NTCA Medical Insurance

found a mess of bad things about it. Consequently, it appears you are not covered under an insurance contract issued by an insurance company, but instead covered under a self-funded health plan operated by NTCA. It is important to mention that NTCA is not licensed as an insurance company in North Carolina and I doubt it is licensed as an insurance company in any state. The following is a link to a publication posted on the US Department of Labor website http://www.dol.gov/ebsa/Publications/mewas.html#section4 ..which provides information on "multiple employer welfare arrangements", i.e., MEWAs. Generally, MEWAs must be issued and insured by a state licensed insurance company or if self-funded, must be licensed by the states the MEWA operates in.... and are generally subject to state insurance laws. However, please note under section 3. entitled "What is a Multiple Employer Welfare Arrangement"? ...federal laws provide an exception for rural telephone cooperative associations. The point of making you aware of this information is that most likely, the plan you are covered under is not subject to our state regulatory jurisdiction (nor the regulatory jurisdiction of any state). For that reason, I suggest that you review, follow, and pursue an appeal in accordance with the provisions stated in your plan contract. If you have already done so, you might consider contacting the US Department of Labor [Employee Benefit Security Administration] and see if they are able to assist you in any manner. Prior to you contacting this Department, we were not aware of NTCA or the NTCA Group Health Plan. I note that information on the NTCA website indicates NTCA has a group health plan service center in Asheville, NC, and I suppose that is why you contacted this Department. Consequently I plan to contact the NTCA on your behalf and also question them on their authority to operate without being licensed in North Carolina. However, they likely will respond by claiming exemption under the above mentioned federal laws, and it is unlikely we will be able to subject the NTCA group health plan to our jurisdiction and oversight. I will never undstand how they get away with this. Michael