Tamara Burns  |  July 25, 2016

Category: Closed Class Actions

Top Class Actions’s website and social media posts use affiliate links. If you make a purchase using such links, we may receive a commission, but it will not result in any additional charges to you. Please review our Affiliate Link Disclosure for more information.

This settlement is closed!

Please see what other class action settlements you might qualify to claim cash from in our Open Settlements directory!

Anthem logo

A class action settlement has been reached with Anthem Blue Cross & Life Insurance Co. in California to resolve allegations that the healthcare insurance provider falsely advertised ACA-compliant health service plans to California subscribers.

The Anthem Blue Cross settlement covers four consolidated class action lawsuits including one initially filed by Betty Fesler in 2014 that claimed Anthem misled consumers into thinking that their healthcare plans under the Affordable Care Act, more commonly known as Obamacare, covered specific physicians and hospitals when they were not.

The allegations also claimed that Anthem concealed and failed to disclose that the provider network under the new ACA plans were much narrower than previous plans set forth by the company.

Class Members also accused Anthem of sending incorrect ID cards to members, or failing to send any member ID cards at all.

Anthem has continued to deny the allegations set forth in the class action lawsuits and both parties have come to an agreement that the settlement will best resolve the issues brought forth.

Entering into a class action settlement rather than proceeding to trial allows Class Members to acquire immediate monetary relief, and saves time, money, and the uncertainty of the trial outcome.

Eligible Class Members who visited a doctor or hospital thinking the entity was In-Network but was charged Out-of-Network fees during 2014 will automatically receive a payment.

With the information Anthem has on file for Out-of-Network claims for eligible Class Members, a total of $14,959,435 in checks will be mailed to eligible claimants. Additional monies may be paid by Anthem if Class Members submit more documentation of provider visits that were not recorded in Anthem’s system.

Additionally, Anthem has agreed to engage in new practices to improve the information provided to members, providers and brokers regarding the ACA-compliant plans, expand access to providers who are In-Network and maintain accurate provider lists.

Who’s Eligible

You are included in the Anthem Blue Cross class action settlement and can potentially get payment under the settlement if you were enrolled in an Anthem individual PPO or EPO health plan in 2014. The settlement only applies if you individually purchased a health plan and does not include those provided by an employer. It also does not apply to grandfathered health plans.

Potential Award

Varies.

Class Members will have the opportunity to recover all of the Out-of-Network expenses incurred during 2014.

Class Members enrolled in the EPO plan will receive a payment equal to 70% of the billed charges incurred.

Class Members enrolled in the PPO plan will receive 50% of the billed charges incurred.

After Class Members receive their Settlement check, if it does not include all of the expenses, they may submit additional records to receive additional payment.

Proof of Purchase

N/A

Claim Form

If Anthem has a record of your out-of-network medical services, you will automatically receive a check if the Court approves the settlement at the Aug. 12, 2016 Final Fairness Hearing.

If the amount of the reimbursement check does not fully reimburse you, you will be able to submit a Claim Form for additional amounts. Once the Court approves the settlement, Anthem will mail you the reimbursement check along with a “Claim Form for Out-of-Pocket Expenses in Excess of Settlement Payment.” You must submit the Claim Form for Out-of-Pocket Expenses in Excess of Settlement Payment within 30 days of receiving the reimbursement check in order to get an additional payment. This Claim Form will be available at the Settlement Administrator’s website after the settlement is approved:

felseranthembluecrossacasettlement.com

If Anthem does not have a record of your out-of-network medical services, you will receive a Claim Form that you MUST submit in order to receive a payment. You must submit the Claim Form within 30 days of receiving it in order to get a payment. This Claim Form will be available at the Settlement Administrator’s website after the settlement is approved:

felseranthembluecrossacasettlement.com

Claim Form Deadline

30 days from receipt of Claim Form.*

Following final approval and resolution of appeals, all eligible Class Members with records on file indicating they had Out-of-Network records will be mailed a check automatically from Anthem with no Claim Form needed.

*Members were mailed a Claim Form if Anthem had no record of Out-of-Network visits. Only Class Members who visited an Out-of-Network provider during the Class period and who did not submit the claim to Anthem must fill out the Claim Form. If you did not receive a Claim Form and believe you are eligible, contact the Settlement Administrator: 1-866-384-9362.

Case Name

Anthem Blue Cross Affordable Care Act Cases, Case No. 4805, Superior Court of the State of California for the County of Los Angeles.

Final Hearing

08/12/2016

UPDATE: On August 19, 2016, the court granted the Anthem Blue Cross Individual Health Plan settlement final approval.  Let Top Class Actions know when you receive a check in the comments section below or on our  Facebook page.

Settlement Website

www.FelserAnthemBlueCrossACASettlement.com

Claims Administrator

Fesler Settlement Administrator
P.O. Box 2508
Faribault, MN 55021-9508
1-866-384-9362

Class Counsel

Michael J. Bidart
Travis M. Corby
SHERNOFF BIDART ECHEVERRIA BENTLEY LLP

Jerry Flanagan
Laura Antonini
CONSUMER WATCHDOG

Robert S. Arns
Julie C. Erickson
Robert C. Foss
THE ARNS LAW FIRM

Scott C. Glovsky
Ari Dybnis
LAW OFFICES OF SCOTT C. GLOVSKY, APC

Defense Counsel

Kurt C. Peterson
Kenneth N. Smersfelt
REED SMITH LLP

Molly Moriarty Lane
MORGAN LEWIS & BOCKIUS LLP

We tell you about cash you can claim EVERY WEEK! Sign up for our free newsletter.

3 thoughts onAnthem Blue Cross Individual Health Plan Class Action Settlement

  1. JL says:

    only 2014?!?! This exact thing happened to me earlier this year (2016). Their website last nov said my hospital/doctor was included in the Platinum PPO plan but in fact it was considered out of network. That meant anthem covered 0.0% of the bill and not one penny of it counted towards Max out of Pocket. What bs. The hospital where I had the test wanted $8,000 from me. Their bs continues this year. Trying to convince me how wonderful and flexible their plans are by saying I have the option of going out of network. And when I look at the fine print it says that out of network service will incur a 100% co-insurance and its out of network so max out of pocket doesn’t apply.

  2. Top Class Actions says:

    UPDATE: On August 19, 2016, the court granted the Anthem Blue Cross Individual Health Plan settlement final approval. Let Top Class Actions know when you receive a check in the comments section below or on our Facebook page.

  3. David says:

    They should really should have a separate suit against Blue Shield of California for the same thing.

    They cut the payments to PCP under the ACA causing many to drop out without telling individual consumers that they were going to do that.

Leave a Reply

Your email address will not be published. By submitting your comment and contact information, you agree to receive marketing emails from Top Class Actions regarding this and/or similar lawsuits or settlements, and/or to be contacted by an attorney or law firm to discuss the details of your potential case at no charge to you if you qualify. Required fields are marked *

Please note: Top Class Actions is not a settlement administrator or law firm. Top Class Actions is a legal news source that reports on class action lawsuits, class action settlements, drug injury lawsuits and product liability lawsuits. Top Class Actions does not process claims and we cannot advise you on the status of any class action settlement claim. You must contact the settlement administrator or your attorney for any updates regarding your claim status, claim form or questions about when payments are expected to be mailed out.