Welcome to the Risk Corridors Class Action 2016 Website

Important Update: On July 23, 2020, the United States Court of Federal Claims (“Court”) approved dividing the Class into subclasses, and entered a judgment in favor of the Non-Dispute Subclass. Additionally, the Court set a schedule for determining attorneys’ fees and nontaxable costs payable from the Non-Dispute Subclass’ net judgment proceeds. For more information and to view the Order, please click here.

What is this Lawsuit About?

Plaintiff Common Ground Healthcare Cooperative claims that Defendant United States has not fully paid the risk corridors payments for 2016 to which it and other insurers such as your organization are entitled under the Affordable Care Act. Section 1342 of the Affordable Care Act established a risk corridors program that applied to insurers who offered QHPs on the Affordable Care Act's insurance exchanges in any of the 2014, 2015, or 2016 plan years. The risk corridors program provided that QHP issuers would receive compensation from the United States if their losses exceeded a certain defined amount due to higher-than-expected utilization and medical costs for the issuer's insureds. At the same time, the risk corridors program provided that QHP issuers would pay the government a percentage of any unexpectedly high profits they made over similarly-defined amounts. During 2014, QHPs collectively incurred almost $2.9 billion in compensable losses under the risk corridors program. Similarly, QHPs also incurred substantial compensable losses in 2015, totaling about $5.8 billion, and again incurred approximately $3.95 billion in compensable losses in 2016. Defendant United States has denied it is liable for the alleged losses.

Who is a Class Member?

On January 8, 2018, the United States Court of Federal Claims ("Court") permitted the lawsuit to proceed as a class action on behalf of the following class of people or entities: 

All persons or entities offering Qualified Health Plans under the Patient Protection and Affordable Care Act in the 2016 benefit year, and whose allowable costs in either the 2016 benefit year, as calculated by the Centers for Medicare and Medicaid Services, were more than 103 percent of their target amounts (as those terms are defined in the Patient Protection and Affordable Care Act). 

On July 23, 2020, the Court entered an Order dividing the Class into the following subclasses:

• • Non-Dispute Subclass - All approved class members offering Qualified Health Plans under the Patient Protection and Affordable Care Act in the 2016 benefit year, whose allowable costs in the 2016 benefit year, as calculated by the Centers for Medicare & Medicaid Services, were more than 103 percent of their target amounts (as those terms are defined in the Patient Protection and Affordable Care Act), except those entities with ongoing disputes with the government concerning the amount due to the entity under Section 1342 of the Affordable Care Act, entities that dispute the government’s right to offset debts against a judgment pursuant to Section 1342, and entities that dispute the extent of any such offset.

• • Dispute Subclass - All approved class members offering Qualified Health Plans under the Patient Protection and Affordable Care Act in the 2016 benefit year, whose allowable costs in 2016 benefit year, as calculated by the Centers for Medicare & Medicaid Services, were more than 103 percent of their target amounts (as those terms are defined in the Patient Protection and Affordable Care Act), and that dispute the amount due to the entity under Section 1342 of the Affordable Care Act, and/or dispute the government’s right to offset debts against a judgment pursuant to Section 1342, and/or dispute the extent of any such offset.

What are my Rights and Options?

You will not have to pay any money out of pocket to participate in the Class. If the Class is successful in this litigation, however, Class Counsel (defined below) will ask the Court’s permission to be compensated for litigating this case and representing the successful Class. Any sums received by Class Counsel in compensation will be deducted from any recovery, which will proportionately reduce the amount of any award each Class Member receives. If the case is unsuccessful, you will have no obligation for attorneys’ fees or costs.

Who is Class Counsel?

The Court has decided that attorneys at the law firm of Quinn Emanuel Urquhart & Sullivan, LLP, led by partners Stephen Swedlow, J.D. Horton, and Adam Wolfson, are qualified to represent you and all Class Members. Quinn Emanuel Urquhart & Sullivan, LLP is called “Class Counsel.” Class Counsel has experience handling this type of lawsuit. More information about Class Counsel is available at: www.quinnemanuel.com.

You do not need to hire your own lawyer because Class Counsel will work on your behalf and represent your interests if you join the Class. You have the right to have your own lawyer. Your own lawyer can appear in court for you if you want someone other than Class Counsel to speak on your behalf. If you choose to hire your own lawyer, you will have to pay that lawyer.

For more information including a Class Action Opt-In Notice Form and Detailed Notice, please visit the Important Documents page of this website.