Aetna $1.75M LGBTQ+ Infertility Coverage Settlement

Danielle Toth

Editor

Published

February 26, 2026 5:32 PM

Updated

February 26, 2026

Who are the class members?

Individuals may be eligible for compensation if they meet all of the following criteria:

They resided in California and enrolled in an Aetna commercial health plan that covered infertility benefits at any time between April 17, 2019, and Dec. 31, 2024.
They had a uterus during the relevant time period.
They engaged in an eligible LGBTQ+ relationship during the relevant time period.
Aetna’s policy directly impacted them because they:

Sought and received insurance denial for IUI or ICI that Aetna would have covered if it did not consider them "infertile" OR
Did not seek coverage because they believed could not receive insurance coverage and paid out of pocket for IUI or ICI while on an Aetna plan

The settlement divides the class into four categories:

Category A: California residents whose Aetna records show the company denied them coverage for IUI or ICI based on the infertility definition, they had a uterus and they engaged in an eligible LGBTQ+ relationship during the class period
Category B: California residents whom Aetna denied coverage for IUI or ICI based on the infertility definition and who submit an attestation confirming they had a uterus and engaged in an eligible LGBTQ+ relationship when they sought coverage
Category C: California residents and Aetna plan members during the class period who submit an attestation and provide proof of out-of-pocket expenses for IUI or ICI services their plan would have covered
Category D: California residents whom Aetna denied coverage for IUI or ICI during the class period but later approved or paid within 90 days and who provide proof of unpaid out-of-pocket costs for artificial insemination services their plan would have covered. Category D-A includes residents Aetna identifies as being in an eligible LGBTQ+ relationship, and Category D-B includes residents who submit an attestation.

An eligible LGBTQ+ relationship is defined as a personal relationship (not including surrogacy) involving two individuals: one with a uterus and another incapable of producing viable sperm due to being assigned female at birth, intersex or transitioning from male to female.

How much can class members get?

The amount each class member can receive depends on the number of eligible claimants and their individual circumstances:

Default monetary payment: $10,000 if 175 or fewer class members; otherwise, a pro rata share of $1,750,000
Dollars for benefits payment: At least $1,408 for unreimbursed IUI or ICI expenses (calculated as 125% of the average CMS rates for relevant CPT codes, weighted for frequency and multiplied by the average number of cycles)
Special harms common fund: $250,000 in additional compensation for documented extraordinary harm, such as expenses exceeding the default payment, pain and suffering or loss of ability to get pregnant. The settlement administrator will split any leftover funds in this pool among class members who cashed their first checks.

How to claim a class action rebate

Class members in Category A do not need to take any action to receive the default payment unless they wish to claim additional compensation. Category B, C and D class members must submit a claim form via the online claim portal or by downloading, printing and completing the appropriate PDF claim form and sending it to the settlement administrator.

Settlement administrator's mailing address: Berton v. Aetna Inc., c/o Atticus Administration, PO Box 64053, St. Paul, MN 55164

What proof or documentation is necessary to submit a claim?

To file an online claim, class members must provide the notice ID from the settlement notice they received and their last name.
Category A claimants do not need to provide proof for the default payment but must provide proof for additional claims.
Category B claimants must provide an attestation to certify their eligible LGBTQ+ relationship status.
Category C and D claimants must provide an attestation and evidence of out-of-pocket expenses.

Payout options

The settlement administrator will issue payments by check to the address on file or provided on the claim form.
Checks are valid for at least 180 days after issuance. The settlement administrator will send uncashed checks to the California state controller’s unclaimed property division where class members can claim their awards later.

$1.75 million settlement fund

The $1,750,000 settlement fund covers.

Settlement administration costs: To be determined
Attorneys' fees: $1,600,000
Attorneys' expenses: Up to $25,000
Service award to class representative: $15,000
Payments to eligible class members: Up to $1,750,000

Important dates

Deadline to file a claim: June 29, 2026
Fairness hearing: Nov. 12, 2026

When is the Berton v. Aetna payout date?

The settlement administrator will issue payments to class members approximately 60 days after the court resolves any appeals and grants final approval of the settlement.

Why did this class action settlement happen?

The class action lawsuit alleged Aetna’s policies discriminated against LGBTQ+ individuals seeking infertility coverage. Under the policy, people in LGBTQ+ relationships had to pay out of pocket for multiple artificial insemination cycles before being considered "infertile" and eligible for further treatment coverage while heterosexual couples only needed to report 12 months of unprotected intercourse.

Aetna denied wrongdoing but agreed to settle to avoid the risk and expense of further litigation. The settlement also requires Aetna to change its policies nationwide to ensure equal access to infertility benefits.