Georgia Pathway Class Action Settlement

What happened

BCBS-GA allegedly misrepresented the scope of its healthcare provider network to consumers who purchased individual or family Pathway health insurance plans beginning in the November 2015 open enrollment period for the 2016 plan year, and improperly required Pathway members to obtain a referral from a primary care physician to see a specialist for the 2019 plan year. Both sides agreed to settle before any judgment was entered; BCBS-GA admits no wrongdoing.

Do you qualify?

Non-excluded Georgia residents who were enrolled in a BCBS-GA Pathway Plan between January 1, 2016, and December 31, 2022, and have Qualifying Billed Charges (non-covered charges for out-of-network claims or documented out-of-network issues).

What you can claim

Read from the official settlement notice.

• Reimbursement for Qualifying Billed Charges

  Settlement Class Members with Qualifying Billed Charges (non-covered charges denied due to out-of-network provider issues or certain 2019 referral-related denials) will receive payment from the Distributable Settlement Amount.

Who is in the class

non-excluded Georgia residents enrolled in a BCBS-GA Pathway Plan between January 1, 2016, and December 31, 2022

Quoted from the settlement notice.

How to file

The claim deadline of February 26, 2026 has passed. Settlement Class Members in BCBS-GA's records with qualifying billed charges that are already documented will receive payment from the distributable settlement amount after deduction of court-approved fees, costs, and administration expenses. Those not in records or with additional undocumented charges had to submit a Claim Form by the deadline.