlement class members will receive a nominal payment of $100 or a pro rata reimbursement based on their individual claims, subject to certain maximums.

The court originally certified the class in March 2024. The certified class includes any member of a health benefit plan governed by ERISA administered by Anthem who was denied behavioral health coverage for lack of medical necessity based on certain guidelines subject to the suit and in defiance of their plan terms.

In related news, another health insurer, Aetna, recently agreed to a $3.4 million settlement to resolve allegations the company wrongly denied claims for proton beam cancer radiation treatment.

What do you think about the Anthem mental health settlement agreement? Tell us in the comments.

The plaintiffs are represented by D. Brian Hufford, Caroline E. Reynolds and Jason S. Cowart of Zuckerman Spaeder LLP, Julie Selesnick of Berger Montague and Meiram Bendat of Psych Appeal Inc.

The Anthem mental health class action lawsuit is Collins, et al. v. Anthem Inc., et al., Case No. 2:20-cv-01969, in the U.S. District Court for the Eastern District of New York.

Read About More Class Action Lawsuits & Class Action Settlements:

• Google must pay Android users $314M for secretly harvesting their data
• Dialpad class action claims AI tech company illegally ‘taps’ T-Mobile customer service calls
• Chrysler recalls over 250,000 vehicles due to dangerous airbag issues
• Kraft Heinz recalls 368,000 pounds of cooked turkey bacon over listeria concerns