End of year insurance questions

Hi, I just want to get some input on what my options may be, if I have any chance of getting the surgery. I work for state government, and they have always covered WLS. I researched all the options about the surgeries over the course of a year, spoke to my doctor about it numerous time, and finally in September, took a deep breath and decided to go to a seminar on WLS, where I learned about lap band. My biggest reservation about bypass had been the risks of surgery, but lap band seemed perfect. However, one day before the seminar, we got our new insurance info, and i found that they have added an exclusion that states they do not cover "Surgical intervention for obesity." I immediately got all my forms completed and wrote letters to the doctor's office about this situation. They have been helpful and willing to do what they need to, for the most part, although I was set back a couple of weeks when the office WLS coordinator went on vacation and the doctor's letter did not get sent out very quickly. I have gotten a letter from my PCP, copies of all medical records and compiled a family history and diet history and sent all this to the insurance company. I am 5'2 290 lbs, BMI 52+, have severe sleep apnea, asthma, hypothyroidism, so I meet all the requirements for the surgery without any doubt (this year's insurance pays for WLS for morbid obesity with comorbidities). I got a denial of lap band as "experimental" on November 15 (though it's been FDA approved since 2001), immediately overnighted the company an appeal with tons of documentation showing that this is not experimental, and asked for expedited appeal on November 16 on grounds that my sleep apnea is life-threatening (I know that they mean immediately life threatening, but gave it a shot). Yesterday the insurance (Group Health Plan) called and said it couldn't be expedited, but they would review within 20 business days, might be a little sooner. My question is, if they continue to drag their feet, which is what I feel sure is happening, as they are not even going to be a carrier on our plan next year in addition to the provision changing, do I have any recourse at all if they run out my time to have the surgery? Do they have any obligation to honor my appeal? I have to change to UHC after January 1. Any ideas on what I can do? I have appealed to the insurance, I have sent an appeal to the state (employer) and done everything I can think of. I haven't filed an appeal with the Dept of Insurance, because under state law, they are technically allowed this much time to process the appeal, but if I can show they are just coming up with things to deny on, would they have to do anything after the 1st of the year? thanks for any help!

I'm sorry for the amount of stress you are enduring during your wait. Although I don't have any answers to your questions, may I suggest this site: http://www.obesitylaw.com/ Perhaps they have info on what an insurer is required to honor. Best of luck Carmen