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Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 6 of 121exclude and/or limit coverage of services to treat conditions identified in the DSM2violates the Federal Parity Act and the terms of the Plan as modified by the Federal Parity3Act. Adjudication of this issue will in turn determine whether the Plan is liable under4ERISA for its conduct.516.Separate suits would create risk of varying conduct requirements. The6prosecution of separate actions by class members against the Plan would create a risk of7inconsistent or varying adjudications with respect to individual class members that8would establish incompatible standards of conduct. Certification is therefore proper9under Federal Rule of Civil Procedure 23(b)(1).1017.The Plan has acted on grounds generally applicable to the class. The Plan,11by applying policies and practices that result in the improper exclusion and limitation of12certain services to treat certain conditions listed in the DSM, have acted on grounds13generally applicable to the class, rendering declaratory relief appropriate respecting the14entire class.15Procedure 23(b)(2).1618.Certification is therefore proper under Federal Rule of CivilQuestions of law and fact common to the class predominate over17individual issues. The claims of the individual class members are more efficiently18adjudicated on a class-wide basis. Any interest that individual members of the classes19may have in individually controlling the prosecution of separate actions is outweighed20by the efficiency of the class action mechanism. Upon information and belief, there is no21pending class action suit filed against these defendant for the same relief requested in22this action, for a class of ERISA insureds.2319.Venue. This action can be most efficiently prosecuted as a class action in24the Western District of Washington, where the breach of contract and violation of the25Parity Act occurred and where D.T. resides. Issues as to The Plan’s conduct in applying26COMPLAINT (CLASS ACTION) – 6[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 7 of 121standard policies and practices towards all members of the class predominate over2questions, if any, unique to members of the class. Certification is therefore additionally3proper under Federal Rule of Civil Procedure 23(b)(3).420.56Class Counsel. D.T. has retained experienced and competent class counsel.V. FACTUAL BACKGROUND21.During certain time periods on and after October 3, 2009, D.T. and7members of the class have been, are or will be participants or beneficiaries of the Plan,8which is subject to ERISA pursuant to 29 U.S.C. § 1003.922.Since October 3, 2009, and continuing to the present, D.T. and other10members of the class have been diagnosed with developmental mental health conditions11listed in the DSM, such as autism and/or ASD.1223.D.T. and other members of the class have required, currently require or13will require NDT and ABA services to treat their developmental mental health14conditions. As defined by the Plan and relevant state and federal law, their NDT and15ABA services are “mental health services.” The Plan, however, has denied all coverage16of such treatment through the application of exclusions and limitations.1724.The application of these uniform Plan exclusions and limitations is not “at18parity” with the Plan’s coverage of medical/surgical services. Specifically, the Plan19covers developmental and autism screening/diagnostic services as a medical/surgical20preventive service, as well as other medical/surgical services for enrollees with21developmental mental health conditions. The Plan, however, excludes NDT and ABA22therapies, the essential mental health services to treat these conditions. As a result, D.T.23and other members of the class have paid for NDT and ABA services out of their own24pockets, or face the imminent threat that they will have to do so in the near future. Other25class members have been forced to forgo needed treatment due to the Plan’s conduct.26COMPLAINT (CLASS ACTION) – 7[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 8 of 12125.In light of the established Plan documents, statements and written2representations by the Plan to the parents and providers of D.T. and other members of3the class, any attempt by class members to pursue administrative remedies is futile.4Nonetheless, D.T. has completed the internal appeal process within the Plan over its5denial of coverage of his NDT and ABA services to no avail. He has exhausted his6administrative remedies.7VI. CLAIMS FOR RELIEF8FIRST CLAIM:BREACH OF FIDUCIARY DUTIESERISA § 404(a)(1), 29 U.S.C. § 1104(a)91026.D.T. re-alleges all paragraphs above.1127.The Plan is a fiduciary under ERISA § 3(21)(A), 29 U.S.C. § 1002(21)(A),12because it is the Plan Administrator and a Plan fiduciary. The Board of Trustees are13fiduciaries under ERISA § 3(21)(A) because they are the “appropriate named fiduciary”14of the Plan and exercise discretionary authority or discretionary control with respect to15the denial and appeal of denied claims under the Plan.1628.ERISA imposes strict fiduciary duties upon plan fiduciaries.ERISA17§ 404(a)(1)(C), 29 U.S.C. § 1104(a)(1)(C), states, in relevant part, that a plan fiduciary18must discharge its duties with respect to a plan “solely in the interest of the participants19and beneficiaries and in accordance with the documents and instruments governing20the plan insofar as such documents and instruments are consistent with the provisions21of this title and Title IV.”222324252629.ERISA § 409(a), 29 U.S.C. § 1109(a), states, in relevant part:Any person who is a fiduciary with respect to a plan whobreaches any of the responsibilities, obligations, or dutiesimposed upon fiduciaries by this title shall be personally liableto make good to such plan any losses to the Plan resulting fromeach such breach, and to restore to such plan any profits ofCOMPLAINT (CLASS ACTION) – 8[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 9 of 12such fiduciary which have been made through each suchbreach, and to restore to such plan any profits of such fiduciarywhich have been made through use of assets of the Plan by thefiduciary, and shall be subject to such other equitable orremedial relief as the court may deem appropriate, includingremoval of such fiduciary.1234530.The terms of an ERISA plan include non-preempted provisions of6substantive law, such as the requirements in the Federal Parity Act. The Plan and the7Board of Trustees have failed to comply with the terms of the Plan, which include the8requirements of the Federal Parity Act and its implementing regulations.931.The Plan and the Trustees violated their obligations under ERISA10§ 404(a)(1), 29 U.S.C. § 1104(a)(1), by failing to act in accordance with the documents and11instruments governing the Plan, and breached their fiduciary duties to the Plan, D.T. and12all class members.1332.As a direct and proximate result of these acts and omissions, D.T., class14members and the Plan have suffered losses and are entitled to relief under ERISA against15The Plan and the Trustees.1633.D.T., class members and the Plan seek recovery of all losses to the Plan,17including, but not limited to, relief compelling the Plan and UHC to restore to the Plan18all losses, including interest, arising from the breaches of fiduciary duties when19treatment required by the terms of the Plan as modified by the Federal Parity Act and20implementing regulations was denied.21SECOND CLAIM:CLAIM FOR RECOVERY OF BENEFITS, CLARIFICATION OF RIGHTSUNDER TERMS OF THE PLANS AND CLARIFICATION OFRIGHT TO FUTURE BENEFITS UNDER THE PLANERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B)22232434.D.T. re-alleges all the paragraphs above.2526COMPLAINT (CLASS ACTION) – 9[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 10 of 12135.ERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B), provides that a participant2or beneficiary may bring an action to “recover benefits due to him under the terms of his3plan, to enforce his rights under the terms of the plan, or to clarify his rights to future4benefits under the terms of the plan.”536.D.T. and the class are entitled to recover benefits due them under the terms6of the Plan. They are also entitled to a declaration of present and future rights to7coverage of NDT and ABA services to treat their developmental mental health8conditions.91011THIRD CLAIM:CLAIM TO ENJOIN ACTS AND PRACTICES IN VIOLATION OF THE TERMSOF THE PLANS, TO OBTAIN OTHER EQUITABLE RELIEF AND TOENFORCE THE TERMS OF THE PLANSERISA § 502(a)(3), 29 U.S.C. § 1132(a)(3)1237.D.T. re-alleges all the paragraphs above.1338.ERISA § 502(a)(3), 29 U.S.C. § 1132(a)(3), provides that a participant or14beneficiary may “enjoin any act or practice which violates any provision of this15subchapter or the terms of the plan.” D.T. and the class seek to enjoin the Plan and the16Trustees from continuing to apply exclusions and limitations on all coverage of NDT and17ABA services to treat developmental mental health conditions. D.T. and the class also18seek to have the Plan and the Trustees provide the class with corrective notice and19reformation of the relevant Plan documents.2039.ERISA § 502(a)(3), 29 U.S.C. § 1132(a)(3), further provides that a21participant or beneficiary may obtain other appropriate equitable relief to redress22violations of ERISA or enforce plan terms. To the extent full relief is not available under23ERISA § 502(a)(1)(b), 29 U.S.C. § 1132(a)(1)(B) or ERISA § 502(a)(2), 29 U.S.C.24§ 1132(a)(2), then D.T. and the class seek equitable remedies including, without25limitation, unjust enrichment, disgorgement, restitution, and surcharge arising out of the26COMPLAINT (CLASS ACTION) – 10[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 11 of 121failure to administer the terms of the Plan as modified by the Federal Parity Act and2implementing regulations.3VII. DEMAND FOR RELIEF4WHEREFORE, D.T. requests that this Court:51.Certify this case as a class action, designate named plaintiff D.T. as class6representative, and designate SIRIANNI YOUTZ SPOONEMORE HAMBURGER, Richard E.7Spoonemore, and Eleanor Hamburger as class counsel;8910112.Enter judgment on behalf of the Plan, D.T. and the class for losses sustainedby such Plan due to the Plan and the Trustees’ breaches of fiduciary duty and failure topay Plan benefits;3.Declare that the Plan and the Trustees may not apply contract provisions,12policies or practices that wholly exclude or impermissibly limit NDT and ABA services13to treat developmental mental health conditions, since such exclusions and/or14limitations are not predominantly applied to medical and surgical services;1516174.Enjoin the Plan and the Trustees from further violations of the terms of thePlan as modified by the Federal Parity Act and implementing regulations;5.Enter judgment in favor of D.T. and the class for damages in an amount to18be proven at trial due to the failure to provide benefits due under the Plan as modified19by the Federal Parity Act and its implementing regulations;2021226.Award D.T. and the class their attorney fees and costs under ERISA§ 502(g), 29 U.S.C. § 1132(g); and7.Award such other relief as is just and proper.23242526COMPLAINT (CLASS ACTION) – 11[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1 Filed 01/04/17 Page 12 of 121DATED: January 4, 2017.2SIRIANNI YOUTZSPOONEMORE HAMBURGER34By: s/ Richard E. SpoonemoreBy: s/ Eleanor HamburgerRichard E. Spoonemore (WSBA #21833)Eleanor Hamburger (WSBA #26478)56701 Fifth Avenue, Suite 2560Seattle, WA 98104Tel. (206) 223-0303Fax (206) 223-0246Email: eys for NT (CLASS ACTION) – 12[Case No. 2:17-cv-00004]SIRIANNI YOUTZSPOONEMORE HAMBURGER701 FIFTH AVENUE, SUITE 2560SEATTLE, WASHINGTON 98104TEL. (206) 223-0303 FAX (206) 223-0246

Case 2:17-cv-00004 Document 1-1 Filed 01/04/17 Page 1 of 2JS 44 (Rev. 12/12)CIVIL COVER SHEETThe JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except asprovided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for thepurpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)I. (a) PLAINTIFFSDEFENDANTSNECA/IBEW Family Medical Care Plan, The Board of Trustees of the NECA/IBEWFamily Medical Care Plan, Salvatore J. Chilia, Robert P. Klein, Darrell L. McCubbins,Geary Higgins, Lawrence J. Moter, Jr., Kevin Tighe, Jerry Simms, et al.D.T., by and through his parents and guardians, K.T. and W.T.,individually, on behalf of similarly situated individuals, and on behalf ofthe NECA/IBEW Family Medical Care Plan(b) County of Residence of First Listed PlaintiffSnohomishCounty of Residence of First Listed Defendant(EXCEPT IN U.S. PLAINTIFF CASES)NOTE:(IN U.S. PLAINTIFF CASES ONLY)IN LAND CONDEMNATION CASES, USE THE LOCATION OFTHE TRACT OF LAND INVOLVED.Attorneys (If Known)(c) Attorneys (Firm Name, Address, and Telephone Number)Katie M. Burch, POTTS-DUPRE, HAWKINS & KRAMER, CHTD.900 Seventh Street, N.W., Suite 1020, Washington, DC 20001(202) 223-0888Eleanor Hamburger and Richard E. SpoonemoreSirianni Youtz Spoonemore Hamburger701 Fifth Avenue, Suite 2560, Seattle, WA 98104 (206) 223-0303II. BASIS OF JURISDICTION (Place an “X” in One Box Only)’ 1U.S. GovernmentPlaintiffx 3’Federal Question(U.S. Government Not a Party)’ 2U.S. GovernmentDefendant’ 4Diversity(Indicate Citizenship of Parties in Item III)III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff(For Diversity Cases Only)PTFCitizen of This State’x 1DEF’ 1and One Box for Defendant)PTFDEFIncorporated or Principal Place’ 4’ 4of Business In This StateCitizen of Another State’ 2’2Incorporated and Principal Placeof Business In Another State’ 5’x 5Citizen or Subject of aForeign Country’ 3’3Foreign Nation’ 6’ 6IV. NATURE OF SUIT (Place an “X” in One Box ORTS110 Insurance120 Marine130 Miller Act140 Negotiable Instrument150 Recovery of Overpayment& Enforcement of Judgment151 Medicare Act152 Recovery of DefaultedStudent Loans(Excludes Veterans)153 Recovery of Overpaymentof Veteran’s Benefits160 Stockholders’ Suits190 Other Contract195 Contract Product Liability196 �’’REAL PROPERTY210 Land Condemnation220 Foreclosure230 Rent Lease & Ejectment240 Torts to Land245 Tort Product Liability290 All Other Real Property’’’’’’’PERSONAL INJURY310 Airplane315 Airplane ProductLiability320 Assault, Libel &Slander330 Federal Employers’Liability340 Marine345 Marine ProductLiability350 Motor Vehicle355 Motor VehicleProduct Liability360 Other PersonalInjury362 Personal Injury Medical MalpracticeCIVIL RIGHTS440 Other Civil Rights441 Voting442 Employment443 Housing/Accommodations445 Amer. w/Disabilities Employment446 Amer. w/Disabilities Other448 EducationFORFEITURE/PENALTYPERSONAL INJURY’ 365 Personal Injury Product Liability’ 367 Health Care/PharmaceuticalPersonal InjuryProduct Liability’ 368 Asbestos PersonalInjury ProductLiabilityPERSONAL PROPERTY’ 370 Other Fraud’ 371 Truth in Lending’ 380 Other PersonalProperty Damage’ 385 Property DamageProduct LiabilityPRISONER PETITIONSHabeas Corpus:’ 463 Alien Detainee’ 510 Motions to VacateSentence’ 530 General’ 535 Death PenaltyOther:’ 540 Mandamus & Other’ 550 Civil Rights’ 555 Prison Condition’ 560 Civil Detainee Conditions ofConfinement’ 625 Drug Related Seizureof Property 21 USC 881’ 690 OtherBANKRUPTCY’ 422 Appeal 28 USC 158’ 423 Withdrawal28 USC 157PROPERTY RIGHTS’ 820 Copyrights’ 830 Patent’ 840 Trademark’’’’’’xLABOR710 Fair Labor StandardsAct720 Labor/ManagementRelations740 Railway Labor Act751 Family and MedicalLeave Act790 Other Labor Litigation791 Employee RetirementIncome Security Act’’’’’SOCIAL SECURITY861 HIA (1395ff)862 Black Lung (923)863 DIWC/DIWW (405(g))864 SSID Title XVI865 RSI (405(g))FEDERAL TAX SUITS’ 870 Taxes (U.S. Plaintiffor Defendant)’ 871 IRS—Third Party26 USC 7609OTHER ’’’375 False Claims Act400 State Reapportionment410 Antitrust430 Banks and Banking450 Commerce460 Deportation470 Racketeer Influenced andCorrupt Organizations480 Consumer Credit490 Cable/Sat TV850 Securities/Commodities/Exchange890 Other Statutory Actions891 Agricultural Acts893 Environmental Matters895 Freedom of InformationAct896 Arbitration899 Administrative ProcedureAct/Review or Appeal ofAgency Decision950 Constitutionality ofState StatutesIMMIGRATION’ 462 Naturalization Application’ 465 Other ImmigrationActionsV. ORIGIN (Place an “X” in One Box Only)x 1 Original’Proceeding’ 2 Removed fromState Court’ 3Remanded fromAppellate Court’ 4 Reinstated orReopened’ 5 Transferred fromAnother District(specify)’ 6 MultidistrictLitigationCite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):ERISA Sec. 502(e)(2), 29 U.S.C. Sec. 1132(e)(2)VI. CAUSE OF ACTION Brief description of cause:Seeking remedies for breach of fiduciary duty, recovery of denied benefits, and injunction’x CHECK IF THIS IS A CLASS ACTIONVII. REQUESTED INUNDER RULE 23, F.R.Cv.P.COMPLAINT:VIII. RELATED CASE(S)(See instructions):IF ANYJUDGEDATECHECK YES only if demanded in complaint:’ Yes’ NoJURY DEMAND:DEMAND DOCKET NUMBERSIGNATURE OF ATTORNEY OF RECORDs/ Eleanor Hamburger (WSBA #26478)01/04/2017FOR OFFICE USE ONLYRECEIPT #AMOUNTPrintAPPLYING IFPSave As.JUDGEMAG. JUDGEReset

JS 44 Reverse (Rev. 12/12)Case 2:17-cv-00004 Document 1-1 Filed 01/04/17 Page 2 of 2INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44Authority For Civil Cover SheetThe JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers asrequired by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, isrequired for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk ofCourt for each civil complaint filed. The attorney filing a case should complete the form as follows:I.(a)(b)(c)Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, useonly the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency andthen the official, giving both name and title.County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at thetime of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In landcondemnation cases, the county of residence of the "defendant" is the location of the tract of land involved.)Attorneys. Enter the firm name, address, telephone n

NECA/IBEW Family Medical Care PlanDefendant . The Plan USA, Inc. Employee Benefit Plan ("Plan") is an employee welfare benefit plan under the Employment Retirement Security of Act of 1974 ("ERISA"). The Plan covers more than 50 employees. The Plan is a self -funded group plan that provides both medical/surgical