Recent content by SaulGoodman

I'm not saying I wasn't necessarily covered under a Plan; I'm saying I was covered under a Plan that never told me what the Exclusions are...so then legally how can those Exclusions apply? Per www.shrm.org: "ERISA requires plan administrators to disclose to plan participants any changes that...

How do I get the procedure pre-approved when I don't have a Plan Document that tells me what requires approval? Under our old Plan not every procedure required pre-approval, nor would the carrier do a pre-approval if it didn't require it. How do I know what is or isn't covered by the Plan...

What is the name of your state? State: CO I'm covered under a self-funded Plan through my employer and I incurred a medical service in June of this year that the Third Party Administrator denied as an exclusion. We switched to a new carrier on 11/01/17. Although the coverage was effective on...