AMERICAN ARBITRATION ASSOCIATION

Transcription

1 AMERICAN ARBITRATION ASSOCIATION In the Matter of the Arbitration Between JOHN IVAN SUTTER, M.D., P.A., on behalf of himself, and all others similarly situated, Claimant, -v- AAA No.: OXFORD HEALTH PLANS, INC., Respondent. NOTICE OF PROPOSED SETTLEMENT OF CLASS ARBITRATION, OF FINAL FAIRNESS HEARING TO CONSIDER THE PROPOSED SETTLEMENT, AND OF YOUR RIGHTS CONCERNING THE PROPOSED SETTLEMENT A PROPOSED CLASS SETTLEMENT INVOLVING OXFORD HEALTH PLANS LLC, FORMERLY KNOWN AS OXFORD HEALTH PLANS, INC. ( OXFORD ), WILL PROVIDE CASH PAYMENTS TO NEW JERSEY PARTICIPATING PHYSICIANS AND PRACTICE GROUPS WHO FURNISHED HEALTHCARE SERVICES TO ENROLLEES IN OXFORD S HEALTH PLANS. IF YOU ARE A PHYSICIAN OR PRACTICE GROUP WHO OR WHICH WAS CONTRACTED TO PARTICIPATE IN OXFORD S NETWORKS IN THE STATE OF NEW JERSEY AT ANY TIME DURING THE PERIOD FROM DECEMBER 11, 1996 THROUGH DECEMBER 31, 2004, PLEASE READ THIS NOTICE CAREFULLY. THIS CLASS ARBITRATION AND THE PROPOSED SETTLEMENT MAY AFFECT YOUR RIGHTS. An arbitrator authorized this Notice. This is not a solicitation from a lawyer. YOUR LEGAL RIGHTS AND OPTIONS IN THIS PROPOSED SETTLEMENT Submit A Claim Ask To Be Excluded Object The way to get a payment. You must fill out the attached Claim Form in accordance with the attached Claim Form Instructions and return the Claim Form by first-class mail, postmarked no later than June 30, 2015, or via by no later than June 30, 2015 (see below). Get no payment: The only option that allows you to individually sue Oxford over the claims resolved by the proposed Settlement. You must submit a request to be excluded postmarked no later than June 30, 2015 (see below). Write to the Arbitrator about why you do not agree with the proposed Settlement. You cannot object if you ask to be excluded from the proposed Settlement. You must submit your written objection no later than June 30, 2015 (see below). Go To The Final Fairness Hearing Do Nothing The Final Fairness Hearing will be held on August 12, 2015 at 10:30 a.m. Eastern time, at which time the Arbitrator will make a final decision as to whether the proposed Settlement is fair to all members of the Settlement Class. If you wish, you may attend the hearing and ask to speak about the proposed Settlement. You must submit a request to appear at the hearing, postmarked no later than June 30, 2015 (see below). Get no payment and give up your rights. N4371 v Page 1 of 8

2 These rights and options and the deadlines to exercise them are explained in this Notice and the Settlement Agreement. The proposed Settlement will resolve all claims against Oxford as explained in the Settlement Agreement. The Arbitrator in charge of this case still has to decide whether to approve the proposed Settlement. Payments will only be made if the Arbitrator approves the Settlement, a court confirms that approval, and any appeals are resolved in favor of the proposed Settlement. Please be patient. BASIC INFORMATION I. WHY YOU SHOULD READ THIS NOTICE If you are a physician or a practice group who or which practiced in New Jersey at any time from December 11, 1996 through December 31, 2004, your rights may be affected by a proposed settlement ( Settlement ) with Oxford in the class arbitration entitled John Ivan Sutter, M.D., P.A. v. Oxford Health Plans, Inc., American Arbitration Association ( AAA ) Case No (the Arbitration ), which is pending before arbitrator W.L.D. Barrett (the Arbitrator ). Mr. Barrett received his Bachelor s degree from Yale University in 1960, received his law degree from Harvard University in 1963, and has been practicing law since He presently serves as Of Counsel in the New York office of Fulton, Rowe & Hart LLP and, in addition to having presided over numerous AAA arbitrations, also serves on the AAA s board of directors and executive and finance committees. The Arbitrator authorized this Notice because you have a right to know about the proposed Settlement, including the right to claim money and about all of your options, before the Arbitrator decides to give final approval of the Settlement. The proposed Settlement will resolve the claims asserted against Oxford in the Arbitration. This Notice explains the Arbitration, the Settlement, your legal rights, the benefits that are available, who may be eligible for them, and how to get them. You may be a Settlement Class Member (described below) in the Arbitration if you have participated in an Oxford physician network in the State of New Jersey. The representative claimant, John Ivan Sutter, M.D., P.A. (the Claimant ), is a board-certified pediatrician who maintains his medical practice in Clifton, New Jersey. Dr. Sutter received his undergraduate degree from New York University in 1974, a medical degree from Far Eastern University in 1978, and has been practicing medicine since Dr. Sutter has served as a class representative in connection with similar class action settlements that have been approved by courts. Claimant has agreed to settle and dismiss with prejudice all claims asserted by Settlement Class Members against Oxford in the Arbitration and the Litigation (described below) in exchange for the establishment of a Settlement Fund with respect to which Settlement Class Members can make claims for a settlement payment. The Arbitrator has scheduled a hearing (the Final Fairness Hearing ) to consider the fairness, reasonableness, and adequacy of the proposed Settlement on August 12, 2015 at 10:30 a.m. Eastern time, or such other date as the Parties and Arbitrator mutually agree after that date, at the law offices of Weil, Gotshal & Manges LLP, 767 Fifth Avenue, New York, New York Please note that the Arbitrator may adjourn the Final Fairness Hearing without further written notice to Settlement Class Members. You may be a Settlement Class Member entitled to receive the benefits of the proposed Settlement. As a Settlement Class Member, however, you also will be bound by the release and other provisions of the Settlement Agreement if it is approved by the Arbitrator, confirmed by a court, and any appeals are resolved in favor of the proposed Settlement. You may elect to Opt Out of the Settlement Class and the Settlement, as explained below. You also may have a right to object to the Settlement or to the applications for Attorneys Fees, Expenses, and a Class Representative Fee to the Claimant, but only if you comply with the procedures described in this Notice. BECAUSE YOUR RIGHT TO PURSUE CERTAIN TYPES OF CLAIMS AGAINST OXFORD MAY BE AFFECTED BY THE SETTLEMENT, YOU SHOULD READ THIS NOTICE CAREFULLY. II. WHAT IS THIS ARBITRATION ABOUT? The Demand for Arbitration (the Demand ) alleges, among other things, that Oxford systematically denied and reduced reimbursement to Claimant and other participating physicians and practice groups in Oxford s provider networks in New Jersey for medically necessary services by routinely and unjustifiably refusing to pay for, or reducing payment for, more than one healthcare service per visit or incident, referred to as bundling ; by routinely and unjustifiably ignoring codes, known as modifiers, that are supposed to increase levels of reimbursement for complicated medical procedures that require physicians to expend extra time and resources on the treatment of a N4372 v Page 2 of 8

3 particular patient; and by other related practices. Claimant further alleges that Oxford routinely and unjustifiably failed to make payments to Claimant and other participating physicians and practice groups in Oxford s provider networks in New Jersey within the required time periods prescribed by the applicable provisions of Oxford s provider agreements and New Jersey state law, and that Oxford failed to pay interest on claims that were past due. The Demand claims that the conduct described above constitutes, among other things, a breach of contract. Oxford denies the factual allegations and legal claims asserted in the Demand and denies any liability or wrongdoing relating thereto. The Arbitrator has not decided in favor of either side in this case. The Parties have entered into the proposed Settlement to avoid the expense, inconvenience, uncertainty, risk, and burden of a protracted and complex class arbitration and subsequent proceedings, including possible appeals. If you would like further information about the claims asserted in the Arbitration, you can review a copy of the Demand at Claimant initially filed a complaint against Oxford and other defendants in the Superior Court of New Jersey Law Division Essex County in 2002 asserting various claims involving Oxford s payment practices in an action entitled, John Ivan Sutter, M.D., P.A. v. Horizon Blue Cross Blue Shield of New Jersey, Inc. et al., Docket No. L (the Litigation ). Oxford filed a motion to compel arbitration based on the arbitration clause in Claimant s provider agreement, which was granted by the Court. Later the same year, Claimant initiated the Arbitration against Oxford. Since the initial Demand was filed, the Arbitrator certified an arbitration class and has also issued numerous rulings on a wide variety of other issues, and the case has undergone multiple appeals to the United States District Court for the District of New Jersey, the Third Circuit Court of Appeals, and the United States Supreme Court to resolve issues concerning whether the Arbitration could be pursued on a class basis. After significant discovery since 2003 and extensive settlement discussions in 2008, 2013, and 2014, the Parties reached a proposed Settlement in principle, subject to definitive documentation and approval by the Arbitrator and the Court, in December, III. WHAT IS A CLASS ARBITRATION, AND WHY IS THIS CASE A CLASS ARBITRATION? In a class arbitration, one or more people, called class representatives, sue on behalf of others with similar legal claims and the same or similar arbitration clauses. All of these people together are called a class or class members. One arbitrator or a panel of arbitrators resolves the issues for all class members, except for those who specifically ask to be excluded from the class, because the claims that were alleged by the class representatives apply similarly to all class members. This case was filed as a class arbitration because Claimant believed that Oxford s claims processing practices operated to improperly deny, reduce, and delay reimbursement of physician claims for healthcare services in breach of Oxford s contracts with participating New Jersey physicians and practice groups. IV. WHAT ARE THE TERMS OF THE PROPOSED SETTLEMENT? In a settlement agreement dated February 20, 2015 (the Settlement Agreement ), Claimant has agreed to settle all claims that were or could have been asserted by Settlement Class Members against Oxford in the Arbitration and Litigation in exchange for monetary consideration. The terms of the Settlement Agreement are summarized in this Notice, but a copy of the entire Settlement Agreement can be reviewed at A. The Settlement Class The proposed Settlement is between Oxford and a class of all physicians and practice groups, regardless of specialty, who or that participated in any of Oxford s physician networks in the State of New Jersey pursuant to a written provider agreement during the period from December 11, 1996 through December 31, 2004 (the Settlement Class Period ) and who during that period or thereafter provided Covered Services to any Plan Member pursuant to such provider agreement, and who do not validly and timely Opt Out of this Settlement (referred to herein collectively as the Settlement Class, and individually as Settlement Class Members ). The Settlement Class has been conditionally certified for purposes of the Settlement. B. The Settlement Consideration The Settlement Agreement provides for monetary benefits, in the form of the Settlement Fund described below, to be provided by Oxford to Settlement Class Members if the proposed Settlement is approved by the Arbitrator, confirmed by a court, and any appeals are resolved in favor of the proposed Settlement. N4373 v Page 3 of 8

4 C. The Settlement Fund As a part of the Settlement, Oxford has agreed to make a settlement payment of $1,380,000, which, together with accrued interest and less the payment of any applicable tax-related costs and expenses, will be distributed to physicians and practice groups who are Settlement Class Members and who timely file a valid Claim Form (the Physician Amount and Practice Group Amount, respectively). If the proposed Settlement is approved by the Arbitrator, confirmed by a court, and any appeals are resolved in favor of the proposed Settlement, these Settlement Class Members will be entitled to payments from the Settlement Fund in accordance with formulas that are set forth in the Settlement Agreement. Each Settlement Class Member who files a valid Claim Form postmarked by June 30, 2015 shall be entitled to receive payment from the Settlement Fund. The amount of each Settlement Class Member s payment will be determined according to whether he, she, or it is a Physician or Practice Group in accordance with the formulas set forth below and in the Settlement Agreement. The Physician Amount will be determined by reference to Physician Settlement Class Member s estimated Gross Receipts for providing Covered Services to Plan Members pursuant to a participating provider agreement with Oxford during any three (3) calendar years between selected by the Settlement Class Member, combined, were (x) less than $5,000, (y) at least $5,000 but less than $50,000, or (z) $50,000 or greater. The Practice Group Amount shall be determined by reference to the estimated Gross Receipts for providing Covered Services to Plan Members for each Physician within the Practice Group, pursuant to a participating provider agreement with Oxford, during any three (3) calendar years between selected by the Settlement Class Member, using the same categories [(x), (y), and (z) above]. A Practice Group Settlement Class Member may submit a Claim Form on behalf of its Physicians only if (a) it identifies the Physicians within the Practice Group on whose behalf it is submitting the Claim Form, and (b) such Physicians do not submit a Claim Form on their own behalf. If any Physician Settlement Class Member within a Practice Group submits his or her own Claim Form, and the Practice Group also submits a Claim Form on behalf of that Physician, the Practice Group s claim as to that Physician in the Claim Form will not be considered for payment from the Settlement Fund. For purposes of this determination, Gross Receipts include amounts paid by Oxford for providing Covered Services to Oxford Plan Members. The category into which each Settlement Class Member falls [(x), (y), or (z) above] shall be based upon the Settlement Class Member s certification in the Claim Form. Each Settlement Class Member may certify the amount of his, her, or its Physicians estimated Gross Receipts based on information and belief, without the necessity of reviewing or submitting records or documentation. Therefore, Settlement Class Members may not contact Oxford to make inquiries, or to request data or other information, concerning their Gross Receipts. Any Settlement Class Member who has questions should contact the Settlement Administrator. Once all timely, valid Claim Forms have been received, the Settlement Administrator shall determine the total number of Settlement Class Members who fall within each of the three categories [(x), (y), and (z)] set forth above and determine the total number of distribution shares (each a Base Amount ) necessary to make distributions according to the following formula: The Physician Amount and Practice Group Amount shall be allocated among all Settlement Class Members who timely file valid Claim Forms such that (i) each Physician Settlement Class Member whose Claim Form establishes that he or she falls within category (x) shall be entitled to receive a single Base Amount; (ii) each Physician Settlement Class Member whose Claim Form establishes that he or she falls within category (y) shall be entitled to receive five (5) times the Base Amount; (iii) each Physician Settlement Class Member whose Claim Form establishes that he or she falls within category (z) shall be entitled to receive ten (10) times the Base Amount; and (iv) each Practice Group Settlement Class Member shall be entitled to receive an amount that reflects the sum that all Physicians within the Practice Group would have received if each had submitted a separate, valid Claim Form. For example, if the Settlement Administrator determines that there are 1,000 Settlement Class Members in each of category (x), (y), and (z), calculation of the Base Amount would be based on the following formula, in which b = the Base Amount: 1,000b + 5,000b + 10,000b = $1,380,000. In this example, the Base Amount would be $86.25, and Settlement Class Members within category (x) would be entitled to receive $86.25, Settlement Class Members within category (y) would be entitled to receive $431.25, and Settlement Class Members within category (z) would be entitled to receive $ A Settlement Class Member who timely files an otherwise valid Claim Form but does not specify a category of estimated Gross Receipts for Covered Services to Plan Members shall be deemed to be entitled to a single Base Amount, and the Settlement Administrator has no obligation to pursue additional information about the Settlement Class Member s amount of estimated Gross Receipts. Each Settlement Class Member who timely files a valid Claim Form will receive the payment to which he, she, or it is entitled from the Settlement Fund. The allocation of the Settlement Fund is described in detail in the Settlement Agreement. N4374 v Page 4 of 8

5 D. The Releases and Dismissal with Prejudice In exchange for the consideration for Settlement Class Members set forth in the Settlement Agreement, and provided the Settlement is given final approval by the Arbitrator, confirmation by a court, and any appeals are resolved in favor of the proposed Settlement, the Litigation and the claims of Settlement Class Members that are asserted in the Arbitration will be dismissed with prejudice. If this occurs, Oxford (which includes its subsidiaries and affiliates) will be released and discharged of any and all claims that are, were, or could have been asserted by any Settlement Class Member based on, by reason of, arising from, in connection with, or in any way relating to the conduct, events, facts, transactions, occurrences, acts, representations, omissions, or other matters set forth, alleged, embraced, or otherwise referred to or alleged in the Arbitration and Litigation, whether any such claim was or could have been asserted by Claimant or any Settlement Class Member on his or her own behalf or on behalf of other persons. These claims include claims that may not currently exist, or that Claimant and Settlement Class Members may not know or suspect to exist, in their favor at the time of the final approval of the Settlement Agreement. In substance, Settlement Class Members are releasing Oxford (along with its subsidiaries and affiliates) from, among others, claims related to the accuracy and timeliness of Oxford s payments to Settlement Class Members based on the submission of health care claims for reimbursement that were processed during the Settlement Class Period or at any time through and including December 31, 2014, where such claims were submitted to Oxford pursuant to a participating provider agreement with Oxford in effect during the Settlement Class Period. Settlement Class Members will be barred from suing or initiating arbitration against Oxford or other released parties for claims that are covered by the releases. The release and covenant not to sue provisions of the Settlement Agreement affect your legal rights, and you should review these provisions carefully. Once again, a copy of the entire Settlement Agreement can and should be reviewed at V. WHAT WILL HAPPEN AT THE FINAL FAIRNESS HEARING As noted above, the Final Fairness Hearing will be held on August 12, 2015 at 10:30 a.m. Eastern time, at the law offices of Weil, Gotshal & Manges LLP, 767 Fifth Avenue, New York, New York However, the order scheduling that hearing also provides that it may be adjourned by the Arbitrator without any additional notice to putative Settlement Class Members. At the Final Fairness Hearing, the Arbitrator will consider several different issues, including the following: First, the Arbitrator will consider whether the proposed Settlement of the Arbitration with Oxford as reflected in the Settlement Agreement is fair, reasonable, and adequate to putative Settlement Class Members. Second, the Arbitrator will consider whether it should certify the Settlement Class for settlement purposes. Among other things, this will require the Arbitrator to determine (i) whether questions of law or fact common to the putative Settlement Class Members predominate over questions affecting only individual putative Settlement Class Members, and (ii) whether a class arbitration is superior to other available methods for fair and efficient adjudication of the controversy. If the Arbitrator certifies the Settlement Class for settlement purposes, putative Settlement Class Members who have timely elected to Opt Out of the Settlement Class by following the procedures described below will be excluded from it. Third, the Arbitrator will consider the application for a payment of the Class Representative Fee to Claimant from Oxford as discussed below. Fourth, the Arbitrator will consider an application by counsel to the Settlement Class for Attorneys Fees and Expenses from Oxford, which also is discussed in more detail below. VI. CAN I PARTICIPATE IN THE FINAL FAIRNESS HEARING? Any putative Settlement Class Member or other interested person who objects to the proposed Settlement with Oxford, the Settlement Agreement, the application for Attorneys Fees and Expenses and the Class Representative Fee, or the other matters to be considered at the Final Fairness Hearing may appear and present such objections, provided, however, that persons who have elected to Opt Out of the Settlement Class and Settlement will not be entitled to object. In order to be permitted to object to the proposed Settlement, you must, on or before June 30, 2015, comply fully with the following requirements: N4375 v Page 5 of 8

6 File with the Arbitrator a written statement setting forth your objections to the matters to be considered and the basis for those objections, together with any documentation you want the Arbitrator to consider. You can file your statement by sending it via U.S. mail, postmarked by June 30, 2015, or overnight delivery to be delivered on or before June 30, 2015, to: Mr. Jonathan Weed, Manager of ADR Services American Arbitration Association 950 Warren Ave. East Providence, RI If you intend to appear at the Final Fairness Hearing, you must also file with the Arbitrator a written notice of intention to appear at this same time (using the same address listed above); and Serve all copies of all such materials either by hand or overnight delivery to be delivered on or before June 30, 2015 upon the following counsel: Eric D. Katz Nicholas J. Pappas Mazie Slater Katz & Freeman, LLC Weil, Gotshal and Manges LLP 103 Eisenhower Parkway 2 nd Floor 767 Fifth Avenue Roseland, NJ New York, NY If you do not comply with the foregoing procedures and deadlines for filing and serving a written statement setting forth your objections, and a written notice of your intention to appear at the Final Fairness Hearing, if applicable, you may lose substantial legal rights, including but not limited to the following: the right to appear and be heard at the Final Fairness Hearing; the right to contest approval of the proposed Settlement or the application for an award of Attorneys Fees and Expenses to Settlement Class Counsel; the right to contest approval of the application for the payment of the Class Representative Fee to Claimant; and the right to contest any other orders, awards, or judgments of the Arbitrator entered in connection with the proposed Settlement. You should consult the Arbitrator s Preliminary Approval Award for additional information on the requirements for objecting to the proposed Settlement or participating in the Final Fairness Hearing. A copy of the Preliminary Approval Award may be reviewed at If the Arbitrator does not approve the proposed Settlement, a court does not confirm the Arbitrator s approval of the proposed Settlement, or any appellate court modifies, vacates, or reverses approval of the proposed Settlement, the proposed Settlement and the Settlement Agreement will be null and void. If there are further actions taken in the Arbitration that affect your rights, you will receive notice as determined by the Arbitrator. VII. HOW DO I FILE A CLAIM? As discussed above, the proposed Settlement contemplates certain settlement payments to Settlement Class Members with respect to valid Claim Forms that are timely submitted to the Settlement Administrator. If you are a Physician Settlement Class Member or the legal heir or representative of a deceased Physician Settlement Class Member, to qualify for a settlement payment, you must complete the enclosed Claim Form in accordance with the enclosed Claim Form Instructions, sign the form, and mail the completed and signed form by NO LATER THAN June 30, 2015 to: Sutter v. Oxford Healthcare Settlement Administrator PO Box 4178 Portland, OR You may also your completed Claim Form NO LATER THAN June 30, 2015 to: Info@NewJerseyHealthcareSettlement.com If you are a Practice Group Settlement Class Member, to qualify for a settlement payment, you must download from the Settlement Administrator s website ( or request from the Settlement Administrator a Practice Group Claim Form and Claim Form Instructions, complete the Practice Group Claim Form in accordance with the Practice Group Claim Form Instructions, sign the Claim Form and mail the completed and signed Claim Form, postmarked by NO LATER THAN June 30, 2015, to the Settlement Administrator s physical address or address above. N4376 v Page 6 of 8

7 IN ORDER TO BE ENTITLED TO RECEIVE ANY PAYMENT FROM THE SETTLEMENT FUND, YOU MUST COMPLETE AND SIGN THE CLAIM FORM, AND THE OR ENVELOPE RETURNING YOUR CLAIM FORM MUST BE MAILED TO THE SETTLEMENT ADMINISTRATOR WITH A POSTMARK DATE NO LATER THAN JUNE 30, IF YOUR SIGNED CLAIM FORM IS NOT MAILED TO THE SETTLEMENT ADMINISTRATOR BY THIS DEADLINE, YOU WILL BE DEEMED TO HAVE WAIVED YOUR RIGHT TO RECEIVE ANY PAYMENT FROM THE SETTLEMENT FUND. Any Physician within a Practice Group that submits an Opt-Out Request may file a Claim Form, and such Physician will be a Settlement Class Member and may receive money from the Settlement Fund. If you do not submit a claim, you will receive no money from the Settlement Fund. Whether or not you submit a claim, if you are a Settlement Class Member and do not Opt Out using the procedures set forth in Section VIII below, you will be bound by all the proceedings, orders, awards, and judgments entered in connection with the proposed Settlement and the Settlement Agreement, including the release, covenant not to sue, and dismissal with prejudice described above. VIII. WHAT IF I DO NOT WANT TO BE PART OF THE SETTLEMENT? If you do not want to be a Settlement Class Member and participate in the proposed Settlement, then you must send a written request to Opt Out of the Settlement Class and the Settlement to the Settlement Administrator postmarked NO LATER THAN JUNE 30, 2015, which Opt-Out Request must include your name, business address, telephone number, federal Social Security Number or Tax Identification Number, and signature. Opt-Out Requests must be submitted to: Sutter v. Oxford Healthcare Settlement Administrator PO Box 4178 Portland, OR TO BE CONSIDERED TIMELY AND TO EFFECTIVELY OPT OUT OF THE SETTLEMENT CLASS AND THE SETTLEMENT, YOUR COMPLETE AND SIGNED OPT-OUT REQUEST MUST BE POSTMARKED BY NO LATER THAN JUNE 30, IF IT IS NOT POSTMARKED BY THAT DATE, YOUR RIGHT TO OPT OUT WILL BE DEEMED WAIVED, AND YOU WILL BE BOUND BY ALL ORDERS, AWARDS, AND JUDGMENTS ENTERED IN CONNECTION WITH THE SETTLEMENT. A Practice Group that chooses to Opt Out of the Settlement and the Settlement Class may submit an Opt-Out Request only on behalf of the Practice Group and not on behalf of the Physicians within the Practice Group, unless the Practice Group certifies that it has the authority to submit an Opt-Out Request on behalf of the Physicians within the Practice Group and provides the name and federal Social Security Number of each such Physician within the Practice Group on whose behalf it is submitting the Opt-Out Request using the Declaration of Authority to file Practice Group Opt Out Request and Rider forms available at which also may be requested from the Settlement Administrator by or phone. If you choose to Opt Out of the Settlement and the Settlement Class, you will not be entitled to receive the benefits of the proposed Settlement with Oxford, including any payment from the Settlement Fund. Your claims against Oxford will not be released and you will be free to pursue any claims you believe you have (consistent with applicable law and rules of procedure) by filing a separate action or demand for arbitration if you are subject to an arbitration agreement. Any claims or counterclaims Oxford may have against you will not be released either. Any putative Settlement Class Member who timely submits a request to Opt Out of the Settlement Class and the Settlement will have until the date of the Final Fairness Hearing to deliver to the Settlement Administrator a written revocation of the request to Opt Out, and shall thereby become a Settlement Class Member. IX. WHAT IF I DO NOTHING AT ALL? If you do nothing, you will get no money from the Settlement Fund, and you will be bound by the release and covenant not to sue provisions of the Settlement Agreement described above. N4377 v Page 7 of 8

8 X. WHAT ABOUT ATTORNEYS FEES AND EXPENSES? The Arbitrator has appointed Eric D. Katz of Mazie Slater Katz & Freeman, LLC, a Roseland, New Jersey lawyer with extensive experience representing plaintiffs in class actions, including class actions similar to this one on behalf of physicians, to represent you and other Settlement Class Members as Settlement Class Counsel. Further information about Settlement Class Counsel can be found on the websites and Since the beginning of this case, neither Settlement Class Counsel nor his law firm has received any payment for services in prosecuting the Arbitration or to reimburse them for out-of-pocket expenses. If the Arbitrator approves the proposed Settlement, Settlement Class Counsel will apply to the Arbitrator for an award of Attorneys Fees and Expenses in an amount up to $1,250,000 to be paid by Oxford, which amount is distinct and separate from the Settlement Fund and does not reduce or otherwise negatively impact the Settlement Fund to Settlement Class Members. If you want to be represented by your own lawyer and have that lawyer appear on your behalf in this case, you must hire one at your own expense. XI. WHAT IS THE CLASS REPRESENTATIVE FEE? In addition to the application by Settlement Class Counsel for Attorneys Fees and Expenses described in the preceding section, in connection with the Arbitrator s consideration of the Settlement, Claimant intends to seek an award from the Arbitrator of $25,000 as a Class Representative Fee, which, if awarded, would be paid by Oxford, which amount is distinct and separate from the Settlement Fund and does not reduce or otherwise negatively impact the Settlement Fund to Settlement Class Members. XII. WHOM CAN I CONTACT WITH QUESTIONS? If you would like further information, or if you have questions regarding this Notice, the proposed Settlement with Oxford, the Settlement Agreement, or the Arbitration generally, you can obtain additional information from the following sources: Online: By Info@NewJerseyHealthcareSettlement.com By Telephone: By Mail: Sutter v. Oxford Healthcare Settlement Administrator PO Box 4178 Portland, OR PLEASE DO NOT CALL OXFORD, ANY REPRESENTATIVE OF OXFORD, THE ARBITRATOR, OR THE AMERICAN ARBITRATION ASSOCIATION. XIII. EXAMINATION OF PAPERS This Notice is a summary and does not describe all details of the proposed Settlement with Oxford, the Settlement Agreement, the Settlement approval proceedings, or the proceedings in the Arbitration generally. Complete copies of the Settlement Agreement, the terms of which govern the Settlement, various settlement-related forms, and certain filings and papers filed in the Arbitration and in connection with the approval of the Settlement can be found for review on the following website: XIV. REQUEST TO FORWARD THIS NOTICE If you would be a Settlement Class Member described in this Notice, but you have assigned any claim that might be covered by the proposed Settlement or the release described above, please forward this Notice to the appropriate person as soon as possible. N4378 v Page 8 of 8