Peters v. Aetna Inc. et al

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF NORTH CAROLINA
ASHEVILLE DIVISION
CIVIL CASE NO. 1:15-cv-00109-MR
SANDRA M. PETERS, on behalf of )
herself and all others similarly )
situated, )
)
Plaintiff, )
)
vs. ) O R D E R
)
AETNA INC., AETNA LIFE )
INSURANCE COMPANY, and )
OPTUMHEALTH CARE SOLUTIONS, )
INC., )
)
Defendant. )
________________________________ )
THIS MATTER is before the Court on the Plaintiff’s Notice of Filing
Proposed Class Notice [Doc. 302]; the Defendants’ Response and
Objections to Plaintiff’s Proposed Class Notice [Doc. 303]; and the Plaintiff’s
Reply in Support of Her Proposed Class Notice [Doc. 304].
On June 5, 2023, the Court entered an Order certifying the following
classes:
• Plan Claim Class: All participants or
beneficiaries of self-insured ERISA health
insurance plans administered by Aetna for
which plan responsibility for a claim was
assessed using an agreed rate between
Optum and Aetna that exceeded the provider’s
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contracted rate with Optum for the treatment
provided.
• Member Claim Class: All participants or
beneficiaries of ERISA health insurance plans
insured or administered by Aetna for whom
coinsurance responsibility for a claim was
assessed using an agreed rate between
Optum and Aetna that exceeded the provider’s
contracted rate with Optum for the treatment
provided.
[Doc. 272 at 43-44].
Pursuant to the Pretrial Order and Case Management Plan entered on
May 7, 2024, the Plaintiff now submits a proposed class notice. [Doc. 302].
The Defendants object to the Plaintiff’s proposed notice, arguing: (1) the
proposed class notice does not accurately reflect the Plaintiff’s surviving
claims and (2) the proposed class notice describes classes that do not satisfy
Rule 23’s ascertainability and predominance requirements or ERISA’s
tracing requirements. [Doc. 303 at 1-3]. The Defendants also raise a
number of procedural issues related to the logistics of sending out any such
proposed notice. [Id. at 4-5]. In response to the Defendant’s objection
pertaining to the wording of the classes, the Plaintiff proposes to add the
phrase “for a claim” to the summary description of the classes set forth in the
first bullet point of the notice such that this first bullet reads as follows:
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If, in connection with such claims, Aetna imposed a
fee for administrative services performed by its
vendor OptumHealth Care Solutions, Inc. (“Optum”),
you may be a member of the two classes certified by
the Court in this lawsuit: (i) a class of plan members
who paid more for a claim than they should have
(referred to herein as the “Member Class”); and/or (ii)
a class of plan members whose Aetna Plans paid
more for a claim than they should have (referred to
herein as the “Plan Class”).
[See Doc. 304 at 2].
The Court concludes that the language of the Plaintiff’s proposed
notice, as revised, is appropriate and therefore will authorize distribution of
the notice. See Hoffman-La Roche Inc. v. Sperling, 493 U.S. 165, 172 (1989)
(holding a district court has discretion to authorize distribution of a notice it
concludes is “timely, accurate, and informative”). As for the Defendant’s
argument that the proposed class notice describes classes that do not satisfy
Rule 23’s ascertainability and predominance requirements or ERISA’s
tracing requirements, this objection merely reasserts the arguments that the
Defendants have previously made, both to this Court and the Fourth Circuit,
regarding the certification of the classes. These arguments do not require
any alteration of the proposed class notice.
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As for the procedural issues raised by the Defendants, the parties are
directed to meet and confer in an expeditious manner to facilitate the prompt
service of the class notification on potential class members.
The Plaintiff’s proposed notice does not specify a particular notice
period. The Court concludes that a forty-five-day notice period is
appropriate. See Regan v. City of Charleston, No. 2:13-cv-3046-PMD, 2014
WL 3530135, at *10 (D.S.C. July 16, 2014) (“[D]istrict courts in the Fourth
Circuit regularly authorize opt-in periods between thirty and sixty days.”).
IT IS, THEREFORE, ORDERED that the Defendants’ Objections [Doc.
303] to the Plaintiff’s proposed notice [Doc. 302] are SUSTAINED IN PART
to the extent they have been incorporated into the revised proposed notice.
IT IS FURTHER ORDERED that Plaintiff’s revised proposed notice is
APPROVED, and the parties shall proceed with the service of the class
notification as set forth in the Pretrial Order and Case Management Plan
[Doc. 301].
IT IS SO ORDERED. Signed: May 27, 2024
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