Any Employer Group, regardless of Industry, may be eligible to seek recovery from being overcharged for Insulin related products, as long as that Employer Group has / had on average more-than 2,000 ‘eligible’ enrolled Plan Members (Employees + Dependents) in their Self-insured / Self-Funded Healthcare Plan between 2011 – 2025 (Fully-Insured Plans are NOT eligible). AND that Employer Group will have had to have had one or more of the named PBM Defendants (Express Scripts, CVS / Caremark or OptumRx) incorporated into their Healthcare Plan during this timeframe. Those Plans that did not use any of these PBMs would NOT be eligible. Completing the Pre-Qualification Questionnaire (PQQ) provides SourceBridge Group with the essential information needed to pursue and attempt to secure recoverable monies on behalf of impacted Employer Groups.
Those Healthcare Providers with total Out-of-Network (OON) billing in excess of $500K, between the years of 2013 – 2023, who’s OON reimbursements were processed through MultiPlan, Data iSight, Viant, NCN, or related systems; which is a service that handles a substantial portion of the OON claims for major payors (UnitedHealth Group, Aetna [a CVS Health company], Elevance Health, Cigna, Health Care Service Corporation [HCSC], Humana, Kaiser Foundation Health Plan Kaiser Permanente, various Blues, Centene Corporation, Health Alliance Medical Plans, etc.). Many Providers may not know whether their OON claims have been handled by MultiPlan, or related systems. We can vet that based on some claims data sampling. We also will exclude any claims for any Payors for which the Provider has been In-Network. Completing the Pre-Qualification Questionnaire (PQQ) provides SourceBridge Group with the essential information needed to pursue and attempt to secure recoverable monies on behalf of impacted Employer Groups.
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