|The Electrical Welfare Trust Fund, The Operating Engineers Trust Fund of Washington, D.C., and The Stone & Marble Masons of Metropolitan Washington, D.C. Health and Welfare Fund v. United States of America
|United States Court of Federal Claims
|Eleni M. Roumel
|The Electrical Welfare Trust Fund, The Operating Engineers Trust Fund of Washington, D.C., and The Stone & Marble Masons of Metropolitan Washington, D.C. Health and Welfare Fund
|United States of America
Serving as Lead Counsel in Electrical Welfare Trust Fund, et al. v. U.S, this case in the U.S. Court of Federal Claims, sought to recover monies illegally collected from plaintiff and similar health plans through the U.S. Government’s interpretation and application of Section 1341 of the ACA. The ACA imposed a reinsurance “Contribution” on group health funds, which was intended to fund reinsurance payments to health insurance issuers during the implementation of the ACA, but did not apply to self-administered plans. The Court denied the Government’s motion to dismiss and held that the Government wrongfully interpreted the ACA to include self-administered, self-insured group health plans, including plaintiff, as contributing entities. Thereafter, the primary questions became whether a Class could be certified, whether judgment should be entered in favor of plaintiff and the Class, and the amount of damages. On June 22, 2022, an illegal exaction opt-in Class was certified. We conducted an extensive notice campaign and 357 health plans opted into the class. After extensive discovery, in May 2023, the Court granted plaintiff's motion for summary judgment and entered judgment for the Class, ordering the Government to pay the Class $185.2 million.