King Rat (gkr) wrote,
King Rat
gkr

Health Insurance

Last year, when I signed up for my health insurance, the plan summaries stated that emergency services were covered at 90% after a $75 copay and my standard deductible. This however was incorrect. Only the services provided by the hospital were covered. The services provided by the doctor at the hospital were covered very differently.

Anyway, Expedia has begun enrollment for 2006 benefits. I requested the actual plan descriptions, so I could know to what I was agreeing, and hopefully not get hit by unexpected expenses. The response I got back from benefits stated explicitly that they did not review last year's summaries, but this year they have. In other words, trust us this time. I think not. The short version is that they won't provide me with the plan description.

The fun part is I went and checked the Department of Labor web site on E.R.I.S.A. (the federal law regulating health benefits) to see what it said. It linked to Cornell, which had the following:

(4) The administrator shall, upon written request of any participant or beneficiary, furnish a copy of the latest updated summary,[1] plan description, and the latest annual report, any terminal report, the bargaining agreement, trust agreement, contract, or other instruments under which the plan is established or operated. The administrator may make a reasonable charge to cover the cost of furnishing such complete copies. The Secretary may by regulation prescribe the maximum amount which will constitute a reasonable charge under the preceding sentence.

Haven't yet thrown that at them.

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