Nagel Rice Settles ERISA Class Action Against Horizon Blue Cross Blue Shield of New Jersey

By Greg Kohn

On July 9, 2014, a federal court in Newark (Hon. Stanley R. Chesler) granted final approval of a class action settlement in a case brought in 2009 against Horizon Blue Cross Blue Shield of New Jersey by a policyholder, a psychologist, and the New Jersey Psychological Association, challenging Horizon’s reimbursement of out of network healthcare claims.  Horizon denied any wrongdoing and contested the allegations in the lawsuit.

Under the terms of the agreement, Horizon will discontinue the use of the Ingenix database, except in limited circumstances, and will also discontinue the use of a Horizon database which was used to determine out-of-network payments.  Horizon also agreed to revise certain of its handbooks, marketing materials, and website disclosures to communicate these changes and to more clearly outline the methodology Horizon will apply to calculate the reimbursements under its plans’ out-of-network benefit provisions.

The settlement covers more than 2.8 million class members.  Judge Chesler said that the class response to the settlement was overwhelmingly positive.  Judge Chesler also praised Nagel Rice’s work stating that the firm handled the case in a “skilled and able” manner.

Under the agreement, Horizon agreed to pay counsel fees of $2.5 million to Bruce H. Nagel, of Nagel Rice in Roseland, who represented the class.  Horizon was represented by Phillip Sellinger and David Jay of Greenberg Traurig in Florham Park.

Click here for Law360’s article on the case

Click here for New Jersey Law Journal’s article on the case

The attorneys at Nagel Rice, LLP represent clients throughout New York and New Jersey in a wide range of matters including personal injury, automobile accidents, brain injuries, medical malpractice, business litigation, and class action cases.

About the Author
Greg Kohn is a partner at Nagel Rice and specializes in complex civil litigation cases, including professional malpractice, personal injury, class actions, wrongful death, products liability, and commercial litigation.  He has extensive experience representing clients in both state and federal court. Greg has tried many jury trials to verdict and has recovered over $50 million in settlements and verdicts in all types of personal injury matters including automobile accidents, wrongful death cases, slip and falls, and other catastrophic injury cases. Greg also handles medical malpractice cases, involving misdiagnoses, wrongful birth, and delayed cancer diagnosis. If you have questions regarding this article, you can contact Greg here.