Anthem Blue Cross of California
Felser-ACA Class Action Settlement for Individual Subscribers
December 5, 2016: Some previous Anthem Blue Cross members have received letters referencing this website and a phone number to call regarding settlement claims. Neither this website nor Kevin Knauss have sent out any letters to anyone regarding the Felser Class Action Lawsuit Settlement with Anthem Blue Cross. The Felser website listed below seems to have been compromised and security software such as McAfee are flagging it as suspicious. The 866-384-9362 provides a menu for information about the settlement, but does not provide additional information when a menu option is selected. It appears there may be a scam involving the Felser settlement being run through unsolicited letters to potential past and former Anthem Blue Cross members. To protect yourself, do not click on any website that is not trusted. Contact Anthem Blue Cross for information on the lawsuit.
April 25, 2016
Subscribers on Anthem Blue Cross (Anthem) individual ACA plans during 2014 are class action members under a class action settlement known as the Felser-ACA Settlement.
Class members may receive payments automatically under the settlement, or pursuant to claim forms, or simply the benefit of process and other improvements.
On May 5, 2016, class members will be sent the summary notice from Rust Consulting, a third party settlement class administrator working on behalf of Anthem and approved by the court. All class member questions about the settlement should be directed to Rust Consulting.
Class members can view the full notice and get more information at www.FelserAnthemBlueCrossACASettlement.com beginning May 5, 2016 or by calling Rust Consulting at 866-384-9362 FREE.
This article applies to:
- California
- Individual (under 65)
Summary Settlement Notice
Dear Current and Former Anthem Blue Cross Enrollees:
A proposed settlement of a class action affects you because you were enrolled in an Anthem Blue Cross of California health plan in 2014. You may be entitled to a payment under the settlement.
What does this settlement provide?
Payment: Anthem has agreed to reimburse Class Members a total of $14.9 million. The $14.9 million represents payments for out-of-network professional services as follows:
- Class Members enrolled in an Exclusive Provider Organization (“EPO”) plan will receive a payment equal to 70% of the “billed charges” for out-of-network services submitted to Anthem by the medical professional or Class Member. For EPO members, the settlement covers charges incurred in 2014 for services from any out-of-network professional.
- Class Members enrolled in a Preferred Provider Organization (“PPO”) plan will receive a payment equal to 50% of the “billed charges” submitted to Anthem for services provided by any medical professional potentially misrepresented as participating in an ACA PPO health plan. For PPO members, the settlement covers charges incurred in 2014 for services from any medical professionals who were listed as in-network in any Anthem ACA PPO plan but who were not participating in-network at the time medical services were provided.
Notably, EPO members have no plan benefits for treatment with out-of-network providers. By contrast, PPO members have some benefits for treatment with out-of-network providers. Accordingly, the settlement percentage for EPO members is higher than it is for PPO members. Once you receive your settlement check you can submit additional records supporting a larger reimbursement if you paid more for the out-of-network services. If you or your doctor have already submitted records of out-of-network services to Anthem, you do not need to do anything to receive reimbursement under the settlement.
Claims: Additionally, all Class Members may submit claims for out-of-network services that have not been previously submitted to Anthem. There is no cap on the claim fund for out-of-network claims for which Anthem does not have a record. If you have incurred charges for out-of-network services that have not previously been reported to Anthem, you must complete a claim form in order to get a payment. You do not need to submit the claim form at this time. Once the Court approves the settlement, Anthem will send you the claim form. For more information, visit: www.FelserAnthemBlueCrossACASettlement.com.
Changes to practices: Anthem has already made changes to its practices, and agreed to make additional changes, including measures to improve: member, provider, and broker understanding about ACA Plans, access to in-network providers, and accuracy of provider lists. Going forward, Anthem will treat a provider as in-network for billing purposes if a provider is listed in-network on Anthem’s Provider Directory and a member relies on that network status when seeking medical services. Anthem will treat that provider as In-network for billing purposes. More information is at: www.FelserAnthemBlueCrossACASettlement.com.
How do I get what I am entitled to?
Once the Court approves the Settlement, Anthem will mail you one of the following:
- A settlement check for the applicable percentage of your total billed amounts of charges for out-of-network services that Anthem has a record of. Enclosed with your settlement check will be a claim form to submit additional records supporting a larger reimbursement if you paid more for the out-of-network services.
- A claim form for payment of charges for out-of-network services that have not been previously submitted to Anthem. You will then have 30 days to complete and return the claim form to the address provided in order to get a payment.
If you do not Opt-Out of the settlement, you will release your right to sue Anthem for any and all known and unknown claims for relief, causes of action, suits, rights of action, or demands, at law or in equity, whether sounding in contract, tort, equity, or any violation of law or regulation, including, without limitation, claims for injunctive or other equitable relief, damages, debts, indemnity, contribution, or for costs, expenses and attorney’s fees, that were or could have been brought in the Lawsuits relating to the marketing and/or sale of ACA Health Plans, including issues relating to the accuracy of provider directories.
What else should I know?
For more information about the Lawsuits, the settlement, or how to object to or exclude yourself from the settlement, other important deadlines (which can change without notice), or the fees requested by attorneys, visit www.FelserAnthemBlueCrossACASettlement.com,
or call toll-free at 866-384-9362.
The Court will hold a Final Fairness hearing on August 12, 2016 at 9:00am to decide whether to approve the settlement. Check www.FelserAnthemBlueCrossACASettlement.com
periodically for updates.
SI NECESITA ASISTENCIA EN ESPAÑOL, POR FAVOR LLAME AL 866-384-9362.
