Berton v. Aetna Class Action Settlement: LGBTQ+ Californians Denied IUI/ICI Coverage May Claim Up to $10,000+

What happened

Class period: April 17, 2019 – December 31, 2024

• Aetna Inc. and Aetna Life Insurance Co. offered California commercial health plan members coverage for infertility treatments like IUI (intrauterine insemination) and ICI (intra-cervical insemination) — but with a catch that applied very differently depending on your relationship
• Under Aetna's Definition of Infertility, heterosexual couples only needed to report 12 months of frequent unprotected intercourse to qualify as "infertile" and unlock coverage — no receipts, no procedures, just their word
• LGBTQ+ members with uteruses, by contrast, were required to actually pay out-of-pocket for up to 12 full cycles of artificial insemination before Aetna would consider them "infertile" — a process that could cost tens of thousands of dollars and take years
• In 2023, plaintiff Mara Berton filed a class action lawsuit (Case No. 4:23-cv-01849-HSG) in the U.S. District Court for the Northern District of California, alleging that Aetna's policy unlawfully discriminated against LGBTQ+ individuals seeking to build families
• Aetna denies all wrongdoing, but the parties agreed in 2025 to settle and avoid the cost and uncertainty of continued litigation
• As part of the settlement, Aetna has also agreed to overhaul its infertility coverage policies nationwide — meaning the changes go beyond just writing checks

What you can get

Key dates

Who may qualify

• You resided in California and were enrolled in an Aetna commercial health plan that covered certain infertility benefits at some point between April 17, 2019 and December 31, 2024
• You have or had a uterus during that period
• You were in an Eligible LGBTQ+ Relationship at the time — meaning a relationship in which one partner has a uterus and the other is unable to produce viable sperm due to being assigned female at birth, being intersex, or being in the process of or having completed a gender transition
• You were directly impacted by Aetna's allegedly discriminatory Definition of Infertility policy, either because you sought and were denied coverage for IUI or ICI, or because you believed you were ineligible and paid out-of-pocket without even attempting to get coverage
• Category A members (Aetna's own records identify you) receive default payments automatically; Category B, C, and D members must submit a Claim Form with an attestation and/or proof of out-of-pocket expenses

How to file

1. 1. Determine your category: check whether you received a Notice with a Notice ID (likely Category A or B) or whether you need to self-identify and submit documentation (Category C or D)
2. 2. If you are a Category A Class Member, you do not need to file a claim to receive the Default Monetary Payment — however, you must submit a Claim Form if you want to pursue a higher Dollars for Benefits payment or a Special Harms Common Fund claim
3. 3. If you are a Category B, C, or D Class Member, you must submit a Claim Form to receive any payment — doing nothing means receiving nothing (and not releasing your claims)
4. 4. Submit your Claim Form online at the settlement website, or complete the paper Claim Form included with your mailed Notice and mail it to: Berton v. Aetna Inc. & Aetna Life Insurance Co., c/o Atticus Administration, PO Box 64053, Saint Paul, MN 55164
5. 5. If there is a problem with your form, the Settlement Administrator will notify you so you can fix it — but no corrections will be accepted after August 28, 2026, so submit as early as possible

Proof required

• Category A members: no documentation required to receive default payments; Aetna's own records establish eligibility
• Category B members: a signed attestation certifying you were an individual with a uterus in an Eligible LGBTQ+ Relationship at the time you sought IUI or ICI coverage
• Category C members: a signed attestation plus documentation of out-of-pocket expenses for IUI or ICI services you paid for that would have been covered under your Aetna plan
• Category D members: evidence of out-of-pocket expenses for artificial insemination services that would have been covered but were not reimbursed, plus a signed attestation if your LGBTQ+ relationship status is not already reflected in Aetna's records
• Special Harms Fund claims (all categories): documentation of additional costs or harms exceeding the sum of your Default Monetary Payment and Dollars for Benefits — this can include medical records, receipts, or other evidence of financial, physical, or other extraordinary harm

Payment timing

Payments will only be issued if the Court grants final approval at the November 12, 2026 Fairness Hearing. If there are appeals, payment could be further delayed. Category A members who do not file a claim form will receive their default payments automatically once the settlement is final. Category B, C, and D members must file to receive anything. Payment method details were not specified on the settlement website; contact the Settlement Administrator for information on disbursement.

Important links

• Official website
• Claim form
• Important dates
• FAQs
• Documents

Contact

Extra details

• Attorneys' fees of up to $1.6 million plus up to $25,000 in expenses will be paid separately by Aetna — they do not reduce any class member payment
• Named plaintiff Mara Berton will request a $15,000 service award for her work bringing the case; this also does not come from the class fund
• Category B, C, and D members who do not submit a Claim Form will not be bound by the settlement's release of claims — meaning they could potentially pursue their own legal action, but they receive no money from this settlement
• You can object to the settlement and still file a Claim Form — objecting does not disqualify you from receiving payment
• The settlement also requires Aetna to implement nationwide policy changes making IUI and ICI standard diagnostic medical benefits, equalizing ovulation cycle requirements for IVF eligibility between LGBTQ+ and heterosexual members, accommodating limited donor sperm availability as a reason to advance to IVF sooner, and ensuring that qualifying for IVF once does not require re-qualifying for subsequent pregnancies
• Class Members who opt out of the settlement (Category A only) will not release their claims and may pursue individual legal action against Aetna, but will receive no settlement benefits

FAQ