Many Bay Area residents could receive cash payments from a $228.5M health insurance settlement

A class action lawsuit brought against Sutter Health has led to a $228.5 million settlement agreement and could result in cash payments for many Bay Area health insurance policyholders.

Many Bay Area residents could be eligible for a payout stemming from a $228.5 million class action settlement related to health insurance premiums made between 2011 and 2021.

The settlement comes out of a lawsuit filed against Northern California healthcare system Sutter Health.

The Sacramento-based hospital system is accused of illegally using "anticompetitive" and unfair terms in its contracts with insurance plans, affecting insurance premiums that were made from 2011 to 2021.

What they're saying:

"The Plaintiffs claim that these terms caused insurance plans to overpay for hospital services, which resulted in higher premiums for individuals and businesses," according to a website set up for claims in the Sutter Health premium case. 

The site invites eligible individuals and businesses to file a claim saying, "You could get a payment."

Who can file a claim?

The firm managing the class-action case, JND Legal Administration, said eligible class members must meet a list of requirements.

The settlement covers California individuals and businesses that paid for health insurance from:

  • Aetna
  • Anthem Blue Cross
  • Blue Shield of California
  • Health Net
  • United Healthcare

The case also named eight of the Bay Area's nine counties where the alleged over-payments were made. They were: 

  • Alameda
  • Contra Costa
  • San Mateo
  • Sonoma
  • Marin
  • San Francisco
  • Napa
  • Solano

Those eligible were living or working in one of those counties, while paying premiums, or they employed workers in an office located there, JND Legal explained.  

SEE ALSO: Rural hospitals prepare for financial hits, potential closures under GOP's $1 trillion Medicaid cut

Other criteria for eligibility to file a claim include making premium payments between January 1, 2011, and March 8, 2021, and the claimant can’t previously have opted out of the case. 

Timeline:

The U.S. District Court for the Northern District of California gave initial approval of the settlement on May 22, after both sides agreed to the deal to avoid further litigation, JND Legal Administration said. 

Sutter Health denied any wrongdoing. 

Hearings will now be held, including one to resolve any appeals, before the court would give final approval on Nov. 6.  

"If approved, the settlement requires Sutter Health to pay $228.5 million and change the way it does business," JND Legal said.

Filing a claim 

Meanwhile, those eligible were encouraged to file a claim to request a payment.

The deadline to file is Sept. 12, 2025.

What we don't know:

There is no word on how much eligible individuals in the class action case would receive.  

Part of the $228.5 million settlement amount would also go toward costs associated with managing the case, including legal and administrative fees.

This story was reported from Oakland, Calif.

Health CareAlameda CountyContra Costa CountySan Mateo CountySonoma CountyMarin CountySan FranciscoNapa CountySolano County