IN THE UNITED STATES DISTRICT COURT. ‘Aicoo0032 FOR THE SOUTHERN DISTRICT OF INDIANA. Pierce, et al. v. Anthem Insurance Companies, Inc. Case No. 1:15-cv-00562-TWP-TAB A court authorized this notice. This is not a solicitation from a lawyer. If your child was the beneficiary of an Anthem-issued health plan who, while over age seven and residing in the State of Indiana, had an autism diagnosis and was denied coverage in whole or in part for ABA therapy at any time from April 9, 2012 through December 31, 2017, this class settlement may affect the rights of your child and you. The legal rights of your child and you are affected whether you act or don’t act. Please read this notice carefully. Stay in this lawsuit. Receive a payment. Give up certain rights. f you do nothing, your child will be considered part of the Settlement Class, and payment will be sent to the address at which you received this, Notice. But you and your child give up the right to sue Anthem separately about the same legal claims in this lawsuit. Jeblaee “pita 4 : Zo Get out of this lawsuit. Get no benefits from it. Keep rights, ‘ASK TO BE EXCLUDED | tf you ask for your child to be excluded, your child won't share in the _| Settlement, but you and your child will keep any rights to sue Anthem _| separately about the same legal claims in this lawsuit. oer Aer n Objection with the Court. igree with any portion of the Settlement Agreement, you may | file a written Objection on behalf of your child with the Court, which will be considered at the Final Approval Hearing. You may also ask to speak at _ SETTLEMENT —_| the hearing on behalf of your child. if you file an Objection, you may not t exclude your child from the Settlement. If the Settlement is approved, your child will receive a payment from the Settlement Fund and will be bound by the Settlement Agreement. Your child will give up any rights to sue Anthem separately about the same legal claims in this lawsuit. Questions? Catt 1-855-349-7023 TOLL Free -1-BASIC INFORMATION ‘The purpose of this Notice is to let you know that a proposed Settlement has been reached in the class action lawsuit entitled Pierce, et al. v. Anthem Insurance Companies, Inc., United States District Court for the Southern District of Indiana Case No. 1:15-cv-00562-TWP-TAB. Judge Tanya Walton Pratt of the United States Dist Court for the Southern District of Indiana has preliminarily approved the proposed Settlement. Your child and you have legal rights and options that you may act on before the Court decides whether to grant final approval of the proposed Settlement. Because the rights of your child and you will be affected by this Settlement, it is extremely important that you read this Notice carefully. ‘Anthem’s records indicate that your child was the beneficiary of an Anthem-issued health plan who, while over age seven and while residing in the State of Indiana, had an autism diagnosis and was denied coverage in whole or in part for ABA therapy at some time from April 9, 2012 through December 31, 2017. This notice explains that the Court has preliminarily approved the Settlement of the claims in this lawsuit. Your child and you have legal rights and options that you may exercise before the fairness hearing (also known as a “Final Approval Hearing”). The Final Approval Hearing is to decide whether the Settlement Agreement is fair, reasonable, adequate, and in the best interest of the Class. [B. what is iB Toned © RRR awa a Ce RR TY In cases brought as class actions, one or more people, called class representatives, sue on behalf of themselves and other people who have similar claims. All of these people are a class or class members. One court resolves the issues for all class members except those who exclude themselves from the class. Plaintiffs’ original complaint alleged that Anthem had violated Ind. Code §§ 27-8-14.2, 27-13-7-14.7 (the “Indiana Autism Mandate”); the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”); and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 29 U.S.C. § 1185a; 42 U.S.C. § 300gg-5; 26 U.S.C. § 9812 (the “Federal Parity Act”) in connection with Anthem’s alleged denial of coverage for services relating to the treatment of autism, including for Applied Behavior Analysis therapy ("ABA Therapy”), for members and beneficiaries of ERISA-governed health plans in Indiana. Plaintiffs’ amended complaint further alleged that Anthem’s denial of coverage for autism-related services violated the Indiana Autism Mandate and breached the contract governing the benefits of individual-plan members in Indiana. Plaintiffs’ class claims for alleged violations of the Indiana Autism Mandate, ERISA, the Federal Parity Act, and breach of contract are collectively referred to as the “Class Claims.” ‘QUESTIONS? CaLt 1-855-349-7023 TOLL FREE -2-Anthem denies that it did anything wrong and the Court did not certify a class as a result of a contested motion. Rather, the parties have agreed to settle the case on a class-wide basis. THE SETTLEMENT The Court did not decide in favor of Plaintiffs or Anthem. Instead, both sides agreed to a settlement. This way, the parties avoid the cost and risk associated with a trial, and the people affected will receive compensation. The Class Representatives and their attorneys think the Settlement is best for the Settlement Class. WHO IS IN THE SETTLEMENT? Your child is in the Settlement Class if he or she was the beneficiary of an Anthem-issued health plan who, while over age seven and while residing in the State of Indiana, had an autism diagnosis and was denied coverage in whole or in part for ABA therapy at any time from April 9, 2012 through December 31, 2017. The Settlement Class does not include anyone for whom a timely and valid exclusion request is submitted, as described under Question 11. Your child is a “Settlement Class Member” if he or she meets the definition set forth above and no exclusion request is submitted for him or her. If you have questions about whether your child is part of the Settlement Class, you may call 1-855- 349-7023 for more information. Do not contact the Court, the Judge, or Anthem regarding this Notice. THE SETTLEMENT BENEFITS To settle this case, Anthem has agreed to pay $1,625,000.00 into a Settlement Fund that will provide for individual payments to the Settlement Class Members, incentive award payments to the Class Representatives, attorneys’ fees and reimbursement of litigation expenses, and the costs of settlement administration, Each Settlement Class Member will receive a check representing the Settlement Class Member's share of the settlement proceeds, which shall be calculated by multiplying the “Settlement Class Payment” by the Settlement Class Member's “Pro Rata Share.” Settlement Class Payment means the Settlement Fund, less any award of attorneys’ fees and costs, less any costs of notice and settlement administration, and less the any incentive payments to the Class Representatives. A Settlement Class Member's “Pro Rata Share” means (i) the sum total of the dollar amounts that Anthem would have paid for the ABA therapy at the time the claims were processed for which Anthem denied coverage in relation to that Settlement Class Member (not including or considering deductibles, co-pays, co-insurance or out-of-pocket maximums) divided by (ii) the total value of all Questions? CALL 1-855-349-7023 ToL FREE -3%dollar amounts that Anthem would have paid for the ABA therapy for which Anthem denied coverage in relation to all Settlement Class Members combined (not including or considering deductibles, co-pays, co-insurance or out-of-pocket maximums). In addition, Anthem agrees that consistent with Indiana and federal law and in connection with its decisions regarding pre-authorization of ABA therapy coverage for Indiana beneficiaries, Anthem shall (i) cease the use of guidelines relating to coverage for ABA therapy based solely on an individual's age; (i) issue a statement to its Utilization Management employees regarding the use of age-related considerations; and (ii) require employees who review treatment plans to participate in periodic external continuing education relating to autism and/or ABA therapy. 7. How much willmychild’spaymentbe? ‘The estimated amount of your child's share of the Settlement Fund is noted on the first page of this Notice. The final amount may be different. This amount was determined by calculating your Pro-Rata Share of the Settlement Fund by taking the total of the dollar amounts that Anthem would have paid for your child’s ABA therapy at the time the claims were adjudicated for which Anthem denied coverage (not including or considering deductibles, co-pays, co-insurance or out-of-pocket maximums) divided by (2) the total value of all dollar amounts that Anthem would have paid for the ABA therapy for which Anthem denied coverage in relation to all Settlement Class Members combined (not including or considering deductibles, co-pays, co-insurance or out-of-pocket maximums) and multiplying that ratio by the Settlement Class Payment. ‘The Court, Anthem, the Settlement Administrator, and Class Counsel cannot provide tax advice regarding your child’s estimated payment. You should consult with a tax professional regarding the tax consequences of any payment received. How You GET A PAYMENT 8. How do we get a payment for our child? Sion aes If your child falls within the Settlement Class and is not excluded from the settlement, a payment will be sent to you, You do not need to submit a claim form or contact anyone. Only a parent or legal guardian may accept a settlement payment for a child Class Member. If you accept and deposit a payment for your child, you are representing to Plaintiffs, Anthem, and the Court that you are the child’s parent or legal guardian. If you have questions about whether you are allowed to accept a payment on behalf of your child, you may call Class Counsel at 1-855-349- 7023. You may also consult with another lawyer at your own expense. Do not contact the Court, the Judge, or Anthem regarding this Notice. QUESTIONS? Catt 1-855-349-7023 TOLL FREE -4Within thirty (30) calendar days after the Court's Final Approval Order becomes final, the Class Administrator will mail checks to Settlement Class Members. The checks will be valid for 120 days from the date of issuance. Unless your child is excluded, he or she will stay in the Settlement Class and will be a Settlement Class Member. That means you and your child can’t sue, continue to sue, or be part of any other lawsuit against Anthem based on the Class Claims as described in Question 3. It also means that all of the Court’s orders will apply to you and your child and will legally bind you and your child, The Settlement Agreement (which you may obtain free of charge by calling 1-855-349-7023 toll free) describes the claims you and your child are releasing (the “Released Claims”) and against whom you and your child are releasing claims (Anthem) in detail, so read it carefully. EXCLUDING YOUR CHILD FROM THE SETTLEMENT. If you don’t want your child to receive a payment from this Settlement or if you and your child want to keep the right to sue or continue to sue Anthem about the claims raised in the lawsuit, then you must take steps to remove your child from the Settlement Class. This is called excluding your child—or is sometimes referred to as “opting out” your child—from the Settlement Class. To exclude your child from the Settlement, you must send a letter saying that you want your child to be excluded from the settlement in Pierce, et al. v. Anthem Insurance Companies, Inc. Case No. 1:15-cv-00562-TWP-TAB. The Exclusion Request must be in writing and include the name and case number of the lawsuit, your name, your address, your telephone number, the relevant member identification number used with Anthem, and your child’s initials. The request must be signed by a parent or legal guardian and include the name of that person if different from you. You must mail your exclusion request postmarked no later than July 3, 2018 to the following address: Anthem Settlement Administrator P.O. Box 91349 Seattle, WA 98111 If you ask for your child to be excluded, your child will not get any payment, and you cannot object to the Settlement. You and your child will not be legally bound by anything that happens in this lawsuit. Questions? CALL 1-855-349-7023 Tou FREE -58No. Unless you exclude your child, you and your child give up any right to sue Anthem for the claims that this Settlement resolves. If you or your child already have a lawsuit related to ‘Anthem’s coverage of ABA therapy, you should speak to your lawyer in that case immediately. You must exclude your child from this Settlement Class to continue with the other lawsuit. The exclusion deadline is July 3, 2018. No. Your child will not receive a payment if you exclude him or her. Your LAWYERS REPRESENTING YOU AND THE CLASS ‘The Court has appointed Terrell Marshall Law Group PLLC and Saeed & Little, LLP to represent your child and other Settlement Class Members. These lawyers are called Class Counsel. You will not be charged for these lawyers. If you or your child want to be represented by your own lawyer, you may hire one at your own expense. The names and addresses of Class Counsel are: Syed Ali Saeed Toby J. Marshall SAEED & LITTLE, LLP Blythe H. Chandler 1433 North Meridian Street, Suite 202 ‘TERRELL MARSHALL LAW GROUP PLLC Indianapolis, indiana 46202 936 North 34th Street, Suite 300 Seattle, Washington 98103-8869 Class Counsel will ask the Court to approve payment to them of up to 33.33% of the net Settlement Fund, or approximately $508,345, for attorneys’ fees and up to $71,000 for their out-of-pocket expenses. This payment would pay Class Counsel for investigating the facts, litigating the case, and negotiating the Settlement. Class Counsel will also request incentive awards of $10,000 each for the two Class Representatives, through their respective parents and guardians, to compensate them for their time and effort. The Class Representatives will be paid no more than a combined total of $20,000 from the Settlement Fund. Once it is filed, you may request a free copy of Class Counsel’s complete request for fees, costs, and incentive awards to the Class Representatives by calling 1-855-349-7023, The Court may award less than these amounts. OBJECTING TO THE SETTLEMENT If your child is a Settlement Class Member and you do not exclude your child from the Settlement Class, you can object to the Settlement if you don’t like any part of it. Your written objection must Questions? CALL 1-855-349-7023 TOLL FREE -6%provide your name, address, telephone number, your child's initials, and the reason(s) for your objection. You must file the objection with the Court no later than July 3, 2018, by mailing it to: Pierce, et al. v. Anthem Insurance Companies, Inc. Case No. 1:15-cv-00562-TWP-TAB Us District Court Clerk’s Office, Room 105 46 East Ohio Street Indianapolis, IN 46204 Objecting simply means telling the Court that you don’t like something about the Settlement. You can object only if you stay in the Settlement Class. Excluding your child from the Settlement Class is telling the Court that you don’t want your child to be part of the Settlement Class. If you exclude your child, you have no basis to object because the case no longer affects your child. THE COURT'S FAIRNESS HEARING The Court will hold the Final Fairness Hearing on July 31, 2018 at 2:00 p.m., before the Honorable Tanya Walton Pratt at the United States District Court for the Southern District of Indiana, Courtroom 344, Birch Bayh Federal Building and U.S. Courthouse, 46 East Ohio Street, Indianapolis, Indiana. The purpose of the hearing is for the Court to determine whether the Settlement is fair, reasonable, adequate, and in the best interest of the Settlement Class. At the hearing, the Court il hear any objections and arguments concerning the fairness of the proposed Settlement, \cluding those related to the amount requested by Class Counsel for attorneys’ fees and expenses and the incentive awards to the Class Representatives. After the hearing, the Court will decide whether to approve the Settlement. We do not know how long these decisions will take. Note: The date and time of the Final Fairness Hearing are subject to change by Court Order. No. Class Counsel will answer any questions the Court may have. You are welcome to come to the hearing at your own expense. If you send an objection, you don’t have to come to the Court to talk about it. As long as your written objection was filed or mailed on time, and meets the other criteria described in the Settlement Agreement, the Court will consider it. You may also pay a lawyer to attend, but you don’t have to. If you do not exclude your child from the Settlement Class, you may ask the Court for permission to speak at the hearing concerning any part of the proposed Settlement Agreement. If you filed an objection (see Question 16 above) and intend to appear at the hearing, you must state your QUESTIONS? CALL 1-855-349-7023 Tout FREE Jeintention to do so in your objection. To speak, you must send a letter saying that it is your “Notice of Intention to Appear” in “Pierce, et al. v. Anthem Insurance ‘Companies, Inc., Case No. 1:15-cv- (00562-TWP-TAB.” Be sure to include your name, address, telephone number, your child's initials, and your signature. Your Notice of Intention to Appear must be received at the address in Question 16, no later than July 20, 2018. You cannot speak at ‘the hearing if you exclude your child. IF You Do NOTHING If you do nothing, your child will be a member of the Settlement Class and will be sent a payment. GETTING More INFORMATION ‘This Notice summarizes the proposed Settlement. More details are in the Settlement Agreement. You may request a copy of the Settlement Agreement free of charge by calling 1-855-349-7023 toll free. You can call 1-855-349-7023 toll free, or write to the Anthem Settlement Administrator, P.O. Box 91349, Seattle, WA 98111. Pease Do Not CONTACT THE COURT, THE JUDGE, OR ANTHEM WITH QUESTIONS ABOUT THE SETTLEMENT. QUESTIONS? CALL 1-855-349-7023 TOLL FREE -8-