Ferrer, et al. v. CareFirst, Inc., et al

CASE NO.: 1:16-cv-02162 (USDC DC)

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

If you 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 August 1, 2012 and August 31, 2018, you may be entitled to a payment from the proposed settlement of a class action lawsuit.

Important Dates

March 11, 2019 - Postmark Deadline to Mail Requests for Exclusion.

March 11, 2019 - Postmark Deadline to File Objections with the Court.

April 9, 2019 at 11:30 A.M. - Final Approval Hearing.

July 8, 2019 - Deadline to Submit a Claim Form. Postmark Deadline for mailed Claim Forms.

YOUR RIGHTS AND OPTIONS, AND THE DEADLINES TO EXERCISE THEM, ARE EXPLAINED IN THE NOTICE. PLEASE READ IT CAREFULLY.

A federal court authorized the Notice. This is not a solicitation from a lawyer.

  • There is a proposed settlement ("Settlement") with CareFirst, Inc., Group Hospitalization and Medical Services, Inc., CareFirst of Maryland, Inc., and CareFirst BlueChoice, Inc. ("CareFirst") in a class action lawsuit, Lindsay Ferrer, Amy Haddad and Sarah Sorscher, et al. v. CareFirst, Inc., et al, Case 1:16-cv-02162 (USDC DC) (the "Action"). CareFirst also does business as CareFirst BlueCross BlueShield.
  • The Settlement involves health care coverage for comprehensive breastfeeding and lactation support and counseling services ("CLS"), which is a mandated preventive health service under the Patient Protection and Affordable Care Act (the "ACA").
  • The Settlement will resolve a lawsuit over whether CareFirst violated federal law and the terms of its sponsored and administered health plans with respect to coverage and adjudication of claims for CLS. CareFirst denies all of the Plaintiffs' claims, but has agreed to the Settlement to resolve the Action.
  • The Action and Settlement do not apply to people who were insured under: a federal employee health plan, or, a grandfathered health plan, sponsored or administered by CareFirst, as explained in Question 3.
  • The Action and Settlement do not apply to breastfeeding supplies and equipment, including breast pumps. The Action and Settlement apply to breastfeeding support and counseling services, as explained in Question 1.
  • Under the Settlement, Class Members will release all legal claims they may have against CareFirst relating to coverage for CLS received between August 1, 2012 and August 31, 2018.
  • If you have questions, call 1-855-441-2329. You can also write to the CareFirst ACA Settlement Claims Administrator, PO Box 58116, 1500 John F Kennedy Blvd, Ste. C31, Philadelphia, PA 19102.

SUMMARY OF YOUR LEGAL RIGHTS AND OPTIONS FOR THE SETTLEMENT:
I. To Receive a Settlement Payment:

A. DO NOTHING:

If you remain in the Settlement Class, you will give up your right to sue CareFirst for certain claims, described in Question 6.

If a Claims Data Sheet (yellow) accompanies the Notice, You automatically are included in the Settlement Class. Your CLS Settlement Payment will be calculated and paid based on CareFirst's records, as reflected on the Claims Data Sheet.

If you do nothing, you will receive the CLS Settlement Payment, but in order to be eligible for a Balance Bill Settlement Payment, you must Respond.

Section A of the Chart Provided in Question 5 Contains Important Details.

B.RESPOND:

Your Proof of Claim Form and documents (if required), must be postmarked no later than July 8, 2019.


If you remain in the Settlement Class, you will give up your right to sue CareFirst for certain claims, described in Question 6.

If a Pre-Populated Proof of Claim Form (pink or blue) accompanies the Notice, you need to follow the directions on the Pre-Populated Proof of Claim Form and timely respond with the requested information in order to be eligible to potentially receive a CLS Settlement Payment.

Sections B and C of the Chart Provided in Question 5 Contain Important Details.

Complete a blank Proof of Claim Form (white), if:

- You did not receive a Claims Data Form or a Pre-Populated Proof of Claim Form, and you believe that you are a Class Member, and that between August 1, 2012 through and including August 31, 2018, you sought and received CLS or incurred a claim for CLS, for which you incurred co-payments, co-insurance, or a deductible, or
- You believe that you had another CLS Claim during the Class Period that is not included in the Claims Data Sheet or the Pre-Populated Proof of Claim Form.

Your Claim will be reviewed to determine whether you are entitled to receive a CLS Settlement Payment based on the information You submit. Click here to download a blank Proof of Claim Form.

Section D of the Chart Provided in Question 5 Contains Important Details.

Complete the Balance Bill Claim section on the Claims Data Sheet and/or Proof of Claim Form, if with respect to a CLS Claim, you incurred a balance bill, which is the difference between the amount paid to an out-of-network provider and any reimbursement made to You by CareFirst for the CLS Claim.

Your Claim will be reviewed to determine whether you are entitled to receive a Balance Bill Settlement Payment based on the information You submit.

Section E of the Chart Provided in Question 5 Contains Important Details.

II. To Exclude Yourself From This Settlement:

Your Request for Exclusion Must be Postmarked no later than March 11, 2019

You may exclude yourself from the Settlement (also known as "opting out" or "opt out") by submitting a letter to Class Counsel at the address in Question 9. If you exclude yourself from the Settlement, you will not give up your claims against CareFirst, and you will not be bound by any judgments or orders of the Court as to the Settlement. However, you also will not be eligible for any payment from the Settlement nor will you be able to object to the Settlement.

For information about how to exclude yourself from the Settlement, see Questions 8, 9 and 10.

III. To Object or Comment on This Settlement:

Your Written Objection Must be Postmarked no later than March 11, 2019

You may object to the Settlement in writing to the Court, informing it why you don't think the Settlement should be approved. You can also write the Court (with copies to the attorneys) to provide comments or reasons why you support the Settlement. For more information on objecting or commenting on the Settlement, see Question 11.

If you object to the Settlement but do not exclude yourself ("opt out") you will remain a member of the Settlement Class.

IV. Go to the Final Approval Hearing:

Your Notification to Appear at the Hearing Must be Postmarked no later than March 11, 2019

The Court will hold the Final Approval Hearing on April 9, 2019 at 11:30 A.M. in Courtroom 10- 4th Floor of the United States District Court for the District of Columbia, 333 Constitution Avenue N.W., Washington, D.C. 20001. At the Final Approval Hearing, the Court will consider and determine whether the Settlement is fair, reasonable, and adequate, and consider Class Counsel's request for attorneys' fees, costs, and expenses, and for Service Awards for the Plaintiffs.

You may attend or speak at the Final Approval Hearing. If you want to speak, you must notify the Court and the parties in writing by March 11, 2019 stating that you intend to speak at the Final Approval Hearing. You cannot speak at the Final Approval Hearing if you opt out of the Settlement. For more information, see Question 17.


Contact the Claims Administrator

MAIL:
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

EMAIL: Questions@CareFirstBreastfeedingSupportClassAction.com

CALL TOLL-FREE: 1-855-441-2329