Class Action Accusing UnitedHealthcare of Failing to Adequately Cover Comprehensive Lactation Services Moves Forward

On August 15, 2017, United States District Judge Vince Chhabria denied, in substantial part, UnitedHealthcare’s Motion to Dismiss Condry, et al. v. UnitedHealth Group Inc., et al., Case Number: 3:17-cv-00183-VC (U.S.D.C. N.D. California), an action filed against UnitedHealthcare charging it with violations of ERISA, the insurance contracts and the Affordable Care Act (ACA) for their failure to provide coverage for Comprehensive Lactation Benefits as a mandated preventive health service.

UnitedHealthcare argued that it covers these services as required by the ACA, even if the availability of these services are not communicated to plan participants, and irrespective of plan participants’ ability to identify, reach, or receive lactation services from any in-network providers. See, Order at pg. 3.  Judge Chhabria called these arguments “absurd,” saying that these services must be available “in a meaningful way” for the plan to comply with the ACA.  Id.

In finding that the “complaint adequately alleges that the defendants failed to provide meaningful coverage for these services”, Judge Chhabria denied UnitedHealthcare’s Motion as to the ERISA claims (for ERISA plaintiffs) and denied UnitedHealthcare’s Motion as to the contract and unjust enrichment claims (for the non-ERISA plaintiff).  Id. at pgs. 4-5. The Order did grant, but with leave to amend, the dismissal of the claim for discrimination under the ACA, 42 U.S.C. §18116(a) (Count III in this Action) stating that “[i]t seems as though the plaintiffs may be able to state a claim for sex discrimination.” Id. at pg. 5.