about self funded insurance

I currently have a self funded plan through a major company. Self funded means that it has the same characteristics of both a PPO and a POS. My question is if I am going to have a revision from an RNY to a DS and there is not a surgeon within my immediate network who performs the procedure but there is one on the national network do I have to take on the coverage of the national network. Example being if I had a surgeon who offered it within the immediate network my total out of pocket expense would be $200. If I have to go to the national network then it goes to an 80/20. 

If the employer plan is

  If the plan is

fully-insured, the insurance company is ultimately responsible for the healthcare costs,and the employer typically purchases a standardized package of coverage.self-insured, the employer is ultimately responsible for the healthcare costs, and therefore can customize the plan to include and exclude specific coverage,such as bariatric surgery coverage.  

You can request from your employer that since there is no providers in your immediate area to do the DS they may be able to overide the out of pocket expense

You may want to see if you can get a referral to that surgeon... call in the insurance company and ask them if there is any way for you to see that surgeon with coverage being considered "in - network".