Firm Settles Class Parity Act Claim

Jordan Lewis, P.A. and cocounsel Milberg Coleman Bryson Phillips Grossman have negotiated a $1,415,000 classwide resolution of a complaint alleging violations of the federal Mental Health Parity And Addiction Equity Act in R.B. v. United Behavioral Health, 1:21-CV-00553 (N.D.N.Y.).  The settlement was preliminarily approved by Judge David Hurd on January 17, 2025.

The Class consists of:

All persons covered under ERISA-governed health care plans, administered or insured by United Behavioral Health, whose requests for coverage for mental health and substance abuse treatment services received at a licensed residential treatment center were denied in total based on its determination that a component of such services is considered experimental, investigational, or unproven.

Notices to Class Members will be mailed by the claims administrator starting February 14.  Among other things, the notice will describe the terms of the substantive terms of the settlement and how plaintiff proposes to distribute the class fund among Class Members. The Court has scheduled a hearing on the settlement, to be conducted telephonically, at 1 p.m. on May 28, 2025. Class Members who wish to object to the settlement must do so by March 31, 2025. Plaintiff will file a motion for attorneys’ fees, class representative award and the reimbursement of costs no later than May 7, 2025.

A Monetary Benefit will be allocated to each Class Member for which there is any valid claim by Settlement Tier.  The estimated amount of Monetary Benefit set forth below and in the Plan of Allocation (attached to the Settlement Agreement) is based on Counsel’s best estimate of what the Monetary Benefits will be for each Settlement Tier based on available information and the Plan of Allocation negotiated between the Parties as part of the Settlement.  The precise dollar amounts ultimately Class Members will receive could vary substantially from these estimates and will depend on the amounts the Court awards for Attorney fees, costs, and any Incentive Award for the Named Plaintiff, and the extent to which Class Members can be located by the Settlement Administrator, among other factors. 

1. If the designation WILDERNESS appears on your Notice, you sought coverage for Wilderness Therapy from Defendant and your request was denied. The Parties’ best estimate is that you will receive approximately $950.
2. If the designation MULTIPLE appears on your Notice, you sought coverage from Defendant for treatment received at a non-wilderness residential treatment program , and your request was denied for multiple reasons. The Parties’ best estimate is that you will receive approximately $9,500.
3. If the designation EXPERIMENTAL appears on your Notice, you sought coverage from Defendant for treatment received at a non-wilderness residential treatment program, and your request was denied because a component of the treatment you received was determined by Defendant to be experimental, investigational, or unproven. The Parties’ best estimate is that you will receive approximately $19,000.

Under the terms of the Settlement Agreement, all Class Members, and each of their respective heirs, executors, administrators, predecessors, successors, insurers, and assigns will fully release the Released Persons (as defined in the Settlement Agreement) from Released Claims.  Released Claims means any and all actions, causes of actions, claims, and demands that are, were, or could have been asserted by Named Plaintiff or any Class Member in the Action during the Class Period, regardless of legal theory, known or unknown, concerning any claims arising out of or related to a denial of coverage (including any pre or post-service denial, initially or on appeal) by any Released Persons for mental health or substance abuse treatment received at a residential treatment or wilderness program, based in whole or in part on a determination that the treatment or a component of the treatment was experimental, unproven or investigatory. 

The Complaint is here. The Court’s class certification order is here. A draft notice that describes all the relevant information needed by class members is here. The terms and conditions of the Settlement are set forth in the Settlement Agreement, which can be found here.  The Court’s preliminary approval order is attached here.