Case: 1:24-cv-11740 Document #: 1 Filed: 11/14/24 Page 1 of 13 PageID #:1

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EMMELINE DUNCKEL, on behalf of herself

and all others similarly situated,
Jury Trial Demanded
Plaintiff,
Rule 23 Class Action
v. FLSA Collective Action

HEALTH CARE SERVICE CORPORATION,

Defendant.

ORIGINAL CLASS AND COLLECTIVE ACTION COMPLAINT

Plaintiff Emmeline Dunckel files this Class and Collective Action Complaint

(“Complaint”) against Defendant Health Care Service Corporation (“Defendant”) and in support

states the following:

Nature of this Lawsuit

1. This lawsuit arises under the Fair Labor Standards Act (“FLSA”), 29 U.S.C. § 201,

et seq., and the Illinois Minimum Wage Law (“IMWL”), 820 ILCS 105/1 et seq., for Defendant’s

failure to pay its Medical Management Specialists all earned overtime wages.

2. Plaintiff brings her FLSA claims on behalf of herself and other similarly situated

Medical Management Specialists.

3. Plaintiff brings her IMWL claims as a class action pursuant to Fed. R. Civ. P.

23(b)(3) and 23(c)(4).

The Parties

4. Defendant is an Illinois Corporation.

5. Defendant’s principal place of business is in Chicago, Illinois.

6. Defendant does business in Illinois as “Blue Cross and Blue Shield of Illinois.”

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7. Plaintiff resides in and is domiciled in Cook County, Illinois.

8. Plaintiff worked for Defendant as a Medical Management Specialist within this

judicial district from approximately August 2022 to April 2024.

Jurisdiction and Venue

9. This Court has subject matter jurisdiction under 28 U.S.C. § 1331 because

Plaintiff’s FLSA claims arise under federal law. See 29 U.S.C. § 216(b).

10. This Court has supplemental jurisdiction over Plaintiff’s IMWL claims under 28

U.S.C § 1367(a) because they arise out of the same facts as Plaintiff’s FLSA claims.

11. Venue is proper in this District under 28 U.S.C. § 1391 because the events forming

the basis of the suit occurred in this District.

Factual Allegations

12. Defendant is a health insurance company that provides health insurance to over 23

million people.

13. Defendant operates under the name “Blue Cross and Blue Shield” in Illinois,

Montana, New Mexico, Oklahoma, and Texas.

14. As part of its “Government” insurance sector, Defendant provides managed care

services to individuals enrolled in government-sponsored health plans, including Medicaid.

15. In Illinois, doing business as Blue Cross and Blue Shield of Illinois, Defendant

entered into a Contract for Furnishing Health Services (the “Medicaid Contract”) with the

Department of Healthcare and Family Services (the “Department”).

16. The Medicaid Contract requires Defendant to provide care coordination and other

managed care services to Illinois Medicaid members.

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17. The Medicaid Contract details Defendant’s obligations, as well as the obligations

of the employees who perform the services required by the Medicaid Contract.

18. Defendant employs individuals under one or more job titles, including, but not

limited to “Medical Management Specialists,” to provide the care coordination services required

under the Medicaid Contract.

19. Defendant classified all Medical Management Specialists, including Plaintiff, as

exempt from state and federal overtime laws and did not pay them overtime wages for all hours

worked over 40 hours per week.1

20. Defendant paid Plaintiff and other Medical Management Specialists a salary.

21. Plaintiff and other Medical Management Specialists regularly worked over 40

hours per week.

22. Defendant re-classified Plaintiff and other Medical Management Specialists as non-

exempt in or around August 2023.

23. In performing the care coordination services required by the Medicaid Contract,

Defendant’s Medical Management Specialists primarily performed non-exempt work, including

(1) completing Health Risk Assessments (“HRAs”), which involved collecting and documenting

general information from Medicaid Members regarding their medical circumstances by asking

standardized questions; (2) completing “care plans” using software provided by Defendant; and

(3) performing follow-up assessments and revising care plans on standardized timeframes

(collectively, “Care Coordination Work”).

24. During her employment, Plaintiff performed Care Coordination Work under the

Medicaid Contract.

1
Unless otherwise specified, allegations in this Complaint refer to events which occurred within the past
three years.
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25. Plaintiff’s job duties included completing HRAs and care plans in compliance with

the required timeframes set by the Medicaid Contract.

26. Plaintiff completed HRAs using software provided by Defendant.

27. Plaintiff’s job duties included traveling to Members’ homes to conduct in-person

HRAs.

28. Plaintiff’s job duties included preparing care plans using Defendant’s software,

which pre-populated portions of the care plan based on answers to the Member’s HRA.

29. Plaintiff’s job duties did not include managing Defendant’s business.

30. Plaintiff’s job duties did not include supervising two or more employees.

31. Plaintiff’s job duties did not include directing the work of individuals employed by

Defendant’s customers.

32. Plaintiff’s job duties did not include overseeing the work of individuals employed

by Defendant’s customers.

33. Plaintiff’s job duties did not include managing any of Defendant’s business

departments or any subdivisions of such departments.

34. Plaintiff did not direct the work of two or more full-time employees in any week.

35. Plaintiff never hired, fired, promoted, or disciplined other employees.

36. Plaintiff did not have the authority to hire, fire, promote, or disciplined other

employees.

37. Plaintiff never provided Defendant with a written recommendation to hire, fire,

promote, or discipline any individual that resulted in that individual actually getting hired, fired,

promoted, or disciplined by Defendant.

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38. Plaintiff did not have the authority to formulate, affect, interpret, or implement

Defendant’s management or operating practices for its business.

39. Defendant did not have the authority to deviate from the procedures and timeframes

for care coordination services set by the Medicaid Contract.

40. Plaintiff’s job duties did not include providing expert advice to Defendant’s

management on how they could more efficiently or profitably provide care coordination services.

41. Plaintiff’s job duties did not include providing expert advice to the Department of

Healthcare and Family Services on how to more efficiently provide care coordination services.

42. Plaintiff’s job duties did not involve planning the long-term or short-term business

objectives of Defendant or Defendant’s customers.

43. Plaintiff’s job duties did not include trouble-shooting or problem-solving on behalf

of Defendant’s management.

44. Plaintiff did not set budgets for Defendant’s business or any segment of

Defendant’s business.

45. Plaintiff never created a corporate policy or operating procedure that has been

followed by one of Defendant’s other employees.

46. Plaintiff’s job duties were routine and rote and did not include the exercise of

discretion and independent judgment with respect to matters of significance.

47. Plaintiff’s job duties did not involve providing traditional nursing care to patients

in a clinical setting.

48. Plaintiff’s job duties did not involve providing traditional nursing care to treat

patients in a clinical setting.

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49. Defendant did not provide Plaintiff with medical malpractice coverage for liability

incurred for work performed within the scope of her job duties.

50. The Care Coordination Work performed by Plaintiff and other Medical

Management Specialists was provided to Members under the “Blue Cross and Blue Shield of

Illinois” trade name.

51. Defendant maintained control, oversight and direction over its operations and

employment practices pertaining to Medical Management Specialists, including Plaintiff.

52. Defendant maintained control, oversight and direction over timekeeping, payroll,

and other employment practices that applied to Medical Management Specialists, including

Plaintiff.

53. Defendant employed Medical Management Specialists, including Plaintiff, to

perform Care Coordination Work for the Department of Healthcare and Family Services consistent

with the requirements and mandatory timeframes set forth in the Medicaid Contract.

54. During her employment, Plaintiff was an “employee” of Defendant as defined by

the FLSA in 29 U.S.C. § 203(e).

55. During her employment, Defendant was Plaintiff’s “employer” as defined by the

FLSA in 29 U.S.C. § 203(d).

56. Defendant is an “enterprise” as defined by the FLSA in 29 U.S.C. § 203(r)(1).

57. Defendant is an enterprise engaged in commerce or in the production of goods for

commerce as defined by the FLSA in 29 U.S.C. § 203(s)(1)(A).

58. Defendant has had more than $500,000 in sales made or business done in each of

the last three calendar years.

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Collective Action Allegations

59. Plaintiff brings her FLSA claims as a collective action.

60. Plaintiff’s consent form to participate in this collective action is attached as

Exhibit A.

61. The collective action is defined as follows:

All individuals employed by Defendant as Medical Management Specialists in

Illinois within the past three years who were paid on a salary basis and classified as
exempt from overtime (collectively, “Collective Action Members”).2 The term
“Medical Management Specialists” includes individuals that held the job positions
“Medical Management Specialist I,” “Medical Management Specialist II,”
“Medical Management Specialist III,” or other similar variations of the “Medical
Management Specialist” job title.

62. Plaintiff is similarly situated to potential Collective Action Members because she

was paid in the same manner and performed the same primary job duties as the Collective Action

Members.

63. Defendant maintained one or more common job descriptions for the Collective

Action Members.

64. Defendant has the names and addresses for potential Collective Action Members in

its payroll or personnel records.

65. Defendant has email addresses for potential Collective Action Members in its

payroll or personnel records.

66. Defendant has phone numbers for potential Collective Action Members in its

payroll or personnel records.

2
To the extent any Medical Management Specialists participated in the settlement reached in Candelaria
v. Healthcare Service Corporation, No. 2:17-cv-404, ECF 84 (D.N.M. Nov. 4, 2020) (approving class and
collective action settlement), this definition excludes any claims released in that settlement.
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67. Defendant is aware or should have been aware that the FLSA required it to pay

potential Collective Action Members overtime because they primarily performed non-exempt

work.

Class Action Allegations

68. Plaintiff brings her IMWL claims as a class action under Rule 23(b)(3) and Rule

23(c)(4) of the Federal Rules of Civil Procedure.

69. Plaintiff seeks class certification under Rule 23 of the following state law class:

All individuals employed by Defendant as Medical Management Specialists in Illinois

within the past three years who were paid on a salary basis and classified as exempt from
overtime (the “Class”).3 The term “Medical Management Specialists” includes individuals
that held the job positions “Medical Management Specialist I,” “Medical Management
Specialist II,” “Medical Management Specialist III,” or other similar variations of the
“Medical Management Specialist” job title.

70. The Class has over 100 members.

71. As a result, the Class is so numerous that joinder of all members is not practical.

72. There are questions of law or fact common to the Class, including: (1) whether

members of the Class primarily performed non-exempt work; (2) whether Defendant violated the

IMWL by refusing to pay members of the Class overtime pay; and (3) the proper measure of

damages if Defendant misclassified members of the Class as exempt from the overtime provisions

of the IMWL.

73. Plaintiff’s overtime claims are typical of those of the Class because they arise out

of Defendant’s uniform compensation practices.

74. Defendant’s defenses to Plaintiff’s claims are typical of its defenses to the claims

of the Class because they are grounded in the same compensation practices.

3
To the extent any Medical Management Specialists participated in the settlement reached in Candelaria
v. Healthcare Service Corporation, No. 2:17-cv-404, ECF 84 (D.N.M. Nov. 4, 2020) (approving class and
collective action settlement), this definition excludes any claims released in that settlement.
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75. Plaintiff can fairly and adequately protect the interests of the Class because she is

asserting the same claims as the Class.

76. Plaintiff can fairly and adequately protect the interests of the Class because she has

no interests adverse to the Class.

77. Plaintiff can fairly and adequately protect the interests of the Class because she has

retained counsel experienced in class action wage-and-hour litigation.

78. The common questions of law and fact in this lawsuit predominate over the

variations which may exist between members of the Class, if any.

79. Common proof will drive the resolution of the predominating questions in this case.

80. Plaintiff and the members of the Class on the one hand, and Defendant on the other,

have a commonality of interest in the subject matter of this lawsuit and remedy sought, namely

back wages, interest, penalties, attorneys’ fees, and costs.

81. If individual actions were required to be brought by each member of the Class

injured or affected, it would necessarily result in a multiplicity of lawsuits, creating a hardship to

the individuals and to the Court, as well as to Defendant.

82. Accordingly, a class action is an appropriate method for the fair and efficient

adjudication of this lawsuit and distribution of the common fund to which the Class is entitled.

83. The books and records of Defendant are material to the claims of the Class because

they disclose the hours worked by each member of the Class and the rate of pay for that work.

COUNT I
Violation of the Fair Labor Standards Act
(Collective Action)

84. Plaintiff incorporates here the previous allegations of this Complaint.

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85. Plaintiff asserts claims for unpaid overtime pursuant to the FLSA on behalf of

herself and the Collective Action Members.

86. This count arises from Defendant’s violation of the FLSA by failing to pay overtime

wages to Plaintiff and the Collective Action Members when they worked over 40 hours in

individual workweeks.

87. Plaintiff and the Collective Action Members were not exempt from the overtime

provisions of the FLSA.

88. Because Plaintiff and the Collective Action Members performed primarily non-

exempt work, Defendant should have classified them as non-exempt under the FLSA.

89. Plaintiff and the Collective Action Members were directed by Defendant to work,

and did work, over 40 hours in one or more individual workweeks during the prior three years.

90. Defendant’s violations of the FLSA were willful because they received complaints

from Medical Management Specialists that alerted Defendant that it was paying one or more of

those employees incorrectly.

91. Alternatively, Defendant’s violations were willful because it classified other

employees who performed many of the same primary job duties as Plaintiff and the Collective

Action Members as non-exempt from the FLSA’s overtime requirements.

WHEREFORE, Plaintiff seeks a judgment against Defendant as follows:

A. All unpaid overtime wages due to Plaintiff;

B. Liquidated damages equal to the unpaid overtime compensation due;

C. Reasonable attorneys’ fees and costs incurred in prosecuting this lawsuit; and

D. Such other relief as this Court deems appropriate.

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COUNT II
Violation of the Illinois Minimum Wage Law – Overtime Wages
(Class Action)

92. Plaintiff incorporates here the previous allegations of this Complaint.

93. This count arises from Defendant’s violation of the IMWL for its failure to pay

Plaintiff and the Class overtime pay for time worked in excess of 40 hours in individual

workweeks.

94. Plaintiff was not exempt from the overtime provisions of the IMWL.

95. Members of the Class were not exempt from the overtime provisions of the IMWL.

96. Because Plaintiff and Class performed primarily non-exempt work, Defendant

should have classified them as non-exempt under the IMWL.

97. Plaintiff was regularly directed to work by Defendant, and did work, over 40 hours

in individual workweeks.

98. Members of the Class were regularly directed to work by Defendant, and did work,

over 40 hours in individual workweeks.

99. Pursuant to 820 ILCS 105/12(a), affected employees are entitled to recover treble

the amount of the unpaid overtime wages for three years prior to the filing of this suit, plus statutory

damages in the amount of five percent (5%) per month of the amount of the underpayment.

WHEREFORE, Plaintiff, on behalf of herself and the Class, seeks a judgment against

Defendant, as follows:

A. All back wages due to Plaintiff and the Class as provided by the Illinois Minimum

Wage Law;

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B. Prejudgment interest on the back wages in accordance with 815 ILCS 205/2 and

treble damages and monthly statutory damages at the rate of 5% per month pursuant to 820

ILCS 105/12(a);

C. Reasonable attorneys’ fees and costs incurred in prosecuting this action; and

D. Such other relief as this Court deems appropriate.

Jury Demand

Plaintiff hereby demands a trial by jury on all counts.

Respectfully submitted,

/s/ Travis M. Hedgpeth

Travis M. Hedgpeth
Texas Bar No. 24074386
THE HEDGPETH LAW FIRM, PC
3050 Post Oak Blvd., Suite 510
Houston, Texas 77056
P: (281) 572-0727
[email protected]

Attorneys for Plaintiff and others similarly

situated

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CERTIFICATE OF SERVICE

I hereby certify that on November 14, 2024 the foregoing was filed electronically and
notice of this filing will be sent to all parties by operation of the Court’s electronic filing system.

/s/ Travis M. Hedgpeth

Travis M. Hedgpeth

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EXHIBIT A




      
Case: 1:24-cv-11740 Document #: 1-1 Filed: 11/14/24 Page 2 of 2 PageID #:15

NOTICE OF CONSENT

I hereby consent to become a party plaintiff in the overtime lawsuit in

which this consent is filed.


Signature Date

  
 
Printed Name
ILND 44 (Rev. 08/23) CIVIL #:
Case: 1:24-cv-11740 Document COVER SHEET
1-2 Filed: 11/14/24 Page 1 of 1 PageID #:16
The ILND 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
as provided 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 the
purpose of initiating the civil docket sheet. (See instructions on next page of this form.)
I. (a) PLAINTIFFS DEFENDANTS
Emmeline Dunckel, on behalf of herself and all others similarly situated Health Care Service Corporation

(b) County of Residence of First Listed Plaintiff Cook County, IL County of Residence of First Listed Defendant
(Except in U.S. plaintiff cases) (In U.S. plaintiff cases only)
Note: In land condemnation cases, use the location of the tract of land involved.

(c) Attorneys (firm name, address, and telephone number) Attorneys (If Known)
The Hedgpeth Law Firm, PC; 3050 Post Oak Blvd., Suite 510, Houston, TX
77056; Phone (281) 572-0727

II. BASIS OF JURISDICTION (Check one box, only.) III. CITIZENSHIP OF PRINCIPAL PARTIES (For Diversity Cases Only.)
(Check one box, only for plaintiff and one box for defendant.)
1 U.S. Government ■3 Federal Question PTF DEF PTF DEF
Plaintiff (U.S. Government not a party.) Incorporated or Principal Place of
Citizen of This State 1 1 4 4
Business in This State

2 U.S. Government 4 Diversity Citizen of Another State 2 2 Incorporated and Principal Place 5 5
Defendant (Indicate citizenship of parties in Item III.) of Business in Another State

Citizen or Subject of a
3 3 Foreign Nation 6 6
Foreign Country
IV. NATURE OF SUIT (Check one box, only.)
CONTRACT TORTS PRISONER PETITIONS LABOR OTHER STATUTES
510 Motions to Vacate 710 Fair Labor Standards
110 Insurance PERSONAL INJURY PERSONAL INJURY Sentence ■ Act
375 False Claims Act
3 530 General 376 Qui Tam (31 USC
120 Marine 310 Airplane 720 Labor/Management
3729 (a))
315 Airplane Product
367 Health Care/ 535 Death Penalty Relations
320 Assault, Libel & Slander 400 State Reapportionment
Pharmaceutical
130 Miller Act
Personal Injury
Other: 740 Railway Labor Act 410 Antitrust
Product Liability
140 Negotiable Instrument 340 Marine 368 Asbestos Personal 540 Mandamus & Other 751 Family and Medical 430 Banks and Banking
150 Recovery of Overpayment 345 Marine Product Liability Injury Product 55 Leave Act 450 Commerce
& Enforcement of Judgment 350 Motor Vehicle Liability 790 Other Labor Litigation 460 Deportation
151 Medicare Act 355 Motor Vehicle Product 560 Civil Detainee - 791 Employee Retirement 470 Racketeer Influenced
152 Recovery of Defaulted Liability PERSONAL PROPERTY Conditions and Corrupt
Income Security Act
Student Loan 360 Other Personal Injury of Confinement Organizations
(Excludes Veterans) 362 Personal Injury - Medical 370 Other Fraud 480 Consumer Credit
153 Recovery of Veteran’s Malpractice PROPERTY RIGHTS
371 Truth in Lending 485 Telephone Consumer
Benefits 820 Copyright
160 Stockholders’ Suits 380 Other Personal 830 Patent Protection Act (TCPA)
190 Other Contract Property Damage 835 Patent - Abbreviated 490 Cable/Sat TV
195 Contract Product Liability 385 Property Damage New Drug Application 850 Securities/Commodities/
196 Franchise Product Liability 840 Trademark Exchange
890 Other Statutory Actions
891 Agricultural Arts
REAL PROPERTY CIVIL RIGHTS BANKRUPTCY FORFEITURE/PENALTY SOCIAL SECURITY 893 Environmental Matters
210 Land Condemnation 422 Appeal 28 USC 158 625 Drug Related Seizure 861 HIA (1395ff) 895 Freedom of Information
423 Withdrawal of Property 862 Black Lung (923) Act
220 Foreclosure 441 Voting 21 USC 881
230 Rent Lease & Ejectment 442 Employment 28 USC 157 690 Other 863 DIWC/DIWW 896 Arbitration
(405(g)) 899 Administrative
240 Torts to Land 443 Housing/ Procedure
2 445 Amer. w/ Disabilities IMMIGRATION 864 SSID Title XVI Act/Review or Appeal of
Employment 462 Naturalization 865 RSI (405(g)) Agency Decision
446 Amer. w/Disabilities - Application 950 Constitutionality of
Other 463 Habeas Corpus – FEDERAL TAXES State Statutes
448 Education Alien Detainee 870 Taxes (U.S. Plaintiff
(Prisoner Petition) or Defendant
465 Other Immigration 871 IRS—Third Party
Actions 26 USC 7609
V. ORIGIN (Check one box, only.)
■1 Original
Proceeding
2 Removed from
State Court
3 Remanded from
Appellate Court
4 Reinstated
or Reopened
5 Transferred
from Another
6 Multidistrict
Litigation -
8 Multidistrict
Litigation -
District Transfer Direct File
(specify)

VI. CAUSE OF ACTION ( Enter U.S. Civil Statute under which you are filing and VII. PREVIOUS BANKRUPTCY MATTERS (For nature of suit 422 and
423, enter the case number and judge for any associated bankruptcy matter previously adjudicated by
write a brief statement of cause.) a judge of this Court. Use a separate attachment if necessary.)
FLSA, 29 U.S.C. Section 201, et seq.; Recover unpaid wages
VIII. REQUESTED IN CHECK Yes only if demanded in complaint:
COMPLAINT:
■ Check if this is a class action under Rule 23,
F.R.CV.P.
Demand $
Jury Demand: ■ Yes No
IX. RELATED CASE(S) IF ANY (See instructions): Judge Case Number
X. Is this a previously dismissed or remanded case? Yes ■ No If yes, Case # Name of Judge

Date: ___________________________________________ Signature of Attorney of Record s/ Travis M. Hedgpeth

______________________________________________