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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...
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