National Women’s Law Center and Law Firm Emery Celli Brinckerhoff Abady Ward & Maazel, LLP Announce Settlement of Class Action Lawsuit Against Aetna Over LGBTQ+ Fertility Coverage
2024年5月4日 - 3:23AM
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The plaintiffs, who are represented by the National Women's Law
Center and Emery Celli Brinckerhoff Abady Ward & Maazel LLP,
who brought a federal class action suit against Aetna over claims
of discriminatory practices faced by LGBTQ+ policyholders seeking
fertility treatment have reached a settlement with the insurance
company, subject to Court approval.
The suit had alleged Aetna’s policy for coverage of artificial
insemination and in vitro fertilization (IVF) treatments
discriminated against LGBTQ+ beneficiaries by requiring them to pay
more out of pocket and wait longer than heterosexual couples.
The proposed settlement between Aetna and plaintiffs, Emma
Goidel, Ilana Lee, Madeleine Lee, and Lesley Brown was filed May 3,
2024, in the U.S. District Court for the Southern District of New
York.
In the lawsuit Goidel et al. v. Aetna, filed in September 2021,
the plaintiffs challenged Aetna’s definition of infertility,
alleging it led to unequal insurance coverage treatment for LGBTQ+
couples. Under Aetna’s policy, a female health plan beneficiary
with a male partner could receive coverage for infertility
treatments by claiming the couple had been unable to become
pregnant after six or twelve months (depending on their age) of
intercourse.
However, couples in LGBTQ+ relationships trying to conceive were
required to pay out of pocket for their first six or twelve cycles
of artificial insemination before they could get coverage for any
additional rounds or become eligible for IVF if otherwise covered
by their plan.
Plaintiffs alleged this policy violated Section 1557 of the
Affordable Care Act, as well as state and city law for some types
of insurance plans.
Under the proposed settlement, Aetna denies liability under
these laws, but has agreed to implement the following policy
changes:
- Aetna will modify its clinical policy to be consistent with
guidelines recently published by the American Society for
Reproductive Medicine, whereby all eligible plan members will have
equal access to fertility treatment regardless of sexual
orientation.
- Aetna will introduce a new standard health benefit plan that
includes artificial insemination as a benefit for all Aetna members
regardless of sexual orientation.
- Aetna will take steps to ensure that requirements to proceed to
IVF in its clinical policies are no more burdensome for LGBTQ+
people than for heterosexual people.
Pursuant to the proposed settlement, Aetna will also compensate
class action members (i.e. members of certain New York commercial
insurance plans who were or would have been denied reimbursement
for artificial insemination) as follows:
- A $2 million common fund will be created to pay additional
compensation to each class member.
- Aetna will re-process eligible insurance claims to reimburse
class members for their out-of-pocket artificial insemination
cycles, up to the plan limits.
- Aetna will also separately pay all the costs of the
administrator and special master who will allocate the common
fund.
"We celebrate this significant stride toward achieving justice
for LGBTQ+ people who have faced obstacle after obstacle trying to
access the health care services that they need to build their
families," said Alison Tanner, Senior Litigation Counsel for
Reproductive Rights and Health at the National Women’s Law
Center. “We are eager to identify all affected class members,
and we remain dedicated to advocating for equal access to fertility
treatments for everyone, regardless of their sexual orientation or
gender identity."
“This settlement will deliver real compensation to LGBTQ+ people
affected by this policy and ensure a new, fair policy going
forward,” said Zoe Salzman, Partner at Emery Celli Brinckerhoff
Abady Ward & Maazel LLP.
"This settlement is a big win for queer families. It means so
many of us who hope to become parents or have more children can now
begin the journey to do that with the same access to fertility
treatment coverage as heterosexual couples," said Emma Goidel,
lead plaintiff on the case. "We hope other insurance companies
will follow Aetna's example and review their policies to make sure
everyone has equal access to fertility care."
If you believe you are in the class of individuals covered by
this settlement, please visit this page or contact:
1-800-205-6861.
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version on businesswire.com: https://www.businesswire.com/news/home/20240503191089/en/
Crystal Mojica, NWLC, cmojica@nwlc.org Zoe Salzman, ECBAWM,
zsalzman@ecbawm.com