The Shane Group, Inc. v. Blue Cross Blue Shield of Michigan United States District Court for the Eastern District of Michigan Case No. 2:10-cv-14360

Frequently Asked Questions



BASIC INFORMATION

  1. About these FAQs

    These Frequently Asked Questions and answers summarize the lawsuit, the Settlement, your legal rights, what benefits are available, who may be eligible for those benefits, and how to get them. For a more detailed and precise explanation of your legal rights and options, you can review the Amended Settlement Agreement.

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  2. What is this lawsuit about?

    The persons and entities who started the lawsuit are the “Plaintiffs.” The company they sued, Blue Cross Blue Shield of Michigan (“BCBSM”), is the “Defendant.” The case is known as The Shane Group, Inc. v. Blue Cross Blue Shield of Michigan, Case No. 2:10-cv-14360. Court records that were recently unsealed are available for your review on the Documents page of this website.

    Plaintiffs allege that BCBSM violated federal and state laws by using most favored nation clauses in contracts with 70 general acute care hospitals in Michigan. Plaintiffs claim that these clauses inflated prices for healthcare services at several Michigan hospitals. BCBSM denies Plaintiffs’ allegations, denies any wrongdoing, and contends that its actions caused lower, not higher, hospital prices.

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  3. Why is this a class action?

    In a class action, one or more people (in this case, Michigan Regional Council of Carpenters Employee Benefits Fund, The Shane Group, Inc., Bradley A. Veneberg, Abatement Workers National Health and Welfare Fund, Monroe Plumbers & Pipefitters Local 671 Welfare Fund, Scott Steele, Anne Patrice Noah, and Susan Baynard) sue on behalf of businesses, other organizations, and people who have similar claims. If allowed by a court, all of these organizations and people become part of a “Class” or “Class Members.” One lawsuit resolves the claims of all Class Members, except for any who exclude themselves from the Class.

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  4. Why is there a Settlement?

    The Court did not decide in favor of Plaintiffs or BCBSM. Instead, both sides agreed to settle this case to avoid the burden, cost, and risk of further litigation. The Settlement does not mean that any law was broken or that BCBSM did anything wrong. By settling, BCBSM is not admitting any wrongdoing or liability. BCBSM continues to deny all legal claims in this case. The Plaintiffs and their lawyers think the Settlement is best for all Class Members.

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WHO IS INCLUDED IN THE NEW SETTLEMENT

  1. How do I know if I am part of the new Settlement?

    The Settlement includes all direct purchasers of healthcare services from a Michigan General Acute Care Hospital between January 1, 2006 and June 23, 2014. The Class includes:

    • Individuals who paid Michigan General Acute Care Hospitals in the form of co-pays, co-insurance, or otherwise;
    • Insurers that paid Michigan General Acute Care Hospitals for their insureds; and
    • Self-insured entities whose health plan participants received healthcare services at Michigan General Acute Care Hospitals.

    There are over 130 general acute care hospitals in Michigan. A list of these hospitals is available on the Documents page of this website.

    The Class does not include BCBSM and related individuals and entities, such as past and present BCBSM employees and others released from liability by the Settlement Agreement. Under the terms of the Amended Settlement Agreement, the Class also does not include any person or entity who released BCBSM from liabilities related to the contract clauses at issue in this case.

    If you received a Postcard Notice in the mail, you have been identified as a potential Class Member based on insurance records. If you did not receive a Postcard Notice in the mail, you still may be a Class Member if you paid a Michigan General Acute Care Hospital during the relevant time period. If you are not sure whether you are included in the Settlement, send an email to info@MichiganHospitalPaymentsLitigation.com, call 1-877-846-0588, or write to:

    Settlement Administrator
    P.O. Box 3240
    Portland, OR 97208-3240

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THE NEW SETTLEMENT – WHAT YOU GET AND GIVE UP IF YOU QUALIFY

  1. What does the new Settlement provide?

    The new Settlement provides for BCBSM to pay $29,990,000 into a Settlement Fund. This money, plus interest, will be paid to:

    • The lawyers representing the Class for their work and to reimburse the expenses they paid or incurred, in an amount approved by the Court;
    • An incentive award for the Plaintiffs for their services on behalf of the Class, in an amount approved by the Court;
    • Expenses incurred in administering the Settlement, such as sending the Notice and the cost to process claims submitted by Class Members, in an amount approved by the Court;
    • Class Members who submit valid Claim Forms; and
    • The non-profit organization Free Clinics of Michigan, in certain circumstances.

    In the earlier Settlement, the Court awarded attorneys’ fees and expenses to Plaintiffs’ Counsel and incentive awards to the Plaintiffs, but the awarded money was not paid because of the Sixth Circuit’s ruling. Plaintiffs and their Counsel will make a new request for attorneys’ fees, expenses and incentive awards in connection with the new Settlement.

    Under the earlier settlement in this case, BCBSM paid $1 million of the $29,990,000 into the Settlement Fund in 2014 to pay for the cost of notifying the Class of the earlier settlement. The $1 million was spent for this purpose.

    Under the new Settlement, BCBSM has paid another $1.2 million of the $29,990,000 into the Settlement Fund to pay for the estimated cost of notifying the Class about the new Settlement. The Court has approved use of the $1.2 million to pay for the new notice costs. However, Plaintiffs’ Counsel will ask for $1.2 million less in attorneys’ fees in connection with the new Settlement (compared to their request in the earlier settlement), so the attorneys, and not the Class, will bear the estimated cost of the new notice.

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  2. Are there differences between the earlier settlement and the new Settlement?

    Yes. The new Settlement is slightly different from the earlier settlement. A redlined version of the Amended Agreement, available here, shows the differences from the earlier settlement. The two main differences are that BCBSM is no longer agreeing not to oppose Plaintiffs’ Counsel’s request for attorneys’ fees, expenses and plaintiff incentive awards, and BCBSM has agreed to pay (and did pay) a little over $1.2 million of the Settlement Amount into the Escrow Account to cover the estimated cost of notifying the Class of the new Settlement.

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  3. How will be payments be calculated?

    Class Members with small purchases of hospital healthcare services may be eligible for minimum payments of $25 and/or $15, depending on their particular purchases. Class Members with large purchases may be eligible for much higher payments, with the size of their payment depending on the factors described below. The maximum possible payment is 3.5% of the Class Member’s total purchases of healthcare services from Michigan General Acute Care Hospitals from January 1, 2006 through June 23, 2014.

    The size of the payment will be determined by:

    • Which general acute care hospital(s) in Michigan the Class Member paid;
    • The amounts paid to the hospital(s) from January 1, 2006 through June 23, 2014; and
    • Which insurer paid the hospital, provided the insurance coverage, or administered the self-insured plan.

    The Settlement Administrator will review each Claimant’s reported purchases to determine how much money, if any, they will receive. For specifics on how payments will be determined, please contact the Settlement Administrator or see the Plan of Allocation available here.

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  4. When will Settlement money be distributed to Claimants?

    Settlement money will be mailed to Claimants after the Court approves the new Settlement and after any appeals are resolved. It is uncertain when and if any appeals will be taken and if so, when they would be resolved, but resolving them can take time. Please be patient. Updates will be posted on this website as they become available..

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  5. What do I give up if the new Settlement is given Final Approval?

    If the new Settlement is given Final Approval, you and all other Class Members will release certain claims defined in the Settlement as “Released Claims.” In general terms, Class Members who do not validly request to be excluded from the new Settlement will each release all of their claims against BCBSM and its affiliated persons and entities arising out of or in any way relating to BCBSM’s most favored nation clauses with Michigan General Acute Care Hospitals, or any matter or event arising out of the dispute being resolved in this Settlement. If the new Settlement is given Final Approval, the claims that were asserted against BCBSM in the lawsuit will be dismissed, with prejudice. A complete copy of the Release is available in paragraphs 58 to 65 of the Amended Settlement Agreement.

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SUBMITTING A CLAIM FORM

  1. How can I get a payment?

    To ask for a payment, you must submit a Claim Form. Claim Forms are available here, by writing to the Settlement Administrator, or by calling the toll-free number. You can also file online here.

    If you submitted a Claim Form in 2014 for the earlier Settlement, your claim will be processed for the new Settlement, and you do not need to submit another Claim Form.

    There are two different Claim Forms: one for Consumers, (individuals) and one for Insurers and Self-Insured Entities. Please be sure to use the right Claim Form.

    The Claim Form for consumers has changed from the one used for the earlier Settlement. The Consumer Claim Form now offers a choice. Consumers can list the actual amount(s) they paid to qualifying hospitals. Or, if they prefer, they can accept a “default” amount to avoid the need to determine the actual amount(s) they paid. The consumer Claim Form explains these options in more detail.

    After carefully reading the Claim Form instructions, fill out the Claim Form, attach any required documentation, sign it, and mail it postmarked no later than November 3, 2018 to:

    Settlement Administrator
    P.O. Box 3240
    Portland, OR 97208-3240

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  2. What should I do if I already submitted a Claim Form for the earlier Settlement?

    If you already submitted a Claim Form for the earlier settlement, you do not need to submit another Claim Form, as your previous claim will be processed.

    Consumers who submitted a Claim Form for the earlier Settlement and claimed purchases less than the default amount will be credited with the default amount, and do not need to submit another Claim Form. See the Consumer Claim Form for details about the default amount.

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  3. What do I do if I have questions about the Claim Form?

    If you have questions about how to file a claim or to check whether you previously submitted a Claim Form, call the toll-free number 1-877-846-0588 or send an email to info@MichiganHospitalPaymentsLitigation.com or a letter to Settlement Administrator P.O. Box 3240 Portland, OR 97208-3240

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EXCLUDING YOURSELF FROM THE NEW SETTLEMENT

If you do not want to participate in this Settlement, and you want to keep the right to sue BCBSM about the dispute in this case, then you must take steps to get out of the Settlement. This is called asking to be excluded from, or sometimes called “opting out” of, the Settlement.

In deciding whether to exclude yourself from the new Settlement, you may review the court records in this case at the Clerk’s Office at Theodore Levin U.S. Courthouse, 231 W. Lafayette Boulevard, Detroit, Michigan, 48226 during business hours. Court records that were recently unsealed have also been posted on the Settlement website and may be reviewed here.

  1. If I exclude myself, can I get anything from this new Settlement?

    No. If you exclude yourself, you may not submit a claim for a payment from the new Settlement, and you cannot object to the new Settlement. However, if you ask to be excluded, you do not release BCBSM from any claims based on the dispute in this case.

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  2. If I do not exclude myself, can I sue later?

    No. Unless you exclude yourself, you give up the right to sue BCBSM for any of the claims that this Settlement resolves. You must exclude yourself from the Class to start your own lawsuit, continue with a lawsuit, or be part of any other lawsuit against BCBSM relating to the “Released Claims” described in Section H of the Amended Settlement Agreement.

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  3. How do I exclude myself from the new Settlement?

    To exclude yourself from the new Settlement with BCBSM, you must send a letter by mail clearly stating that you want to be excluded from the Settlement in The Shane Group, Inc. v. Blue Cross Blue Shield of Michigan, Case No. 2:10-cv-14360. Include your name, your business name (if applicable), address, telephone number, signature, and date. If applicable, your letter must also describe the position that authorizes you to request exclusion on behalf of your company.

    You must mail your request for exclusion postmarked by September 16, 2018 to:

    Settlement Administrator
    P.O. Box 3240
    Portland, OR 97208-3240

    You cannot ask to be excluded on the phone, by email, or on this website.

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  4. If I excluded myself from the earlier Settlement, do I need to exclude myself again?

    Yes. If you submitted a request to exclude yourself from the earlier settlement in this case, that request has no effect for this new Settlement. If you wish to exclude yourself from the new Settlement, you must submit a new request.

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OBJECTING TO THE NEW SETTLEMENT

  1. How do I tell the Court if I do not like the new Settlement?

    You can object to the new Settlement if you do not like some part or all of it. You must give reasons why you think the Court should not approve the new Settlement. You may also object to plaintiffs’ Counsel’s request for attorneys’ fees, reimbursement of expenses, and plaintiff incentive awards. To object, send a letter to the two addresses below, saying that you object to the Settlement in The Shane Group, Inc., v. Blue Cross Blue Shield of Michigan, Case No. 2:10-cv-14360, and file your objection with the Court. Be sure to include any papers or briefs that support your objections.

    You must file your objection with the Court no later than September 16, 2018 and mail your objection to Plaintiff's Counsel and Counsel for BCBSM postmarked no later than September 16, 2018 at the addresses below:

    Court Plaintiff's Counsel Counsel for BCBSM
    Theodore Levin U.S. Courthouse
    231 W. Lafayette Boulevard
    Detroit, MI 48226
    COHEN MILSTEIN SELLERS & TOLL PLLC
    Daniel A. Small
    Brent W. Johnson
    1100 New York Avenue, NW
    Suite 500
    Washington, DC 20005
    SHEARMAN & STERLING LLP
    Todd M. Stenerson
    401 9th Street N.W.
    Washington, DC 20004

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  2. If I objected to the earlier Settlement and want to object to the new Settlement, do I need to object again?

    Yes. If you objected to the earlier settlement in this case, that objection will not be considered for the new Settlement. If you wish to object to the new Settlement, you must send and file a new objection. If you objected before and wish to object again, you may make some or all of your prior arguments, and/or you may make new arguments.

    In deciding whether to object to the new Settlement, you may review the court records in this case at the Clerk’s Office at Theodore Levin U.S. Courthouse, 231 W. Lafayette Boulevard, Detroit, Michigan, 48226 during business hours. Court records that were recently unsealed have also been posted on the Settlement website and may be reviewed here.

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  3. What is the difference between objecting and asking to be excluded?

    Objecting is telling the Court that you do not like something about the new Settlement. You can object only if you stay in the Class. Excluding yourself is telling the Court that you do not want to be part of the new Settlement. If you exclude yourself, you cannot object to the Settlement because the Settlement no longer affects you.

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  4. What happens if I object and the new Settlement is approved?

    If the new Settlement is finally approved and you did not request to be excluded from the Settlement, you will remain a Class Member regardless of whether you objected. You will remain bound by the terms of the Settlement and will not be able to sue BCBSM about the claims in this case.

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THE LAWYERS WHO REPRESENT YOU

  1. Do I have a lawyer in the case?

    The Court appointed four law firms to represent the Class: The Miller Law Firm, P.C.; Cohen Milstein Sellers & Toll PLLC; Gustafson Gluek PLLC; and Wolf, Haldenstein, Adler, Freeman & Herz LLC. These four law firms, together with other law firms that have assisted them, are called “Plaintiffs’ Counsel.” You will not be charged for these lawyers. If you want to be represented by your own lawyer in this case, you may hire one at your own expense.

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  2. How will the lawyers in the case be paid?

    Plaintiffs’ Counsel have asked the Court for attorneys’ fees of $8,631,628.67 and reimbursement of their litigation expenses in this case of $3,500,000. Plaintiffs’ Counsel will also ask the Court to reimburse the total costs of administering this Settlement. Plaintiffs’ Counsel also requested incentive awards of up to $45,000 for each Plaintiff organization and up to $10,000 for each Plaintiff individual, for their services on behalf of the Class. Plaintiffs’ Counsel’s application for attorneys’ fees and expenses is posted here.

    Plaintiffs’ Counsel have requested less in attorneys’ fees in connection with this new Settlement (compared to their request in the earlier settlement), so they (and not the Class) bear the estimated cost of notifying the Class of the new Settlement.

    The Court may award less than the amounts requested by Plaintiffs’ Counsel. Payments approved by the Court will be made from the Settlement Fund.

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THE COURT’S FAIRNESS HEARING

  1. How will the court decided whether to approve the new Settlement?

    At the Fairness Hearing, the Court will consider whether the new Settlement is fair, reasonable, and adequate. The Court will also consider Plaintiffs’ Counsel’s request for attorney fees and expenses and plaintiff incentive awards. If there are objections, the Court will consider them. After the Fairness Hearing, the Court will decide whether to approve the new Settlement and how much to award for fees, expenses, and incentive awards.

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  2. When and where will the Court decide whether to approve the new Settlement?

    The Court will hold the Fairness Hearing at 2:00 p.m., on November 8, 2018, at the United States Courthouse, Theodore Levin U.S. Courthouse, 231 W. Lafayette Boulevard, Detroit, MI 48226. A motion for Final Approval of the Settlement will be filed by Plaintiffs’ Counsel by October 16, 2018. The motion will also be posted on this website.

    The Fairness Hearing may be moved to a different date or time without additional notice, so it is recommended that you periodically check this website for updated information.

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  3. Do I need to come to the hearing?

    No. Plaintiffs’ Counsel will answer any questions the Court may have. However, you are welcome to attend the hearing at your own expense. If you send in a written objection, you do not have to come to the Fairness Hearing to talk about it. As long as you mailed your written objection on time, the Court will consider it. You also may pay your own lawyer to attend the Fairness Hearing, but his or her attendance is not necessary.

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  4. May I speak at the hearing?

    You may speak at the Fairness Hearing if you submitted an objection as described in the answer to FAQ 18 and stated in your objection that you wish to be heard at the Fairness Hearing. You cannot speak at the hearing if you exclude yourself from the new Settlement.

    If you choose to appear in person at the Fairness Hearing, you can appear yourself or by retaining an attorney at your own expense to appear on your behalf. If the attorney is appearing on behalf of more than one Class Member, he or she must identify each of those Class Members.

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GETTING MORE INFORMATION

  1. What happens if I do nothing?

    If you are a Class Member and do nothing, you will not get a payment from this Settlement. And, unless you exclude yourself, you will not be able to start a lawsuit, continue with a lawsuit, or be part of any other lawsuit against BCBSM relating to claims being resolved by this Settlement, ever again.

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  2. How do I get more information?

    The Notice and this website summarize the new Settlement. More details are in the Amended Settlement Agreement available at the Documents page of this website. If you still have questions, call the Settlement Administrator at 1-877-846-0588, send an email to info@MichiganHospitalPaymentsLitigation.com, or write to Settlement Administrator P.O. Box 3240, Portland, OR 97208-3240.

    PLEASE DO NOT CONTACT BCBSM, ITS COUNSEL, THE COURT, OR THE CLERK’S OFFICE.

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