UMR Mailing Regarding UDS Claim Settlement

This week a small subset of NRECA Medical Plan participants received letters and settlement checks regarding the “UMR UDS ER Settlement.”

NRECA has confirmed the authenticity of these letters and checks with UMR as certain NRECA claims were impacted by the UMR UDS ER settlement. This mailing involves approximately 8,400 claims from 4,800 participants.

Participants who have additional questions should use the contact points contained in the letter for further information and assistance.

Background
On July 31, 2023, the U.S. Department of Labor (DOL) filed a complaint in the Western District of Wisconsin alleging that the denial of emergency room claims as non-emergent based solely on a diagnosis code list and certain urinary drug screening (UDS) claims violated ERISA.

UMR and the DOL agreed to settle the lawsuit. As a result of the settlement, UMR agreed to take the following steps for all impacted claims:

• Eligible plan participants who had UDS claims denied as not medically necessary within the impacted dates will automatically receive a per-claim amount.
• Plan participants that incurred out-of-pocket costs greater than the per-claim amount may submit an additional claim with supporting documentation to recover an additional amount up to $103.27 per claim. To receive this additional settlement amount, participants must submit proof of payments to the settlement administrator by September 2, 2025.