Anthem CalPERS PPO (PERSCare PERSELECT PERSChoice) Litigation, Proposed Class Action

Concealment — Civ. Code § 1710(3) – CACI 1901

Concealment(CalPERS and Anthem) CalPERS and Anthem omitted, concealed, and failed to disclose that the base Allowable Amount for “out-of-network” medical services could be substantially lower than the base Allowable Amount for “in-network” services, for the same service.

Concealment, Constructive Fraud (CalPERS, Anthem). CalPERS is a fiduciary that concealed and failed to disclose material information described herein, in a manner that damaged Plaintiffs and allowed CalPERS and Anthem to gain additional monies.

From 2006 to at least 2014, CalPERS and Anthem, separately and jointly, made misrepresentations, committed deceit, concealment, and negligent misrepresentation in the HPGs, HBSs, FAQs, other promotional materials, and the EOC that CalPERS and Anthem used in connection with the sale PERS Care, PERS Choice, PERS Select and/or the reimbursement of “out-of-network” medical services thereunder. Plaintiffs allege that CalPERS and Anthem violated one or more of Civil Code Sections 1571, 1572,1573, 1709, 1710, and 1711.

These facts were known or accessible only to Defendants, and Defendants knew that they were not known to, or reasonably discoverable by, Heinz or the Plaintiffs. At the time of Defendants’ concealment or suppression, Plaintiffs were ignorant of the information concealed or suppressed by Defendants. Plaintiffs are informed and believe that the suppression or concealment of information was undertaken with the intent to induce Plaintiffs to act in reliance thereon and in the manner herein alleged.

Introduction      Misrepresentation       Unfair Business Practices         Example of Class Rep            Class Claims