There is a proposed settlement (the “Settlement”) with Anthem, Inc. and Anthem UM Services, Inc. (together, “Anthem”) in a class action lawsuit, Collins et al. v. Anthem Inc., No. 2:20-cv-01969-FB-SIL (E.D.N.Y) (the “Lawsuit”).
The Settlement resolves a Lawsuit concerning whether Anthem complied with its obligations under the Employee Retirement Income Security Act of 1974 (“ERISA”) and the Mental Health Parity and Addiction Equity Act of 2008 (the “Parity Act”) in its administration of employer-sponsored health plans. The Lawsuit claims that Anthem denied certain coverage requests for residential treatment services, determining that the care was not medically necessary. It further alleges that Anthem applied medical necessity criteria that were more restrictive than generally accepted standards of care, the terms of the relevant health benefit plans, and the criteria used for comparable medical services.
Anthem denies all of the Plaintiffs’ allegations and claims but has entered into this Settlement to avoid the expense and uncertainty of litigation. The Settlement provides for monetary payments to Class Members.
Under the Settlement, Class Members will release any individual legal claims they may have against Anthem arising out of or related to Anthem’s denials of coverage for residential treatment of mental health conditions or substance use disorders for lack of medical necessity between April 29, 2017, and April 30, 2025 (the “Class Period”).
Your rights are affected whether you act or don’t act. Please read the Notice carefully and completely.
Summary of Your Legal Rights and Options in this Settlement | |
Remain a Member of the Class | To remain a Class Member for the Settlement, you do not need to do anything. You automatically will be included in the Class, and you will receive a Nominal Payment from the Settlement Fund. If you remain in the Class, you will give up your right to sue Anthem for claims relating to the subject matter of the Lawsuit. |
Submit a Claim for Reimbursement of Out-Of-Pocket Expenses | If you paid out-of-pocket for residential treatment services after Anthem denied your request for coverage, you may submit a claim for reimbursement of a portion of those expenses from the Settlement Fund. The amount you receive will depend in part on how many Class Members submit claims. It is unlikely you will receive a full reimbursement of all amounts you paid out-of-pocket. The claim form and your proof of payment must be submitted electronically or postmarked no later than January 20, 2026. |
Exclude Yourself from the Class | You may request exclusion from the Class (also known as “opting out”) by filling out the “Opt-Out Form” online or submitting an email or letter to the Settlement Administrator at the address below. The request for exclusion must be submitted electronically or postmarked no later than December 19, 2025. If you exclude yourself from the Settlement, you may pursue your claims individually, and you will not be bound by any judgments or orders of the Court as to the Settlement, but you will not be eligible for any payment from the Settlement, nor will you be able to object to the Settlement. |
Object to the Settlement | To object to the Settlement, you must send a copy of the appropriate papers via mail to the Court, Class Counsel, and counsel for Anthem. Their addresses are listed below. Your written objection must be filed with the Court and sent to Class Counsel and Anthem’s counsel no later than December 19, 2025. If you object to the Settlement, you will remain a Class Member. |
Go to a Hearing | You may ask to speak in Court about the fairness of the Settlement. The Court will hold a Fairness Hearing on January 26, 2026, at 11:00 a.m. to consider whether the Settlement is fair, reasonable, and adequate. The Court may also consider the motion for Class Counsel’s attorneys’ fees expenses and for incentive awards for the class representatives. If you want to speak at the Fairness Hearing, you must let the Court and the parties know by including in your objection a statement confirming you intend to appear at the hearing. Additionally, you cannot speak at the hearing if you opt out of the Settlement. |
Upcoming Important Dates
Notification Mailing
10/20/2025
Objection Deadline
12/19/2025
Opt Out Deadline
12/19/2025
Claim Deadline
1/20/2026
Fairness Hearing
1/26/2026 at 11:00 a.m.