Health Insurance Comp. Filing Bankruptcy

[svjack]

What is the name of your state? NJ
I had health Insurance with "Meridian Benefit Inc" a Third Party Administrator sponsored by my Employer. Now Meridian is filing for bankruptcy and have not paid my claims which is well above $50,000 .

What can i do in this scenario ?. I'm desperately looking for some help...

Thanks

 

[CIAA]

You should contact your district or regional U.S. Department of Labor office (they have enforcement and regulatory authority over Employer Group Plans).

 

[Beth3]

If Meridian is ONLY a third party administrator, then their bankruptcy doesn't have any bearing on liability for payment of the claims, other than an administrative mess. A TPA receives a fixed monthly fee from the employer to pay claims but the money for the claims actually remains with the employer. The TPA writes checks on an account which is funded and controlled by the employer. (As opposed to an insurance company where the money to pay the claims is sent to the insurance carrier by way of a monthly premium.)

svjak, I suggest you speak immediately to the person at work who handles your benefits. It's possible the claims are in limbo while your employer scrambles to contract with a new TPA and arranges for the transfer of all the outstanding claims to the new claims payor.

If you can't get a satisfactory answer as to what's going on, then by all means call the DOL.

 

[CIAA]

svjack,

Beth3 is correct, TPA's may come and go, but the funds are with either the employer or the insurance company if it is a fully insured plan.

So many employers have been hurt financially by self funded plans (they never seem to reserve enough) many have gone to, or are still using, fully insured plans.

Yes, by all means call your HR. If a fully insured plan and you can't get answers, complain to both the Dept. of Insurance and the D.O.L.

 

[HomeGuru]

.