UNITED STATES DISTRICT COURT

DISTRICT OF NEW JERSEY

INTEGRATED ORTHOPEDICS, INC., 

on behalf of itself and a certified class of 

others similarly situated, 

Plaintiff, 

v.

UNITEDHEALTH GROUP, et al., 

Defendants.

Civil Action No. 11-425 (ES)(JAD)

Motion Date: September 8, 2020

DECLARATION OF ANDREW N. GOLDFARB

IN SUPPORT OF PLAINTIFF’S UNOPPOSED MOTION FOR

PRELIMINARY APPROVAL OF CLASS ACTION SETTLEEMNT

I, Andrew N. Goldfarb, submit this unsworn declaration under penalty of

perjury: 

1. I am an attorney with the law firm of Zuckerman Spaeder LLP and

counsel for Plaintiff in this action. I submit this Declaration in support of 

Plaintiff’s Unopposed Motion for Preliminary Approval of Class Action 

Settlement. 

2. This declaration is based on personal knowledge and my review of the

record in the case.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 1 of 74 PageID: 19880
2

3. A Repayment Request1 issued by United to a provider identifies the 

date of the alleged overpayment, requests a refund, and threatens to recover the 

alleged overpayment through an involuntary offset of a future payment if the 

provider does not send United the requested amount by a certain date. 

4. Evidence adduced by Plaintiff showed that, as of 2015, United was 

annually sending approximately 1.6 million Repayment Requests; and, in 2011,

United collected more than $180 million in resulting involuntary offsets, including 

about $31 million against out-of-network providers. (ECF 349 at 31; ECF 308 at 

9.)

5. Extensive discovery was taken by both sides, during both class 

certification and merits phases of this action. Collectively, during the case the 

parties produced over 11,600 documents consisting of approximately 162,000 

pages, and the parties took 27 separate depositions.

6. On September 13, 2016, the parties held a day-long, face-to-face 

mediation session with Judge Brown at JAMS’s offices in New York City. That 

productive mediation resulted in an agreement in principle. The parties then 

negotiated the terms of a settlement agreement and drafted the agreement and 

related documents. The fully-executed Settlement Agreement and all exhibits 

thereto are attached as Exhibit A to this declaration.

1 Capitalized terms not defined herein have the meaning ascribed to them in 

the memorandum in support of Plaintiff’s motion. 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 2 of 74 PageID: 19881
3

7. The parties agreed to use the one-year lookback period for purposes of 

identifying recent Claim Redeterminations because United has represented that it is 

the period of time when (a) in part due to United’s policy of adhering to state law 

time limits on its ability to recoup overpayments, Class Members are at the greatest 

risk of having the alleged overpayment recovered by United, via offset, collection, 

or otherwise; and (b) United has the maximum ability to provide the specified 

appeal rights. The twelve-month period is “approximate” only to reflect that 

United’s internal systems cannot show the exact date on which a reprocessed EOB 

was issued to a provider from its overpayment data system; United will determine 

the universe of eligible providers as closely as can be determined through

reasonable effort.

8. After the Court certified the Class with Integrated Orthopedics as the 

Class Representative, the parties undertook an extensive and intensive period of 

merits discovery in 2015. Three IO personnel sat for lengthy depositions, and IO 

followed case developments throughout the case.

9. During the merits discovery phase, Class Counsel uncovered evidence 

that supported the motion for partial summary judgment that Plaintiffs filed in 

August 2015.

10. Plaintiff was well informed during the settlement negotiation process. 

Plaintiff engaged in aggressive fact discovery in the months after class 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 3 of 74 PageID: 19882
4

certification, deposing over 20 people and gathering significant documentary 

evidence, all of which had informed its decision to move for partial summary 

judgment. In short, Plaintiff went into the mediation and settlement negotiations 

armed with years of evidence to support its claims, and drew on that evidence 

during the settlement activities.

11. As it did when it was appointed Class Representative in 2014, Named 

Plaintiff IO currently has an unresolved Repayment Request.

12. Class Counsel have worked successfully with A.B. Data, Ltd. in other 

class action cases in which Class Counsel have sought the appointment of A.B. 

Data to serve as Settlement Administrator. See www.abdataclassaction.com.

I declare under penalty of perjury that the foregoing is true and correct. 

Executed electronically on August 4, 2020 in Chevy Chase, Maryland.

Respectfully submitted,

 /s/ Andrew N. Goldfarb 

Andrew N. Goldfarb

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 4 of 74 PageID: 19883
EXHIBIT A

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 5 of 74 PageID: 19884
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 6 of 74 PageID: 19885
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 7 of 74 PageID: 19886
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 8 of 74 PageID: 19887
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 9 of 74 PageID: 19888
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 10 of 74 PageID: 19889
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 11 of 74 PageID: 19890
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 12 of 74 PageID: 19891
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 13 of 74 PageID: 19892
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 14 of 74 PageID: 19893
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 15 of 74 PageID: 19894
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 16 of 74 PageID: 19895
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 17 of 74 PageID: 19896
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 18 of 74 PageID: 19897
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 19 of 74 PageID: 19898
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 20 of 74 PageID: 19899
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 21 of 74 PageID: 19900
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 22 of 74 PageID: 19901
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 23 of 74 PageID: 19902
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 24 of 74 PageID: 19903
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 25 of 74 PageID: 19904
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 26 of 74 PageID: 19905
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 27 of 74 PageID: 19906
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 28 of 74 PageID: 19907
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 29 of 74 PageID: 19908
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 30 of 74 PageID: 19909
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 31 of 74 PageID: 19910
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 32 of 74 PageID: 19911
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 33 of 74 PageID: 19912
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 34 of 74 PageID: 19913
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 35 of 74 PageID: 19914
Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 36 of 74 PageID: 19915
Exhibit 1

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 37 of 74 PageID: 19916
7235501.2

[Settlement Administrator]

PO Box XXX

City, ST 12345-0000

[Class Member Name]

[Street Address]

[City, State, ZIP]

THIS IS NOT JUNK MAIL.

THIS POSTCARD

PROVIDES IMPORTANT

INFORMATION ABOUT

YOUR LEGAL RIGHTS IN

A CLASS ACTION CASE.

PLEASE READ.

PRESORTED

First-Class

Mail

US Postage

Paid

City, ST

Permit No.

XXX

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 38 of 74 PageID: 19917
7235501.2

The United States District Court for the District of New Jersey authorized this Notice. This is not a

solicitation from a lawyer.

If you are an Out-of-Network Healthcare Provider who received notice of an alleged 

overpayment from United HealthCare or its affiliates after January 24, 2005, 

you may be affected by a class action settlement.

Why Are You Receiving This Notice? This Notice is about the settlement of a class action lawsuit: Integrated 

Orthopedics, Inc. v. UnitedHealth Group, et al. (the “Lawsuit”). The Lawsuit concerns Repayment Requests sent 

by United HealthCare or its affiliates (“United”) to out-of-network (“ONET”) providers related to alleged 

overpayments. The Court certified the Lawsuit as a class action on December 15, 2014. You are receiving this 

Notice because United has identified you as an ONET provider to whom it sent a Repayment Request on or after 

January 24, 2005 that was still pending as of the date of the Settlement Agreement, and you are thus a member of 

the Class. This notice informs you of the consequences of the Settlement and your right to object.

What Is the Lawsuit About? After paying claims submitted by ONET providers, United sometimes determined 

that it overpaid a claim and sent the provider a Repayment Request seeking repayment of the claimed overpayment. 

Plaintiff alleged that United failed to provide notice and appeal rights required by the Employee Retirement Income 

Security Act of 1974 (“ERISA”) in connection with those Repayment Requests. The Class did not seek the payment 

of any money, but sought to require United to provide ERISA notice and appeal rights to ONET providers in 

connection with past and future Repayment Requests. United denies that it did anything wrong. 

What is the Settlement? With respect to its UNET claim adjudication system, United will make clearer how Class 

members and all other ONET providers can receive certain ERISA rights as Authorized Representatives of United 

insureds in connection with existing and future Claim Redeterminations under ERISA-governed plans, and will 

make it easier for ONET providers to do so. This includes: making available to all providers an exemplar Authorized 

Representative form that United will accept from providers; agreed-upon language that providers can include in 

Assignment of Benefits forms to confirm their status as Authorized Representatives; providing upon provider 

request ERISA notice, appeal, and litigation rights concerning Claim Redeterminations and Repayment Requests 

that United sent to ONET providers within the twelve months preceding the Settlement Agreement; and treating as 

an Authorized Representative any Class Member who litigates United’s pending Repayment Request that caused 

that person to be a Class Member. Subject to approval by the Court, United will pay attorneys’ fees and expenses 

of $4,210,000 to class counsel and a service award of $40,000 to the Class representative. Class members will 

release United from any claims related to United’s alleged failure to afford any member of the Class notice and 

appeal rights required by ERISA for past Overpayment Determinations or related Claim Redeterminations.

What Do I Need to Do Now? You do not have to do anything to be covered by the proposed Settlement. If the 

Settlement is approved by the Court, you will automatically receive all the benefits of the Settlement. You can also 

object to the Settlement. For more information about the Settlement and instructions on objecting, visit the website 

listed below or contact the Settlement Administrator using the contact information below. It is important to note that 

the deadline for objecting is [Month 00, 2020].

Where Can I Get More Information? You can obtain a more detailed notice and other important documents, 

including the Settlement Agreement (which contains definitions of the capitalized terms in this summary notice), at 

www.UnitedERISARightsClassAction.com; or by calling the Settlement Administrator at ###-###-####. Do not call 

United.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 39 of 74 PageID: 19918
Exhibit 2

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 40 of 74 PageID: 19919
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY

QUESTIONS? CALL 1-###-###-#### TOLL FREE

Or Visit: www.UnitedERISARightsClassAction.com

PARA UNA NOTIFICACIÓN EN ESPAÑOL, LLAMAR O VISITAR NUESTRO WEBSITE

7247043.1

If you are an Out-of-Network Healthcare

Provider who received an overpayment notice

from United HealthCare after

January 24, 2005, you may be affected by

a class action settlement.

A federal court authorized this notice. This is not a solicitation from a lawyer.

• The Settlement resolves a certified class action lawsuit alleging that United HealthCare or 

its affiliates (“United”) did not provide notice and appeal rights required by the Employee 

Retirement Income Security Act of 1974 (“ERISA”) in connection with Repayment 

Requests sent by United to out-of-network (“ONET”) providers after January 24, 2005.

• The Class did not seek the payment of any money, seeking instead certain notice and appeal 

rights in connection with United’s Repayment Requests to ONET providers.

• The Settlement will give ONET providers clear guidance on how to exercise ERISA appeal 

rights as Authorized Representatives of their patients whose benefits are insured or 

administered by United. The Settlement also provides certain notice, appeal, and litigation 

rights to Class Members concerning pending Repayment Requests from United. The 

Settlement releases United from liability for any past failure to provide ERISA notice and 

appeal rights in connection with Repayment Requests.

• Subject to Court approval, United will pay court-appointed lawyers for the Class 

$4,210,000 as fees and expenses for investigating the facts, litigating the case, and 

negotiating the Settlement, and a $40,000 service award to the Class Representative.

• This is a non-opt-out class. If the Settlement is approved, your legal rights will be affected 

regardless of whether you act. Read this Notice carefully.

YOUR LEGAL RIGHTS AND OPTIONS IN THIS SETTLEMENT:

DO NOTHING You will remain in the Class and, if the Court grants final approval, 

receive the benefits of the Settlement.

OBJECT

Write to the Court about why you disagree with the Settlement. You 

will remain a part of the Class and entitled to the benefits of the 

Settlement if approved, but may still object to the Settlement, provided 

that you do so by [DATE]. You cannot opt out of the Settlement.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 41 of 74 PageID: 19920
2

7247043.1

GO TO A HEARING

You have the right to attend the Court’s fairness hearing and to speak 

about the fairness of the Settlement is such a hearing, should you timely 

request by [DATE].

• These rights and options—and the deadlines to exercise them—are explained in this 

Notice.

• The Court still has to decide whether to approve the Settlement. 

WHAT THIS NOTICE CONTAINS

BASIC INFORMATION

1. Why did I receive notice of the proposed settlement?

2. What is this lawsuit about?

3. Why is this a class action?

4. Why is there a settlement?

WHO IS IN THE SETTLEMENT

5. How do I know if I am part of the Settlement?

6. Can I exclude myself from the Settlement?

THE SETTLEMENT BENEFITS—WHAT YOU GET

7. What does the Settlement provide?

THE LAWYERS REPRESENTING YOU

8. Do I have a lawyer in the case?

9. How will the lawyers be paid?

10. Will the Class Representative receive anything?

OBJECTING TO THE SETTLEMENT

11. How do I tell the Court that I disagree with the Settlement?

THE COURT’S FAIRNESS HEARING

12. When and where will the Court decide whether to approve the Settlement?

13. Do I have to come to the hearing?

14. May I speak at the hearing?

IF YOU DO NOTHING

15. What happens if I do nothing at all?

GETTING MORE INFORMATION

16. Are there more details available about the Settlement?

17. How do I get more information?

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 42 of 74 PageID: 19921
3

7247043.1

BASIC INFORMATION

1. Why did I receive notice of the proposed settlement?

United has identified you as an out-of-network (“ONET”) provider to whom it sent a request for 

repayment of an alleged claim overpayment (a “Repayment Request”) on or after January 24, 2005,

and which was still pending as of the date of the Settlement. This makes you a member of the 

Class in the Lawsuit (a “Class Member”).

The Court ordered that you receive notice because you have a right to know about the proposed 

settlement in this class action lawsuit and about all of your options before the Court decides 

whether to approve the Settlement. If the Court approves it, and after any objections and appeals 

are resolved, United will provide clear instructions for Class Members and all ONET providers to 

pursue ERISA appeal rights as authorized representatives of patients whose benefits are insured 

or administered by United (“United insureds”) in the future. The Settlement will also provide 

Class Members the opportunity to pursue appeal rights as authorized representatives in connection 

with certain existing Repayment Requests and will provide clear instructions for Class Members 

to challenge United’s recovery of an alleged overpayment. You will be informed of developments 

on the Settlement website. Information provided in this Notice explains the lawsuit, the 

Settlement, and your rights.

The Court in charge of the case is the United States District Court for the District of New Jersey, 

and the case is known as Integrated Orthopedics, Inc. v. UnitedHealth Group, et al., Civil Action 

No. 11-425 (ES) (JAD). The entities that initiated the lawsuit are Plaintiffs, and the United entities 

they sued are Defendants.

2. What is this lawsuit about?

The lawsuit concerned instances where, after first paying a claim submitted by an ONET provider, 

United later determined that it overpaid that claim and sent the provider a Repayment Request. 

The lawsuit claimed that, on and after January 24, 2005, United failed to give ONET providers 

notice and appeal rights required by ERISA in connection with those Repayment Requests.

These notice and appeal rights are set forth in 29 C.F.R. § 2560.503-1(g) and (h) (the “ERISA 

Claims Regulation”). This regulation mandates that “the plan administrator shall provide a 

claimant with . . . notification of any adverse benefit determination . . . [that] shall set forth” (among 

other things) the following:

• “The specific reason or reasons for the adverse determination”; 

• “Reference to the specific plan provisions on which the determination is based”; 

• “A description of the plan’s review procedures and the time limits applicable to such 

procedures, including a statement of the claimant’s right to bring a civil action under 

section 502(a) of the Act following an adverse benefit determination on review”; and

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 43 of 74 PageID: 19922
4

7247043.1

• “If an internal rule, guideline, protocol, or other similar criterion was relied upon in making 

the adverse determination, either the specific rule, guideline, protocol, or other similar 

criterion; or a statement that such a rule, guideline, protocol, or other similar criterion was 

relied upon in making the adverse determination and that a copy of such rule, guideline, 

protocol, or other criterion will be provided free of charge to the claimant upon request; 

and the right to appeal the claim redetermination.”

The regulation also requires the establishment of “a procedure by which a claimant shall have a 

reasonable opportunity to appeal an adverse benefit determination.” 

The Class did not seek the payment of any money but rather that United be required to provide 

these ERISA appeal rights to ONET providers in connection with United’s Repayment Requests.

3. Why is this a class action?

In a class action, one or more people called class representatives (in this case, the Class 

Representative is Integrated Orthopedics, Inc., an Illinois supplier of durable medical equipment 

and durable medical supplies), sue on behalf of people who have similar claims. All of these 

people are class members and together they are the class. A single court will resolve the issues for 

all class members. U.S. District Judge Esther Salas is the judge who presides over this class action.

4. Why is there a settlement?

The Court did not decide in favor of Plaintiffs or Defendants. Instead, both sides agreed to the 

Settlement. That way, both sides avoid the cost and risks of a trial. The Class Representative and 

the attorneys for the Class think that the Settlement is best for all Class Members.

WHO IS IN THE SETTLEMENT

5. How do I know if I am part of the Settlement?

If you received a postcard notice about this settlement from the Settlement Administrator, United 

has identified you as a member of the Class from its records. The Class is defined as all ONET 

providers that any time after January 24, 2005: (1) provided healthcare services or supplies to 

patients insured under a United Plan, (2) after having received benefit payments from United for 

those services or supplies, received one or more Repayment Requests from or on behalf of United 

for all or a portion of such payments, and (3) where at least one such Repayment Request has not 

been fully resolved by payment, offset, or otherwise, as of the Effective Date of the Settlement

Agreement.

6. Can I exclude myself from the Settlement?

No. If you are a Class Member, and the Court grants final approval to the Settlement, you and all 

other Class Members will be bound by the terms of the Settlement. You cannot exclude yourself 

from, or “opt out” of, the Settlement.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 44 of 74 PageID: 19923
5

7247043.1

THE SETTLEMENT BENEFITS—WHAT YOU GET

7. What does the Settlement provide?

The Settlement provides important rights to Class Members and all ONET providers, both for 

future claims, and for existing overpayment claim redeterminations and Repayment Requests. For 

more details, see Section II of the Settlement Agreement, available on the website.

Going Forward: ERISA Appeal Via Authorized Representative Status

United does not automatically provide ERISA appeal rights to ONET providers in connection with 

claim determinations because only ERISA plan participants (i.e., patients) are entitled to those 

rights. The Settlement provides that, in the future, United’s UNET claim adjudication system will 

allow both Class Members and other ONET providers that are the “Authorized Representative” of 

a United plan participant to pursue ERISA appeals on the plan participant’s behalf. An Authorized 

Representative is a person entitled to act on behalf of a plan participant, under section (b)(4) of the

ERISA Claims Regulation.

Under the terms of the Settlement, with respect to the appeal of a future claim redetermination that 

is issued by United’s UNET claim adjudication system in connection with an ERISA-governed 

plan, United will treat as and deem to be an Authorized Representative any ONET provider that

submits to United in connection with that appeal either (a) an executed Authorized Representative 

Form that confers Authorized Representative status (United’s version of an Authorized 

Representative form is attached as Exhibit A to this Notice and will also be made available on 

United’s website and will be made freely available by United to all ONET providers upon request); 

or (b) any Assignment of Benefits form that includes language similar in substance to the language 

in Exhibit B to this Notice, regardless of the effectiveness of that form as an assignment of benefits. 

If you or any ONET provider submit either of these forms to United in connection with an appeal 

of a claim redetermination, United will allow that provider to pursue ERISA appeal rights as an 

authorized representative of a United insured in connection with that claim redetermination. 

Pending Overpayment Claim Redeterminations: ERISA Rights and Authorized

Representative Status

The Settlement also gives Class Members certain rights with respect to pending overpayment 

Claim Redeterminations and Repayment Requests in the event that United recovers any alleged 

overpayment that conferred Class Member status. If United recovers an overpayment that is the 

subject of any Overpayment Determination or Claim Redetermination that is related to a 

Repayment Request that conferred Class Member status, United: (a) will deem, treat, and regard 

Class Members who challenge that recovery in an individual, non-class action under 29 U.S.C. § 

1132(a)(1)(B) as Authorized Representatives for purposes of that litigation; (b) will not contend 

in any such civil action that the Settlement Agreement precludes the Class Member from arguing 

that administrative remedies were exhausted or that such exhaustion should be excused with 

respect to that recovery; (c) acknowledges that it is United’s position that the Repayment Requests

it sends to providers are not intended to alone provide proper notice of an adverse benefit 

determination under the requirements of the ERISA Claims Regulation; and (d) agrees that in any 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 45 of 74 PageID: 19924
6

7247043.1

such civil action, the Class Member may cite that acknowledgment in support of an argument

excusing exhaustion with respect to that recovery.

Class Members to whom United sent a Repayment Request and revised Provider Explanation of 

Benefits that indicated that the overpaid claim had been adjusted within one year prior to the

Effective Date of the Settlement Agreement will receive additional information and rights. The 

Settlement Agreement uses a one-year “lookback” period for the additional information and rights 

because it is the period of time when (a) in part due to United’s policy of adhering to state law 

time limits on its ability to recoup overpayments, Class Members are at the greatest risk of having 

the alleged overpayment recovered by United, via offset, collection, or otherwise; and (b) United 

has the maximum ability to provide the specified appeal rights. Those Class Members will receive 

a spreadsheet listing all such overpayment claim redeterminations with dates, dollar amounts, and 

an explanation for each overpayment claim redetermination. United will: (a) treat, deem, and 

regard all such Class Members as Authorized Representatives for those claim redeterminations; 

(b) give them the opportunity to request (free of charge) additional information about those claim 

redeterminations that affected them; and (c) notify them (i) that they can appeal those claim 

redeterminations within 180 days, (ii) that United will decide any such appeal within 540 days, 

and (iii) that Class Members can file a civil action under ERISA with respect to such overpayment 

claim redeterminations on behalf of the United member once all appeals have been exhausted, so 

long as the civil action is filed within applicable time limitations, which will be tolled while United 

decides the appeal. United further agrees that it will not argue in those appeals or in any postappeal civil action that the Class Member failed to exhaust administrative remedies.

THE LAWYERS REPRESENTING YOU

8. Do I have a lawyer in this case?

The Court appointed the following law firms as Class Counsel to represent Class Members, 

including you. These lawyers are called Class Counsel. You will not be charged for these lawyers. 

If you want to be represented by your own lawyer, you may hire one at your own expense.

John W. Leardi

Vincent N. Buttaci

Paul D. Werner

BUTTACI LEARDI & WERNER LLC

212 Carnegie Center, Suite 202

Princeton, NJ 08540

609-799-5150

D. Brian Hufford

Jason S. Cowart

ZUCKERMAN SPAEDER LLP

485 Madison Avenue, 10th Floor

New York, NY 10022

212-704-9600

Andrew N. Goldfarb

ZUCKERMAN SPAEDER LLP

1800 M Street, NW, Suite 1000

Washington, DC 20036

202-778-1800

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 46 of 74 PageID: 19925
7

7247043.1

9. How will the lawyers be paid?

The Settlement Agreement provides that, with Court approval, United will pay Class Counsel 

$4,210,000 for attorneys’ fees and out-of-pocket expenses incurred to prosecute this case. The 

attorneys’ fees would compensate Class Counsel for their work since 2011 to investigate the facts, 

litigate the case, and negotiate the Settlement—all without receiving any payment to date. None 

of that money will come from, or reduce in any way plan benefits payable to, any Class Member 

or ONET provider.

10. Will the Class Representative receive anything?

Pursuant to the Settlement Agreement, and subject to Court approval, United will pay the Class 

Representative, Integrated Orthopedics, Inc., the separate sum of $40,000 as a service award for 

its services as Class Representative. Those services included investigation of claims, providing 

facts and documents in support of those claims, and giving multiple employee or corporate 

depositions.

OBJECTING TO THE SETTLEMENT

11. How do I tell the Court that I don’t like the Settlement?

If you are a Class Member, you can object to the Settlement if you disapprove of any part of it. To 

object, you must use the Objection Form, which is available on the Settlement website, 

www.UnitedERISARightsClassAction.com. You may also send a letter, provided it contains the 

same information as requested on the Objection Form. You must mail the objection to the 

following four different addresses postmarked no later than [DATE]:

Court Clerk of the Court

United States District Court for the District of New Jersey

Martin Luther King Building & U.S. Courthouse

50 Walnut Street, Room 4015

Newark, NJ 07101

Class Counsel John W. Leardi

BUTTACI LEARDI & WERNER LLC

212 Carnegie Center, Suite 202

Princeton, NJ 08540

Andrew N. Goldfarb

ZUCKERMAN SPAEDER LLP

1800 M Street, NW, Suite 1000

Washington, DC 20036

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 47 of 74 PageID: 19926
8

7247043.1

Defense Counsel Brian D. Boyle

Kevin D. Feder

O’MELVENY & MYERS LLP

1625 Eye Street, NW

Washington, DC 20006

Please note: Judge Salas has ordered that, if you object, Class Counsel and Defense Counsel may 

take your deposition and review any relevant documents you may have, concerning your objection 

to the Settlement. Neither Class Counsel nor Defense Counsel would represent you in those 

proceedings. If you desire to have legal representation in connection with such a deposition, you 

will have to obtain—and pay—for that yourself.

THE COURT’S FAIRNESS HEARING

The Court will hold a hearing (a “Fairness Hearing”) to decide whether to approve the Settlement. 

You (or your lawyer if you have one) may attend, and you (or your lawyer) may ask to speak, but 

you do not have to do so.

12. When and where will the Court decide whether to approve the 

Settlement?

The Court will hold a Fairness Hearing at [DATE AND TIME], at the United States District Court 

for the District of New Jersey, Martin Luther King Building & U.S. Courthouse, 50 Walnut Street, 

Newark, NJ 07101, Courtroom MLK 5A. At this hearing, the Court will consider whether the 

Settlement is fair, reasonable, and adequate. If there are objections, the Court will consider them. 

Judge Salas will listen to people who have asked to speak at the hearing. After the hearing, the 

Court will decide whether to approve the Settlement, including the payment of attorneys’ fees and 

expenses and a service award to the Class Representative. We do not know how long it will take 

the Court to make these decisions.

13. Do I have to come to the hearing?

No. Class Counsel and Defense Counsel will answer questions Judge Salas may have. But you 

(or your lawyer if you have one) are welcome to come at your own expense. If you (or a lawyer 

on your behalf) send an objection, you do not have to come to Court to address it. As long as you 

mailed your written objection on time, the Court will consider it. You may also pay your own 

lawyer to attend, but it is not necessary.

14. May I speak at the hearing?

You (or your lawyer on your behalf) may ask the Court for permission to speak at the Fairness 

Hearing. To do so, you must send a letter stating your “Notice of Intention to Appear in Integrated 

Orthopedics, Inc. v. UnitedHealth Group, et al.” Be sure to include your name, address, telephone 

number, and signature. You may also use the Notice of Intention to Appear form found on the 

website. Your Notice of Intention to Appear must be postmarked no later than [Date] and be sent 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 48 of 74 PageID: 19927
9

7247043.1

to the Clerk of the Court, Class Counsel, and Defense Counsel, at the four addresses in listed in 

the answer to Question 11.

IF YOU DO NOTHING

15. What happens if I do nothing at all?

If you do nothing and the Settlement gains final approval of the Court, you will receive the benefits 

of the Settlement as described in Question 7. If the Settlement is not approved by the Court, your 

legal rights will not be affected by it.

GETTING MORE INFORMATION

16. Are there more details about the Settlement?

This Notice summarizes the proposed settlement. More details can be found on the Settlement

website, www.UnitedERISARightsClassAction.com. These documents include the following:

• Settlement Agreement

• Authorized Representative Form (Exhibit 5 to the Settlement Agreement)

• Assignment of Benefits Language (Exhibit 6 to the Settlement Agreement)

• Court’s August 28, 2014 Opinion Conditionally Granting Class Certification

• Court’s December 15, 2014 Opinion and Order Granting Class Certification

• Court’s [Date] Order Granting Preliminary Approval of Settlement Agreement

• Objection Form

• Notice of Intention to Appear

17. How do I get more information?

You can call 1-xxx-xxx-xxxx toll free; write to Integrated Orthopedics, Inc. v. UnitedHealth

Group Class Action Settlement Administrator, P.O. Box xxx, CITY, STATE, ZIP; or visit the 

Settlement website, www.UnitedERISARightsClassAction.com.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 49 of 74 PageID: 19928
Exhibit 3

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 50 of 74 PageID: 19929
7207159.3

UNITED STATES DISTRICT COURT

DISTRICT OF NEW JERSEY

INTEGRATED ORTHOPEDICS, INC., on 

behalf of a certified class,

Plaintiffs,

v.

UNITEDHEALTH GROUP, et al., 

Defendants.

Civil Action No. 11-425 (ES) (JAD)

FINDINGS AND ORDER GRANTING PRELIMINARY APPROVAL TO

PROPOSED SETTLEMENT, APPROVING FORM AND DISSEMINATION OF

CLASS NOTICE, AND SETTING DATE FOR HEARING ON FINAL APPROVAL

This litigation arose out of claims involving alleged breaches of fiduciary duties in 

violation of the Employee Retirement Income Security Act of 1974 (“ERISA”), as amended, 

29 U.S.C. § 1001 et seq., against UnitedHealth Group, United HealthCare Services, Inc., and 

OptumHealth Care Solutions, Inc. (collectively referred to as “United”).

Presented to the Court for preliminary approval is a settlement of the litigation as against 

United. The terms of the Settlement are set out in a Stipulation and Agreement of Settlement 

dated __________, 2020 (the “Settlement”), executed by counsel for Integrated Orthopedics 

(“Class Representative”) and for United. Except as otherwise defined herein, all capitalized 

terms used herein shall have the same meaning as ascribed to them in the Settlement.

The Court has preliminarily considered the Settlement to determine, among other things, 

whether the Court is likely to find the Settlement to be fair, reasonable, and adequate, and thus 

that members of the Class should receive notice concerning the Settlement. Upon reviewing the 

record and good cause appearing therefor,

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 51 of 74 PageID: 19930
2

7207159.3

It is hereby ORDERED, ADJUDGED AND DECREED as follows:

1. Preliminary Findings Regarding Proposed Settlement: The Court finds that it 

will likely conclude that:

A. The Class Representative and Class Counsel have adequately represented 

the Class.

B. The Settlement resulted from arm’s-length negotiations by experienced 

and competent counsel overseen in part by a neutral mediator;

C. The Settlement was negotiated only after Class Counsel had litigated the 

case for over six years, conducted thorough discovery of documentary evidence and deposition 

testimony; conducted a pre-settlement investigation; received pertinent information and 

documents from Defendants and non-parties; and participated in a year-long mediation before 

the Honorable Garrett E. Brown, Jr. (Ret.);

D. Class Counsel and the Class Representative have concluded that the 

Settlement is fair, reasonable, and adequate; and

E. The relief provided for the Class is adequate, taking into account the 

factors in Fed. R. Civ. P. 23(e)(2)(C) as relevant, including: (i) the costs, risks, and delay of trial 

and appeal; (ii) the effectiveness of distributing the proposed relief to the Class; and (iii) the 

terms of any proposed award of attorney’s fees, including timing of payment.

F. The Settlement treats Class members equitably relative to each other.

2. Fairness Hearing: A hearing (the “Fairness Hearing”) is scheduled at the United 

States District Court for the District of New Jersey, Judge Esther Salas presiding, at 

_____________.m. on ___________, 20__, [a date no sooner than one hundred twenty (120) 

calendar days after the date the Preliminary Order is filed] to determine, among other issues:

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 52 of 74 PageID: 19931
3

7207159.3

A. Whether the Settlement should be approved as fair, reasonable, and 

adequate;

B. Whether the Court should enter the Final Approval Order, and

C. Whether the Court should approve any motion for Attorneys’ Fees and 

Costs, and Class Representative Service Awards.

3. Class Certification: Pursuant to Fed. R. Civ. P. 23(c)(1)(C), the definition of the 

previously certified ONET Repayment Demand Class will be revised on a preliminary basis and 

for settlement purposes only as follows: 

All ONET Providers (such as individual practitioners, or durable medical 

equipment providers or facilities) who, at any time after January 24, 2005: (1) 

provided healthcare services or supplies to patients insured under a United Plan, 

(2) after having received benefit payments from United for those services or 

supplies, received one or more Repayment Requests from or on behalf of United 

for all or a portion of such payments, and (3) where at least one such Repayment 

Request has not been fully resolved by payment, offset, or otherwise, as of as of 

the Effective Date of This Agreement. 

4. Class Counsel: The Court appoints as counsel for the Class D. Brian Hufford, 

Jason S. Cowart, and Andrew N. Goldfarb of the law firm of Zuckerman Spaeder LLP; John W. 

Leardi, Vincent Buttaci, and Paul D. Werner of the law firm of Buttaci Leardi & Werner LLC; 

and Anthony Maul of The Maul Firm, P.C.

5. Settlement Administrator: The Court appoints _____ as Settlement 

Administrator.

6. Class Notice: The Settling Parties have presented to the Court proposed forms of 

notice regarding the settlement for mailing to Class Members (“Settlement Notices”).

A. The Court finds that the proposed forms and content therein fairly and 

adequately:

i. Describe the terms and effect of the Settlement;

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 53 of 74 PageID: 19932
4

7207159.3

ii. Notify the Class that Class Counsel will seek compensation for 

Attorneys’ Fees and Costs, and Class Representative Service 

Awards via an application to be filed with the Court at least 

fourteen (14) days before the deadline for submission of 

objections;

iii. Give notice to the Class of the time and place of the Fairness 

Hearing, and Class Members’ right to appear; and

iv. Describe how the recipients of the Class Notice may object to the 

Settlement, or to any requested attorneys’ fees and costs, or Class 

Representative Service Awards.

B. The Settlement Administrator will, at United’s expense, mail to Class 

members listed on the Class List the Short Form Notice in substantially the same form as Exhibit 

1, and post on the Website the Long Form Notice substantially in the same form as Exhibit 2. 

The Settlement Administrator shall use its best efforts to complete the mailing of the Short Form 

Notice to Class members within thirty (30) days after date of this order.

C. Pursuant to Rules 23(c)(2) and (e) of the Federal Rules of Civil Procedure, 

the contents of the Settlement Notices, the mailing of the Short Form Settlement Notice, and 

posting of the Long Form Notice on the Website constitute the best notice practicable under the 

circumstances, provide due and sufficient notice of the Fairness Hearing and of the rights of all 

Class Members, and comply fully with the requirements of Fed. R. Civ. P. 23, the Constitution of 

the United States, and any other applicable law.

7. Preliminary Injunction: Each Class Member and their respective heirs, 

beneficiaries, executors, administrators, estates, past and present partners, officers, directors, 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 54 of 74 PageID: 19933
5

7207159.3

agents, employees, owners, attorneys, predecessors, successors, and assigns, are preliminarily 

enjoined from commencing or prosecuting against the Released Parties any action, proceeding, 

suit, cause of action, or claim that alleges any of the Released Class Claims, even if any Class 

Member may thereafter discover facts in addition to or different from those which the Class 

Members or Class Counsel now know or believe to be true with respect to the Litigation and the 

Released Class Claims. Further, pending final determination of whether the Settlement should 

be approved, no Class Member may directly, through representatives, or in any other capacity, 

including as authorized representatives or assignees of patients, commence or prosecute any 

action, proceeding, suit, cause of action, or claim in any court or tribunal asserting any of the 

Released Class Claims against the Released Parties. However, nothing shall prevent United 

from seeking to dismiss or otherwise terminate any action or proceeding related to a Released 

Class Claim on grounds other than operation of the Settlement and/or this Final Approval Order; 

nor shall the assertion of other grounds for the dismissal or termination of an action or 

proceeding related to a Released Class Claim prevent United to from later asserting that such 

action or proceeding is prohibited under the Settlement and/or this Final Approval Order.

8. Fee and Expense Application: Class Counsel shall file a Fee and Expense 

Application (which may be part of Plaintiffs’ Motion for Final Approval) no later than fourteen 

(14) days prior to the date set forth in this Order as the deadline for the objections.

9. Objections to Settlement: Any objections to the fairness, reasonableness or 

adequacy of the Settlement, to any term of the Settlement, to the proposed Attorneys’ Fees and 

Costs, or Class Representative Service Awards shall be considered by the Court at the Fairness 

Hearing, if they have been filed validly with the Clerk of the Court and copies provided to Class 

Counsel and Defense Counsel. To be filed validly, the objection and any supporting documents 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 55 of 74 PageID: 19934
6

7207159.3

must be filed at least twenty-eight (28) days prior to the scheduled Fairness Hearing. Any person 

wishing to speak at the Fairness Hearing shall (personally or through counsel) file and serve a 

notice of intent to appear within the time limitation set forth above.

10. Responses to Objections and Final Approval Motion: Any party may file a 

response to an objection by a Class Member at least fourteen (14) days before the Fairness 

Hearing, and Plaintiffs shall file their Final Approval Motion at least seven (7) days before the 

Fairness Hearing.

11. CAFA Notices: The form of notices pursuant to the Class Action Fairness Act 

(“CAFA”), 29 U.S.C. § 1711, et seq., attached hereto, is approved. Upon mailing of the CAFA 

notices, Defendants shall have fulfilled their obligations under CAFA.

12. Stay of Litigation Proceedings That Are Unrelated to Settlement. Pending 

final determination of the joint application for approval of the Settlement Agreement, all 

proceedings in this Litigation other than settlement approval proceedings shall be stayed.

13. Continuance of Hearing: The Court may adjourn or continue the Fairness 

Hearing without further direct notice to the Class Members, other than by notice to Class 

Counsel.

IT IS SO ORDERED.

DATED:_______________ , 2020

HON. ESTHER SALAS

UNITED STATES DISTRICT JUDGE

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 56 of 74 PageID: 19935
Exhibit 4

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 57 of 74 PageID: 19936
7207170.2

UNITED STATES DISTRICT COURT

DISTRICT OF NEW JERSEY

INTEGRATED ORTHOPEDICS, INC., on 

behalf of a certified class,

Plaintiffs,

v.

UNITEDHEALTH GROUP, et al., 

Defendants.

Civil Action No. 11-425 (ES) (JAD)

FINAL APPROVAL ORDER AND JUDGMENT

Wherefore, this ___ day of __________, 20__, upon consideration of Plaintiffs’ motion 

for final approval of the Stipulation and Agreement of Settlement dated _____________ (herein 

the “Settlement”) in the above matter, the Court hereby orders and adjudges as follows:

1. For purposes of this Final Approval Order and Judgment, except as otherwise 

defined herein, all capitalized terms used herein shall have the same meaning as are ascribed to 

them in the Settlement.

2. The Court has jurisdiction over the subject matter of this action and personal 

jurisdiction over all parties to the action, including all members of the Class.

3. The Class is the previously-certified ONET Repayment Demand Class whose 

definition is hereby revised pursuant to Fed. R. Civ. P. 23(c)(1)(C) to be as follows:

All ONET Providers (such as individual practitioners, or durable medical 

equipment providers or facilities) who, at any time after January 24, 2005: 

(1) provided healthcare services or supplies to patients insured under a 

United Plan, (2) after having received benefit payments from United for 

those services or supplies, received one or more Repayment Requests from 

or on behalf of United for all or a portion of such payments, and (3) where 

at least one such Repayment Requests have not been fully resolved by 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 58 of 74 PageID: 19937
2

7207170.2

payment, offset, or otherwise, as of as of the Effective Date of This 

Agreement. 

4. Pursuant to Fed. R. Civ. P. 23(e)(2), the Court hereby approves and confirms the 

Settlement and the terms therein as being a fair, reasonable, and adequate settlement and 

compromise of the claims asserted in the Litigation.

5. The Court hereby approves the Settlement and orders that the Settlement shall be 

consummated and implemented in accordance with its terms and conditions.

6. In accordance with the Court’s Orders, and as reflected in the information from 

the Settlement Administrator, ____ Settlement Notices were timely distributed by first-class mail 

to all Class Members who could be identified with reasonable effort. Of those, ____ (____%) 

were returned as undeliverable. The Settlement Administrator searched for updated address 

information for those returned as undeliverable, and re-mailed notices to those Class Members. 

7. All requirements of the Class Action Fairness Act (“CAFA”), 29 U.S.C. § 1711, 

et seq., have been met, and Defendants have fulfilled their obligations under the Class Action 

Fairness Act, 29 U.S.C. § 1711, et seq., by timely providing notice of the Settlement to the 

Attorneys General for each of the states in which a Class Member resides, the Attorney General 

of the United States, and the United States Secretary of Labor.

8. The form and methods of notifying the Class Members of the terms and 

conditions of the proposed Settlement met the requirements of Fed. R. Civ. P. 23(c)(2) and (e), 

and due process, and constituted the best notice practicable under the circumstances; and due and 

sufficient notices of the Fairness Hearing and the rights of all Class Members have been 

provided to all people, powers, and entities entitled thereto.

9. The Court finds that the Settlement is fair, reasonable, and adequate, based on the 

following findings of fact, conclusions of law, and determinations of mixed fact/law questions:

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 59 of 74 PageID: 19938
3

7207170.2

a. The Class Representative and Class Counsel have adequately represented 

the Class.

b. The Settlement resulted from arm’s-length negotiations by experienced 

and competent counsel overseen in part by a neutral mediator;

c. The Settlement was negotiated only after Class Counsel had litigated the 

case for over six years, conducted thorough discovery of documentary evidence and deposition 

testimony; conducted a pre-settlement investigation; received pertinent information and 

documents from Defendants and non-parties; and participated in a year-long mediation before 

the Honorable Garrett E. Brown, Jr. (Ret.);

d. Class Counsel and the Class Representative have concluded that the 

Settlement is fair, reasonable, and adequate; and

e. The relief provided for the Class is adequate, taking into account the 

factors in Fed. R. Civ. P. 23(e)(2)(C) as relevant, including: (i) the costs, risks, and delay of trial 

and appeal; (ii) the effectiveness of distributing the proposed relief to the Class; and (iii) the 

terms of any proposed award of attorney’s fees, including timing of payment.

f. The Settling Parties were well-positioned to evaluate the value of the 

Litigation;

g. If the Settlement had not been achieved, both Plaintiffs and Defendants 

faced the expense, risk, and uncertainty of extended litigation;

h. The Class Representative has actively and independently participated in 

the Litigation;

i. Class Members had the opportunity to be heard on all issues regarding the 

resolution and release of their claims by submitting objections to the Settlement to the Court; and

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 60 of 74 PageID: 19939
4

7207170.2

j. There were ___ objections to the Settlement. ___ of those objections were 

timely. The Court has considered all of them, including the untimely ones, and has overruled 

them with prejudice.

10. The Motion for Final Approval of the Settlement is hereby GRANTED, the 

settlement of the Litigation is APPROVED as fair, reasonable, and adequate to the Class, and the 

Settling Parties are hereby directed to take the necessary steps to effectuate the terms of the 

Settlement.

11. The operative Second Amended Complaint and all claims asserted therein, 

whether asserted by the Class Representative on its own behalf or on behalf of the Class 

Members, or derivatively to secure relief for the United Plans, are hereby dismissed with 

prejudice and without costs to any of the Settling Parties, except as otherwise provided for in the 

Settlement.

12. Each member of the Class and their respective heirs, beneficiaries, executors, 

administrators, estates, past and present partners, officers, directors, agents, attorneys, 

predecessors, successors, and assigns, shall be (i) conclusively deemed to have, and by operation 

of this Final Approval Order shall have, fully, finally, and forever settled, released, relinquished, 

waived, and discharged the Released Parties from all Released Class Claims, and (ii) barred and 

enjoined from suing the Released Parties in any action or proceeding alleging any of the 

Released Class Claims. This provision shall apply to all such persons regardless of whether any 

such person (A) may thereafter discover facts in addition to or different from those which such 

person or Class Counsel now know or believe to be true with respect to the Litigation and the 

Released Class Claims, or (B) may have filed an objection to the Settlement.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 61 of 74 PageID: 19940
5

7207170.2

13. United shall be conclusively deemed to have, and by operation of this Final 

Approval Order shall have, fully, finally, and forever settled, released, relinquished, waived, and 

discharged Named Plaintiffs, members of the Class, or Class Counsel from all Released United 

Claims.

14. The Class Members hereby settle, release, relinquish, waive, and discharge any 

and all rights or benefits they may now have, or in the future may have, under any law relating to 

the releases of unknown claims, including without limitation, Section 1542 of the California 

Civil Code, which provides: “A general release does not extend to claims which the creditor 

does not know or suspect to exist in his favor at the time of executing the release, which if 

known by him must have materially affected his settlement with the debtor.” The Class

Members with respect to the Released Class Claims also hereby waive any and all provisions, 

rights, and benefits conferred by any law of any State or territory of the United States or any 

foreign country, or any principle of common law, which are similar, comparable or equivalent in 

substance to Section 1542 of the California Civil Code.

15. The Court finds that it has subject matter jurisdiction over the claims herein and 

personal jurisdiction over the Defendants and the Class Members pursuant to the provisions of 

ERISA and expressly retains that jurisdiction for purposes of enforcing this Final Approval 

Order and/or the Settlement. Any motion to enforce this Final Approval Order or the Settlement, 

including by way of injunction, may be filed in this Court, and the provisions of the Settlement 

and/or this Final Approval Order shall serve as and may be asserted as an absolute and complete 

affirmative defense and/or counterclaim to any action that is asserted in violation of the 

Settlement, in this or any other forum. However, nothing shall prevent United from seeking to 

dismiss or otherwise terminate any action or proceeding related to a released claim on grounds 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 62 of 74 PageID: 19941
6

7207170.2

other than operation of the Settlement and/or this Final Approval Order; nor shall the assertion of 

other grounds for the dismissal or termination of an action or proceeding related to a released 

claim prevent United from later asserting that such action or proceeding is prohibited under the 

Settlement and/or this Final Approval Order.

16. Upon the effective date of this Order, Plaintiffs, Defendants, and all Class 

Members shall be bound by the Settlement.

IT IS SO ORDERED.

DATED: ___________, 20___

HON. ESTHER SALAS

UNITED STATES DISTRICT JUDGE

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 63 of 74 PageID: 19942
Exhibit 5

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 64 of 74 PageID: 19943
6993849.1

Exhibit 5

Authorized Representative Form:

United will treat all forms executed by a plan beneficiary or plan participant as conferring 

Authorized Representative status on a provider that “authorize,” “designate,” “appoint,” “select” 

or “identify” a provider to act as the beneficiary or plan participant’s “representative.”

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 65 of 74 PageID: 19944
Exhibit 6

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 66 of 74 PageID: 19945
6993851.1

Exhibit 6

Assignment of Benefits:

United will treat all forms executed by a plan beneficiary or plan participant as an 

Assignment of Benefits where that form purports to “assign,” “convey,” or “transfer” to a 

provider any “right,” “claim,” “cause of action,” or “chose in action” with respect to the plan 

beneficiary’s or plan participants’ plan or insurance policy. Nothing in this Settlement prevents 

United from enforcing the terms of any plan provisions preventing plan participants from 

assigning rights to providers (“anti-assignment provisions”).

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 67 of 74 PageID: 19946
Exhibit 7

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 68 of 74 PageID: 19947
EXHIBIT 7

7235503.1

7247045.1

Legal Notice

A settlement has been approved by the Court in the class action lawsuit, Integrated Orthopedics 

v. UnitedHealth Group, Civil Action No.: 11-425 (ES) (JAD), (D.N.J). You have received this 

information because you have been identified as a class member who has provided service to a 

United member whose claim for healthcare benefits was redetermined within twelve (12) months

of the Effective Date of the Agreement (“Recent Claim Redetermination”). Pursuant to the 

terms of the settlement, the enclosed spreadsheet provides the following information about these 

recently redetermined claims:

• the claim number;

• the date(s) of service;

• the date of Repayment Request;

• the date of Claim Redetermination and associated reprocessed provider explanation of 

benefits;

• the dollar amount associated with each Claim Redetermination; and

• the remark codes from the member explanation of benefits explaining the basis for the 

Claim Redetermination.

Under the terms of the settlement, United has agreed to deem, regard, and treat you as an 

Authorized Representative for the United members on whose behalf you submitted these claims. 

As an Authorized Representative, you may appeal the redeterminations of the claims identified 

on the enclosed spreadsheet within 180 days pursuant to the ERISA Claims Regulation. If you 

appeal any such Claim Redetermination, United shall provide that United member with an appeal 

consistent with the requirements of § (h) of the ERISA Claims Regulation, 29 C.F.R.

§ 2560.503-1(h). United will decide any appeals filed pursuant to this process within 540 days 

of receipt of the appeal by United. Once all appeals have been exhausted, you may subsequently 

file a civil action under ERISA on the United member’s behalf.

You may also request (free of charge) information relevant to the Claim Redeterminations 

identified on the enclosed spreadsheet.

Should you choose to file an appeal under this process for any of the claims identified on the 

enclosed spreadsheet, please send those appeals to [NAME/ADDRESS] within 180 days.

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 69 of 74 PageID: 19948
CAFA Template Notice

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 70 of 74 PageID: 19949
7293548.2

July [--], 2020

BY CERTIFIED MAIL

TO: ALL ADDRESSEES LISTED IN ATTACHMENT A

Re: Notice of Stipulated Class Action Settlement

Integrated Orthopedics, Inc., on behalf of a certified class v. UnitedHealth Group, 

et al., Civil Action No.: 11-425 (ES) (JAD) (D.N.J.)

Dear [Attorney General] [Commissioner]:

Pursuant to 28 U.S.C. § 1715, enacted as part of the Class Action Fairness Act of 2005 

(“CAFA”), the undersigned settlement administrator, at the request of Defendants UnitedHealth 

Group, United HealthCare Services, Inc., and OptumHealth Care Solutions, Inc. (collectively 

referred to as “United” herein), hereby provides your office with notice of the proposed class 

settlement between Plaintiffs and United in the above-referenced matter pending in the United 

States District Court for the District of New Jersey before Judge Esther Salas.

Enclosed is a CD containing the following documents relating to the proposed settlement as

required by 28 U.S.C. §§ 1715(b)(1), (2), (3), (4), and (8). 

• Plaintiffs’ Complaint, Integrated Orthopedics, Inc., on behalf of a certified class v. 

UnitedHealth Group, et al., Civil Action No.: 11-425 (ES) (JAD) (D.N.J.);

1

• Plaintiffs’ First Amended Class Action Complaint;

• Plaintiffs’ Second Amended Class Action Complaint;

• Plaintiffs’ Motion for Preliminary Approval of Settlement with United, attaching Plaintiffs’ 

Memorandum in Support of Motion for Preliminary Approval of Settlement with United,

the Stipulation and Agreement of Settlement Between Plaintiffs and United, and the 

exhibits incorporated thereto, including:

o Proposed Short-Form Notice to be mailed to class members by the Settlement 

Administrator;

o Proposed Long-Form Notice for posting on the settlement website established, 

maintained and operated by the Settlement Administrator;

o Proposed Findings and Order Granting Preliminary Approval to Proposed

Settlement, Approving Form and Dissemination of Class Notice, and Setting Date 

for Hearing on Final Approval; and

 1 The caption for this matter was originally Premier Health Center, P.C., et al. v. UnitedHealth Group, et 

al. It was changed to the current caption by court order on July 7, 2015. 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 71 of 74 PageID: 19950
7293548.2

2

o Proposed Final Approval Order and Judgment.

• The Final Approval Hearing will be held on a date to be set by the Court.

Pursuant to 28 U.S.C. §§ 1715(b)(5) and (6), please be advised that counsel for United and 

counsel for Plaintiffs have not entered into any other settlement or other agreement at the time 

of the settlement, and the Court has yet to order any final judgment or notice of dismissal.

Pursuant to 28 U.S.C. § 1715(b)(7), because Plaintiffs and United settled before the parties 

identified the members of the putative class, it is not feasible now to provide the names of the 

class members who reside in each state. United has attempted to make a reasonable estimate 

of the number of potential class members residing in each state, and also to make a reasonable 

estimate of the proportionate share of the class members residing in each state relative to the 

total expected class membership. Because this litigation, and the settlement, do not involve 

monetary relief for class members, it is not possible to estimate the proportionate share of the 

claims of potential class members residing in any state in relation to the entire settlement 

amount.

If you have any questions about this notice, the proposed settlement, or the enclosed materials, 

please do not hesitate to contact United’s counsel, Brian Boyle of O’Melveny & Myers LLP, 

1625 Eye Street, NW, Washington, DC 20006.

Sincerely,

[INSERT NAME OF SETTLEMENT 

ADMINISTRATOR]

At the request of Defendants UnitedHealth Group, United HealthCare Services, Inc., and 

OptumHealth Care Solutions, Inc.

Enclosure

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 72 of 74 PageID: 19951
7293548.2

3

ATTACHMENT A

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 73 of 74 PageID: 19952
7293548.2

4

ATTACHMENT B 

Case 2:11-cv-00425-ES-CLW Document 421-2 Filed 08/05/20 Page 74 of 74 PageID: 19953