ERISA Health Care Litigation Related to Deductibles and Out-of-Pocket Expenses

Plaintiffs, enrollees in the insurer's ERISA employee health benefit plans during a specified time, allege that the defendant did not properly track whether or not they met their annual deductibles and out-of-pocket maximums. As a result, they claim to have been billed for covered services or prescriptions in excess of the plan's deductible or out-of-pocket maximum. The Analysis Group team, led by Managing Principal Mark Gustafson, verified the defendant's calculations of the named plaintiff's plan deductible and out-of-pocket maximum accumulations.