Employer gets to make the final decision after appeal?

So Aetna denied the 1st time for lack of 5 year info. and now that my appeal has been submitted, I find out it has been forwarded to my employer's HR dept. who's going to have a meeting about me on Friday and decide if I get surgery or not . So much for discretion. I work for a HUGE company. Anybody ever heard of this or been through this? And what can I do if my employer denies me?

It sounds as if your insurance is self funded.  What the means is that your employer has set aside a pool of money to pay for claims and such and is allowing an insurance company to manage that pool.  With a few exceptions, your insurance works just like any other insurance plan.  The primary difference, however, is that the employer makes determinations on what procedures to certify and what claims to pay.  That is why your employer is having a meeting about your surgery.  Looking at your medical information, they feel that they can make an educated decision about how to proceed (we hope it's educated.) If you do not receive a favorable determination, you can check your explanation of coverage for information on the proper appeals process.  You can also check with your human resources department for more information on it, too. My best wishes to you in pursuing the surgery!

Thanks Xavier! I'm starting to get it ....