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Highmark, Inc.

Cole et al v. Highmark, Inc.
Case No. 2:05-mc-02025 (Western District of Pennsylvania)

On April 6, 2021, we filed an overtime lawsuit against Highmark, Inc. (“Highmark”). The named plaintiff asserts claims individually and on behalf of other similarly situated individuals, including Care Management Nurses, Utilization Management Nurses, Utilization Review Nurses, Care Coordinators, Nurse Reviewers, or in similar job titles. The primary job of Care Management Nurses, and others in similar positions, was to perform utilization review work, which consists of applying pre-determined criteria and guidelines to authorization requests submitted by healthcare providers for insurance coverage and payment purposes.

Care Management Nurses, and those in similar titles, regularly work overtime hours and are paid a salary with no extra pay for their overtime hours. The Complaint alleges that Highmark has misclassified its Care Management Nurses, Utilization Management Nurses, Utilization Review Nurses, Care Coordinators, and Nurse Reviewers as exempt from the Fair Labor Standards Act’s (“FLSA”) overtime protections, and improperly denied them overtime pay.

The plaintiff brought the case as a putative collective action under the FLSA and as a putative class action under Pennsylvania state law seeking to recover unpaid overtime compensation, liquidated (double) damages, premium pay for overtime, and other statutorily-permitted relief.

Type of Case

Unpaid Overtime


Am I eligible?

Because this lawsuit arises under both federal and state law, you may have a qualifying state law claim, federal law claim, or both federal and state law claims.

Do I Have a Qualifying Federal Law Claim?

You may be eligible to make a claim under federal law in this case if you worked for Highmark as a Care Management Nurse or similar title at any time within the past three years, in any state, and were not paid an overtime premium for all of the hours you worked over 40 per week. 

Do I Have a Qualifying State Law Claim?

You may have a claim under Pennsylvania state law if you worked for Highmark in Pennsylvania as a Care Management Nurse or similar job title at any time within the past four years

Additional Information

Is This a Class Action? What Does that Mean?

This case is both a potential collective action under federal law and a potential class action under Pennsylvania state law. This means that, depending on the type of claim you have, there may be a slightly different process for joining and participating in this suit. See below for more details on this process.

Although the process and terminology may differ slightly, the idea behind both a class and collective action is the same: it allows one or more people to sue on behalf of themselves and other similarly situated people who have similar claims. In order to proceed as a group, though, the Court must certify the class and collective. Because we are in the early stages of the case, this has not happened yet, but we intend to seek the company’s agreement or file the motions at the appropriate times asking the Court to grant these certifications.

Which Locations Are Included?

This case seeks to include all Care Management Nurses that work or have worked for Highmark in any state anywhere across the country within the past three years. 

How Do I Join This Case?

In order make a claim in this case for your unpaid overtime under the FLSA, the federal law, you must complete a consent form and return it to our office. You can sign up electronically by clicking here.

What Time Frame Does This Case Cover?

The claim has what is called a statute of limitations, which allows workers to recover unpaid overtime wages within specific time periods.  Under federal law, the statute of limitation is two years back from when the worker signs up to join the lawsuit by completing and returning the written consent form referenced above.  If we can prove that Highmark intentionally or recklessly violated the law, then the statute of limitations may be extended to three years.

Do I Have to Pay Anything?

You do not have to pay anything if you join the lawsuit. We are handling this case on a contingency fee basis. This means we will only be paid if the lawsuit is successful in obtaining relief either through a settlement, award, or a final judgment, and that payment will only come out of that settlement, award, or final judgment.

How Do I Prove I Worked Overtime?

If you have records of the hours you worked, please preserve and keep them until we ask you for them. However, you do not need to have records of your work hours to make a claim for your overtime pay in this case. If Highmark did not keep accurate time records, most courts will permit you to make a good-faith estimate of your work hours. Through this lawsuit, we will seek any records the company may have of your hours worked as well.

What About Retaliation?

It is against the law for an employer to retaliate against a person for joining a lawsuit to reclaim unpaid wages. If you currently work for Highmark and you believe you may be the victim of retaliation for joining or participating in this lawsuit, contact the case clerk, Jacob Vandervest, at or (612) 256-3221 immediately.

How Long Will This Case Take?

The length of this kind of lawsuit varies from case to case, but they typically last one to three years.

Is There Money Available Now?

No. This is a pending lawsuit. There is no money currently available and there is no guarantee that you will receive money for joining the lawsuit.

How Can I Help?

If you know any Care Management Nurse interested in making a claim for unpaid overtime, they should contact the case clerk, Jacob Vandervest, at or (612) 256-3221 to sign up.

How Do I Learn More?

To learn more about this case, feel free to contact the case clerk, Jacob Vandervest, at or (612) 256-3221.

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