Disappointed in Oxendine's office

I got a letter in the mail today from the investigator in Oxendine's office who was looking into my complaint.  Apparently, because the SHBP is self-funded, the insurance commissioner's office has no jurisdiction.  She did forward my letter on to Dr. Medows at the SHBP (I already did that) and Cigna.  She said they will forward me any new information they get.

Still, I'm very disappointed.  And Commissioner Oxendine, if you are by any chance reading this post, YOU JUST LOST MY VOTE FOR GOVENOR!  Heck, I don't think I'd vote for you again for Insurance Commissioner!  And you got that vote from me 2 or 3 times....

I read that on the website when I went to make a complaint, so I didn't bother.

Here is what it says:

  The Consumer Services Division does not have jurisdiction over the following plans:

1. Self-insured employers and health & welfare benefit plans – Many large employers provide health benefits for their employees through self-insured plans. Although self-insured plans are frequently administered by an insurance company, it is the employer and not the insurance company that bears the risk for paying claims. Federal law exempts self-insured employer plans from state insurance regulation. The same is true of health & welfare benefit plans (union plans).
   
   Although the Georgia Department of Insurance does not regulate self insured ERISA plans, we will provide assistance in resolving those issues if Georgia consumers request our assistance. While the Division of Insurance is willing to accept your complaint and forward it to the plan, we are not always successful in obtaining a response and we have no statutory authority to require the plan to take specific action. We recommend you refer to your member handbook on how to file an appeal under the plan.
   
   Click here to view the contact information for the list below:
2. Federal Employees' health and life insurance
3. Medicare HMOs
4. Military Insurance
5. Policies purchased in another state (HMO policies may be the exception. Call our Division for assistance if you are covered by an HMO)
6. Medicare
7. Medicaid
8. State of Georgia Employee’s Health Plan
9. University System of Georgia

So, it's not like he just ignored you or refused to look into it.
If he has no jurisdiction, there is nothing he can do.

Well, I'm still glad I filed my complaint.  And the letter did mention they sent my concern to Cigna and would send me any correspondence they receive in return.  But still...this means self-funded plans can get away with ANYTHING and not be responsible to ANYONE.  I find there to be something "fishy in Denmark" about that....

I still think if Cigna gets enough letters forwarded from the insurance commissioners office their ears will perk up a little.  They don't want bad press.  Plus Oxendine may have some influence on the benefits state employees receive, since he's in the governor's office.

He has no say unfortunately.  The funny thing is the state knows that they are self insured and any regulations they make do not include them

Linda