Part of our utilization review cases →
New Directions Behavioral Health provides benefit determinations for health plans. Its Utilization Managers, as the court’s order describes them, "review[] health insurance benefit requests against predetermined guidelines and criteria for insurance and payment purposes."1 New Directions paid them a salary and classified them as exempt. Plaintiff Maria Krott alleged that she worked more than 40 hours in a week and was owed overtime. New Directions denied that she was owed overtime.1
On September 10, 2020, the court conditionally certified a collective of salaried Utilization Managers. On January 13, 2022, Judge Greg Kays approved a $290,000 settlement covering 32 people.1
Read about the certification ruling →
The administrative exemption covers employees whose primary duty includes "the exercise of discretion and independent judgment with respect to matters of significance." 29 C.F.R. § 541.200(a)(3). Checking a request against criteria someone else wrote is not that. Whatever the job title, if the work is applying the insurer’s guidelines, the administrative exemption should not apply.
$290,000, approved by the court on January 13, 2022. It covered 32 people.
That New Directions classified its Utilization Managers as exempt even though they reviewed benefit requests against predetermined guidelines and criteria.
Often, yes. Reviewers who apply set guidelines rather than exercising independent judgment may not meet the administrative exemption.
If you did this kind of work for another employer and weren't paid overtime for hours over 40, tell us your job title, your employer and the state you worked in. We'll tell you plainly whether we think you have a case. Federal law makes it illegal to retaliate against you for asking.
Siegel Law Group PLLC concentrates in unpaid overtime cases under the FLSA and state wage laws. The firm has filed more than 100 federal overtime cases, obtained more than 50 class and collective certifications, and recovered more than $100 million for workers. Free consultation. Contingency fee: we advance case costs, and they are repaid from any recovery. No recovery, no fee and no costs. Phone: (214) 790-4454 | Email: [email protected]
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