United Healthcare Services Up Against ERISA Class Action

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A class action has been filed in Pennsylvania against United Healthcare Services, Inc. over alleged violations of the Employee Retirement Income Security Act of 1974 (ERISA). Although it is a health insurance provider, United Healthcare Services is defined as a fiduciary under ERISA and, as such, must adhere to the Act’s codes of loyalty and prudency and act in the sole interest of healthcare plan participants. The 24-page complaint outlines allegations that the company, despite requirements set forth by the Pregnancy Discrimination Act of 1978 (PDA) and the 2010 Affordable Care Act (ACA), failed to cover certain maternity-related expenses. Specifically, the complaint continues, even though the ACA mandates that insurers cover breastfeeding support and supplies, United Healthcare Services reportedly failed to provide in-network lactation consultants in the Philadelphia metro area and elsewhere in the U.S. Additionally, United Healthcare Services has allegedly refused to reimburse health and ERISA plan participants for expenses incurred because they were forced to go out of network.

Furthermore, the lawsuit says United Healthcare Services has failed to properly and in a timely fashion process participants’ benefits claims related to certain maternity expenses, adding that the company’s claims administration “is reminiscent of a Kafkaesque bureaucratic nightmare.”