Published
November 21, 2025 9:49 AM
Updated
November 27, 2025
Individuals covered by health benefits under a LocalPlus plan Cigna administered and who received an explanation of benefits that incorrectly listed their provider as in-network when they were actually out-of-network due to a system error may be eligible to submit a claim for a cash payment from a class action settlement.
Cigna Health and Life Insurance Co. agreed to pay $5.71 million to resolve a class action lawsuit alleging it misclassified certain out-of-network health care providers as in-network, which resulted in some members receiving unexpected balance bills.
Who can file a Cigna settlement claim?
Class members must meet the following criteria:
- A LocalPlus Plan for which Cigna provided administrative services covered them for health benefits.
- They received medical treatment and an explanation of benefits from Cigna indicating the provider was in-network.
- The provider they received treatment from was actually out-of-network due to a configuration error in Cigna’s system.
- They received a balance bill because the provider did not honor in-network status.
How much is the class action payout?
- Pro rata cash payment: Eligible class members can submit a claim to receive a pro rata cash payment. The settlement administrator will determine the final amount by the number of valid claims.
- If the total value of all approved claims is $300,000 or less, each claimant will receive the full amount of their documented balance bill, including interest, penalties or debt collection fees directly related to the balance bill.
- If the total value of approved claims exceeds $300,000, each claimant will receive a proportional share of the $300,000 fund and not the total balance bill amount.
- Injunctive relief: Cigna will not recategorize any additional LocalPlus Plan out-of-network claims coded as in-network in error.
How to claim a class action rebate
To receive a settlement payment, eligible class members must submit a claim form. They can submit a claim online or print snd mail a PDF claim form to the settlement administrator. Class members must submit their claim online or postmark it by Jan. 5, 2026.
Settlement administrator’s mailing address: Cigna LocalPlus Settlement Administrator, Attn: claim forms, 1650 Arch St., Suite 2210, Philadelphia, PA 19103
Additional instructions:
Class members must:
- Provide their name, address, phone number, email, Cigna member ID and Cigna claim ID
- Attach proof of the balance bill or, if unpaid, a signed affirmation that they will use settlement funds to pay the balance bill
- Certify under penalty of perjury that the information is accurate and that they meet the class criteria
Required proof and claim information
- To submit an online claim, class members must provide the notice ID and confirmation code from their settlement notice.
- The claim form requires the Cigna member ID and Cigna claim ID.
- All class members must provide proof of the balance bill they received from the health care provider.
- Class members who have paid their balance bill must provide proof of payment, including any interest, penalties or debt collection fees incurred.
- Class members who have not paid their balance bill must submit a signed attestation agreeing to use the settlement payment to pay the owed balance bill, including any interest, penalties,or debt collection fees.
$5.71 million settlement fund
The $5,712,152.03 settlement fund includes:
- Attorneys’ fees and costs: $750,000
- Service awards to class representatives: $10,000 each ($20,000 total)
- Cash payments to approved claimants: $300,000
- Injunctive relief: $4,642,152.03
The defendant will pay settlement administrator costs separately.
Important dates
- Deadline to file a claim: Jan. 5, 2026
- Opt-out deadline: Jan. 5, 2026
- Final approval hearing: March 24, 2026
When is the Cigna out-of-network settlement payout date?
The settlement administrator will issue payments to valid claimants after it completes claim processing and the court grants final approval of the settlement.
Why is there a class action settlement?
This class action lawsuit alleged Cigna violated the Employee Retirement Income Security Act by misclassifying certain out-of-network providers as in-network due to a configuration error. As a result, some members received unexpected balance bills.
Cigna denies any wrongdoing but agreed to settle to avoid the risks and expense of further litigation.
