Frequently Asked Questions

BASIC INFORMATION

  1. About these FAQs

    These Frequently Asked Questions and answers summarize the lawsuit, the Settlement, your legal rights, what benefits are available, who may be eligible for those benefits, and how to get them. For a more detailed and precise explanation of your legal rights and options, you can review the Settlement Agreement.

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  2. What is this lawsuit about?

    The persons and entities who started the lawsuit are the “Plaintiffs.” The company they sued, Blue Cross Blue Shield of Michigan (“BCBSM”), is the “Defendant.” The case is known as The Shane Group, Inc. v. Blue Cross Blue Shield of Michigan, Case No. 2:10-cv-14360.

    Plaintiffs allege that BCBSM violated federal and state laws by using most favored nation clauses in contracts with 70 general acute care hospitals in Michigan. Plaintiffs claim that these clauses inflated prices for healthcare services at several Michigan hospitals. BCBSM denies Plaintiffs’ allegations, denies any wrongdoing, and contends that its actions caused lower, not higher, hospital prices.

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  3. Why is this a class action?

    In a class action, one or more people (in this case, Michigan Regional Council of Carpenters Employee Benefits Fund, The Shane Group, Inc., Bradley A. Veneberg, Abatement Workers National Health and Welfare Fund, Monroe Plumbers & Pipefitter Local 671 Welfare Fund, Scott Steele, Anne Patrice Noah, and Susan Baynard) sue on behalf of businesses, other organizations, and people who have similar claims. If allowed by a court, all of these organizations and people become part of a “Class” or “Class Members.” One lawsuit resolves the claims of all Class Members, except for any who exclude themselves from the Class.

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  4. Why is there a Settlement?

    The Court did not decide in favor of Plaintiffs or BCBSM. Instead, both sides agreed to settle this case to avoid the burden, cost, and risk of further litigation. The Settlement does not mean that any law was broken or that BCBSM did anything wrong. By settling, BCBSM is not admitting any wrongdoing or liability. BCBSM continues to deny all legal claims in this case. The Plaintiffs and their lawyers think the Settlement is best for all Class Members.

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WHO IS INCLUDED IN THE SETTLEMENT

  1. How do I know if I am part of the Settlement?

    To see if you will be affected by this Settlement and if you are eligible to get money from it, you first have to determine if you are a Class Member.

    The Settlement includes all direct purchasers of healthcare services from a Michigan General Acute Care Hospital between January 1, 2006 and June 23, 2014. The Class includes:

    • Individuals who paid Michigan General Acute Care Hospitals in the form of co-pays, co-insurance, or otherwise;
    • Insurers that paid Michigan General Acute Care Hospitals for their insureds; and
    • Self-insured entities whose health plan participants received healthcare services at Michigan General Acute Care Hospitals.

    There are over 130 general acute care hospitals in Michigan. A list of these hospitals is available at the Documents page of this website. The Class does not include BCBSM and related individuals and entities.

    If you received a Postcard Notice in the mail, you have been identified as a potential Class Member based on insurance records. If you did not receive a Postcard Notice in the mail, you still may be a Class Member if you paid a Michigan General Acute Care Hospital during the relevant time period. If you are not sure whether you are included in the Settlement, you may send an email to info@MichiganHospitalPaymentsLitigation.com, call (877) 846-0588, or write to: Settlement Administrator, PO Box 3240, Portland, OR 97208-3240.

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THE SETTLEMENT - WHAT YOU GET AND GIVE UP IF YOU QUALIFY

  1. What does the Settlement provide?

    BCBSM will pay $29,990,000 into a Settlement Fund. This money, plus interest, will be paid to:

    • The lawyers representing the Class for their work and to reimburse the expenses they paid, in an amount approved by the Court;
    • An incentive award for the Plaintiffs for their services on behalf of the Class, if approved by the Court;
    • Expenses incurred in administering the Settlement, such as sending this Notice and the cost to process claims submitted by Class Members;
    • Class Members who submit valid Claim Forms; and
    • The non-profit organization Free Clinics of Michigan, in certain circumstances.

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  2. How will be payments be calculated?

    Class Members with small purchases of hospital healthcare services may be eligible for minimum payments of up to $40. Class Members with large purchases may be eligible for much higher payments, with the size of their payment depending on the factors described below. The maximum possible payment is 3.5% of the Class Member’s total purchases of healthcare services from Michigan General Acute Care Hospitals from January 1, 2006 through June 23, 2014.

    The size of the payment will be determined by:

    • Which general acute care hospital(s) in Michigan the Class Member paid;
    • The amounts paid to the hospital(s) from January 1, 2006 through June 23, 2014; and
    • Which insurer paid the hospital, provided the insurance coverage, or administered the self-insured plan.

    The Settlement Administrator will review each Claimant’s reported purchases to determine how much money, if any, they will receive. For specifics on how payments will be determined, please see the Plan of Allocation available at the Documents page of this website.

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  3. When will Settlement money be distributed to Claimants?

    Settlement money will be mailed to Claimants after the Court approves the Settlement and after any appeals are resolved. It is uncertain when any appeals taken will be resolved, and resolving them can take time. Please be patient. Updates will be posted on this website as they become available.

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  4. What do I give up if the Settlement is given Final Approval?

    If the Settlement is given Final Approval, you and all other Class Members will release certain claims defined in the Settlement as “Released Claims.” In general terms, Class Members who do not validly request to be excluded from the Settlement will each release all of their claims against BCBSM and its affiliated persons and entities arising out of — or in any way relating to — BCBSM’s most favored nation clauses with Michigan General Acute Care Hospitals, or any matter or event arising out of the dispute being resolved in this Settlement. If the Settlement is given Final Approval, the claims that were asserted against BCBSM in the lawsuit will be dismissed, with prejudice. A complete copy of the Release is available on the Documents page of this website.

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SUBMITTING A CLAIM FORM

  1. How can I get a payment?

    To ask for a payment, you must submit a Claim Form. Claim Forms are available at the Documents page of this website, upon request from the Settlement Administrator, or by calling the toll-free number. You can also file online here.

    After carefully reading the Claim Form instructions, fill out the Claim Form, attach the required documentation, sign it, and mail it postmarked no later than November 16, 2014 to:

    Settlement Administrator
    PO Box 3240
    Portland, OR 97208-3240

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  2. What do I do if I have questions about the Claim Form?

    If you have questions about how to file a claim, call the toll-free number (877) 846-0588 or send an email to info@MichiganHospitalPaymentsLitigation.com or a letter to Settlement Administrator, PO Box 3240, Portland, OR 97208-3240.

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EXCLUDING YOURSELF FROM THE SETTLEMENT

If you do not want to participate in this Settlement, and you want to keep the right to sue BCBSM about the dispute in this case, then you must take steps to get out of the Settlement. This is called asking to be excluded from — or sometimes called “opting out” of — the Settlement.

  1. If I exclude myself, can I get anything from this Settlement?

    No. If you exclude yourself, you may not submit a claim for a payment from the Settlement, and you cannot object to the Settlement. However, if you ask to be excluded, you may sue BCBSM based on the dispute in this case.

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  2. If I do not exclude myself, can I sue later?

    No. Unless you exclude yourself, you give up the right to sue BCBSM for any of the claims that this Settlement resolves. You must exclude yourself from the Class to start your own lawsuit, continue with a lawsuit, or be part of any other lawsuit against BCBSM relating to the “Released Claims” described in Section H of the Settlement Agreement.

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  3. How do I exclude myself from the Settlement?

    To exclude yourself from the Settlement with BCBSM, you must send a letter by mail clearly stating that you want to be excluded from the Settlement in The Shane Group, Inc. v. Blue Cross Blue Shield of Michigan, Case No. 2:10-cv-14360. Include your name, your business name (if applicable), address, telephone number, signature, and date. If applicable, your letter must also describe the position that authorizes you to request exclusion on behalf of your company.

    You must mail your request for exclusion postmarked by September 24, 2014 to:

    Settlement Administrator
    PO Box 3240
    Portland, OR 97208-3240

    You cannot ask to be excluded on the phone, by email, or on this website.

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OBJECTING TO THE SETTLEMENT

  1. How can I tell the Court I don't like the Settlement?

    You can object to the Settlement if you do not like some part or all of it. You must give reasons why you think the Court should not approve the Settlement. You may also object to Plaintiffs’ Counsel’s request for attorneys’ fees, reimbursement of expenses, and Plaintiff incentive awards. To object, send a letter to the two addresses below, saying that you object to the Settlement in The Shane Group, Inc., v. Blue Cross Blue Shield of Michigan, Case No. 2:10-cv-14360, and file your objection with the Court. Be sure to include any papers or briefs that support your objections.

    You must file your objection with the Court no later than September 24, 2014 and mail your objection to these two addresses postmarked no later than September 24, 2014:

    PLAINTIFFS’ COUNSEL COUNSEL FOR BCBSM
    COHEN MILSTEIN SELLERS & TOLL PLLC
    Daniel A. Small
    Brent W. Johnson
    1100 New York Avenue, NW
    Suite 500
    Washington, DC 20005
    HUNTON & WILLIAMS LLP
    Todd M. Stenerson
    D. Bruce Hoffman
    2200 Pennsylvania Ave, NW
    Washington, DC 20037

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  2. What is the difference between objecting and asking to be excluded?

    Objecting is telling the Court that you do not like something about the Settlement. You can object only if you stay in the Class. Excluding yourself is telling the Court that you do not want to be part of the Settlement. If you exclude yourself, you cannot object to the Settlement because the Settlement no longer affects you.

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  3. What happens if I object and the Settlement is approved?

    If the Settlement is finally approved and you did not request to be excluded from the Settlement, you will remain a Class Member regardless of whether you objected. You will remain bound by the terms of the Settlement and will not be able to sue BCBSM about the claims in this case.

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THE LAWYERS WHO REPRESENT YOU

  1. Do I have a lawyer in the case?

    The Court appointed four law firms to represent the Class: The Miller Law Firm, P.C.; Cohen Milstein Sellers & Toll PLLC; Gustafson Gluek PLLC; and Wolf, Haldenstein, Adler, Freeman & Herz LLC. These four law firms, together with other law firms that have assisted them, are called “Plaintiffs’ Counsel.” You will not be charged for these lawyers. If you want to be represented by your own lawyer in this case, you may hire one at your own expense.

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  2. How will the lawyers in the case be paid?

    Plaintiffs’ Counsel will ask the Court for attorneys’ fees of no more than one-third of the Settlement Fund and reimbursement of the expenses they had in this case of approximately $3,500,000. Plaintiffs’ Counsel will also ask the Court to reimburse the costs of administering this Settlement. Plaintiffs’ Counsel’s application for attorneys’ fees and expenses will be filed with the Court by July 26, 2014 and posted on the Settlement website. Plaintiffs’ Counsel will also ask for incentive awards of up to $50,000 for each Plaintiff organization and up to $10,000 for each Plaintiff individual, for their services on behalf of the Class.

    The Court may award less than the amounts requested by Plaintiffs’ Counsel. Payments approved by the Court will be made from the Settlement Fund.

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THE COURT’S FAIRNESS HEARING

  1. How will the Court decide whether to approve the Settlement?

    At the Fairness Hearing, the Court will consider whether the Settlement is fair, reasonable, and adequate. The Court will also consider Plaintiffs’ Counsel’s request for attorney fees and expenses and Plaintiff incentive awards. If there are objections, the Court will consider them. After the Fairness Hearing, the Court will decide whether to approve the Settlement and how much to award for fees, expenses, and incentive awards.

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  2. When and where will the Court decide whether to approve the Settlement?

    The Court will hold the Fairness Hearing on November 12, 2014 at 2:00 pm, at the United States Courthouse, Theodore Levin U.S. Courthouse, 231 W. Lafayette Boulevard, Detroit, Michigan, 48226. A motion for Final Approval of the Settlement will be filed by Plaintiffs’ Counsel by October 24, 2014. The motion will also be posted on the Settlement website.

    The Fairness Hearing may be moved to a different date or time without additional notice, so it is recommended that you periodically check this website for updated information.

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  3. Do I need to come to the hearing?

    No. Plaintiffs’ Counsel will answer any questions the Court may have. However, you are welcome to attend the hearing at your own expense. If you send in a written objection, you do not have to come to the Fairness Hearing to talk about it. As long as you mailed your written objection on time, the Court will consider it. You also may pay your own lawyer to attend the Fairness Hearing, but his or her attendance is not necessary.

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  4. May I speak at the hearing?

    You may speak at the Fairness Hearing if you submitted an objection as described in the answer to Question 15 and stated in your objection that you wish to be heard at the Fairness Hearing. You cannot speak at the hearing if you exclude yourself from the Settlement.

    If you choose to appear in person at the Fairness Hearing, you can appear yourself or by retaining an attorney at your own expense to appear on your behalf. If the attorney is appearing on behalf of more than one Class Member, he or she must identify each of those Class Members.

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GETTING MORE INFORMATION

  1. What happens if I do nothing?

    If you are a Class Member and do nothing, you will not get a payment from this Settlement. And, unless you exclude yourself, you will not be able to start a lawsuit, continue with a lawsuit, or be part of any other lawsuit against BCBSM relating to claims being resolved by this Settlement, ever again.

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  2. How do I get more information?

    The Notice summarizes the Settlement. More details are in the Settlement Agreement available at the Documents page of this website. If you still have questions, call the Settlement Administrator at (877) 846-0588, send an email to info@MichiganHospitalPaymentsLitigation.com, or write to Settlement Administrator, PO Box 3240, Portland, OR 97208-3240.

    Please do not contact BCBSM, its counsel, the Court, or the Clerk’s office.

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NOTICE: This website provides a summary of the Settlement and is provided for informational purposes only. In the event of any discrepancy between the text of this website and the original text upon which it is based, the text of the original document shall prevail.

Questions? Contact the Settlement Administrator at (877) 846-0588 or info@MichiganHospitalPaymentsLitigation.com