& another thing...ERISA!

I e-mailed my HR department and asked if our insurance program was self funded and governed by ERISA? They replied that it was fully funded but all insurances programs were governed by ERISA. Does this makes any sense? Beth M

Sounds to me like they are confused. Or stupid. Fully INSURED ... non-ERISA...subject to state insurance laws Self insured (self funded) ...subject to ERISA Look in your Summary Plan Description Booklet (SPD.) It will tell you whether the Plan is self funded or fully insured. Check under the appeal process...

Thank you Roberta. Beth M

Beth, If your insurance is fully funded they follow ERISA appeal process, but you would be entitled to an outside review. Self funded insurance is the hardest to get around. This I know. Good luck.

I had my hubby talk to the HR department today, his insurance is NOT self funded and it is IBA that has written the exclusion into the policy NOT the employer. So what I'm wondering is why the state external review board wouldn't even consider "hearing" my case, before saying they couldn't help me. Still saving pennies for Gary.......... Cynthia