The Core Formula
Payout = ( Adjusted Premiums / Total Aggregate Class Premiums ) × Net Settlement Fund
The settlement operates on a pro-rata basis. This means your piece of the pie depends not just on how much you paid, but on the total amount paid by every other person and company that filed a valid claim.
1. The Net Settlement Fund (The Pie)
The total settlement is $2.67 billion, but after attorney fees, administrative costs, and class representative awards, the Net Settlement Fund is approximately $1.9 billion. This is split into two separate “buckets”:
- Fully Insured (FI) Sub-Class: Contains about $1.78 billion. Claims are based on Total Premiums Paid.
- Self-Funded (SF) Sub-Class: Contains about $120 million. Claims are based on Administrative Services Only (ASO) fees paid.
2. Adjusted Premiums (Your Slice)
In employer-sponsored plans, both the employer and employee pay a portion of the premium. If you didn’t upload specific documentation (like W2s or paystubs) to prove your exact contribution percentage, the Settlement Administrator assigns a default percentage based on historical data from the Kaiser Family Foundation (KFF).
| Fund Type |
Coverage Tier |
Employee Share |
Employer Share |
| Fully Insured (FI) |
Single |
15% |
85% |
| Family |
34% |
66% |
| Self-Funded (SF) |
Single |
18% |
82% |
| Family |
25% |
75% |
Note: Individual policyholders (non-employer groups) retain 100% of their base premium for calculation purposes.
3. The Unknown Denominator (Why we use estimates)
The biggest unknown in class action settlements is the claim rate. How many people actually filed a claim? How many massive Fortune 500 companies filed claims for millions in premiums? Because we don’t know the exact Total Aggregate Class Premiums (the denominator), we calculate ranges based on historical mega-fund mechanics:
Base Estimate (0.59% Multiplier)
Assumes a standard 10-20% claim rate typical for well-publicized corporate/consumer class actions. A balanced mix of large corporate claimants and individual employees.
Optimistic Estimate (1.18% Multiplier)
Assumes a lower claim rate (e.g., <10%). If fewer entities filed claims, the denominator shrinks, making your specific slice of the $1.9B pie proportionally larger.
Conservative Estimate (0.34% Multiplier)
Assumes a high claim rate heavily weighted by massive corporate employers who have entire HR/Legal departments dedicated to extracting these funds, inflating the denominator and shrinking individual slices.
