Common Ground Healthcare Cooperative v. United States
Common Ground Healthcare Risk Corridors Class Action
Case No. 17-cv-00877-MMS

Welcome to the Risk Corridors Class Action 2016 Website

 

What is this Lawsuit About?

Plaintiff Common Ground Healthcare Cooperative claims that Defendant United States has not fully paid the risk corridors payments for 2016 to which it and other insurers such as your organization are entitled under the Affordable Care Act. Section 1342 of the Affordable Care Act established a risk corridors program that applied to insurers who offered QHPs on the Affordable Care Act's insurance exchanges in any of the 2014, 2015, or 2016 plan years. The risk corridors program provided that QHP issuers would receive compensation from the United States if their losses exceeded a certain defined amount due to higher-than-expected utilization and medical costs for the issuer's insureds. At the same time, the risk corridors program provided that QHP issuers would pay the government a percentage of any unexpectedly high profits they made over similarly-defined amounts. During 2014, QHPs collectively incurred almost $2.9 billion in compensable losses under the risk corridors program. Similarly, QHPs also incurred substantial compensable losses in 2015, totaling about $5.8 billion, and again incurred approximately $3.95 billion in compensable losses in 2016. Defendant United States has denied it is liable for the alleged losses.

Who is a Potential Class Member?

The Class is defined to include all persons or entities offering Qualified Health Plans under the Patient Protection and Affordable Care Act in the 2016 benefit year, and whose allowable costs in either the 2016 benefit year, as calculated by the Centers for Medicare and Medicaid Services, were more than 103 percent of their target amounts (as those terms are defined in the Patient Protection and Affordable Care Act).  Excluded from the Class are the Defendant and its members, agencies, divisions, departments, and employees.

What are my Rights and Options?

YOUR LEGAL RIGHTS AND OPTIONS IN THIS CLASS ACTION LAWSUIT:

Ask to Be Included

(Opt Into the Class)

Receive any risk corridor payments generated from this lawsuit, and be bound by its results.

If you are eligible to be a Class member and asked to be included by filling out the form mailed to you or located on the Important Documents page of this website, the Court will include you in the Class. As a Class member, you will have the right to receive a portion of any money that results from the Court’s decision in this case, but you will not be obligated in any way to conduct the lawsuit yourself.  You will be bound by any judgment or order in this case, both favorable and unfavorable.  This means that if you joined the Class, you will not be able to sue the United States separately for the same legal claims.

In order to join the Class, you must submit a Class Action Opt-In Notice Form electronically, by facsimile, by first-class mail, or by pre-paid delivery service. The Class Action Opt-In Notice Form must be submitted, faxed, postmarked, or delivered by Monday, April 23, 2018.

Do Nothing

Get no benefits from the lawsuit.  Keep rights to sue the United States separately.

By doing nothing, you will not be included in this lawsuit and you will have no rights to any money or benefits that may come from the Court’s decision. However, you keep the right to hire your own lawyer or proceed without counsel to sue the United States separately about the same legal claims in this lawsuit and you will not be legally bound by any decision of the Court in this class action.

 

You will not have to pay any money out of pocket to participate in the Class. If the Class is successful in this litigation, however, Class Counsel (defined below) will ask the Court’s permission to be compensated for litigating this case and representing the successful Class. Any sums received by Class Counsel in compensation will be deducted from any recovery, which will proportionately reduce the amount of any award each Class Member receives. If the case is unsuccessful, you will have no obligation for attorneys’ fees or costs.

Who is Class Counsel?

The Court has decided that attorneys at the law firm of Quinn Emanuel Urquhart & Sullivan, LLP, led by partners Stephen Swedlow, J.D. Horton, and Adam Wolfson, are qualified to represent you and all Class Members. Quinn Emanuel Urquhart & Sullivan, LLP is called “Class Counsel.” Class Counsel has experience handling this type of lawsuit. More information about Class Counsel is available at: www.quinnemanuel.com.

You do not need to hire your own lawyer because Class Counsel will work on your behalf and represent your interests if you join the Class. You have the right to have your own lawyer. Your own lawyer can appear in court for you if you want someone other than Class Counsel to speak on your behalf. If you choose to hire your own lawyer, you will have to pay that lawyer.

For more information including a Class Action Opt-In Notice Form and Detailed Notice, please visit the Important Documents page of this website.

KEY DATES

Date Event
April 23, 2018 Opt-In Deadline

FOR MORE INFORMATION

Visit this website often to get the most up-to-date information.

Mail

Risk Corridors Class Action Plan Year 2016
c/o JND Legal Administration
PO Box 91307
Seattle, WA 98111