Local 130 U.A., Plumbers’ Welfare Fund v. Express Scripts, The Cigna Group, Evernorth Health Services

On February 17, 2026, Plaintiff Plumbers’ Welfare Fund, Local 130 U.A. (“Plumbers’ Welfare Fund”) filed a class action lawsuit in the Northern District of Illinois against Express Scripts – the nation’s largest Pharmacy Benefits Manager (“PBM”) – and its parent companies, Cigna and Evernorth.

Plumbers’ Welfare Fund provides healthcare benefits for members of Chicago-based Plumbers Local 130 and contracted with Express Scripts to provide pharmacy benefit management services. Express Scripts promised Plumbers’ Welfare Fund, and other Express Scripts PBM customers, that it would provide significant cost savings by negotiating with drug companies on their behalf to secure rebates to reduce the cost of drugs, and through “ongoing formulary management” such as promptly replacing high-cost drugs with low-cost equivalents on Express Scripts standard formularies.

In truth, Defendants Express Scripts, Cigna, and Evernorth, together with non-party Cigna entity Ascent Health Services (“Ascent”) and non-party drug companies, orchestrated an elaborate, fraudulent scheme to sell access to the drug formularies used by Express Scripts PBM customers. As part of this conspiracy, Express Scripts manipulated its formularies to give access and preferential placement to high-cost drugs. Defendants implemented this scheme by using Express Scripts’ negotiating power to convince drug companies to divert exorbitant “fees” to Ascent, which traditionally would have been considered rebates and passed on to Express Scripts PBM customers. In doing so, Defendants maximized their own profits while limiting Express Scripts PBM customers’ access to their contractually-guaranteed rebates and driving up Express Scripts PBM customers’ prescription drugs costs instead of reducing such costs.

To address this misconduct, Plumbers’ Welfare Fund, on behalf of itself and a class of Express Scripts PBM customers, alleges that Defendants Express Scripts, Cigna, and Evernorth acted in violation of the Racketeer Influenced and Corrupt Organizations (“RICO”) Act, and that Defendant Express Scripts breached its contracts with its PBM customers.