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Patients who received proton beam radiation therapy for prostate cancer and whom Anthem denied insurance coverage for their treatments may be eligible to claim reimbursement for out-of-pocket costs from a class action settlement.
Blue Cross Blue Shield Healthcare Plan of Georgia Inc. and Anthem Insurance Companies Inc. (collectively, Anthem) agreed to pay $3,625,000 to settle a class action lawsuit. The lawsuit alleges Anthem improperly denied benefits for PBRT for prostate cancer under Employee Retirement Income Security Act of 1974 plans because it said the treatment was experimental, investigational or unproven.
Who can file a claim?
Class members must meet all of the following criteria:
- They received PBRT for prostate cancer.
- They sought coverage from Anthem for this treatment.
- Insurance (Anthem or any other insurer) did not cover their PBRT treatments.
- Anthem identified them as a class member during the lawsuit’s discovery process.
The class includes individuals whose requests for preauthorization Anthem denied as well as those whom Anthem denied claims for reimbursement after treatment. Anthem must have denied the claim because it determined PBRT was experimental; investigational; unproven; not sufficiently proven in effectiveness; not medically necessary; did not meet clinical policy, criteria or coverage; or similar language.
How much can class members get?
The settlement fund is $3,625,000, but the settlement administrator will reduce this amount by court-approved attorneys’ fees and costs, service awards to class representatives and administration expenses before it makes payments to class members. Eligible class members will receive a payment based on the total amount they paid out-of-pocket for PBRT for prostate cancer that insurance did not cover.
If total valid claims are less than the net settlement fund, the settlement administrator may reimburse claimants up to their full out-of-pocket amount. If claims exceed the net fund, it will reduce payments proportionally.
How to claim a settlement payment
To receive a payment, class members must download, print and complete the PDF claim form and mail it to the settlement administrator. There is currently no online claim submission option.
Settlement administrator's mailing address: Taylor, et al. v. Blue Cross Blue Shield Healthcare Plan of Georgia Inc., et al. Settlement Administrator, P.O. Box 301132, Los Angeles, CA 90030-1132
The claim deadline is Oct. 10, 2026.
Is proof or documentation required to submit a claim?
Yes. Claimants must submit documentation showing:
- Provider’s name
- Provider’s address
- Date(s) of service
- Description of services provided
- Amount paid out-of-pocket for PBRT
Acceptable documentation includes provider bills, receipts or other records confirming the payment and treatment details.
Payout options
The settlement administrator will mail checks to the address class members provide.
$3.63 million settlement fund breakdown
The $3,625,000 settlement fund will cover:
- Settlement administration and costs: $20,000 for initial notices and expenses
- Attorneys' fees: Up to $906,250
- Attorneys' costs: $68,325.48
- Service awards: $10,000 each for two class representatives ($20,000 total)
- Payments to eligible class members: Remainder after above deductions
Important dates
- Deadline for exclusion: July 27, 2026
- Final approval hearing: Aug. 19, 2026
- Deadline to file a claim: Oct. 10, 2026
When is the Taylor v. Anthem payout date?
The settlement administrator will distribute payments after the court resolves any appeals and grants final approval to the settlement.
Why did this class action settlement happen?
The class action lawsuit alleged Anthem improperly denied PBRT coverage for prostate cancer patients under ERISA plans, labeling the treatment as experimental or not medically necessary.
Anthem denies wrongdoing but agreed to settle to avoid the risks and costs of ongoing litigation.
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