Featured Business Litigation Verdict: Blue Shield of California Settles Affordable Care Act Class Action Lawsuit for $18.5M

Case No. CJC-14-004800 – Ernesto Jimenez et al v. BMC West, LLC et al

Plaintiffs filed a Class Action lawsuit against Defendant, Blue Shield of California (“Blue Shield”), in which Plaintiffs alleged that Blue Shield engaged in unfair business practices under California law, including violations of the Consumer Legal Remedies Act (California Civil Code Section 1750 et seq.) and Unfair Competition Law (California Business and Professions Code Section 17200 et seq.). Plaintiffs signed up for health care plans with Blue Shield under the Patient Protection and Affordable Health Care Act of 2010. After Plaintiffs discovered that Blue Shield managed two separate provider networks—a large network and a smaller, more exclusive subset of the large network—Plaintiffs alleged that they were provided medical services through the large network, which did not cover all such services. As a result, Plaintiffs incurred greater expenses than originally anticipated. Plaintiffs alleged that they were falsely lead to believe that all such services would be covered under their health plan.

The Defendants denied all allegations.

The parties eventually settled for the sum of $18.5M. In addition, the court awarded Plaintiffs attorney fees and costs in the amount of $4.9M.