All Providers in the U.S. (other than Excluded Providers, who are not part of the Settlement Class) who currently provide or provided healthcare services, equipment or supplies to any patient who was insured by, or was a Member of or a beneficiary of, any plan administered by any Settling Individual Blue Plan during from July 24, 2008 to October 4, 2024 (“Settlement Class Period”).
Excluded from the Settlement are:(i) Providers owned or employed by any of the Settling Defendants(ii) Providers owned or employed exclusively by Government Entities or Providers that exclusively provided services, equipment or supplies to members of or participants in Medicare, Medicaid or the Federal Employee Health Benefits Programs*(iii) Providers that have otherwise fully released their Released Claims against the Releases prior to the Execution Date, including but not limited to Providers that were members of any of the settlement classes in Love v. Blue Cross and Blue Shield Association, No. 1:03-cv-21296-FAM (S.D. Fla.)(iv) Providers that exclusively provide or provided (a) prescription drugs (b) durable medical equipment (c) medical devices (d) supplies or services provided in an independent clinical laboratory or (e) services, equipment or supplies covered by standalone dental or vision insurance. Any Provider that falls within the exclusion(s) set forth in clauses (i), (ii) or (iv) of this paragraph for only a portion of the Settlement Class Period is a Settlement Class Member that may recover in the Settlement.
*“Commercial Health Benefit Product” means any product or plan providing
for the payment or administration of healthcare services (including but not limited to
medical, pharmacy, dental, and vision products and services) or expenses through
insurance, reimbursement, or other similar healthcare financing mechanism, for Members
in the U.S. (however funded, including insured or self-funded) other than a product or plan
purchased or offered by a Government Entity such as Children with Special Health Care Needs Program (CSHCN) Children’s Health Insurance Program (CHIP) Civilian Health and Medical Program of the Department of Veteran’s Affairs (CHAMPVA) Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Indian Health Service, Tribal, and Urban Indian Health Plan Medicaid Medicare Medicare Advantage (including but not limited to Medicare Advantage Prescription Drug Plans and Special Needs Plans, including but not limited to Medicare-Medicaid or Dual-Eligible Plans) Medicare Stand-Alone Prescription Drug Plans Refugee Medical Assistance Program State Maternal and Child Health Program (MCH) or TriCare.
Any Provider who was a member of any of the settlement classes in Love v. Blue Cross and Blue Shield Association, and who did not opt out, will be considered an Excluded Provider. Such Excluded Providers include medical doctors who were licensed to practice prior to March 12, 2008.
For the avoidance of doubt, dental or vision providers who exclusively provided services, equipment or supplies covered by standalone dental or vision insurance are not Settlement Class Members.
