Learning About the Lawsuit
In 2023, Plaintiff Mara Berton filed a class action lawsuit against Aetna Inc. & Aetna Life Insurance Co. (“Aetna”). Ms. Berton alleged, on behalf of herself and all similarly situated people, that Aetna denied equal access to insurance coverage for infertility treatment to individuals in LGBTQ+ relationships. Ms. Berton claimed that Aetna’s policy was discriminatory to her and others like her seeking to get pregnant through artificial insemination. This is because under Aetna’s policy, she would have had to pay out-of-pocket to complete 12 cycles of artificial insemination (e.g., intrauterine insemination (IUI), intra-cervical insemination (ICI), or intravaginal insemination (IVI)) to qualify as “infertile” and get infertility treatment coverage. By contrast, Ms. Berton alleged that people in straight relationships only had to say that they had 12 months of frequent intercourse to qualify as “infertile,” and did not have to pay out-of-pocket for infertility treatment.
Aetna denies that it did anything wrong. The Court did not make a final ruling in favor of either Ms. Berton or Aetna.
In 2025, the parties agreed to settle, which means they have reached an agreement to resolve the lawsuit. Both sides want to avoid the risk and expense of further litigation.
The settlement is on behalf of Plaintiff Mara Berton and all similarly situated individuals, which includes Aetna members on commercial health plans in California who have uteruses and were in LGBTQ+ relationships and who, between 4/17/19 and 12/31/24, were unable to access insurance coverage for IUI or ICI and other fertility treatments because of Aetna’s allegedly discriminatory policy. The Court has not finally decided this case in favor of either side.
The Court will hold a Fairness Hearing to decide whether to approve the settlement. The hearing will be held at:
Where: U.S. District Court for the Northern District of California, Oakland Courthouse, Courtroom 2 – 4th Floor, 1301 Clay Street, Oakland, CA 94612.
When: 2:00 p.m. on November 12, 2026.
The Court has directed the parties to send you this notice about the proposed settlement. Because the settlement of a class action decides the rights of all members of the proposed class, the Court must give final approval to the settlement before it can take effect. Payments will only be made if the Court approves the settlement.
You don’t have to attend the Fairness Hearing, but you may at your own expense. You may also ask the Court for permission to speak and express your opinion about the settlement. If the Court does not approve the settlement, it will be void and the lawsuit will continue. The date of the hearing may change without further notice to members of the class.
Learning About the Settlement
The following classes of individuals have been certified by the Court to participate.
1. Category A Class Members, comprising California residents who the Parties agree sought and were denied coverage for IUI or ICI due to the Definition of Infertility during the Class Period and whose Aetna records suggest they were individuals with uteruses in an Eligible LGBTQ+ Relationship during the Class Period;
2. Category B Class Members, comprising California residents who the Parties agree sought and were denied coverage for IUI or ICI due to the Definition of Infertility during the Class Period, and who submit an attestation certifying that they were individuals with uteruses in an Eligible LGBTQ+ Relationship at the time they sought coverage (the “Attestation”);
3. Category C Class Members, comprising California residents who submit an Attestation, were members of an Aetna plan during the Class Period, and provide evidence of out-of-pocket expenses for IUI or ICI services received that would have been covered by their Aetna plan; and
4. Category D Class Members, comprising California residents who sought coverage for IUI or ICI during the Class Period that was denied, then followed by an approval within 90 days or otherwise paid by Aetna, and who meet the following:
Category D-A is made up of individuals whose Aetna records indicate were individuals with uteruses of reproductive age in an Eligible LGBTQ+ Relationship during the Class Period and who provide evidence of out-of-pocket expenses for artificial insemination services received that would have been covered by their Aetna plan, but have not yet been paid;
Category D-B is made up of individuals who submit an Attestation and who provide evidence of out-of-pocket expenses for artificial insemination services received that would have been covered by their Aetna plan, but have not yet been paid.
The settlement pays money to Aetna members with uteruses in LGBTQ+ relationships who were unable to access insurance benefits for IUI or ICI between 4/17/19 and 12/31/24 because of Aetna’s allegedly discriminatory policy. Aetna has also agreed to implement nationwide its new policy making IUI and ICI standard diagnostic medical benefits, and it has agreed that individuals with uteruses who are of reproductive age and in LGBTQ+ relationships at the time of seeking services are no longer required to undergo any greater number of ovulation cycles to qualify for IVF than similarly-situated individuals with uteruses who are of reproductive age in heterosexual relationships. Aetna will also change its clinical policy to make it clear that the limited availability of chosen donor sperm can be taken into account if someone wants to move from IUI or ICI to IVF earlier than would otherwise be covered, and it will ensure that if someone qualifies for IVF coverage once, they do not have to do any additional ovulation cycles to qualify again for a later attempt at pregnancy through IVF.
At this time, the exact size of the class is unknown, but Aetna estimates based on its records that there will be fewer than 175 Class Members. Accordingly, Aetna has agreed to pay benefits to all individuals who are part of the Class as follows:
• If there are 175 or fewer Class Members, Aetna has agreed to pay all eligible Class Members a “Default Monetary Payment” of $10,000. But if there are more than 175 Class Members, Class Members will equally split a $1,750,000 Settlement Fund and will receive less than $10,000.
• Aetna has agreed to separately pay Class Members for what their plan would have paid to providers for artificial insemination if Aetna’s allegedly discriminatory policy had not been applied to them. These “Dollars for Benefits” payments will equal no less than $1,408.
• Aetna has agreed to create a “Special Harms Common Fund” in the amount of $250,000 for Class Members who submit proof of additional costs or harms. Any funds remaining in the Special Harms Common Fund after those claims are determined will be split equally among Class Members who cashed their first checks. Claims made on this fund will be decided by an independent third party, retired United States Magistrate Judge Steven Gold.
Aetna will also pay a separate amount for attorneys’ costs and fees, to be approved by the Court, and a separate amount for administering this settlement. Ms. Berton will also ask the Court for a $15,000 award for her work bringing this case. These amounts will not reduce the amount of payment Class Members will receive in this settlement.
Members of the settlement class will “release” their claims as part of the settlement, which means they cannot participate in another lawsuit against Aetna for the same issues in this lawsuit. The full terms of the release can be found HERE.
You may be part of the Class if you meet all of the following criteria:
1. You resided in California & were on an Aetna plan that covered certain infertility benefits between April 17, 2019 and December 31, 2024; and
2. You had a uterus between those dates; and
3. You were in an Eligible LGBTQ+ Relationship between those dates; and
4. You were directly impacted by Aetna’s allegedly discriminatory policy, either because you:
A. Sought and were denied coverage for IUI or ICI your plan would have covered if you were considered infertile; or
B. Did not seek coverage because you believed you were ineligible, and paid out of pocket for IUI or ICI at a time when you were on an Aetna plan.
An “Eligible LBGTQ+ Relationship” means a personal relationship (but not including a surrogacy relationship) involving two individuals who, at the time of seeking services, self-identify as “LGBTQ+,” meaning lesbian, gay, bisexual, transgender, queer, intersex, and/or nonbinary, consisting of one individual with a uterus and another individual incapable of producing viable sperm due to being assigned the female sex at birth, being intersex, or having been assigned the male sex at birth and having transitioned or being in the process of transitioning to the female gender. “Incapable of producing viable sperm” is intended to include circumstances in which, due to gender dysphoria, sperm production and/or intercourse resulting in egg-sperm contact are clinically inadvisable.
Your total payments received from the settlement will depend on how many individuals establish they are part of the Class, as some class members are required to make submissions to qualify.
Settlement Benefit
Default Monetary Payment
If there are up to 175 Class Members:
$10,000
If there are more than 175 Class Members:
Payments will be reduced so that you receive a proportionate share of a $1.75 million fund.
(E.g. if there are 200 Class Members, you will receive $8,750 ($1.75 million / 200 = $8,750)
Default “Dollars for Benefits” Payment
You will receive $1,408 if you underwent IUI or ICI and Aetna did not cover your treatment.
Potential additional compensation
Higher “Dollars for Benefits Payment
Instead of the default “Dollars for Benefits” payment, you may request a higher Dollars for Benefits payment and potentially receive an amount greater than the default payment. You may be eligible for a higher payment if had you been considered infertile, your plan would have paid your provider more than the Default Dollars for Benefits payment.
Special Harms Common Fund
If you experienced additional “special harms,” including expenses that exceed the sum of the Default Monetary Payment and Dollars for Benefits Payment, pain and suffering from medical procedures you underwent to meet Aetna’s requirements, delay in getting pregnant or loss of the ability to get pregnant, or other extraordinary harm, you may submit a claim form and potentially receive a payment from a $250,000 “Special Harms Common Fund.”
Deciding What to Do
*You can object to the Settlement AND submit a Claim Form to receive payment.
Submitting a Claim
If you are a Category A Class Member you do not need to do anything to receive the default money. To potentially receive additional money, or if you are a Category B, C, or D Class Member, you must submit a Claim Form. You may submit the Claim Form included with your Notice by mail or submit a claim online HERE. If there is a problem with your Claim Form the Settlement Administrator will promptly notify you so you can fix it. No more corrections will be allowed after August 28, 2026.
In a class action, the court appoints Class Representatives and lawyers to work on the case and represent the interests of all the Class Members. For this settlement, the Court has appointed the following individuals and lawyers.
Your Class Representative:
Mara Berton
Your lawyers:
| KATZ BANKS KUMIN LLP Rebecca Peterson-Fisher Jennifer L. Liu Hugh Baran Marilyn Robb 235 Montgomery St. Suite 665 San Francisco, CA 94104 | NATIONAL WOMEN’S LAW CENTER Michelle Banker Noel León Alison Tanner 1350 I Street NW Suite 700 Washington, DC 20005 | ALTSHULER BERZON LLP Barbara J. Chisholm Connie K. Chan Robin S. Tholin 177 Post Street Suite 300 San Francisco, CA 94108 |
These are the lawyers who negotiated this settlement on your behalf.
If you want to be represented by your own lawyer, you may hire one at your own expense.
No. Lawyers’ fees and costs will be paid by Aetna, separate from the payments to Class Members.
To date, your lawyers have not been paid any money for their work or the expenses that they have paid for the case. To pay for some of their time and risk in bringing this case without any guarantee of payment unless they were successful, your lawyers will request, as part of the final approval of this settlement, that the Court approve a payment of up to $1.6 million total in attorneys’ fees plus the reimbursement of up to $25,000 in out-of-pocket expenses. This payment will not come out of the money already set aside for Class Members.
Lawyers’ fees and expenses will only be awarded if approved by the Court as a fair and reasonable amount. You have the right to object to the lawyers’ fees even if you think the settlement terms are fair.
If you are a Category A Class Member and do not want to be part of the settlement: Please see the question “How do I opt out?” below for information about opting out of the settlement.
If you are a potential Category B, C, or D Class Member and do not want to be part of this settlement: Do not send in a Claim Form. You will not receive any money and you will not be bound by anything that happens in this lawsuit and may be able to file your own case. You cannot exclude yourself from the policy changes called for by the proposed settlement.
Opting Out
If you wish to opt out of the settlement, you must complete the Opt Out Form included with the Notice and mail it by June 29, 2026 to the Settlement Administrator at:
Berton v. Aetna Inc. & Aetna Life Insurance Co.
c/o Atticus Administration
PO Box 64053
Saint Paul, MN 55164
1-800-842-7690
Objecting
If you disagree with any part of the settlement (including the lawyers’ fees) but don’t want to opt out, you can ask the Court to deny approval by filing an objection. You can’t ask the Court to order a different settlement; the Court can only approve or reject the settlement. If the Court denies approval, no settlement payments will be sent out, and the lawsuit will continue. If that is what you want to happen, you should object. You only have the right to object if you are a Class Member, which means if you are in Categories B, C or D, you also must send in a Claim Form for your objection to be considered.
Any objection to the proposed settlement must be in writing. If you file a timely written objection, you may, but are not required to, appear at the Fairness Hearing, either in person or through your own attorney. If you appear through your own attorney, you are responsible for hiring and paying that attorney.
All written objections and supporting papers must:
1. Clearly identify the case name and number (Berton v. Aetna Inc. et al, Case No. 4:23-cv-01849 (HSG)).
2. Be submitted to the Court either by filing them electronically or in person at any location of the United States District Court for the Northern District of California or by mailing them to the Clerk of the United States District Court for the Northern District of California, 1301 Clay Street, Oakland California.
3. Include the objector’s full name, address, telephone number, and email address (if you have one).
4. Explain the reasons for the objection, and whether your objection applies to just you, to a subset of the class, or the entire class.
5. Be filed or postmarked on or before June 29, 2026.
Doing Nothing
If you are a Category A Class Member, you will get the Default Payments described above and will be bound by the settlement and its “release” provisions. That means you won’t be able to start, continue, or be part of any other lawsuit against Aetna about the issues in this case.
If you are a Category B, C, or D Class Member and you do nothing, you will not get any money and you will not release any claims.
Key Resources
You can get additional information by going to the website for the settlement or by contacting the Settlement Administrator or your lawyers using the contact information below.
Settlement Administrator
Berton v. Aetna Inc. & Aetna Life Insurance Co.
c/o Atticus Administration
PO Box 64053
Saint Paul, MN 55164
1-800-842-7690
Designated Points of Contact for Your Lawyers
KATZ BANKS KUMIN LLP
Marilyn Robb
11 Dupont Circle NW
Suite 600
Washington, DC 20036
[email protected]
NATIONAL WOMEN’S LAW CENTER
Alison Tanner
1350 I Street NW, Suite 700
Washington, DC 20005
(202) 588-5180
[email protected]
ALTSHULER BERZON LLP
Robin S. Tholin
177 Post Street, Suite 300
San Francisco, CA 94108
(415) 421-7151
[email protected]