Health Net used bait-and-switch tactics to enroll Californians into its inferior health plans under the federal Affordable Care Act, a class claims in court.
Rebecca Lehman, of Los Angeles County, and Heather Womick, of Orange County, filed the complaint on December 19 in Los Angeles Superior Court against Health Net of California Inc., and its subsidiary Health Net Life Insurance Co.
Despite Health Net's representations between Oct. 1, 2013, and March 31, 2014, consumers who enrolled in the new plans soon "discovered that their provider networks did not include the providers Health Net had represented as in-network, and that those provider networks were much more limited than previously represented by Health Net," according to the complaint.
"Due to Health Net's actions and misrepresentations, plaintiffs and class members are not able to fully access the benefits of the plans they purchased," the complaint continues.
Among the superlatives that such conduct has earned, the class notes that "Health Net made the fewest doctors available to its enrollees in 2014, 'less than half what some other companies are offering in Southern California.'"
Things are also going to get worse at Health Net in 2015, since the company "will no longer offer PPO plans inside the covered California exchange" as of Dec. 31, 2014, the complaint states.
"Compared to Health Net's PPO plans, Health Net's EPO plans offer 54% fewer doctors," the class adds.
Consumers say Health Net's practices allowed it to "significantly increase its share of the California individual health plan market, while offering inferior products," the complaint states.
Because Health Net concealed plan limitations from consumers, however, they are now locked in those plans until the next enrollment period, according to the complaint.
"Health Net's practices improperly shift the cost of medical care onto plaintiffs and class members," the complaint states. "Class members with HMO and EPO plans, (sic) are at risk of huge unpaid medical bills if they cannot access medical care in a timely manner from the limited number of in-network providers. For those with PPO plans, the reduced networks can transform fixed co-payments into percentage-based co-insurance arrangements that can leave enrollees on the hook for hundreds of additional dollars."
The class says "Health Net's deceptive business practices resulted in mass confusion."
Calling customer service at Health Net means that consumers "spend hours navigating through a labyrinth of automated phone trees, multiple transfers, average hold times of two to three hours, and disconnections," the complaint states.
The class wants punitive damages for breach of contract and other violations.
Consumer Watchdog attorney Harvey Rosenfield, Esq., of Santa Monica, also filed the complaint.
The class is represented by:
Travis M. Corby, Esq.
SHERNOFF BIDART ECHEVERRIA BENTLEY
600 South Indian Hill Blvd.
Claremont, CA 9171
Telephone: (800) 458-3386
Facsimile: (909) 625-6915
E-mail: [email protected]
