December 12, 2018 – Haverford, PA -The United States District Court for the District of Colombia today granted the parties’ motion for preliminary approval of class action settlement to resolve claims that CareFirst denied coverage for comprehensive breastfeeding and lactation support and counseling services required under the Affordable Care Act and plan documents.
The proposed Settlement has two components encompassing both retrospective and prospective benefits flowing to the Class.
With respect to the retrospective relief achieved, the Settlement provides for a Class Member to receive Cash Payments: (i) a Comprehensive Lactation Services (“CLS”) Settlement Payment, which is a full reimbursement of the total amount of cost-sharing incurred for a CLS Claim; and, (ii) a Balance Bill Settlement Payment, which is 25% of the difference between an amount actually paid to an out-of-network provider and any reimbursement that had been received from CareFirst for the CLS Claim. For denied out-of-network claims and claims that were never submitted, the amount of the CLS Settlement Payment will equal (i) the network level of benefit, plus (ii) the Balance Bill Settlement Payment.
In regards to prospective relief, the Settlement would add trained providers of CLS to CareFirst’s network, and provide CareFirst’s insureds with (and the tools to access) relevant information about CLS coverage and participating providers.
You may obtain claim forms and other relevant Settlement documents, including the Settlement Stipulation, online at http://www.CareFirstBreastfeedingSupportClassAction.com, or by calling 1-855-441-2329.
You may also click on the below links to view other important Settlement documents.
Proposed Class Action Notice
Proof of Claim Form