J.P. v Premera, King County Cause No. 12-2-33676-8 SEA, was filed on October 15, 2012, on behalf of J.P., an individual with autism spectrum disorder (“ASD”) and on behalf of similarly situated individuals. J.P. alleged that Premera used uniform practices, policies and procedures designed to limit and exclude coverage of medically necessary ABA therapy to treat ASD. J.P. alleged that such system-wide practices violated the Washington State Mental Health Parity Act (“Parity Act”).
The parties engaged in extensive discovery related to Premera’s coverage policies regarding ABA therapy to treat ASD. In the fall of 2013, the parties agreed to attempt to negotiate a global settlement of this case along with A.G. v. Premera and R.H. v. Premera. The parties engaged in mediation on February 24, 2014, but a settlement agreement remained elusive. The parties then engaged another mediator to mediate an agreement in sessions held on March 14 and May 1, 2014. Late in the evening on May 1, 2014, the parties in each of the three cases reached a global Settlement Agreement, contingent upon final approval by all three Courts.
The main points of the agreement with respect to the J.P. class are described below. You are encouraged to review the entire proposed agreement, which is available here . All three Courts must approve the agreement before it can go into effect.
Comment on, Object to, or Support the Proposed Settlement Agreement.
You do not need to take any action to receive coverage for medically necessary applied behavior analysis therapy as described in the settlement agreement. Class members’ claims for ABA therapy damages, however, are NOT be released by this action. If you have such claims, you must pursue them within the relevant statute of limitations period. You should consult with an attorney if you have such claims.
Final Approval Hearing: January 16, 2015 at 1:00 p.m.
The A.G. v. Premera Court will hold a hearing on January 16, 2015 at 1:00 p.m. The hearing will be located in Courtroom E-815 at the King County Superior Court, 516 Third Avenue, Seattle, WA 98104. You are not required to attend the hearing.
A copy of the complaint is here . Premera’s answer is here .
The Court’s Order granting certifying a settlement class may be found here .
The Court’s Order preliminarily approving the proposed settlement agreement is here . Note, however, that the dates in this order have changed, and the new deadline for comments and objections is November 21, 2014, and the final hearing is January 16, 2015 at 1:00 p.m.
The class’s motion for preliminary approval is here , with supporting material here .
Check back here for updates on the approval and claims process. Class counsel filed a motion for attorney fees, costs and incentive awards, which is posted in “Key Court Documents and Filings, above.