Goidel v. Aetna Life Insurance Company

CourtDistrict Court, S.D. New York
DecidedOctober 8, 2024
Docket1:21-cv-07619
StatusUnknown

This text of Goidel v. Aetna Life Insurance Company (Goidel v. Aetna Life Insurance Company) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Goidel v. Aetna Life Insurance Company, (S.D.N.Y. 2024).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK --------------------------------------------------------- X : EMMA GOIDEL, : on behalf of themselves and all others similarly : situated, et al., : : 21-CV-7619 (VSB) Plaintiffs, : : OPINION & ORDER - against - : : : AETNA LIFE INSURANCE COMPANY, : : Defendant. : : --------------------------------------------------------- X

Appearances:

Zoe Antonia Salzman Debra Lea Greenberger Eric Abrams Emery Celli Brinckerhoff Abady Ward & Maazel LLP New York, NY and Alison Ann Tanner Donya Khadem Michelle Iris Banker Sudria H Twyman Noel Leon National Women’s Law Center Washington, DC Counsel for Plaintiffs and the Proposed Class

Earl B. Austin Sarah Reeves Baker Botts LLP New York, NY and Dallas, TX and Mariellen Dugan Calcagni & Kanefsky LLP Newark, NJ Counsel for Defendant VERNON S. BRODERICK, United States District Judge: This class action was filed on September 13, 2021, on behalf of a class of LGBTQ1 individuals insured by Defendant Aetna Life Insurance Company (“Aetna”) who want to have children but cannot conceive through sexual intercourse with their partners, and can become pregnant only with medical assistance, such as fertility treatments like intrauterine insemination

(“IUI”) and in vitro fertilization (“IVF”). (See Doc. 1 ¶¶ 2–14.) Plaintiffs allege that Aetna’s policies require LGBTQ individuals Aetna insures to pay out-of-pocket for several rounds of fertility treatments before insurance will pay for treatment. (Id.) Non-LGBTQ individuals that Aetna insures, however, do not need to pay out-of-pocket for fertility treatment; Aetna will pay for non-LGBTQ fertility treatment immediately upon representation that the insured has not been able to conceive naturally in the past year. (Id.) Plaintiffs allege that this difference in treatment is unlawful discrimination on the basis of sexual orientation in violation of Section 1557 of the Patient Protection and Affordable Care Act (“ACA”), the New York State Human Rights Law (“NYSHRL”), and the New York City Human Rights Law (“NYCHRL”). (Id.)

Before me is the joint motion by Plaintiffs Emma Goidel, Ilana Lee, Madeline Lee, and Lesley Brown, (collectively, “Plaintiffs”), on behalf of themselves and two putative classes of persons similarly situated, for preliminary approval of the class action settlement they have reached with Aetna. (See Doc. 92 (motion for preliminary settlement approval); Doc. 93 (the memorandum in support, or “Mem.”)). The motion for preliminary settlement approval is unopposed. Along with the motion, Plaintiffs have submitted a declaration of Zoe Salzman, a partner at Plaintiffs’ law firm, (Doc. 94 (“Salzman Decl.”)), a declaration of Bryn Bridley, an

1 “LGBTQ” means persons who identify as “lesbian, gay, bisexual, transgender, queer, intersex, or non-binary.” (Doc. 1 ¶ 2.) executive at Plaintiffs’ chosen settlement administration firm, (Doc. 95 (“Bridley Decl.”)), the proposed settlement agreement, (Doc. 94-1 (“Agreement”)), and a proposed order preliminarily approving the settlement agreement, (Doc. 94-2). Because I find after a preliminary evaluation that the settlement is fair, reasonable, and the result of good faith negotiation, Plaintiffs’ motion is GRANTED.

I. Background I adopt the factual and procedural background set out in the “Factual and Procedural Background” section of the memorandum of law in support of the motion for preliminary settlement approval and provide a summary below. (Mem. at 3–11.) “Plaintiffs are a class of individuals who want to have children but cannot conceive through sexual intercourse with their partners, and rather can become pregnant only with medical assistance, such as fertility treatments like intrauterine insemination (‘IUI’) and in vitro fertilization (‘IVF’).” (Mem. at 3.) “Plaintiffs alleged that Defendant issued, designed, marketed, and administered health benefits plans containing a discriminatory Definition of Infertility that, on its face, denied LGBTQ[] individuals equal access to their health benefits

based on sex, in violation of federal law and New York state and city law.” (Id. at 3–4.) Plaintiffs propose two classes as part of the settlement agreement: One “‘Injunctive Settlement Class,’ is defined as all individuals in an Eligible LGBTQ+ Relationship2, who are currently covered by a health plan provided or administered by Aetna in New York, and who currently or will in the future want to obtain coverage for IUI or IVF treatments.” (Agreement

2 “Eligible LGBTQ+ Relationship” is defined as “a personal relationship (but not including a surrogacy relationship) involving two individuals who self-identify as ‘LGBTQ+,’ consisting of one individual with a uterus who was in an LGBTQ+ relationship with a partner who was incapable of producing sperm due to being an individual who was assigned the female sex at birth, was intersex, or was assigned the male sex at birth and had transitioned or was in the process of transitioning to the opposite gender.” (Agreement ¶ 33.) ¶ 55.) In short, the injunctive relief sought by this class is for Aetna to change its policy so that LGBTQ individuals will not need to pay out of pocket for fertility treatments. (See Mem. at 1– 2.) The other proposed class—the “Damages Settlement Class”—consists of individuals in an Eligible LGBTQ+ Relationship with an Aetna insurance plan that covered infertility treatments during the class period,3 but that had to pay out-of-pocket for rounds of IUI or IVF because of

the way Aetna defined “infertility.”4 (See Agreement ¶ 66.) These individuals will be eligible to receive payments meant to cover damages incurred in paying out-of-pocket for fertility treatments. (See Mem. at 4–5.) Specifically, class members will each receive a payment of at least $2,300 as direct compensation for any prior out-of-pocket payments, plus a lump-sum payment of approximately $10,000 for “additional damages suffered.” (Id. at 15; see also Agreement ¶¶ 66(c), 67(a).) Plaintiffs filed their complaint on September 13, 2021, (Doc. 1), and filed a First Amended Complaint on November 5, 2021, (Doc. 20.) Defendant answered on January 21, 2022. (Doc. 26.) Following an extensive period of discovery, the parties engaged in settlement

discussions, including before a retained mediator. (See Mem. at 7–11.) Plaintiffs filed their motion for preliminary settlement approval on May 3, 2024, seeking: (i) preliminary approval of the settlement; (ii) preliminary certification of the settlement class and appointment of Emery

3 The class period is September 1, 2017 to May 31, 2024. (Agreement ¶ 19.) 4 The Damages class is separated into three categories: “Category A” are individuals the parties have already identified fit the class definition. (Agreement ¶ 65(a).) “Category B” are individuals with Aetna coverage who had to pay out-of-pocket for fertility treatments, but for whom the parties have not determined were in an Eligible LGBTQ+ Relationship during the class period. (Id. ¶ 65(b).) “Category C” are individuals with Aetna coverage who received fertility treatments, but for whom the parties cannot identify whether the individuals incurred out-of- pocket expenses for fertility treatments or whether they were in an Eligible LGBTQ+ Relationship during the class period. (Id. ¶ 65(c).) The Agreement contemplates that Category A class members will be entitled to payment upon verification of their address and without submitting additional documentation, and that Category B and C class members will need to submit additional documentation in order to be eligible for payment under the Agreement. (Id.

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Goidel v. Aetna Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/goidel-v-aetna-life-insurance-company-nysd-2024.