UMR UDS-ER Settlement: Payouts, Claims, and Administrator Contact

The UMR UDS-ER settlement is a $20.25 million consent judgment between the U.S. Department of Labor and UMR, Inc., a UnitedHealthcare subsidiary that administers self-funded employer health plans, resolving allegations that UMR improperly denied emergency room and urinary drug screening claims going back to January 2015. A federal court in the Western District of Wisconsin entered the judgment on March 19, 2025.¹ Baseline checks for drug-screening claims went out in June 2025, and larger proven-payment checks were scheduled to be mailed by January 13, 2026.²

What UMR Was Accused of Doing

The Department of Labor’s Employee Benefits Security Administration said UMR’s denial practices touched at least 2,136 self-funded plans.³ Two practices were at the center of the case.

On emergency room visits, the government alleged UMR denied claims based on the final diagnosis code rather than the patient’s symptoms at the time care was sought. The Affordable Care Act and ERISA require insurers to apply a “prudent layperson” standard, meaning a reasonable person’s read of the symptoms controls the coverage decision. The DOL said UMR’s “True Emergency” policy ignored that rule across 371 plans.⁴

On urinary drug screenings, the DOL alleged that from August 2015 through August 2018, UMR denied every UDS claim without any medical-necessity review. UMR later modified the practice after finding that 98% of UDS denials arising from ER visits were being overturned on appeal, and in 2019 shifted its denial code from “lack of medical necessity” to a request for more records, but the DOL said the underlying denial still violated plan terms and fiduciary duties.⁵ UnitedHealth Group said when the suit was filed that the practices described in the complaint were “no longer in place.”⁴

Who Got Paid and How Much

The settlement treated the two claim types differently.

Urinary Drug Screening Claims

Every eligible participant or beneficiary with a covered UDS claim received an automatic baseline payment of $68.85 per claim, with no action needed.² Members who had paid more than that out of pocket could submit documentation and a signed release for an additional payment of up to $103.27 per claim. Maximum recovery on a single UDS claim was $172.12.⁶

Emergency Room Claims

How an ER claim was paid depended on whether the plan still worked with UMR. If it did, UMR was required to reprocess the denied claim and pay the provider directly under the plan’s terms.⁷ If the plan had left UMR, individual members who had paid out of pocket could submit a claim form, a signed release, and proof of payment to receive up to $353.22 per ER claim.²

UMR paid all administrative costs and could not pass them on to any plan or member.⁸

Deadlines and Where Things Stand

Baseline UDS checks were mailed on June 17, 2025, and had to be cashed by November 14, 2025.⁶ The claim window for anyone seeking a proven ER payment or an additional UDS payment closed on September 2, 2025. Late submissions are not accepted.²

Proven-payment checks were scheduled to go out by January 13, 2026. Anyone who disputes the amount of a payment has 30 days from receiving it to contact the settlement administrator, whose decision is final.²

What Accepting Payment Means

Cashing the baseline UDS check, or signing the release for an ER or additional UDS payment, gives up the right to sue UMR or join any other lawsuit over the same denied claims. The settlement also bars UMR from retaliating against anyone for participating.²

What UMR Cannot Do Going Forward

UMR represented in the consent order that it had already stopped the True ER Policy and the UDS Protocol. The order forbids reinstating either practice unless a change in law or regulation allows it, and requires UMR to give the Acting Secretary of Labor advance notice before doing so. The court kept jurisdiction over the case only to enforce these terms.⁸

How to Reach the Settlement Administrator

JND Legal Administration is handling payments and questions. You can call 1-877-930-8068, email info@UDSERSettlement.com, or write to UMR UDS-ER Settlement, c/o JND Legal Administration, P.O. Box 91226, Seattle, WA 98111. The settlement website at UDSERSettlement.com has a portal that lets you review your covered claims using the unique ID and PIN from your notice.⁹

1
CourtListener. Micone, Vincent N. v. UMR, Inc. Docket
2
UDS-ER Settlement. FAQ
3
U.S. Department of Labor. DOL News Release
4
Star Tribune. U.S. Labor Department Sues UnitedHealth Group Over Denied Claims
5
Becker’s Payer Issues. Labor Department, UnitedHealth Settle Alleged Emergency Claims Issues
6
UDS-ER Settlement. Settlement Home Page
7
Georgetown Law Litigation Tracker. Unopposed Motion to Approve Consent Order and Judgment
8
Miller & Chevalier. Micone v. UMR Consent Order
9
UDS-ER Settlement. Contact